Parkinson’s disease is a brain disorder that causes unintended or uncontrollable movements, such as shaking, stiffness, and difficulty with balance and coordination.

Symptoms usually begin gradually and worsen over time. As the disease progresses, people may have difficulty walking and talking. They may also have mental and behavioral changes, sleep problems, depression, memory difficulties, and fatigue.

While virtually anyone could be at risk for developing Parkinson’s, some research studies suggest this disease affects more men than women. It’s unclear why, but studies are underway to understand factors that may increase a person’s risk. One clear risk is age: Although most people with Parkinson’s first develop the disease after age 60, about 5% to 10% experience onset before the age of 50. Early-onset forms of Parkinson’s are often, but not always, inherited, and some forms have been linked to specific gene mutations.

What causes Parkinson’s disease?

The most prominent signs and symptoms of Parkinson’s disease occur when nerve cells in the basal ganglia, an area of the brain that controls movement, become impaired and/or die. Normally, these nerve cells, or neurons, produce an important brain chemical known as dopamine. When the neurons die or become impaired, they produce less dopamine, which causes the movement problems associated with the disease. Scientists still do not know what causes the neurons to die.

People with Parkinson’s disease also lose the nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, which controls many functions of the body, such as heart rate and blood pressure. The loss of norepinephrine might help explain some of the non-movement features of Parkinson’s, such as fatigue, irregular blood pressure, decreased movement of food through the digestive tract, and sudden drop in blood pressure when a person stands up from a sitting or lying position.

Many brain cells of people with Parkinson’s disease contain Lewy bodies, unusual clumps of the protein alpha-synuclein. Scientists are trying to better understand the normal and abnormal functions of alpha-synuclein and its relationship to genetic mutations that impact Parkinson’s and Lewy body dementia.

Some cases of Parkinson’s disease appear to be hereditary, and a few cases can be traced to specific genetic mutations. While genetics is thought to play a role in Parkinson’s, in most cases the disease does not seem to run in families. Many researchers now believe that Parkinson’s results from a combination of genetic and environmental factors, such as exposure to toxins.

Symptoms of Parkinson’s disease
Parkinson’s has four main symptoms:

• Tremor in hands, arms, legs, jaw, or head
• Muscle stiffness, where muscle remains contracted for a long time
• Slowness of movement
• Impaired balance and coordination, sometimes leading to falls

Other symptoms may include:

• Depression and other emotional changes
• Difficulty swallowing, chewing, and speaking
• Urinary problems or constipation
• Skin problems

The symptoms of Parkinson’s and the rate of progression differ among individuals. Early symptoms of this disease are subtle and occur gradually. For example, people may feel mild tremors or have difficulty getting out of a chair. They may notice that they speak too softly, or that their handwriting is slow and looks cramped or small. Friends or family members may be the first to notice changes in someone with early Parkinson’s. They may see that the person’s face lacks expression and animation, or that the person does not move an arm or leg normally.

There are lots of fun and simple ways to build exercise into your daily routine. Find ideas for activities to do with your family and ways to stay active in all four seasons.

Family Activities to Help You Get Exercise
Being physically active with your family is a great way to stay healthy and make exercise fun. Whether you play team sports with the entire family or take brisk walks with your spouse, child, or grandchild, you’ll be rewarded with improved health and time spent together.

Here are a few activity ideas for you to do with your grandchildren:

Infants and Toddlers
Take them for walks in the stroller and rides on your bike. Don’t forget your helmets.
Play games that get your bodies moving—Wheels on the Bus, Pretend We’re Animals, and Hide-and-Seek.
Sign up for baby yoga or exercise classes.
Try baby-friendly swimming classes.
School-Aged Children
Walk to the park and push their swing.
Jump rope together.
Build a fort—indoors or out.
Play catch, kickball, basketball, or soccer.
Go swimming or biking together.
Play a video fitness game together and see who wins!
Teens and Young Adults
Participate in activities that interest them. Try hiking, skating, or tennis.
Go golfing or swimming. Invite them to join you in physical activities that require two people, such as tennis or ping pong.
Ask them to help you in the garden or with heavy-duty household chores.
Search for Move Your Way: Tips for Getting Active as a Family on YouTube for more tips on getting active with your family.

Be Physically Active Without Spending a Dime!
You don’t need to spend a fortune to be physically active. In fact, you can be active in many ways without spending any money. You don’t need special exercise equipment other than comfortable walking shoes. Here are a few ideas to help get you moving for free:

Make your own weights from household items such as soup cans or bottles of water.
Try out free demonstration exercises classes at your local senior center or fitness center.
Go for a hike in a park.
Participate in community-sponsored fun runs or walks.
Yard work such as raking, digging, and planting can keep you active.
Make sure to drink water or juice after exercise.
Summer
Swim laps or take a water aerobics class. These are both refreshing once the weather gets steamy.
Walking in the mall is a cool way to beat the heat.
Now that the grandchildren are out of school for the summer, ask them to teach you their favorite sport or physical activity.
Celebrate National Bowling Week the first week in August. Get friends and family together and challenge each other to a friendly tournament.

by Patricia Schallert

There are many seniors among us who have lived and continue to live lives that can be considered “success stories”…. Let’s meet Kathleen Wheeler and see how she sees it.

Kathleen is a 72 young retired woman, born in Baltimore, Maryland, who lived in Antigua as a youngster and then moved to Ventura where she graduated from Ventura High School in 1968. She lived in San Diego for a number of years before retiring seven years ago and moved back to Ventura where she now considers herself a “local”.

As Kathleen reflected on her retirement, she knew when it was time to retire. She enjoyed her career working in “Organization Development” as a psychologist very much and thought she would stay in her career until, she said “she dropped”. Her work was intense, with demanding bosses, paperwork and deadlines.

Upon retirement Kathleen and her husband moved to Ventura in December, 2017, the day before the Thomas Fire started. Still living out of boxes, they evacuated to a family friend’s house where they waited out the fire and prayed their house would still be standing when the evacuation orders were lifted.

She no longer had deadlines, paperwork and those challenging bosses. But Kathleen discovered through her friend’s connections that there was a passion growing inside her that she had not thought of as she waited out the fire. Her family friend was a scientist who asked her to help him write an essay on “Climate Change and Culture”.

“With the freedom that retirement provides, finding purpose and meaning and the right balance of activity vs leisure, is not always a slam dunk”, she said. She began to facilitate workshop sessions and supported others though her church to get in touch with new ways of looking at retirement. With her community members from her church, she explored the ideas of volunteering, a possible second career or a more leisurely life.

Learning to just “Be”, was difficult at first. The absence of structure, the absences of dead lines or commitments to others was challenging, and to no longer be defined by the career itself, helped her focus on how to create her own structure in her life.

But with retirement came an unlimited amount of possibilities which at times was overwhelming. “You can do many things when you retire, just not everything” was one of many lessons she learned.

Unexpected events were the hardest to accept for Kathleen. There were also difficulties with the loss that comes with working, since most people are defined by their work or career until they retire. Structure, alarm clocks and deadlines were no longer a part of her life, but independence moved to the front of the line and with that came writing classes, workshops and community involvement. A particular class about climate change became a turning point in Kathleen’s life and she has become a relentless activist on the importance of climate action, most recently by pushing for an “Electrification Ordnance” in Ventura.

Reducing green house gasses by starting the Ventura Climate Coalition keeps her busy most days, sometimes “too busy.” The Ventura Climate Coalition is just one voice, but there are a growing number and the hope is that eventually, they will be heard.

But the joy is in the involvement and the support she has gained from the community and tiny baby steps in the process. Kathleen accepts failure as a part of the growth and learning and has learned to value acceptance and compassion in the process of having those difficult conversations with those who have a different point of view. For Kathleen, “Retirement is about meaning, legacy, reconciliation, forgiveness and spirituality”.

Editor: If you are a senior, or know of one, who would like to share their retirement, or job, with us let us know at [email protected].

Scientists are conducting studies to learn more about plaques, tangles, and other biological features of Alzheimer’s disease. Advances in brain imaging techniques allow researchers to see the development and spread of abnormal amyloid and tau proteins in the living brain, as well as changes in brain structure and function. Scientists are also exploring the very earliest steps in the disease process by studying changes in the brain and body fluids that can be detected years before Alzheimer’s symptoms appear.

One of the great mysteries of Alzheimer’s disease is why it largely affects older adults. Research on normal brain aging is exploring this question. For example, scientists are learning how age-related changes in the brain may harm neurons and affect other types of brain cells to contribute to Alzheimer’s damage. These age-related changes include atrophy (shrinking) of certain parts of the brain, inflammation, blood vessel damage, production of unstable molecules called free radicals, and mitochondrial dysfunction (a breakdown of energy production within a cell).

Most people with Alzheimer’s have the late-onset form of the disease in which symptoms become apparent in their mid-60s or later. Researchers have not found a specific gene that directly causes late-onset Alzheimer’s, but having a form of the apolipoprotein E (APOE) gene increases a person’s risk. This gene has several forms, and one of those, APOE ε4, increases a person’s risk of developing Alzheimer’s and is also associated with an earlier age of disease onset. However, carrying the APOE ε4 form of the gene does not mean that a person will definitely develop the disease, and some people with no APOE ε4 may also develop Alzheimer’s.

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Physical frailty is associated with abnormal structures in white matter of the brain, according to a study funded in part by NIA. The research, led by an NIA scientist and published in the Journal of Gerontology, Series A: Biological Sciences and Medical Sciences, suggests that these abnormal structures may be an important biomarker for future frailty risk.

Frailty is common in older adults and is characterized by susceptibility to poor health, a loss of physical or psychological function, and an elevated risk of disease and death. Physical frailty is associated with an increased risk of developing dementia and other neurologic disorders, but few studies have examined the neurobiological changes that underlie frailty and frailty risk. The research team studied the association of cerebral white matter structure with current and future frailty.

The researchers engaged participants in the Atherosclerosis Risk in Communities Study (ARIC) Neurocognitive Study, an ongoing, community-based study that recruited 15,792 volunteers aged 45-65 years from Washington County, Maryland; Forsyth County, North Carolina; northwestern suburbs of Minneapolis; and Jackson, Mississippi.

Using brain MRI data from 1,754 participants in the ARIC Neurocognitive Study, the researchers found that frail individuals had more abnormal white matter structures in their brains, known as white matter hyperintensities (WMH), than non-frail participants. WMH are brain lesions that indicate injury or disease and show up as bright areas during MRI scans.

Non-frail participants with a high volume of WMH had an increased risk of developing frailty during a seven-year follow-up period, suggesting that WMH may be an important biomarker for future frailty risk. The findings held true for Black and white participants, men and women, and those without a history of dementia or stroke. Though frailty is unlikely to cause these brain changes, it is possible that structural damage to cerebral white matter promotes the development of frailty.

The research suggests physical frailty may serve as a clinical indicator of cerebral small vessel disease and perhaps a sign that a person has an increased risk for future dementia or cognitive deterioration. The team noted that implementing a frailty assessment in a health care setting may help identify individuals at risk for cognitive and functional decline. Additionally, they acknowledged that other biomarkers of brain health, such as brain volume, may also relate to frailty risk.

Further studies are needed to determine whether neurological factors play a causal role in frailty development.

This research was supported in part by NIA grants ZIAAG000348 and P30AG021334.

by Patricia Schallert

There are many seniors among us who have lived and continue to live lives that can be considered “successful” stories…. Let’s meet Amursana Khiyod and see how he sees it.

Amur is a 68 years young retired man, born and raised in Taiwan where he grew up with his parents and three older sisters. His parents and grandparents are Mongolian and have settled in Thousand Oaks, California after leaving Taiwan in 1981.

Amur reflected on his retirement. As an educated engineer, he knew when it was time to retire. His work was intense and he was instrumental in setting up the 911 system that all of us use in emergencies. As his company was reorganizing and implementing new and faster systems, Amur felt it was time for the younger generation of engineers to take the reins. Upon the advice of his financial planner, he was happy to let go of the day to day work, that was actually 7am to 10pm almost every day, and finally, after years, retire.

So, Amur has been retired since August 2017 and is now able to practice, he says “NIKSEN” which is a life style of purposely “doing nothing”. He believes it is great for those who are “burned out from their work”. There is less stress but one has to be financially okay to be able to practice “NIKSEN”.

Like many people, Amur wasn’t sure what to expect when his wife retired and they decided to move to California from Chicago. He figured he could still work remotely and believed that “happy wife, means happy life”. So off they went and discovered the peace and quiet of Ventura life.

Originally Amur thought he would be working till he dropped. He developed a good financial plan, which changed that for him. His new mantra was “You don’t plan to fail… you fail if you don’t plan”…This thinking was very helpful , so he made the leap to retired and is grateful to be now living in a good place that offers friendly neighbors and cultural opportunities along with great weather.

Amur keeps himself busy and has enjoyed cooking with his wife, taking care of his dog and focusing on the recovery from “work burn out”. He believes in self care, reading books when he gets to them and he studies the Mongolian language. There is always something to do besides dead lines and work projects which were difficult to let go of in the beginning of his retirement.

Like many retirees, Amur had life changing turning points that affected him as he grew up in Taiwan. School wasn’t easy but logic was and so engineering became a focus.

He values principles and does not judge others. His father told him when he was a young boy of 12 “that if he is an honest man, he will always be provided for and to never avoid his responsibilities”.

Amur said that stuck with him and he continues to take responsibilities for his work, and own his mistakes and his values, gifts he learned from his father.

Amur enjoys riding his bike, walking his dog and has learned his own self care. He believes he is happy because he is healthy, independent and believes in staying positive. His mantra is “My very existence is being sustained. I surrender myself to the flow of nature. Yielding to Divine Will. Letting be all that is around me”

Editor: If you are a senior or know of one who would like to share their retirement or job with us let us know at [email protected].

As people age, they often find themselves spending more time alone. Being alone may leave older adults more vulnerable to loneliness and social isolation, which can affect their health and well-being. Studies show that loneliness and social isolation are associated with higher risks for health problems such as heart disease, depression, and cognitive decline.

If you are in poor health, you may be more likely to be socially isolated or lonely. If you are socially isolated or feeling lonely, it can put your physical and mental health at risk. Adults who are lonely or socially isolated are less healthy, have longer hospital stays, are readmitted to the hospital more often, and are more likely to die earlier than those with meaningful and supportive social connections.

The number of older adults age 65 and older is growing, and many are socially isolated and regularly feel lonely. The coronavirus outbreak in 2020 brought even more challenges due to health considerations and the need to practice physical distancing.

Loneliness and social isolation are different, but related. Loneliness is the distressing feeling of being alone or separated. Social isolation is the lack of social contacts and having few people to interact with regularly. You can live alone and not feel lonely or socially isolated, and you can feel lonely while being with other people.

Older adults are at higher risk for social isolation and loneliness due to changes in health and social connections that can come with growing older, hearing, vision, and memory loss, disability, trouble getting around, and/or the loss of family and friends.

People who are socially isolated or lonely are more likely to be admitted to the emergency room or to a nursing home. Social isolation and loneliness also are associated with higher risks for:

People who are lonely or socially isolated may get too little exercise, drink too much alcohol, smoke, and often don’t sleep well, which can further increase the risk of serious health conditions.

People who are lonely experience emotional pain. Losing a sense of connection and community can change the way a person sees the world. Someone experiencing chronic loneliness may feel threatened and mistrustful of others.

Emotional pain can activate the same stress responses in the body as physical pain. When this goes on for a long time, it can lead to chronic inflammation (overactive or prolonged release of factors that can damage tissues) and reduced immunity (ability to fight off disease). This raises your risk of chronic diseases and can leave a person more vulnerable to some infectious diseases.

Social isolation and loneliness may also be bad for brain health. Loneliness and social isolation have been linked to poorer cognitive function and higher risk for dementia, including and especially for Alzheimer’s disease. Also, little social activity and being alone most of the time may contribute to a decline in the ability to perform everyday tasks such as driving, paying bills, taking medicine, and cooking.

The Eldercare Locator connects the public to services for older adults and their families. This resource seeks to provide assistance for a wide range of issues affecting older Americans, including social isolation and loneliness.

Call the Eldercare Locator at 800-677-1116 or visit https://eldercare.acl.gov/ to get connected today.

For additional resources on older adults and social isolation and loneliness visit, Expand Your Circles: Prevent Isolation and Loneliness As You Age (PDF, 4.75M).

Decline in sense of smell is connected to faster buildup of Alzheimer’s disease-related pathology seen in brain scans, according to new research focused on older adults who live outside of nursing homes. The findings provide additional evidence that loss of smell (known as anosmia) is a key early sign of Alzheimer’s-related cognitive impairment and the accumulation of associated harmful proteins, such as amyloid-beta and tau. The research, led by NIA scientists, was published in the Journal of Alzheimer’s Disease.

Decline in sense of smell had previously been confirmed as an early warning sign for Alzheimer’s in both human and animal studies, but its connection to the uptick of dementia-related brain imaging biomarkers over time had not been as closely studied in larger populations of older adults. For this study, the team tracked 364 participants from the Baltimore Longitudinal Study of Aging (BLSA) over an average period of about 2.5 years. The NIA-led BLSA is the longest running study of healthy aging in America.

The participants were initially cognitively normal and given baseline cognitive and odor identification tests and PET scans, a type of brain imaging that can detect amyloid-beta and tau deposits associated with Alzheimer’s and related dementias. Over the study period, 17 participants, or 5% of the total tracked, were diagnosed with mild cognitive impairment (MCI), of which 11 cases were associated with Alzheimer’s, three with vascular dementia, and one with frontotemporal dementia. Two were unspecified based on clinical characteristics.

The research team found that each point of lower odor identification test performance was associated with a 22% higher chance of developing MCI. This relation remained similar even after the investigators adjusted for age, sex, race, education, olfactory test version, apolipoprotein E gene (APOE ε4) carrier status, smoking, elevated depressive symptoms, and vascular disease. The PET brain scans of this subset of participants showed that lower olfactory scores were associated with higher levels of Alzheimer’s pathology in the brain, particularly in regions associated with the sense of smell, including parts of the orbital frontal cortex, and regions important to memory and learning, such as the temporal lobe. Further, participants with greater olfactory decline over time had higher levels of amyloid and tau in some regions related to both smell and memory function.

These results indicate that loss of olfactory function is closely tied to both the level and progression of neuropathological damage seen in Alzheimer’s. The study provides new evidence that may explain why poorer sense of smell is an early warning sign for Alzheimer’s-related MCI. The researchers hope to follow up on this work to look deeper into whether olfaction can predict other types of dementia-related neurodegenerative changes.

This research was supported by the Intramural Research Program grant Z01-AG000015-57 and NIA grant P30AG066507.

These activities relate to NIA’s AD+ADRD Research Implementation Milestone 9.M, “Develop diagnostics/biomarkers in asymptomatic individuals.”

In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles).

These plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease. Another feature is the loss of connections between neurons in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body.

During the very early stage of Alzheimer’s, toxic changes are taking place in the brain, including abnormal buildups of proteins that form amyloid plaques and tau tangles. Previously healthy neurons stop functioning, lose connections with other neurons, and die. Many other complex brain changes are thought to play a role in Alzheimer’s as well.

The damage initially appears to take place in the hippocampus and the entorhinal cortex, which are parts of the brain that are essential in forming memories. As more neurons die, additional parts of the brain are affected and begin to shrink. By the final stage of Alzheimer’s, damage is widespread and brain tissue has shrunk significantly.

Memory problems are typically one of the first signs of cognitive impairment related to Alzheimer’s. Some people with memory problems have a condition called mild cognitive impairment (MCI). With MCI, people have more memory problems than normal for their age, but their symptoms do not interfere with their everyday lives. Movement difficulties and problems with the sense of smell have also been linked to MCI. Older people with MCI are at greater risk for developing Alzheimer’s, but not all of them do so. Some may even revert to normal cognition.

The first symptoms of Alzheimer’s vary from person to person. For many, decline in nonmemory aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment may signal the very early stages of the disease. Researchers are studying biomarkers (biological signs of disease found in brain images, cerebrospinal fluid, and blood) to detect early changes in the brains of people with MCI and in cognitively normal people who may be at greater risk for Alzheimer’s. More research is needed before these techniques can be used broadly and routinely to diagnose Alzheimer’s in a health care provider’s office.

As Alzheimer’s worsens, people experience greater memory loss and other cognitive difficulties. Problems can include wandering and getting lost, trouble handling money and paying bills, repeating questions, taking longer to complete normal daily tasks, and personality and behavior changes. People are often diagnosed in this stage.

In recent years, scientists have made tremendous progress in better understanding Alzheimer’s and the momentum continues to grow. Still, scientists don’t yet fully understand what causes Alzheimer’s disease in most people. In people with early-onset Alzheimer’s, a genetic mutation may be the cause. Late-onset Alzheimer’s arises from a complex series of brain changes that may occur over decades. The causes probably include a combination of genetic, environmental, and lifestyle factors. The importance of any one of these factors in increasing or decreasing the risk of developing Alzheimer’s may differ from person to person.

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

Alzheimers.gov
www.alzheimers.gov
Explore the Alzheimers.gov portal for information and resources on Alzheimer’s and related dementias from across the federal government.

Alzheimer’s Association
800-272-3900
866-403-3073 (TTY)
[email protected]
www.alz.org

Eldercare Locator
800-677-1116
[email protected]
https://eldercare.acl.gov

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.