HEALTHY DIET AND EXERCISE

Live event held April 28, 2008

In putting this topic together, Dr. Kimberly Taylor of the Virginia Commonwealth University and Mary Ann Johnson of the Alzheimer’s Association Greater Richmond Chapter have brought to our attention the need to stress the importance of good nutrition, socialization and exercise. Moreover, as they both described in the live discussion of the 28th of April, 2008, this combination of a healthy diet, keeping fit and interacting with others are not only for the persons diagnosed with dementia but also for their care partners. Adjusting to the new challenges of the disease and defining new strategies to improving the quality of life and living for both, person with Alzheimer’s and care partner, will be at the core of this newsletter and an invitation to join in with your own solutions, experiences and questions.

The discussion’s objectives included:

  • Provide a general understanding of the two most common forms of dementia and present the risk factors for cognitive decline
  • Stress the importance of good nutrition for the person with dementia and their care partner
  • Showcase healthy habits to encourage good nutrition
  • Provide cooking tips to add vitamins to foods and supplements to promote good nutrition
  • State the importance of exercise and socialization to aid in good nutrition
  • Examine preventive strategies that include nutrition and physical activity
  • Discuss a plan to integrate these strategies
  • Discuss the risk of caregiving
  • Present the “10 Commandments”

Alzheimer’s Disease and Dementia: Living Well to Care for and Preserve Cognition

by Kimberly F. Taylor, PhD

As we get older, many worry about the “losing their minds”, losing their independence or getting Alzheimer’s disease. It is important to point out that Alzheimer’s disease is not a normal part of aging; however the number of individuals who are affected increases from about 5% at age 65 to about 40% for individuals 85 and over. Therefore, risk factors and preservation strategies may be useful tools to ensure a lifetime of cognitive abilities and independence.

Risk factors for Alzheimer’s disease are of two categories: non-modifiable and modifiable.

Non-modifiable risk factors

  • age
  • female gender
  • apo E4 genotype
  • family history
  • genetics, and
  • Down’s syndrome

Modifiable risk factors

  • head injury
  • psychological stress
  • high cholesterol
  • hypertension
  • diabetes
  • smoking, and
  • increased fat around the abdomen.

It is no accident that the risk factors associated with heart disease and type 2 diabetes are associated with Alzheimer’s disease. Keep in mind that the human body is an organism, and factors that affect the heart, as in heart disease, are likely to exert influence on other organs or organ systems within the organism. Recently, in the medical literature, Alzheimer’s disease has been referred to as type III diabetes.

So, what to do to preserve optimal cognitive functioning throughout the lifespan? Anything that decreases risk of other chronic diseases of the vascular system would reduce your risk. A natural starting point would be to engage in regular activity eat a well balanced diet. It has been demonstrated that exercise protects against cognitive decline in a specific manner. It decreases amyloid precursor protein (APP). This is the precursor to the beta amyloid plaques which are part of the characteristic pathology of Alzheimer’s disease. Exercise also increases naprilysin, an enzyme that degrades beta amyloid plaques. Although there isn’t an exercise recommendation specific to cognition, engaging in 30 minutes of moderate intensity aerobic exercise is beneficial. It has also been suggested that varying the mode of aerobic exercise may enhance the benefits.

Because excess calories are suspect when it comes to abdominal fat, consuming less is an improvement. However, there are certain foods that should not be eliminated, as they have been demonstrated to benefit cognition over the lifespan. Daily consumption of fruits and vegetables should be increased, thus providing an antioxidant rich diet. It has been demonstrated that individuals who eat the greatest number of servings of especially vegetables, have a much lower risk of dementia. The recommended daily allowance for vegetables is 3-5 servings per day and 2-4 servings per day for fruits. Regular consumption of fish (two servings per week) and the use of monosaturated fats have also been shown to reduce the risk of Alzheimer’s and dementia. Accompanying your meals with a glass of red wine has been shown to be beneficial. Resveratrol, the polyphenol found in the skin of red grapes, can decrease the oxidative stress causing beta amyloid plaques. So have a European meal! It will not only protect your heart, but your brain as well!

Living well also includes engaging in a lifetime intellectual activities. This includes, but is not limited to, learning a new hobby, writing, playing games or resolving puzzles or reading things that are different from your comfort zone. There are even computer programs that are designed to improve your “cognitive fitness.” By engaging in cognitive challenges, spatial memory, neuronal development and neurotropin growth factor increases. This protects against cognitive decline in a manner that is different from exercise or diet.Therefore, living well to preserve cognition should involve a 3 pronged approach: eat well, exercise and keep on learning!

PANELISTS

Kimberly Taylor, PhD is Assistant Professor in the Department of Gerontology at VirginiaCommonwealth University in Richmond, VA. Her approach to gerontology, or the study of aging, is from a lifestyle perspective. Her research interests are in treatment and prevention of chronic diseases such as obesity, metabolic syndrome, diabetes, cardiovascular disease and polycystic ovarian syndrome. Currently, Taylor and her students are investigating the influence of aerobic exercise vs. metformin on metabolic syndrome in obese men and women 60 years old and older. She is also interested in inflammation and oxidative stress and its relationship to cognitive decline and metabolic syndrome. She has examined the influence of exercise and other secretagogues on growth hormone production. In previous research, she compared the effects of lifestyle vs. pharmacology vs. lifestyle and pharmacology on body composition, glucose tolerance, cholesterol, cytokines and menstrual cyclicity in women with polycystic ovarian syndrome. She is a dedicated teacher and lectures on topics including the biology and physiology of aging, nutrition and aging, chronic disease, as well as physical activity and aging.

Mary Ann Johnson, MA,is the Program Director for the Alzheimer’s Association, Greater Richmond Chapter (www.alz.org/grva/). In this position, she oversees all core chapter services and is responsible for developing new curriculum training programs.

Mary Ann had served on committees for the National Alzheimer’s Association to review programs, committees to develop evaluation tools for core services for the Association, the committee to review implementation of early stage support groups, the mission focus committee for Early On-set/ Early Stage, the development committee for the End of Life Module for Foundations of Quality Care. She had also developed a training program for hospital staff, parish nurses and clergy and lay leaders of faith based communities. Mary Ann holds a Masters in Christian Education from Union-PSCE and is a Master Trainer for Alzheimer’s Association’s educational programs. In addition, she chairs the Innovative Program Committee, Program Clearinghouse, National Alzheimer’s Association and is the co-author of “Caregiver Burden in Alzheimer’s Disease,” Consultant Pharmacist, April, 2004. Mary Ann is the recipient of the 2005 Mary Ellen Cox Award for Advocacy for Seniors from Senior Connections-Area Agency on Aging.

MODERATOR

Ayn WellefordE.  Ayn Welleford, PhD, is Chair, VCU Department of Gerontology, Associate Professor,VCU Department of Gerontology, and Associate Director, Virginia Geriatric Education Center. Dr. Welleford received her B.A. in Management/ Psychology from Averett College, M.S. from the Department of Gerontology and Ph.D. in Developmental Psychology from VCU. She has taught extensively in the areas of Lifespan Development, and Adult Development and Aging. As an educator, researcher, and previously as a practitioner she has worked with a broad spectrum of individuals across the caregiving continuum. As a gerontologist she currently works extensively with formal and informal caregivers to improve elder care through education. Outside of the classroom and working with various community agencies, Dr. Welleford provides community education on a variety of topics, including: Steps to Aging Well, Building Successful Mother-Daughter Relationships, Intergenerational Programs, and Family Caregiving. Dr. Welleford conducts research, through mixed methodology, in the areas of caregiver burden, coping with distress, adult mother-daughter relationships, successful aging, and geriatric education.

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