Memory Loss

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By Michael Howard, Ph.D.

While some memory loss — such as misplacing the car keys or wondering where that library book is — happens to people as they age, the memory loss associated with Alzheimer’s disease (AD) and other dementing illnesses is far more dramatic, severe, and progressive.

Memory loss is one of the distinguishing symptoms of AD, and it influences other aspects of the disease as well. Memory loss affects communication because the individual begins to forget words and, over time, loses the ability to read and write. Memory loss also affects mood and behavior because patients inevitably become frustrated, angry, and depressed as continual and worsening lapses impair their ability to think and function effectively. Several medications have been shown to slow memory loss and other cognitive decline. Many professionals also believe that exercises designed to stimulate memory, including memory enhancement and reality orientation exercises, may help slow deterioration somewhat. However, these exercises are demanding because they need to be repeated several times a day, and it would be helpful if caregivers could enlist the help of friends and relatives to work with the patient at specific times of the day or week.

Short-term memory loss, that is, loss of memories of events that occurred from several seconds to several days or weeks ago, is the first type of memory to become impaired with dementia. Patients may forget that they just finished a meal, or that a favorite cousin just paid a visit. Loss of long-term memory, memory for events that occurred months or years ago and that also involves remembering how to perform basic tasks such as cooking and dressing, is affected during the middle and later stages of the illness. The effects of memory loss cut across every aspect of the lives of people with AD and other dementias, affecting their ability to communicate, work, enjoy free time and relaxation, and care for themselves. In the later stages of illness, individuals lose their ability to recognize their spouses, family members, and friends. They forget how to bathe, dress, feed themselves, and use the toilet.

A Bit Of A Twist

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Have you given a thought to Valentine’s Day yet?  I suspect for most people it’s a last minute scramble for dinner reservations or roses.  The Valentine cards and candy in stores have been staring us in the face since Christmas Eve.  But most of us have had a few other things on our minds, things like floods, flu, holiday bills, and taxes.  Hearts and flowers aren’t top priorities for most folks unless they work for Hallmark or Russell Stover.

This year there’s a bit of a twist.  February 14th is Valentine’s Day and Ash Wednesday.  It’s most unusual.  As soon as I noticed this anomaly on the calendar, I realized several things would happen.  Some people would turn it into a theological controversy over which observance should take precedence.  I’ve always been perplexed by the propensity of some people to promote “either-or” thinking.  Sure enough, several prominent clerics have issued stern statements about the obligation of their members to fast and forego any Valentine treats.  That’s their call.

Some people will slog through the day unaware of either observance.  They don’t worry about philosophical or theological dilemmas, and, for the most part, they’re not terribly romantic or thoughtful to begin with.  No big deal.

I have a different take on this.  As a 63-year-old woman, I’ve had my share of lovely Valentine surprises and a few bitter disappointments.  That’s life.  As a geriatrician, I know how many sick, lonely, elderly people are ignored on Valentine’s Day.  That’s sad.  As a lifelong Catholic, I understand that Ash Wednesday is all about spiritual priorities and discipline.  We’re not supposed to be self-indulgent morning, noon, and night.  That’s prudent.

Here’s the good part:  Valentine’s Day and Ash Wednesday don’t have to be at odds with each another.  There is no need for “either-or” thinking.  St. Valentine was a real man, a priest who brought great kindness and love to persecuted people in third century Rome.  He was martyred for his devotion in 270 A.D.  Ash Wednesday is a major reminder that life is short.  The only thing we’ll take with us at the end is the love and compassion we have shown to others.

We all have patients, colleagues, neighbors, and even passing strangers in our lives who will be neglected on February 14th unless we remember them.  Valentine’s Day and Ash Wednesday.  Curious.  There’s never a need to “fast” from being thoughtful.

Drink Coffee, Live Longer?

Posted on Posted in Continuing Education, Homestudy, Nutrition, Seminars

By Dr. Laura Pawlak

A coffee plant can live 100 years.  Could humans extend their lives closer to a century by enjoying a cup — or more — of the brew each day?

Coffee beans are seeds of a red fruit called the coffee cherry.  Like all plant foods, coffee beans contain more than a thousand healthful chemicals.

The benefits of drinking coffee are pretty impressive.  The roasted bean has been shown to enhance brain function, increase metabolic rate, and improve exercise performance.  Used to make a daily beverage, the bean has also been linked to a lower risk of dementia, Parkinson’s disease, Type 2 diabetes, stroke, liver disease, and some cancers.

Several studies have found that men who regularly consumed the most coffee (including decaffeinated) had a 60 percent lower risk of advanced or lethal prostate cancer than nondrinkers.  Even drinking one to three cups per day was linked to a 30 percent lower risk.

However, the coffee bean also contains a potentially harmful chemical called acrylamide.  In 2002, Swedish scientists discovered that acrylamide was a product of the browning reaction.  When foods are heated at a high temperature during baking, broiling, frying, or roasting, the appearance, flavor, aroma, and texture of foods are enhanced by the browning reaction — as in toasted bread, French-fried potatoes, and roasted coffee.

The amount of acrylamide in coffee can vary greatly.  Well-roasted, dark coffee beans have less of the chemical than light, roasted beans.  All instant coffees have more acrylamide than fresh versions.

There is no way to remove all the acrylamide from coffee.  Still, the coffee industry is working on practical solutions to reduce its presence.  Should buyers be informed about this chemical with warning labels on the package?  This question is currently being debated in the California court system.

Presently, Americans consume less acrylamide than the maximum exposure levels recommended by the European Food Safety Authority.  To top it off, two recent studies in the Annals of Internal Medicine found that coffee drinkers have modestly lower mortality rates than people who don’t drink coffee.

The Food and Drug Administration’s best advice regarding acrylamide is that consumers adopt a healthy eating plan.  The Wellness Letter, University of California, Berkeley, states:  “There is no reason to deprive oneself of coffee if you like the lift it gives and the sociability it affords.”  If coffee affects you adversely, tea is another popular beverage linked to many health benefits.


Dr. Laura Pawlak (Ph.D., R.D. emerita) is a world-renown biochemist and dietitian emerita.  She is the author of many scientific publications and has written such best-selling books as “The Hungry Brain,” “Life Without Diets,” and “Stop Gaining Weight.”  On the subjects of nutrition and brain science, she gives talks internationally.

That Time Of Year Again: Cold and Flu Season

Posted on Posted in Continuing Education, Nutrition, Seminars, Webinars

By Mary O’Brien, M.D.

It’s that time of the year again.  It’s that awful season when nearly every third person you encounter looks and feels miserable.  Headache, fever, cough, congestion, myalgia, and malaise signal flu season is in full force.  Health officials are already proclaiming this (2017-18) the worst flu outbreak in over a decade.  Considering the dreadful natural disasters of 2017 and record-breaking cold temperatures across two-thirds of the nation, we shouldn’t be surprised.  Every year flu outbreaks spike shortly after the holidays, and the travel, stress, sleep deprivation, and crowds associated with the holidays.

A few time-tested, common sense measures may help protect you, your loved ones, colleagues, and patients:

  • Wash your hands. Wash your hands.  Wash your hands — thoroughly and often.  Hot, soapy water is best, but hand sanitizers and disinfectant wipes come in handy at the grocery store or in the car.
  • Avoid touching your face, especially around your eyes, nose, and mouth. These areas can serve as an entrance ramp for viruses.  Try to resist the temptation.
  • Increase your fluid intake. Bitter cold temperatures combined with heat from furnaces and fireplaces increase insensible fluid losses (fluid lost from skin and breathing).  The resulting dry mucus membranes are not only uncomfortable, but they’re more vulnerable to viral penetration.  Water is best here.
  • Get more sleep than you think you need. A single night of inadequate sleep can compromise lymphocyte numbers and function.  Give your immune system the restorative time it needs to protect you.
  • Don’t overextend yourself. Most folks are already tired from the holidays.  Give yourself some downtime before you have no choice in the matter.
  • Avoid crowds like the plague. Contagion is partly a numbers game.  No one has to go to a crowded movie theater or restaurant.  Stay home and clean out a closet.
  • Consider getting a flu shot now. So far this year (2018), the efficacy rating is not good.  But, some protection is better than none.  Remember, antibody production will take about two weeks after the shot.

And — finally — if you do get the flu, please stay home.  There is nothing noble or heroic about spreading influenza to colleagues and patients.

In the meantime, stay warm and well.  I have to go wash my hands now.

Protein Powders

Posted on Posted in Continuing Education, Homestudy, Nutrition, Seminars, Webinars

By Annell St. Charles, PhD, R.D., L.D.N.

Protein supplements and powders have become all the rage over the last few years, particularly for people trying to build muscle.  However, most Americans already get all the protein they need from their diet, and some may even be getting too much.

Proteins are made up of amino acids, which are the key component of muscles and play many important roles in body maintenance.  Meat, poultry, fish, eggs, nuts, seeds, and legumes (dry beans or peas such as lentils, chickpeas, and kidney beans) are good sources of protein, and most Americans consume 12 to 18 percent of their calories as protein.  Dr. Van S. Hubbard, director of the NIH Division of Nutrition Research Coordination, says that most Americans do not need to worry about getting enough protein. “Unless they have some other medical problem, most people are meeting or exceeding their protein requirements,” he says. “Since protein is such a common component of most foods that you eat, if you’re eating a relatively varied diet, you’re getting enough protein.”  However, some populations, like vegetarians and older people, need to be aware of the protein in their diets.  Vegetarians can get the protein they need from rice, beans, eggs, peanut butter, dairy products, and bread.  Vegans need to be particularly careful, as they do not consume either eggs or dairy products.

A recent National Institutes of Health study of men and women age 70 years and older found that those who ate the least protein lost significantly more muscle than those who ate the most protein.  Older adults who lose muscle in their legs and hips are more likely to fall and have injuries like broken hips.  They may also have trouble doing basic things like getting up from a chair, walking upstairs, or taking a stroll due to loss of muscle strength.  For elderly people who cannot eat enough protein or who have diseases that leave them malnourished, a protein supplement can be one way to help get enough protein.

Nevertheless, the majority of Americans derive little benefit from increasing their protein intake.  Long-term studies found that high-protein diets that result in weight loss usually work as a result of the amount of calories rather than the amount of protein being consumed.

Recent weight loss, muscle fatigue, or a drop in muscle strength may be signs of protein deficiency, but these symptoms could also be due to other health conditions.

The Party’s Over

Posted on Posted in Continuing Education, Homestudy, Nutrition, Seminars, Webinars

By Dr. Laura Pawlak

Holiday food and spirits may have disappeared, but those extra calories can stubbornly remain as body fat.  With each new year, an array of diets emerges, promising to restore your former shape.

My suggestion?  This year, follow a new plan called Intermittent Fasting, which has captured the interest of both dieters and researchers.  Intermittent Fasting is a structured program without the drudgery of daily calorie deprivation.

Although traditional reduced-calorie diets are certainly science-based, intermittent fasting is a sensible alternative.  Studies suggest a modified fast is just as beneficial for weight loss as other diets.

For this program, the term “fasting” is defined as consuming a total of 500 calories for women and 600 calories for men on fasting days. If calorie counting is not convenient, you can eat about 25 percent of your normal calories on fasting days.  More importantly, you abstain from eating all calorie-containing foods and beverages for 14 hours (women) or 16 hours (men) on fasting days.

The popular 5:2 Intermittent Fasting Diet is appealing because the two fasting days each week can be chosen to fit one’s schedule best.  On the remaining five days, you eat sensibly.  If weight loss is your goal, it is important to avoid overcompensation during non-fasting days.

Alternate-day Fasting is a more aggressive approach to weight loss.  You consume only 500-600 calories every other day following the 14- to 16-hour fast. Recently, scientists compared the Alternate-day Fasting program with a standard weight-loss diet for six months followed by a maintenance diet for an additional six months.  Persons choosing the fasting program had slightly greater weight loss than individuals following the standard low-calorie diet.

To limit calories during fasting days, consider making a homemade soup, then establish portions and freeze individual servings.  A simple vegetable soup with legumes and wild rice or whole wheat quinoa is nutritious, high in fiber, and low in calories.  A variety of salad ingredients with fish or turkey and calorie-free dressing is always an excellent choice.  An egg-white omelet using fresh or leftover vegetables provides quality protein needed to protect muscle mass.

To dampen appetite during fasting days, choose vegetables high in fiber and protein-rich foods low in fat. Try adding herbs and spices to cooked vegetables.  They light up your taste buds with pleasing flavors and aromas.


Dr. Laura Pawlak (Ph.D., R.D. emerita) is a world-renowned biochemist and dietitian emerita.  She is the author of many scientific publications and has written such best-selling books as “The Hungry Brain,” “Life Without Diets,” and “Stop Gaining Weight.”  On the subjects of nutrition and brain science, she gives talks internationally.

A Different Tradition

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Has your home returned to a relative state of post-holiday normality?  I’m almost there.  The boxes and bags and bows and ribbons have been put away until next year.  The “thank you” notes are in the mail.  And my kitchen table has been restored to an acceptable state of neatness.

Many people will start to focus on new year’s resolutions now, knowing full well the resolutions are unlikely to last.  I have a different tradition at the end of December.  It goes back quite a few years.  In a reflective state of blissful solitude, I write down my own little “year in review.”  It takes some time, thought, and effort, but it’s an exercise that can generate some profound insights.

  • What were the best or most positive events of 2017 — personally, nationally, and globally?
  • What were the worst or most tragic events of 2017 — personally, nationally, and globally? How did I cope or respond?
  • What event or situation made me feel most grateful?
  • What was the most beautiful, unusual, or remarkable sight I saw in 2017? (Personally, it would be difficult to top the perfect, unobstructed view of the total solar eclipse I had from my own backyard in August 2017.)
  • What was the biggest mistake I made in 2017? This one can be tough and sobering.
  • What was the most important lesson I learned in 2017? It’s often related to the biggest mistake I made.
  • What experience or moment touched me the most deeply?
  • What was the most noble, courageous, or generous thing I did in the past year? Coming up short on this one is not a good sign.
  • And finally, what could I do in 2018 to become a better person — physically, mentally, emotionally, and spiritually?

The little, personal “year in review” may not be as fascinating as a list of the year’s top news stories, viral videos, or celebrities who have passed.  It will, however, become profoundly revealing to you 10 or 20 years from now.

Have a happy new year.

 

Something Feels Different

Posted on Posted in Continuing Education, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Are we there yet? I wonder as I stare at my kitchen table covered with gift bags, wrapping paper, bows, ribbon, tape, and scissors. Every year, I tell myself I’ll cut back a bit next year. It never happens. The pressure starts with Christmas-in-July sales on shopping channels. I confess I find it difficult to resist. I love buying and wrapping presents for people. It truly makes me happy, especially when someone is genuinely surprised and delighted. It’s a constructive way to take the focus off myself.

This year however, something feels different. It’s been a tough year with historic, natural disasters. Devastating hurricanes, floods, tornadoes, earthquakes, wildfires, and blizzards have wreaked havoc on tens of millions of people. Mass shootings, riots, and appalling, vicious acts of violence have left most of us stunned and horrified. My heart breaks for all of those who have lost loved ones and homes. How I wish I could ease their anguish.

I cannot restore lost loved ones, homes, and treasured possessions for people in California, Texas, Florida, and Puerto Rico. I can write a few checks and say a few prayers. Those are good things to do, but they never seem to be enough.

Then it dawned on me. There are lots of people suffering all around us every day. They just don’t appear on the evening news. Here, in Myrtle Beach, South Carolina, there are nearly 2,500 homeless teenagers. That seems ironic in a town that’s largely focused on tourism and fun. I decided to give some money to my almost-adult niece and nephew. I gave them instructions to go buy clothes for homeless teenagers. I have no clue what teenagers would want or need, but my niece and nephew do, and they did well. Unloading their bags full of jackets, hoodies, sweaters, socks, underwear, scarves, and hats, they announced they “had a blast” doing it. Surprise! Thinking of other people can be fun.

My kitchen table is still a mess. But this year, I realize how blessed I am to have a kitchen, messy table and all.

 

Let It Go!

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Did you survive Thanksgiving without major family stress or tension? If the answer is “no,” you’re not alone. Holiday gatherings don’t always bring out the best in everyone. Some folks are already frazzled by travel nightmares. Those hosting the feast are tense and worn down by days of planning, preparation, and cooking. No one ever has quite enough room in her kitchen for all the food, much less the guests who congregate in the middle of the mess. There’s nearly always one culinary mishap and someone is sure to announce she has a life-threatening allergy to gravy.

But wait! We haven’t even begun to address deeply ingrained differences in political perspectives, religious beliefs, and good, old-fashioned feuds and grudges. Was all of this supposed to be fun? Fortunately or not, many of us will have another crack at family festivity soon as we try to celebrate Christmas or Hanukkah. I have a few time-tested thoughts that might help—at least a bit.

  • Psychologists tell us that it takes 21 days to replace a bad habit with a good one. That means we have just enough time to make a difference. Starting now, try not to criticize, condemn, or complain. It’s not easy, especially in this culture. However, it will make the next family gathering much easier to endure, if not actually enjoy.
  • Remember some basic neurophysiology. The human brain cannot hold onto diametrically opposed emotions simultaneously. We can’t feel love and hatred at the same time. We can’t feel empathy and anger in the same moment. And we can’t experience gratitude and resentment all at once. It may sound simplistic, but gratitude is often the best remedy for resentment, anger, anxiety, and sadness. Those of us who have food, water, shelter, clothes, electricity, a little money, and a few loved ones have more than hundreds of millions of people around the world. Smile and say “thank you” — a lot.
  • Forgive yourself and everyone else. I’ve watched relatives feud for decades. They make themselves and everyone else miserable. None of us is perfect. We’ve all said and done things that were misguided or thoughtless. However, refusing to forgive is like drinking poison. It makes no sense. Forgiveness represents the ultimate act of overcoming ego. Let it go. LET IT GO!

Please don’t make me sing that song from “Frozen.” I have relatives who would never forgive me.

 

Vitamins & Minerals: What Does The Body Need?

Posted on Posted in Brain Science, Continuing Education, Elder Care, Homestudy, Nutrition, Seminars

By Annell St. Charles, Ph.D., R.D., L.D.N.

In 1912, Casimir Funk, a Polish biochemist, isolated a concentrate from rice polishings that cured polyneuritis in pigeons.  He called the substance a “vital amine” or “vitamine” because it appeared to be vital for life.  There was widespread interest in eradicating several prevalent diseases at the time, and, in an article published in 1912, Funk postulated the existence of four substances:  one that prevented beriberi (“antiberiberi”), one that prevented scurvy (“antiscorbutic”), one that prevented pellagra (“antipellagric”), and one that prevented rickets (“antirachitic”).  Funk was one of several researchers in the early 20th century investigating these and other substances and their connection to health.

Epidemiologists, physicians, physiologists, and chemists all worked on this puzzle through the mid-20th century; the work was slow and onerous and plagued by many setbacks and contradictions.  Chemists were the ones ultimately able to identify and isolate the substances we call vitamins, leading to the development of synthetic forms that are available for wide consumption.  The proposed benefits and risks of vitamins and vitamin supplementation continue to be hot topics today.

The vitamins needed by the body for growth and normal development are:

  • Vitamin A
  • B Vitamins (vitamin B6, vitamin B12, folate, and others)
  • Vitamin C
  • Vitamin D
  • Vitamin E
  • Vitamin K

Vitamins are divided into two groups:

  • Water-soluble are easily absorbed by the gut and stored only minimally. These include Vitamin C, thiamin, riboflavin,niacin, biotin, pantothenic acid, B6, folic acid, B12, and others.
  • Fat-soluble are stored in body tissues and excess accumulation can be toxic.  Vitamins A, D, E, and K are fat-soluble vitamins.

Macrominerals & Trace Elements

These essential inorganic elements are categorized by abundance:

  • Macro-minerals are present in the body over 100 mg:  calcium, phosphorus, magnesium, potassium, sodium, chloride, and sulfur.
  • Trace elements are present in microgram or low-milligram amounts:  iron, zinc, iodine, selenium, copper, manganese, fluoride, chromium, molybdenum, silicon, nickel, boron, arsenic, tin, and vanadium.