Is It Normal Aging or Early Signs of Dementia?

Laura Williamson wrote . . . . . . . . .

Misplacing keys. Forgetting names. Struggling to find the right word. Walking into a room and forgetting why.

Are these early signs of dementia? Or normal signs of aging?

It all depends on the circumstances, health experts say. To distinguish between changes associated with typical aging and concerning signs of cognitive loss requires a deeper look.

“Instead of thinking about things in terms of what is a sign of dementia, I would ask, ‘What is the situation in which those signs appear?'” said Dr. Jeffrey Keller, founder and director of the Institute for Dementia Research and Prevention in Baton Rouge, Louisiana. “It’s how the brain functions in response to a challenge that demonstrates early changes that can lead to dementia.”

In other words, a person experiencing normal aging may experience some memory lapses, he said. But more important than whether they’ve misplaced their keys is whether they’re able to retrace their steps to find them. Or whether they can retain information long enough to carry out a multi-part task, such as filling out medical or tax forms, even if interrupted while doing so.

For people with cognitive decline, “when you throw a monkey wrench in, things fall apart,” Keller said. “That’s when you see if there’s an ability to switch tasks.”

The loss of executive function skills – the ability to plan, multi-task, make decisions and solve problems – is a greater indication of deteriorating brain health than the occasional memory lapse. And it can manifest in a variety of ways, according to experts in the field of aging.

For example, people who are losing executive function often exhibit a loss of financial management skills long before being diagnosed with dementia. Research shows people with Alzheimer’s disease begin missing bill payments up to six years prior to diagnosis, and they have drops in their credit scores 2.5 years prior to diagnosis.

There also may be other signs of poor financial decision-making, said Dr. James Galvin, a neurologist and director of the University of Miami’s Comprehensive Center for Brain Health. “They might start making purchases they have not made before or fall prey to scams because judgment and their ability to understand the consequences of decisions may be impaired.”

The Alzheimer’s Association lists 10 early signs and symptoms of dementia: memory loss that disrupts daily life; challenges in planning or solving problems; difficulty completing familiar tasks; confusion with time or place; trouble understanding visual images and spatial relationships; problems with language while speaking or writing; misplacing things and losing the ability to retrace steps; decreased judgment; withdrawal from work or social activities; and changes in mood or personality.

The question isn’t whether a person sometimes exhibits one of these signs; it’s whether these behaviors are frequent or severe enough to disrupt daily work and social living, Keller said.

If any of these behaviors do appear, he said, it’s important to first rule out other health problems.

For example, uncontrolled high blood pressure, diabetes, depression and other illnesses can cause changes in brain function, including memory loss.

“The first stop is the primary care provider, because the person generally has a relationship with them,” he said. “They can make a diagnosis or start a work-up to make sure the changes aren’t from another cause.”

Another reason to get someone evaluated before problems progress is to maximize the chances they are included in what can be difficult future decisions if they do have dementia, Galvin said. “Do they want a DNR (do-not-resuscitate order)? Who will be their health care proxy? Who will have durable power of attorney? We discuss these things right at the onset. It’s best to address these questions early, so the person’s wishes can be accounted for.”

Knowing when to bring a person in for evaluation can be tough, Galvin said. “It’s never too early and it’s never too late, but it’s better to be early than to be late.”

Once a diagnosis is made, that’s the time to discuss independence, and topics such as driving and personal finances. “Those are very tricky negotiations,” Galvin said. “Our approach is to empower the patient. Get them on board as much as possible. Don’t focus on the disability, focus instead on their capabilities so we can reset the bar based on their abilities at that time. When we do that, we get fairly good buy-in.”

While dementia cannot be cured, there are steps to slow cognitive decline, experts say. Practicing healthy behaviors earlier in life has been shown to preserve brain health as people age.

Research shows there are generally seven risk factors and behaviors people can change to preserve good brain health. Called Life’s Simple 7, they are not smoking, staying physically active, losing weight, eating a healthy diet, and controlling blood pressure, cholesterol and blood sugar levels.

A recent American Heart Association report calls upon primary care providers to help promote better brain health by also evaluating and treating patients for depression, diabetes, obesity, social isolation, hearing loss, sleep disorders and excessive alcohol use.

Another thing people can do to preserve brain function is to continually challenge themselves to learn new things, Keller said. “Learning a new language, developing knowledge about a new field you are interested in, finding new hobbies – those are things that help you maintain cognitive flexibility, which is very important for cognitive preservation.”

Source: American Heart Association

Box Fan Air Cleaner Greatly Reduces Virus Transmission

Improved ventilation can lower the risk of transmission of the COVID-19 virus, but large numbers of decades-old public school classrooms lack adequate ventilation systems. A systematic modeling study of simple air cleaners using a box fan reported in Physics of Fluids, by AIP Publishing, shows these inexpensive units can greatly decrease the amount of airborne virus in these spaces, if used appropriately.

A low-cost air cleaner can be easily constructed from a cardboard frame topped by an air filter and a box fan. The air filter is placed between the fan and the cardboard base. The fan is oriented so that air is drawn in from the top and forced through the filter, discharging cleaned air downward.

The investigators measured the clean air delivery rate of the air cleaning system in experiments conducted at two independent laboratories. Tobacco smoke was used to simulate the airborne virus, since the virus is known to travel through the air after exhalation in droplets about the same size as smoke particulates.

The experimental measurements were incorporated into a detailed computational model of a classroom. In addition to the box fan air cleaner, a ventilation unit known as an HUV, or a horizontal unit ventilator, was included in the simulation. This type of ventilation system is very common in public schools and is usually placed along an outside wall, drawing in air near the floor and exhausting it at the top to circulate fresh air around a classroom.

A cloud of virus particles was assumed to enter the simulation from an infected individual. The investigators assumed this individual was the instructor and experimented with different placements of the box fan air cleaner.

“Placing the air cleaner near the potential infector is the most effective way to reduce the aerosol spread,” said author Jiarong Hong.

The simulations showed the best results were obtained by shifting both the box fan air cleaner and the infected instructor to a location near the HUV.

“At this location, owing to its proximity to both the infector and the HUV, the air cleaner extracts the majority of aerosols, leaving only a small percentage suspended in the air,” Hong said.

Although placing the air cleaner near an infected individual is best, it is not always possible to know who is infected. In this situation, the investigators recommend placing the air cleaner near the HUV, with the air cleaner outflow pointing toward the inlet of the HUV.

“In addition, we find that in large classrooms, distributing multiple air cleaners in the space is more effective in controlling aerosol spread than simply enhancing the flow rate of the HUV or air cleaners alone,” Hong said.

Source: AIP Publishing

New Donuts at the Stores of Krispy Kreme in the U.S.

Obesity Raises Odds for Many Common Cancers

Steven Reinberg wrote . . . . . . . . .

Being obese or overweight can increase the odds of developing several types of cancers, new research from the United Kingdom reveals.

But shedding the excess pounds can lower the risk, researchers say.

Reducing obesity cuts the risk for endometrial cancer by 44% and uterine cancer by 39%, and could also prevent 18% of kidney cancers and 17% of stomach and liver cancers, according to the study.

“It all depends on keeping the weight off,” said lead researcher Carlos Celis-Morales of the BHF Institute of Cardiovascular and Medical Sciences at the University of Glasgow in Scotland. He noted that many people lose weight only to regain it back — and then some.

“What we need is kind of a long-term healthy weight and people that achieve that will reduce the risk,” Celis-Morales said. “That is why it’s so important that people improve the quality of their lifestyle in order to keep a healthy body weight.”

He cautioned, however, that this study can’t prove that excess weight causes cancer or that losing weight prevents it, only that there seems to be a strong connection between excess weight and cancer risk.

For the study, Celis-Morales and his colleagues drew on data from the U.K. Biobank on more than 400,000 men and women who were cancer-free.

The investigators wanted to know the risk of developing and dying from 24 cancers based on six markers of obesity: body fat percentage, waist-to-hip ratio, waist-to-height ratio, waist and hip circumferences and body mass index (BMI), an estimate of body fat based on height and weight.

No matter which way it was measured, obesity increased the odds of developing 10 of the most common cancers, the study found. A larger waist and hips, BMI or percentage of body fat all provided similar cancer risk.

Celis-Morales said BMI is an adequate way to gauge weight-related cancer risk, and there’s no benefit in turning to more complex or costly measures such as waist size or body fat percentage.

For example, a BMI score of 24.9 is considered normal, and every addition of about 4 for men and 5 for women above 25 was linked a 3% higher risk of cancer overall.

It also increased the risk of cancers of the stomach (35%), gallbladder (33%), liver (27%), kidney (26%), pancreas (12%), colon (10%), and bladder (9%).

That same amount of excess weight was also associated with a sharply higher odds of two cancers affecting women — 73% for endometrial cancer and 68% for uterine cancer. It also was linked to an 8% increase for postmenopausal breast cancer.

Lauren Teras, scientific director for epidemiology research at the American Cancer Society, reviewed the findings.

“Some of the ways in which obesity is thought to impact cancer includes elevated levels of sex hormones such as estrogen and progesterone, also insulin-related growth factors and leptin and adiponectin, which are proteins given off by fat tissue,” she said.

Despite strong evidence that excess weight boosts risk for many cancers, less is known about whether losing weight can successfully reverse it, Teras said.

“This is likely because losing weight in adulthood is relatively uncommon, making it difficult to study,” she said. “However, several studies of patients undergoing major weight-loss surgeries have found lower risk of several types of cancer in these patients.”

Maintaining a normal weight, eating a balanced diet and being physically active are beneficial for many aspects of health, Teras said.

“My advice is to find a plan that works for you and stick with it until it becomes a habit,” she suggested. “To increase your physical activity, do what sounds fun to you. Eat a diet that is customized to your preferences, but includes fruits, vegetables and whole grains. Limit portion sizes.”

Then find an accountability partner to keep you on track. “We’re all more likely to succeed when we have support,” Teras said.

The findings were published in the journal BMC Medicine.

Source: HealthDay

Vietnamese-style Sweet and Sour Fish Soup

Ingredients

7 oz mackerel fillets
6 cups fish stock
2 tsp chili oil
1 tbsp garlic, chopped
salt and pepper to taste
1 tbsp sugar
3-1/2 oz pineapple, diced
8 tbsp tamarind paste
1 tomato, quartered
1 tbsp spring onion, chopped
1-1/2 oz fresh mint leaves
1-1/2 oz okra, sliced
1-1/2 0z taro, small dice
2 tbsp nuoc mam (fish sauce)
1 red chili, finely sliced

Method

  1. In a large saucepan, add chili oil and lightly brown garlic.
  2. Add fish stock. When starting to simmer, season with salt, pepper, sugar and tamarind paste.
  3. Add fish fillets, pineapple and tomato. Bring to a simmer, add bean sprouts, spring onion, most of the mint, okra and taro. (Potato can be substituted if taro not available.)
  4. Remove from heat as soon as vegetables soften.
  5. Add fish sauce. Sprinkle red chili slices and remainder of fresh mint on top.
  6. Serve with a bowl of cooked rice.

Makes 4 servings.

Source: Street International


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