Eating healthfully and having an active lifestyle can support healthy aging.

Simple adjustments can go a long way toward building a healthier eating pattern. Follow these tips to get the most out of foods and beverages while meeting your nutrient needs and reducing the risk of disease:

Enjoy a variety of foods from each food group to help reduce the risk of developing diseases such as high blood pressure, diabetes, and heart disease. Choose foods with little to no added sugar, saturated fats, and sodium.

To get enough protein throughout the day and maintain muscle, try adding seafood, dairy, or fortified soy products along with beans, peas, and lentils to your meals. Learn more about protein and other important nutrients.

Add sliced or chopped fruits and vegetables to meals and snacks. Look for pre-cut varieties if slicing and chopping are a challenge for you.

Try foods fortified with vitamin B12, such as some cereals, or talk to your doctor about taking a B12 supplement. Learn more about key vitamins and minerals.

Reduce sodium intake by seasoning foods with herbs and citrus such as lemon juice.

Drink plenty of water throughout the day to help stay hydrated and aid in the digestion of food and absorption of nutrients. Avoid sugary drinks.

It can be hard for some people to follow through on smart food choices. Read about common roadblocks and how to overcome them and check out the USDA’s tips for older adults.

Eating habits can change as we grow older. The USDA has developed Food Patterns to help people understand different ways they can eat healthy. The food patterns include:

Healthy U.S.-Style Eating Pattern: This is based on the types of foods Americans typically consume. The main types of food in this eating pattern include a variety of vegetables, fruits, whole grains, fat-free or low-fat dairy, seafood, poultry, and meat, as well as eggs, nuts, seeds, and soy products. Check out this sample menu to get started.

Healthy Mediterranean-Style Eating Pattern: This one contains more fruits and seafood and less dairy than the Healthy U.S.-Style Eating Pattern.

Healthy Vegetarian Eating Pattern: This pattern contains no meat, poultry, or seafood, but does contain fat-free or low-fat dairy. Compared with the Healthy U.S.-Style Eating Pattern, it contains more soy products, eggs, beans and peas, nuts and seeds, and whole grains.

Visit the USDA Food Patterns webpage for more information on each eating pattern and recommended daily intake amounts for each food group.

Use these tips to plan healthy and delicious meals:

Plan in advance. Meal planning takes the guesswork out of eating and can help ensure you eat a variety of nutritious foods throughout the day.

Find budget-friendly foods. Create a shopping list in advance to help stick to a budget and follow these SNAP-friendly recipes.

Consider preparation time. Some meals can be made in as little as five minutes. If you love cooking, or if you’re preparing a meal with or for friends or family, you may want to try something a little more challenging.

Keep calories in mind. The number of calories people need each day varies by individual.

Always discuss your weight and fitness goals with your health care provider before making big changes. Read about calorie goals and healthy food swaps.

Happy New Year! Looking for a way to stay on top of your health in 2023? Medicare covers many preventive and screening services. These services can help keep you from getting sick, and can help find health problems early when treatment is most likely to work best. Talk to your doctor about which ones might be right for you.

See What’s Covered

If you have Original Medicare (Part A and/or Part B), sign in to your secure Medicare account to see a personalized list of current and upcoming preventive services. If you don’t already have an account, it’s free — and easy — to sign up.

If you’re in a Medicare Advantage Plan, contact your plan for a list of covered preventive services. MA Plans must cover all the same preventive services as Original Medicare, and some may offer additional services.

Good news: Now people with Medicare Part D drug coverage will pay nothing out-of-pocket for even more vaccines, including the shingles vaccine, that are recommended by the Advisory Committee on Immunization Practices.

Here’s to your health in the new year!

Sincerely,

The Medicare Team

Alzheimer’s disease and related dementias affect more than 46 million people worldwide. Safe and affordable treatments to prevent cognitive decline in older adults are urgently needed. In response to this need, certain dietary supplements have been touted as having protective effects on cognition.

Normal brain function requires various vitamins, minerals, and other nutrients. Deficiencies in these nutrients may increase the risk for cognitive decline and dementia with age. Yet clinical trials of individual nutrients’ effects on cognition have yielded mixed results. Prior research suggests that flavanols in particular — compounds found in high levels in unprocessed cocoa — might benefit cognition.

Much of the research on flavanols was based on observational studies, rather than clinical trials. And previously, the effects of a multivitamin on cognition in older adults had been studied only in a few short clinical trials (less than 12 months) and a single longer trial that included older male physicians.

An NIH-funded research team led by Drs. Laura Baker and Mark Espeland at Wake Forest University School of Medicine aimed to fill the gaps in our understanding of these supplements’ effects on cognition. They examined more than 2,200 participants, ages 65 and older, who enrolled in the study from August 2016 to August 2017. The participants’ average age was 73.

Participants were given a cocoa extract supplement and/or a multivitamin-mineral supplement daily for three years, or an inactive placebo for comparison. They completed a battery of cognitive tests over the phone at the beginning of the study and once a year afterward. The researchers evaluated participants on global cognition (a wide range of cognitive measures), memory, and executive function (attention, planning, and organization). Results appeared in the journal Alzheimer’s & Dementia on Sept. 14, 2022.

The team found no difference in global cognition between those who took cocoa extract and those who did not. But participants taking the multivitamin had higher global cognition scores than those who didn’t. The improvement was most pronounced in those with a history of cardiovascular disease. Significant improvements with daily multivitamin use were also seen in memory and executive function. Cocoa extract had no effect on either.

The results suggest that a safe and affordable daily multivitamin-mineral supplement might improve cognition in older adults or protect cognitive health with age. Yet the researchers caution that the results, while promising, are still preliminary.

“It’s too early to recommend daily multivitamin supplementation to prevent cognitive decline,” Baker says. “While these preliminary findings are promising, additional research is needed in a larger and more diverse group of people. Also, we still have work to do to better understand why the multivitamin might benefit cognition in older adults.”

— by Brian Doctrow, Ph.D.

This research was supported in part by NIA grant R01-AG050657.

High blood pressure, diabetes, heart disease, and obesity are risk factors that may raise a person’s chances of experiencing the type of brain blood vessel damage that often underlies strokes and other neurovascular disorders. A gene called FMNL2 may play a critical role in linking these factors to the brain damage seen in some cases of Alzheimer’s disease, according to an NIA-funded study by Columbia University researchers.

NIA-funded scientists found that a gene called FMNL2 may tie cerebrovascular risk factors to Alzheimer’s disease. Experiments in zebrafish suggested that FMNL2 helps reshape the protective blood-brain barrier during Alzheimer’s. Courtesy of Mayeux lab, Columbia University Irving Medical Center.

FMNL2 encodes a protein that is known to help build the structures (known as cytoskeletons) found in cells throughout the body. The findings, published in Acta Neuropathologica, suggest that in Alzheimer’s, FMNL2 helps reshape a protective barrier between the brain and blood vessels, and that this process may speed the removal of damaging proteins.

For decades, some scientists have strongly suspected that Alzheimer’s is, in many ways, a blood vessel disorder. About 70% of patients show signs of the types of brain blood vessel damage often observed after strokes, and many of the risk factors that raise the chances of developing heart disease do the same for Alzheimer’s. In this new study, the researchers searched for clues as to how these factors may interact with one’s genes to elevate the chances of experiencing Alzheimer’s.

To this end, they analyzed the health and genomic data of 14,669 individuals of diverse racial and ethnic backgrounds who participated in several aging and Alzheimer’s studies conducted across the United States. The average age of the participants was approximately 80 years old, and nearly 38% had been diagnosed with Alzheimer’s.

First, the researchers used four factors to calculate a cerebrovascular risk score: diabetes; heart disease; obesity; and hypertension, which is sometimes called high blood pressure. Multiple previous studies have indicated these factors are often associated with experiencing strokes and other cerebrovascular diseases, as well as with Alzheimer’s.

In this study, about 70% of the participants had hypertension, 33% had heart disease, and 21% had diabetes. Based on body mass index scores, the average participant could also be classified as obese. Hypertension and diabetes were both highly correlated with and strongly influenced the Alzheimer’s risk scores.

Next, the team used several advanced data analysis techniques to test how the risk factors may combine with each gene on an individual’s chromosomes. They consistently found that the FMNL2 gene interacted the most with the cerebrovascular risk factors to raise Alzheimer’s risk.

Further support for this idea evolved when the scientists examined autopsied brain tissue. The brains of Alzheimer’s patients had high levels of the FMNL2 proteins surrounding blood vessels. The proteins appeared concentrated in astrocytes, which are star-shaped brain cells that line the blood-brain barrier. The blood-brain barrier prevents pathogens and toxins, which circulate throughout the blood system, from entering the brain.

In the brains of people who had died with Alzheimer’s, some astrocytes appeared “reactive” — in other words, in a diseased state — and detached from the barrier. The researchers observed these findings regardless of whether the person had been diagnosed with atherosclerosis, a disease that hardens blood vessels. In contrast, in the brains of age-matched control subjects without Alzheimer’s, FML2 proteins appeared sparsely, the astrocytes looked healthy, and the blood-brain barriers were intact.

The researchers saw similar signs of damage in the brains of mice that had been genetically engineered to mimic certain aspects of Alzheimer’s, supporting the idea that these changes may be a common reaction to the disease.

Overall, the results suggest that FMNL2 and other genes involved with blood-brain-barrier maintenance may be important candidates for developing new treatments that can counteract the damage caused by Alzheimer’s, especially in those who experience cerebrovascular risk factors.

The National Alzheimer’s Coordinating Center (NACC) provided some of the data for this study. NACC provides researchers with free, standardized clinical and neuropathological data collected from NIA’s Alzheimer’s Disease Research Centers.

If a primary care doctor suspects Alzheimer’s, he or she may refer the patient to a specialist who can provide a detailed diagnosis or further assessment. Specialists include:

Geriatricians, who manage health care in older adults and know how the body changes as it ages and whether symptoms indicate a serious problem.

Geriatric psychiatrists, who specialize in the mental and emotional problems of older adults and can assess memory and thinking problems.

Neurologists, who specialize in abnormalities of the brain and central nervous system and can conduct and review brain scans.

Neuropsychologists, who can conduct tests of memory and thinking.

Memory clinics and centers, including Alzheimer’s Disease Research Centers, offer teams of specialists who work together to diagnose the problem. In addition, these specialty clinics or centers often have access to the equipment needed for brain scans and other advanced diagnostic tests.

What are the benefits of an early Alzheimer’s diagnosis?
Alzheimer’s disease slowly worsens over time. People living with this disease progress at different rates, from mild Alzheimer’s, when they first notice symptoms, to severe, when they are completely dependent on others for care.

Early, accurate diagnosis is beneficial for several reasons. While there is no cure, there are several medicines available to treat Alzheimer’s, along with coping strategies to manage behavioral symptoms. Beginning treatment early in the disease process may help preserve daily functioning for some time. Most medicines work best for people in the early or middle stages of the disease. Learn more about Alzheimer’s medications.

In addition, having an early diagnosis helps people with Alzheimer’s and their families:

Plan for the future
Take care of financial and legal matters
Address potential safety issues
Learn about living arrangements
Develop support networks
An early diagnosis also provides people with more opportunities to participate in clinical trials or other research studies testing possible new treatments for Alzheimer’s.

Sign up for e-alerts about Alzheimers.gov highlights
Email Address
For more information about Alzheimer’s
NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center
800-438-4380
[email protected]
www.nia.nih.gov/alzheimers
bout Alzheimer’s & Dementia, please call us at 1-800-438-4380, Mon-Fri, 8:30 am-5:00 pm Eastern Time or send an email to [email protected]

Many people are unprepared to deal with the legal and financial consequences of a serious illness such as Alzheimer’s disease or a related dementia. Legal and medical experts encourage people recently diagnosed with a serious illness — particularly one that is expected to cause declining mental and physical health — to examine and update their financial and health care arrangements as soon as possible. Basic legal and financial documents, such as a will, a living trust, and advance directives, are available to ensure that the person’s late-stage or end-of-life health care and financial decisions are carried out.

A complication of diseases such as Alzheimer’s and related dementias is that the person may lack or gradually lose the ability to think clearly. This change affects his or her ability to make decisions and participate in legal and financial planning.

People with early-stage Alzheimer’s or a related dementia can often understand many aspects and consequences of legal decision-making. However, legal and medical experts say that many forms of planning can help the person and his or her family address current issues and plan for next steps, even if the person is diagnosed with later-stage dementia.

There are good reasons to retain a lawyer when preparing advance planning documents. For example, a lawyer can help interpret different state laws and suggest ways to ensure that the person’s and family’s wishes are carried out. It’s important to understand that laws vary by state, and changes in a person’s situation — for example, a divorce, relocation, or death in the family — can influence how documents are prepared and maintained. Life changes may also mean a document needs to be revised to remain valid.

Families beginning the legal planning process should discuss their approach, what they want to happen, and which legal documents they’ll need. Depending on the family situation and the applicable state laws, a lawyer may introduce a variety of documents to assist in this process, including documents that communicate:

Advance directives for health care are documents that communicate a person’s health care wishes. Advance directives go into effect after the person no longer can make decisions on their own. In most cases, these documents must be prepared while the person is legally able to execute them. Health care directives may include the following:

A durable power of attorney for health care designates a person, sometimes called an agent or proxy, to make health care decisions when the person with dementia can no longer do so.

A living will records a person’s wishes for medical treatment near the end of life or if the person is permanently unconscious and cannot make decisions about emergency treatment.

A do not resuscitate order, or DNR, instructs health care professionals not to perform cardiopulmonary resuscitation (CPR) if a person’s heart stops or if he or she stops breathing. A DNR order is signed by a doctor and put in a person’s medical chart.

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Newly discovered blood biomarkers may help detect cognitive impairment in people with Parkinson’s disease. In a study published in Brain, NIA researchers demonstrated the ability of extracellular vesicle biomarkers to identify whether an individual with Parkinson’s had a cognitive impairment.

Extracellular vesicles are tiny sacs released by cells in the body that transport “cargo molecules” between cells and communicate information. Extracellular vesicles originating from neurons have proteins such as alpha-synuclein, beta-amyloid, phosphorylated tau, and an insulin-signaling protein called Insulin Receptor Substrate 1 (IRS-1). These proteins are biomarkers, measurable indicators of body processes that can help doctors diagnose diseases. Alpha-synuclein buildup in the brain is a key pathological hallmark of Parkinson’s and may also contribute to dementia. Buildups of beta-amyloid and phosphorylated tau are typically associated with brain changes in Alzheimer’s disease but are also present in Parkinson’s. Additionally, insulin resistance — an impaired response to the hormone insulin, resulting in increased blood sugar — is associated with Parkinson’s. Extracellular vesicles and their cargo molecules can be isolated and measured in blood to identify potential Parkinson’s biomarkers.

NIA researchers collaborated with scientists in New Zealand and France to isolate neuronal extracellular vesicles in blood samples from more than 200 people. The samples came from participants in the New Zealand Parkinson’s Progression Programme who had Parkinson’s, either with normal cognition or with cognitive impairment (mild cognitive impairment or dementia, excluding Lewy body dementia), and 49 people without Parkinson’s. The researchers measured the levels of alpha-synuclein, beta-amyloid, phosphorylated tau, and active IRS-1 proteins in each sample.

Those with Parkinson’s had less alpha-synuclein and IRS-1 and more phosphorylated tau than healthy individuals. Among those with Parkinson’s, participants with normal cognition had more alpha-synuclein and IRS-1 and less phosphorylated tau than participants with cognitive impairment. However, beta-amyloid did not differ between groups. This indicates that alpha-synuclein, phosphorylated tau, and IRS-1 play a role in the progression of Parkinson’s with cognitive impairment. The results also seem to suggest that phosphorylated tau and alpha-synuclein are jointly involved in producing cognitive impairment in Parkinson’s.

Analyzing extracellular vesicles may be an effective way to find new biomarkers for neurodegenerative diseases such as Parkinson’s. Blood biomarkers that help detect cognitive impairment in Parkinson’s could improve timely diagnosis and treatment. Future studies may measure extracellular vesicle biomarkers over time to establish a timeline for biomarker changes in people with Parkinson’s.

A community-based support group focusing on sharing relevant information and education about all things Parkinson’s.

Meetings are held monthly on the third Tuesday, 10-11am, at Crosspointe Church (5415 Ralston Ave.). Next meeting: Tuesday, January 17, 2022

Ventura County Parkinson’s Support Group gets together every month with skilled, experienced professionals who present significant breakthroughs, strategies and related issues surrounding Parkinson’s. The group’s mission is for participants to better understand and talk about how this information impacts their own lives and affects immediate family members. In addition to those diagnosed with PD, caregivers, family members and friends are ALL welcome to attend FREE of charge.

More than just a meeting, all discussions/presentations offer interactive, 0-pcompassionate, relevant education on PD. Topics range from “How to get up off the floor when you’ve fallen,” to “Nutrition and Parkinson’s” to “The benefits of deep brain stimulation and assessing if you’re a good candidate for DBS.”

Jon Everhart, retired accountant, US Marine and regular group attendee said, “It’s nice comparing treatments, symptoms, and the challenges we all face living with Parkinson’s.” This caring group empowers people like Jon to be more proactive and to participate in deciding the direction of his treatment, complemented by his team of doctors’ suggestions.

This unique group gives everyone a great opportunity to learn more about current PD research, to gain more awareness about local help and resources, to share relevant experiences with others — and to have fun along the way.

The Ventura County Parkinson’s Support Group was recently resurrected (post-Covid) by Dr. Vanessa White, owner of Ventura County Neurofitness (a local fitness program designed specifically for those with Parkinson’s and other neurological degenerative diseases). The impetus for her assuming this responsibility was after her mother-in-law, Toy White, was diagnosed several years ago with PD. This important, special group was born upon her passing.