Have you been worried about your driving? Have your family or friends expressed concern? Changes in your health may affect your driving skills over time. Don’t risk hurting yourself or others. Talk with your doctor about any concerns you have about your health and driving.

As you age, your joints may get stiff, and your muscles may weaken. Arthritis, which is common among older adults, might affect your ability to drive. These changes can make it harder to turn your head to look back, turn the steering wheel quickly, or brake safely.

See your doctor if pain, stiffness, or arthritis seem to get in the way of your driving.

If possible, drive a car with automatic transmission, power steering, power brakes, and large mirrors.

Be physically active or exercise to keep and even improve your strength and flexibility.

Think about getting hand controls for both the gas and brake pedals if you have leg problems.

Your eyesight can change as you get older. It might be harder to see people, things, and movement outside your direct line of sight. It may take longer to read street or traffic signs or even recognize familiar places. At night, you may have trouble seeing things clearly. Glare from oncoming headlights or streetlights can be a problem. Depending on the time of the day, the sun might be blinding.

Eye diseases, such as glaucoma, cataracts, and macular degeneration, as well as some medicines, can also cause vision problems.

If you are 65 or older, see your eye doctor every year. Ask if there are ways to improve your eyesight.

If you need glasses or contact lenses to see far away while driving, make sure your prescription is up-to-date and correct. Always wear them when you are driving.

Cut back on or stop driving at night if you have trouble seeing in the dark. Try to avoid driving during sunrise and sunset, when the sun can be directly in your line of vision.

Trouble Hearing

As you get older, your hearing can change, making it harder to notice horns, sirens, or even noises coming from your own car. Hearing loss can be a problem because these sounds warn you when you may need to pull over or get out of the way.

Have your hearing checked at least every 3 years after age 50.

Discuss concerns you have about hearing with your doctor. There may be things that can help.

Try to keep the inside of the car as quiet as possible while driving.

Dementia and Driving

In the very early stages of Alzheimer’s disease or other types of dementia, some people are able to keep driving. But, as memory and decision-making skills get worse, they need to stop.

People with dementia often do not know they are having driving problems. Family and friends need to monitor the person’s driving ability and take action as soon as they observe a potential problem, such as forgetting how to find familiar places like the grocery store or even their home. Work with the doctor to let the person know it’s no longer safe to keep driving.

A person with dementia will need more care as symptoms worsen over time. Problems with memory, thinking, and behavior often present challenges for those with dementia as well as for their family members. Whether the disease is in early or late stages, there are support systems, resources, and services that can help.

While it can be difficult for some to admit they need assistance with care or caregiving, it is okay to ask for help. In fact, when it comes to caregiving, taking care of yourself is one of the most important things you can do.

There are many different types of care available depending on the level of help or care you need.

Day-to-day support can be found through adult day centers and respite services. These options provide short-term care for a person with dementia and allow the caregiver to take a break. Day-to-day support may include supervision, meals delivered to the home, and/or transportation.

Long-term care in the home may be provided by unpaid family members and friends or by paid service providers and can involve general care or medical care. Home care services often focus on everyday activities such as bathing, dressing, eating, and ensuring the person with dementia is safe. Home health care services involve licensed medical professionals and require a doctor’s order.

Residential care may become necessary as a person with dementia requires more care and supervision than can be provided at home. Assisted living facilities may be able to provide enough support in the early stages of dementia, whereas nursing homes may be more appropriate for people who are no longer able to live safely at home. Continuing care retirement communities are multi-level care facilities that provide living accommodations and health services. A resident can move between multiple levels of care as needed.

Hospice services provide end-of-life care and comfort for people with dementia and their families. These services can be received in the home or at a residential care facility, hospital, or hospice facility.

What is the difference between Alzheimer’s disease and dementia?
Alzheimer’s disease is a type of dementia. Dementia is a loss of thinking, remembering, and reasoning skills that interferes with a person’s daily life and activities. Alzheimer’s disease is the most common cause of dementia among older people. Other types of dementia include frontotemporal disorders, Lewy body dementia, and vascular dementia.

What are the early signs of Alzheimer’s disease?
Memory problems are typically one of the first signs of Alzheimer’s disease, though different people may have different initial symptoms. A decline in other aspects of thinking, such as finding the right words, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimer’s disease.

Mild cognitive impairment, or MCI, is a condition that can also be an early sign of Alzheimer’s disease — but not everyone with MCI will develop Alzheimer’s. In addition to memory problems, movement difficulties and problems with the sense of smell have been linked to MCI. If you have MCI, it’s important to see a doctor or specialist regularly to monitor any changes in memory or thinking .

What are the stages of Alzheimer’s disease?
Alzheimer’s disease progresses in several stages: preclinical, early (also called mild), middle (moderate), and late (severe). During the preclinical stage of Alzheimer’s disease, people seem to be symptom-free, but toxic changes are taking place in the brain. A person in the early stage of Alzheimer’s may exhibit the signs listed above.

As Alzheimer’s disease progresses to the middle stage, memory loss and confusion grow worse, and people may have problems recognizing family and friends. As Alzheimer’s disease becomes more severe, people lose the ability to communicate. They may sleep more, lose weight, and have trouble swallowing. Eventually, they need total care.

What are the causes of Alzheimer’s disease?
Scientists do not yet fully understand what causes Alzheimer’s disease in most people. In early-onset Alzheimer’s, which occurs between a person’s 30s and mid-60s, there may be a genetic component. Late-onset Alzheimer’s, which usually develops in a person’s mid-60s, arises from a complex series of age-related brain changes that occur over decades. The causes probably include a mix of these changes, along with genetic, environmental, and lifestyle factors. These factors affect each person differently.

Is there a cure for Alzheimer’s disease?
Currently, there is no cure for Alzheimer’s disease. Some sources claim that products such as coconut oil or dietary supplements can cure or delay Alzheimer’s. However, there is no scientific evidence to support these claims.

The U.S. Food and Drug Administration (FDA) has approved several drugs to treat people with Alzheimer’s disease, and certain medicines and interventions may help control behavioral symptoms.

Scientists are developing and testing possible new treatments for Alzheimer’s. Learn more about taking part in clinical trials that help scientists learn about the brain in healthy aging and what happens in Alzheimer’s and other dementias. Results of these trials are used to improve diagnosis, treatment, and prevention methods.

Currently, there is no definitive evidence about what can prevent Alzheimer’s disease or age-related cognitive decline. What we do know is that a healthy lifestyle — one that includes a healthy diet, physical activity, appropriate weight, and control of high blood pressure — can lower the risk of certain chronic diseases and boost overall health and well-being. Scientists are very interested in the possibility that a healthy lifestyle might delay, slow down, or even prevent Alzheimer’s. They are also studying the role of social activity and intellectual stimulation in Alzheimer’s disease risk.

For more information about Alzheimer’s
NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center
800-438-4380 (toll-free)
[email protected]
www.nia.nih.gov/alzheimers

For many, the holiday season is a joyful one spent together with loved ones—including families affected by dementia. Being adaptable and building an inclusive environment are key to creating dementia-friendly holidays and celebrations. With the holiday season right around the corner, the Alzheimer’s Foundation of America (AFA) is providing tips on how families affected by dementia can adapt holiday gatherings to make them safe and dementia-friendly during this festive time.

“The best way to support someone with dementia during the holiday season is to create an inclusive environment to enjoy holidays and celebrations, while understanding and adapting to changes and being aware of the many emotions the holidays can bring,” said Jennifer Reeder, LMSW, AFA’s Director of Educational and Social Services.

Families caring for someone with dementia should consider the following steps:

Build on old traditions where you can, such as enjoying favorite music or movies. Start new ones around things the persons can, and likes to do, such as touring neighborhood holiday lights, and do it together. Whenever possible, involve the person by asking what traditions are important to them (this will help you prioritize and plan). For example, if the person used to do all the holiday cooking, make it a new tradition to cook together as a family. If they oversaw hanging holiday lights, make it a group effort.

Excess stimuli may be challenging for someone with dementia. Too many flickering lights or an abundance of decorations can be overstimulating and disorienting. Also, be aware of the person’s sensitivity to factors such as loud noises.

Avoid fragile decorations (which can shatter and create sharp fragments) and ones that could be mistaken for edible treats (which can create a choking hazard or broken teeth). Reduce clutter to avoid potential tripping hazards. Securely hook Christmas trees to the wall to avoid falls and utilize menorahs or kinaras with electric candles to reduce fire hazards.

Like with traditions, adapting celebrations is key for a dementia-friendly holiday. Try to focus on what they enjoy while keeping in mind their safety and comfort.

Before the celebration

Prepare the person.

Help build familiarity and comfort by showing them photos of the guests or arrange a phone call/Facetime chat with the visitors beforehand.

Consider sharing beneficial information with guests beforehand, such as ways they can communicate with the person, what they respond well to, and what may upset them—especially visitors who don’t regularly interact with the individual. This will guide them on how they can be helpful and supportive.

During the celebration

Preserve normal routine.

Changes in daily routine can be challenging for someone living with dementia. If the person usually takes an afternoon walk, build in time for that. If they go to bed early, hold the celebration earlier in the day so that everyone can participate.

Take a Strengths-Based and Person-Centered Approach.

Focus on what the person is still able to do and what they choose to do now, rather than dwelling on what they used to do.

The AFA Helpline is available seven days a week to help provide additional information about creating dementia-friendly holidays or any other caregiving questions. Connect with a licensed social worker by calling 866-232-8484, web chatting at www.alzfdn.org or sending a text message to 646-586-5283. The web chat and text message features can serve individuals in more than 90 different languages.

Fraud occurs when someone tricks an elder into handing over assets such as money or investments. Watch out for many different schemes and scams. Remember, fraudsters vary their scams to catch their victims off guard. Financial elder abuse is most often perpetrated by someone an elder knows such as a caregiver, friend,or sadly, a relative. It involves taking assets by directly taking control of an elder’s finances or becoming close with an elder and convincing them to hand over their assets. Things to watch for include: making unauthorized (or fraudulently obtained) withdrawals or purchases using the elder’s ATM or credit card, or making unauthorized (or fraudulently obtained) changes to an elder’s will or power of attorney.

The need for senior fraud awareness and prevention has become greater than ever. Seniors are often easy targets for fraud, whether it’s for fraudulent sweepstakes prizes or too-good-to-be-true investment returns. Fraud can happen by phone, mail, online, and in person. Fraud can happen to wealthy seniors, and to those of limited means and on fixed incomes. Although anyone can commit senior fraud, the Los Angeles branch of Adult Protective Services reports that about 90% of their cases involve allegations that a family member has financially abused an elder. Education and awareness are the first steps to help protect seniors from becoming a victim of crime and fraud.

According to the Federal Trade Commission (FTC), con artists are more likely to target seniors than other age groups. Seniors are more susceptible to such scams because they are polite and trusting and often have good credit and own their own home and/or have other financial assets. The FTC reports that fraudulent telemarketers direct up to 80 percent of their calls at senior citizens. Seniors citizens continue to be a rapidly increasing segment of the population, and that makes them a prime target for con artists and thieves. Education and awareness are the first steps to help protect seniors from becoming a victim of crime and fraud.

The FTC is getting reports about people pretending to be from the Social Security Administration (SSA) who are trying to get your Social Security number and even your money. In one version of the scam, the caller says your Social Security number has been linked to a crime (often, he says it happened in Texas) involving drugs or sending money out of the country illegally. He then says your Social is blocked – but he might ask you for a fee to reactivate it, or to get a new number. And he will ask you to confirm your Social Security number.

Many people make assumptions about aging, what it is like to grow “old”, and how older age will affect them. But as we are getting older, it is important to understand the positive aspects of aging. Research has shown that you can help preserve your health and mobility as you age by adopting or continuing healthy habits and lifestyle choices.

1. If a family member has Alzheimer’s disease, I will have it, too.

A person’s chance of having Alzheimer’s disease may be higher if he or she has a family history of dementia because there are some genes that we know increase risk. However, having a parent with Alzheimer’s does not necessarily mean that someone will develop the disease.

Environmental and lifestyle factors, such as exercise, diet, exposure to pollutants, and smoking also may affect a person’s risk for Alzheimer’s. While you cannot control the genes you inherited, you can take steps to stay healthy as you age, such as getting regular exercise, controlling high blood pressure, and not smoking.

2. Now that I am older, I will have to give up driving.

As the U.S. population ages, the number of licensed older adults on the road will continue to increase. The Federal Highway Administration (FHWA) recorded a record-high 221.7 million licensed drivers in the U.S. in 2016, including 41.7 million — or almost one in five — who are 65 years or older. The question of when it is time to limit or stop driving should not be about age, rather, it should be about one’s ability to drive safely.

3. Only women need to worry about osteoporosis.

Although osteoporosis is more common in women, this disease still affects many men and could be underdiagnosed. While men may not be as likely to have osteoporosis because they start with more bone density than women, one in five men over the age of 50 will have an osteoporosis-related fracture. By age 65 or 70, men and women lose bone mass at the same rate.

Many of the things that put men at risk are the same as those for women, including family history, not enough calcium or vitamin D, and too little exercise. Low levels of testosterone, too much alcohol, taking certain drugs, and smoking are other risk factors.

4. I’m “too old” to quit smoking.

It doesn’t matter how old you are or how long you have been smoking, quitting at any time improves your health. Smokers who quit have fewer illnesses such as colds and the flu, lower rates of bronchitis and pneumonia, and an overall better feeling of well-being.

The benefits of quitting are almost immediate. Within a few hours, the carbon monoxide level in your blood begins to decline and, in a few weeks, your circulation improves, and your lung function increases.

5. My blood pressure has lowered or returned to normal, so I can stop taking my medication.

High blood pressure is a very common problem for older adults — especially those in their 80s and 90s — and can lead to serious health problems if not treated properly. If you take high blood pressure medicine and your blood pressure goes down, it means the medicine and any lifestyle changes you have made are working. However, it is very important to continue your treatment and activities long-term. If you stop taking your medicine, your blood pressure could rise again, increasing your risk for health problems like stroke and kidney disease.

More in next issue.

Engaging in high or medium levels of physical activity was associated with slower rates of cognitive decline in people with high or low levels of tau, compared to those with little physical activity. Led by researchers from the Rush University Medical Center, the findings were published in JAMA Network Open on Aug. 11. The researchers noted that measuring levels of tau, a protein that is a hallmark of Alzheimer’s disease, in the blood could help identify people who might benefit from early intervention to slow cognitive decline.

In people living with Alzheimer’s, abnormal accumulation of tau builds up into tangles in the brain. Higher levels of tau are associated with cognitive decline and an increase in memory and thinking problems. Research has shown that physical activity may help slow cognitive decline, but it was unknown if physical activity rates were associated with slow cognitive decline in people who have high levels of tau.

A team of researchers used data from 1,159 older adults who took part in a large study called the Chicago Health and Aging Project (CHAP) between 1993 and 2012. CHAP researchers assessed cognitive function using various tests, asked participants about their physical activity, and collected blood samples from the participants, who did not have Alzheimer’s at the start of the study. In 2019, researchers measured tau concentrations in the blood samples, which had been frozen, and compared rates of cognitive decline among people with high and low tau concentrations and high, medium, and low physical activity levels.

The researchers found that, among participants with high tau concentrations, those who had reported medium levels of physical activity had a 58% slower rate of cognitive decline than participants with low physical activity levels. Those who reported high physical activity levels had a 41% slower rate of cognitive decline than those with low self-reported physical activity levels. For participants with low tau concentrations, those with high physical activity levels had significantly slower cognitive decline than those with medium or low physical activity levels.

The study had some limitations. It included only white and African American participants, and it measured the duration but not the intensity of physical activity. The researchers also note that the rate of cognitive decline was sometimes lower among participants with medium physical activity levels than among those with high physical activity levels; the reasons for this variation warrant further study.

The findings suggest that measuring proteins — such as tau — in the blood could help identify people who would benefit from increased physical activity or other behavior changes that could help slow cognitive decline. Measuring such proteins could also help future studies measure the benefits of behavior changes in people who are at higher risk of Alzheimer’s.

This research was supported by NIA grants R01AG03154, R01AG051635, RF1AG057532, and R01AG058679.

by National Institute of Health

Statistical trends show that by 2050, approximately a quarter of the world population will consist of older adults. This forecast highlights the need for strategies to promote healthy aging and the development of biological markers that can identify which individuals are at increased risk for age-related conditions and disabilities.

The risk and progression of multiple aging conditions can be influenced by several fundamental mechanisms and processes such as damage and repair of tissue components, alterations in cellular bioenergetics, and changes in genomic structure and function. Thus, the discovery of biomarkers — whether circulating in the body or in specific organs and tissues — can help us track and better understand how these mechanisms and processes affect long-term health outcomes. Biomarkers could also lead to better ways of testing new therapies to treat or prevent age-related conditions.

With this immense scientific potential in mind, NIA seeks to support technological innovations that make new biomarker discoveries possible. Among the areas we hope to develop are:

High-throughput ways to analyze blood and its components

Translational research on crucial methodologic issues for collection and storage conditions for human biospecimens to assess the activity of specific cellular pathways

Development of statistical methods that will help researchers evaluate the relationships of mechanistic markers to aging-related outcomes

Research to understand the relationships between levels of a marker in one tissue compared with other organs and tissues

NIA’s Predictive Biomarkers Initiative

In 2019, NIA launched the Predictive Biomarkers Initiative and established an innovative research network focusing on the development and validation of high-throughput assays to examine several aging-related processes through biomarker detection and validation. This network is currently assessing and refining analytical methods, developing and validating markers of multiple aging mechanisms, testing variability of markers in human populations, and establishing relationships between biomarkers and aging-related traits from a variety of longitudinal cohort studies and/or clinical trials.

There is exciting progress being made already! Project highlights include:

Biomarkers focusing on cell-specific profiles and mechanistic measures in blood and skeletal muscle biopsies

Validating and optimizing the use of the epigenetic clock as a biomarker of healthspan and lifespan using blood and saliva samples

Applying state-of-the-art proteomics technologies to identify and refine robust senescence-related biomarkers

Investigating viral burden and systemic inflammation as predictive biomarkers for chronic disease and frailty

Validating non-invasive single-cell imaging technologies as reliable biomarkers

87-year-old Lee Mills of Ventura and daughter Lori Mills ran the Surfer’s Point marathon on Nov.7. Lee won Gold for being the oldest racer in the 10k. Daughter Lori ran the half marathon. 

Lee lives in the California Veteran’s Home in Ventura. Lori is the owner of the Malibu Contemporary Art Gallery.

by National Institute on Aging

A caregiver, sometimes referred to as a caretaker, refers to anyone who provides care for another person. Millions of people living in the United States take care of a friend or family member with Alzheimer’s disease or a related dementia. Sometimes caregivers live with the person or nearby, other times they live far away. For many families, caring for a person with dementia isn’t just one person’s job, but the role of many people who share tasks and responsibilities. No matter what kind of caregiver you are, taking care of another person can be overwhelming at times.

These tips and suggestions may help with everyday care and tasks.

Tips for Everyday Care for People With Dementia

Early on in Alzheimer’s and related dementias, people experience changes in thinking, remembering, and reasoning in a way that affects daily life and activities. Eventually, people with these diseases will need more help with simple, everyday tasks. This may include bathing, grooming, and dressing. It may be upsetting to the person to need help with such personal activities. Here are a few tips to consider early on and as the disease progresses:

Try to keep a routine, such as bathing, dressing, and eating at the same time each day.

Help the person write down to-do lists, appointments, and events in a notebook or calendar.

Plan activities that the person enjoys and try to do them at the same time each day.

Consider a system or reminders for helping those who must take medications regularly.

When dressing or bathing, allow the person to do as much as possible.

Buy loose-fitting, comfortable, easy-to-use clothing, such as clothes with elastic waistbands, fabric fasteners, or large zipper pulls instead of shoelaces, buttons, or buckles.

Use a sturdy shower chair to support a person who is unsteady and to prevent falls. You can buy shower chairs at drug stores and medical supply stores.

Be gentle and respectful. Tell the person what you are going to do, step by step while you help them bathe or get dressed.

Serve meals in a consistent, familiar place and give the person enough time to eat.

Tips for Changes in Communication and Behavior for People With Dementia

Communication can be hard for people with Alzheimer’s and related dementias because they have trouble remembering things. They also can become agitated and anxious, even angry. In some forms of dementia, language abilities are affected such that people have trouble finding the right words or have difficulty speaking. You may feel frustrated or impatient, but it is important to understand that the disease is causing the change in communication skills. To help make communication easier, you can:

Reassure the person. Speak calmly. Listen to his or her concerns and frustrations. Try to show that you understand if the person is angry or fearful.

Allow the person to keep as much control in his or her life as possible.

Respect the person’s personal space.

Build quiet times into the day, along with activities.

Keep well-loved objects and photographs around the house to help the person feel more secure.

Remind the person who you are if he or she doesn’t remember, but try not to say, “Don’t you remember?”

Encourage a two-way conversation for as long as possible.

Try distracting the person with an activity, such as a familiar book or photo album, if you are having trouble communicating with words.