by National Institute on Aging

Staying in your own home as you get older is called “aging in place.” With the right help, you might be able to do just that. These three tips can help you age in place:

Reach out to people you know. Family, friends, and neighbors are the biggest source of help for many older people. Talk with those close to you about the best way to get what you need. If you are physically able, think about trading services with a friend or neighbor. For example, one could do the grocery shopping, and the other could cook dinner.

Talk to geriatric care managers. These specially trained professionals can help find resources to make your daily life easier. They will work with you to form a long-term care plan and find the services you need. Geriatric care managers can be especially helpful when family members live far apart.

Learn about community and local government resources. Health care providers and social workers may have suggestions for services in your community. The local Area Agency on Aging, local and state offices on aging or social services, and your tribal organization may have lists of services. If you belong to a religious group, talk with the clergy, or check with its local office about any services they offer for older adults.

Researchers in NIA’s Clinical and Translational Neuroscience Section in the Laboratory of Behavioral Neuroscience are leading an innovative new study to determine whether medicines currently used to treat conditions other than dementia can help prevent or treat Alzheimer’s disease. Plans for the Drug Repurposing for Effective Alzheimer’s Medicines (DREAM) study were published recently in Alzheimer’s and Dementia: Translational Research and Clinical Interventions.

The NIA team, led by Madhav Thambisetty, M.D., Ph.D, collaborated with researchers at Harvard Medical School, Rutgers University, and Johns Hopkins University School of Medicine to design a new approach that would be an alternative to traditional drug discovery. This method focuses the search on drugs that have already been shown safe and effective for other conditions. And, instead of beginning the search for treatments by testing compounds in lab animals for effectiveness, the team will first look at data from large numbers of people who had already been treated with those compounds for other disorders. Later, researchers may conduct animal studies to validate findings for dementia before planning studies with people.

The research team has already made progress with their plans for drug repurposing research. First, the research team identified a network of about 20 biological pathways linked to abnormal brain metabolism in people with Alzheimer’s disease and related dementias. These abnormalities may precede or influence the brain changes that lead to dementia.

Next, they identified 35 FDA-approved drugs that might be active against the network of 20 pathways. These drugs are used already to treat diseases other than Alzheimer’s and related dementias. Of these 35, the team selected 15 drugs as the best candidates for further analysis.

From this point, the team plans to analyze data collected during routine health care for the effects of a candidate drug on the development of dementia. Data sources include electronic health records from U.S. Medicare and the United Kingdom. The analysis will estimate the incidence of dementia for people treated with the candidate drug and compare it to those receiving another drug for the same disease.

Results from the DREAM study will help guide future research. If a drug appears to reduce the risk or severity of Alzheimer’s and related dementias, researchers could conduct lab tests to determine how the drug works against dementia, and the drugs could eventually be tested with people in clinical trials.

The researchers noted that the DREAM study relies on the accuracy of information in the databases being analyzed. The researchers plan to use multiple methods of rigorous analysis to ensure that the study’s results are as accurate as possible.

This project is funded by the intramural research program of the National Institute on Aging. It relates to NIH’s AD+ADRD Research Implementation Milestone 7.B, “Initiate research programs for translational bioinformatics and network pharmacology to support rational drug repositioning and combination therapy from discovery through clinical development.”

Reference: Desai RJ, et al. Targeting abnormal metabolism in Alzheimer’s disease: The Drug Repurposing for Effective Alzheimer’s Medicines (DREAM) study. Alzheimer’s & Dementia

Treating people in early adulthood for cardiovascular risk could preserve their ability to think clearly, learn, and remember as they age, a new study pooling large sets of population data suggests. The findings showed that risk factors such as elevated body mass index, fasting glucose, and systolic blood pressure were associated with worse cognitive health later in life. Funded in part by NIA, the research was published in the March 17 online issue of Neurology, the medical journal of the American Academy of Neurology.

Researcher measuring breathing, heart rate, and blood pressure of participant while walking on a treadmill, results appear on a computer screen. Existing evidence suggests that maintaining heart health, in particular blood pressure control, may slow cognitive decline. Yet research to date on delaying cognitive decline has focused on reducing cardiovascular risk during midlife. To address this gap, researchers compiled data from different groups and measured the association of early adult, midlife, and late-life cardiovascular risk with late-life cognitive decline.

The research team found that across the adult life course, elevated cardiovascular risk factors, including elevated body mass index, fasting glucose, and systolic blood pressure, but not total cholesterol, were associated with greater cognitive decline in late life. Lead author Kristine Yaffe, MD, from the University of California San Francisco, noted that the findings are particularly noteworthy because they show cardiovascular risk exposures in early life in particular are associated with late-life cognitive change, even after accounting for risk exposures in mid- and late-life.

To get a full adult life-course perspective on cardiovascular risk factors and cognitive decline, the research team combined data from four NIH-funded studies: Coronary Artery Risk Development in Young Adults (CARDIA), Multi Ethnic Study of Atherosclerosis (MESA), Cardiovascular Health Study (CHS), and Health, Aging and Body Composition (Health ABC). CARDIA included data of young to middle-aged adults, MESA of middle-aged to older adults, and the CHS and Health ABC studies of older adults. This pooled cohort included Black and white adult participants ages 18 to 95 years old at enrollment. The researchers assigned values over time for body mass index, fasting glucose, systolic blood pressure, and total cholesterol for 15,001 adults.

Yaffe, who recently described the importance of this kind of population-based evidence in an NIH lecture, “Epidemiology of Cognitive Aging: Why Observational Studies Still Matter,” noted a strength of this study is its large sample size and ability to study exposures over the adult life course. Limitations described include that the missing measures of early- and mid-life cardiovascular risk were imputed and these values tended toward average levels, thereby lessening the strength of the associations with cognitive decline. However, the analysis suggests that absence of cardiovascular risk factors in early adulthood is associated with better cognitive health in old age, even when midlife and late life cardiovascular factors are taken into account. Next steps in this area of research would be to determine if treating early-life cardiovascular risk factors has an effect on cognition in late-life.

This research was supported by NIA grants 1RF1AG054443 and K01AG047273.

Ventura County participants are joining in with others across the country to fight the darkness of Alzheimer’s by doing an activity that they love for The Longest Day — an Alzheimer’s Association

fundraiser that culminates on the summer solstice, the day with the most light.

“The Longest Day is a fun way for people to join the fight to end Alzheimer’s and other dementia by involving their business, friends and family in any hobby or activity of their choice,” said Jeffery Glover, Development Specialist with the California Central Coast Chapter of the Alzheimer’s Association. “All proceeds provide local care and support, as well as critical global research.”

This year, fundraising activities are taking form in a variety of different ways, from bake sales to video game tournaments.

Leila Thayer Malone has been restoring pieces of antique furniture in her workshop, which she describes as her “happy place.”

Riptide Big Band, the Central Coast’s premier 15-piece dance band, will be playing a concert at a senior club.

Laura DeLoye is doing dance-grams while dressed up as Uma the Unicorn, a returning event from last year that successfully raised over $2,500 in 2020.

Others are taking advantage of the beautiful outdoors along California’s central coast.

Juerg Geser will be paddle boarding in the Channel Islands Harbor from sunrise to sunset on June 20, accompanied by local friends and others around the world.

Glover shares that the need for support is greater than ever. “There are over 690,000 Californians currently living with Alzheimer’s or some other form of dementia, with over one million caregivers watching over them,” says Glover. “The chances are very high that you or someone you know has been affected by this disease in one way or another.”

To learn more or get involved in The Longest Day, visit alz.org/tld or contact Jeffery Glover at [email protected].

People with dementia have a higher risk of getting COVID-19, are more likely to require hospitalization, and are more likely to have severe or fatal cases of this disease compared with people without dementia. This risk is even higher in Black patients with dementia, according to a new study funded in part by NIA and published in Alzheimer’s & Dementia.

A person’s age and preexisting health conditions such as asthma, diabetes, heart disease, and obesity are significant risk factors for serious illness from COVID-19. Interestingly, these factors are also linked to dementia. However, scientists and doctors have little information about how COVID-19 affects people who have dementia. The new study, led by researchers at Case Western Reserve University, used information from the electronic health records of about 61.9 million U.S. adults from all 50 states to explore the link between dementia and COVID-19. The data was collected as part of the IBM Watson Health Explorys database. In this dataset, more than 1 million patients had dementia, 15,770 had COVID-19, and 810 had both.

The study found that people with dementia were twice as likely to get COVID-19 compared with people without dementia, even after adjusting for age, sex, living in a nursing home, and having similar preexisting conditions. The researchers suggest that the memory problems associated with dementia might make it difficult for patients to stick to safety measures such as wearing masks, washing hands frequently, and social distancing.

Results showed that 73% of Black patients with dementia and 54% of White patients with dementia were hospitalized within 6 months of their COVID-19 diagnosis, compared with 25% of patients without dementia. Only 20% of Black patients with dementia but not COVID-19 and 12% of White patients with dementia but not COVID-19 were hospitalized within the same time frame. Patients of either race with dementia were almost four times more likely to die from COVID-19 than patients without dementia. The researchers also found that vascular dementia, which is caused by damage to the vessels that supply blood to the brain, led to the highest risk of COVID-19, suggesting that damaged blood vessels might make it easier for disease-causing bacteria and viruses to get from a person’s blood into the brain.

Although their findings need to be replicated using other databases and registries, the researchers note that the study lays the foundation for future research into the interactions between COVID-19 and brain diseases, including whether COVID-19’s effects on the brain increase the risk of or worsen dementia. The study demonstrates the need for innovative and effective measures to protect older adults with dementia from COVID-19 as part of controlling the pandemic and highlights the pressing need to address health disparities.

This research was supported in part by NIA grants AG057557 and AG062272.

Reference: Wang Q, et al. COVID-19 and dementia: Analyses of risk, disparity, and outcomes from electronic health records in the US. Alzheimer’s & Dementia. 2021, Feb 9. doi: 10.1002/alz.12296. E-published ahead of print.

Dementia is an umbrella term used to describe conditions affecting the brain that get worse over time. Researchers have connected changes in the brain that damage nerve cells to certain forms of dementia. The five most common forms of dementia are listed below.

Alzheimer’s disease is typically associated with abnormal buildups of proteins in the brain along with a loss of connection among nerve cells.

Vascular dementia is caused by vascular changes in the brain, such as a stroke or injury to small vessels carrying blood to the brain.

Lewy body dementia is typically associated with abnormal deposits of a protein (Lewy bodies) in the brain.

Frontotemporal dementia is often linked to abnormal amounts or forms of proteins and the loss of nerve cells in the frontal and temporal lobes.

Mixed dementia refers to when someone has a combination of brain changes associated with different forms of dementia, such as both Alzheimer’s disease and vascular dementia.

Find more information on the causes of dementia on Alzheimers.gov.

Senior News Line
by Matilda Charles

If you’re confused about COVID vaccine and when our lives are going to change for the better, you’re not alone.

We’re considered to be fully vaccinated once two weeks have passed after the second dose of Pfizer or Moderna vaccines, or two weeks after the one-dose Johnson & Johnson.

What’s new is this, per the Centers for Disease Control and Prevention: If fully vaccinated, you can be indoors with other fully vaccinated people without wearing a mask. You can meet indoors with unvaccinated people in one household unless one of those people has a health risk. If you’ve been around someone who has COVID, you don’t have to stay away from people or get tested unless you have symptoms … or live in a group setting. In that case, stay away from others for 14 days and get tested, even if you don’t have symptoms.

Clear as mud, right?

It gets worse. According to the CDC, as fabulous as this new vaccine is, even if fully vaccinated, we still need to wear masks in public. We still need to social distance. We still need to avoid medium and large crowds. We still need to stay out of poorly ventilated spaces. We should delay travel.

So what’s the holdup? Why are we still under restrictions after getting the vaccine? The best I can figure out is that the answer lies with the COVID variants, the different versions created as the virus mutates. It appears that not all of the vaccines work equally well on all of the variants. Frankly, some of the vaccines work rather poorly, depending on which variant it encounters.

Until scientists figure this out, we still need to be cautious: wear masks, stay away from people, stay out of crowds. Except for getting the vaccine, not much has changed.

A Box of Greeting Cards

A few months ago, I got the idea to send greeting cards to some residents of a local nursing home who were locked down and not allowed to have visitors. It started small: a box of greeting cards and the first names of some of the residents, courtesy of the facility director. The idea has, to put it mildly, expanded.

First there was the call from the facility director wanting to know if I could enlarge my list because the residents were talking among themselves about who got cards and who didn’t.

“Certainly,” I said, and bought more cards.

A further expansion came when a woman called me saying that her mother was in that facility, but her mother-in-law was in another local place, and would I send cards to a few people there as well?

“Certainly,” I said, and bought more cards.

You see where this is going? It wasn’t long before I knew I needed some help. It wasn’t only signing and addressing the cards, it was writing an individual letter to go in each envelope.

I called the guidance counselor at the high school and the ideas just flew. The service club is writing letters; they roped in the art club, which is producing individual drawings and paintings for each nursing home resident. The chorus stepped up and is planning an outdoor concert in the front of each facility when the weather warms up. (At this point they practice their music on Zoom calls.) And two students have initiated a project wherein they’re collecting craft supplies for the therapist at the nursing home to use with the residents.

Does this sound like something you can start in your own area? You can start small. All it takes is a box of greeting cards — and a few ideas.

(c) 2021 King Features Synd., Inc.

by Matilda Charles

A third round of stimulus payments are on their way. But has your second one shown up yet? Next question: Did you file last year’s 2019 taxes on paper instead of e-filing? If so, that might well be the reason you don’t have your money yet.

The IRS got behind on processing the paper tax forms we sent a year ago. If all had gone well, those who were eligible should have received a $600 stimulus check (the second one) by Jan. 29, 2021.

The IRS has a specific page for you to check the status of your stimulus payment, but it’s only good for the third stimulus check. All information for your first and second stimulus money has been removed from their website.

Start with www.irs.gov/coronavirus/get-my-payment and scroll to Get My Payment. Click on it and fill out the information. You’ll go to a page that tells you the status of the payment you’re to receive now, the third payment. If it says that payment information is Not Available, it means you’re not going to receive a payment the easy way (and might be why your second payment is still missing). On the Get My Payment page, click on Frequently Asked Questions to see what applies to you.

Even if you don’t normally file, you’ll need to file for 2020 (preferably e-file) if you want that stimulus money quickly. Look for Line 30 on the Form 1040 or 1040-SR. It’s called the Recovery Rebate Credit. If you received Notice 1444 or 1444B in the mail from the IRS, it will tell you what figures to use.