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Should I Consume Olive Oil Every Day?

A study presented at NUTRITION 2023, the annual meeting of the American Society of Nutrition, looked at how olive oil intake and dementia-related death could potentially be connected. Prevention’s recent article, “Olive Oil Linked to Lower Risk of Dying From Dementia, Study Shows,” reports that researchers looked at data from more than 90,000 Americans—60,582 women and 31,801 men. The study took place over 30 years in which 4,749 participants died from dementia.

Researchers found that participants who consumed more than ½ a tbsp of olive oil each day had a 28% lower risk of dying from dementia than individuals who never or rarely consumed olive oil. They also saw that switching 5 g (or about 1 tsp) a day of margarine or mayonnaise for olive oil was linked to an 8–14% lower risk of dementia-related death.

The study noted that those who died of dementia were more likely to be APOe4 carriers, a gene that increases the risk of Alzheimer’s disease. However, they said the results were still consistent after adjusting for the genetic risk factors.

These findings suggest that olive oil may have beneficial properties for brain health and may play a part in lowering the risk of dementia-related death.

With its antioxidants and powerful anti-inflammatory compounds, olive oil has many health-protective benefits. Generally, olive oil may help reduce the risk of heart disease, boosting gut health, protecting brain health, and improving health parameters, like A1C levels associated with type 2 diabetes.

Diets like the Mediterranean diet that are rich in unsaturated fats have been found to have cardiovascular health benefits. Plus, studies have found that this diet plays a role in reducing the risk of cognitive decline in individuals at risk of dementia.

“Because olive oil is a source of unsaturated fat and a major component of the Mediterranean diet, incorporating olive oil into a healthy lifestyle may provide additional cardiovascular and brain health benefits,” the article explained.

Compared with rarely or never enjoying olive oil, having more than 1½ tsp of olive oil a day may be linked with a 25% reduced risk of fatal dementia. So, keep a small bottle of extra-virgin olive oil on the table so it’s available for drizzling onto your meals for its various health-protective benefits.

Reference: Prevention (July 29, 2023) “Olive Oil Linked to Lower Risk of Dying From Dementia, Study Shows”

How Do I Make a Care Plan for Mom?

Medicare typically doesn’t pay for basic assistance, and families often don’t try to determine how to provide this care until there is a health crisis, which can lead to unnecessary stress, conflicts and escalating costs.

Nerd Wallet’s recent article, “Create a Care Plan for Older Parents (or Yourself),” says that making a care plan well in advance lets families organize, locate appropriate resources and determine ways to pay for care before a crisis hits.

A care plan is thinking through the logistics of what you’ll need as you age, so that you are prepared when the poop hits the fan with aging. A way to cope is to plan for temporary rather than permanent disability. Ask what kind of help you or your loved one might need after a hip or knee replacement. How well is the home set up for recovery? Who would help with household tasks? Contemplating a two- or three-month disability with an eventual return to health is less daunting but involves much of the same planning as a more lasting decline.

Many seniors would like to stay in their current homes as they age, something called “aging in place.” That typically means relying on family members for care, using paid workers, or both. However, if family members will be tapped, discuss the logistics, including whether and how much they will be paid. If home health aides will be hired, consider who will supervise the process.

Look at any savings that can be tapped and whether the senior may qualify for government help, such as veterans benefits, Medicaid, or state programs. Families may want to consult an elder law attorney for personalized advice.

It is important to look at the current home as “aging friendly.” An occupational therapist can suggest adaptations allowing the older person to remain in the home if they’re disabled. The sooner you get this evaluation, the more time you’ll have to prepare. Even if the home supports aging in place, the neighborhood might not. Consider how the older person will socialize, get groceries, and make it to health appointments if they can no longer drive.

An independent living or senior living facility could provide more amenities. However, these typically don’t provide long-term care. Therefore, see if the senior is okay with moving again later or whether they should begin with an assisted living or continuing care facility that can provide more help.

Once you have a plan, capture the details and share it with family members or others who may be involved. Revisit the document periodically as circumstances change. Aging planning is an ongoing process.

Reference: Nerd Wallet (Aug. 24, 2023) “Create a Care Plan for Older Parents (or Yourself)”

How to Plan Ahead in Case a Loved One Has Dementia

Have the conversation about dementia, says The Tribune-Democrat’s recent article entitled, “Dealing with dementia | Planning ahead: ‘Have the conversation.’” Next, get the legal documents and define the future care. Note that the documents’ provisions are ineffective, until the person cannot make their own decisions.

Having the documents in place can help prevent the person from being placed in guardianship by the court. If they have no advance healthcare directives, the family or caregivers must apply to the court for guardianship if incapacity can be proven. When granted, the court appoints a decision-maker, taking away the individual’s ability to make decisions – either in whole or in part. This court oversight continues throughout the individual’s life.

Advanced directives, like a living will, health care power of attorney and financial power of attorney, allow those facing dementia to make their own decisions while they still have the capacity. Family members and potential caregivers should encourage their loved ones to act and get these important documents in place.

An advanced health care directive can include both a living will, which makes known what end-of-life care the individual wants, and a health care power of attorney, which assigns an agent to carry out the individual’s wishes when making health care decisions. The document states goals and values on which to base the decisions. It doesn’t take away the individual’s rights to make those decisions and can cover a broad range of medical decisions, or it can be narrow and limit the types of decisions.

The documents can be revoked anytime but don’t expire until the individual dies. The agents also don’t become personally responsible for the individuals’ debts. Careful consideration should be used in choosing the agent, which can be a family member or other trusted person. The agent should be capable and have a good relationship with the person.

A financial power of attorney is similar. It names an agent and doesn’t take away the individual’s decision-making ability. It ends with death and can be revised anytime. It can include handling money, checks, deposits, property sales and pursuing legal action. However, changing beneficiaries of insurance or making gifts requires specific instructions.

The agent selected should be a person who understands the individual’s feelings and point-of-view and is trusted to respect the individual’s wishes. They should be adept at handling their finances, as financial management becomes very important regarding where you will stay.

Reference: The Tribune-Democrat (July 29, 2023) “Dealing with dementia | Planning ahead: ‘Have the conversation’”

Will Exercise Help My Memory?

The study, published in the Journal of Epidemiology & Community Health, looked at data from nearly 4,500 people in the UK who had activity monitors attached to their thighs for 24 hours a day over the course of a week. Researchers analyzed how their activity levels impacted their short-term memory, problem-solving skills and ability to process things.

Prevention’s recent article entitled, “These 5 Exercises Boost Brain Health and Improve Memory, Study Finds,” reports that the study found that doing moderate and vigorous exercise and activities—even those that were done in under 10 minutes—were associated with much higher cognition scores than people who spent most of their time sitting, sleeping, or doing gentle activities.

The researchers found that people who did these workouts had better working memory (the small amount of information that can be held in your mind and used in the execution of cognitive tasks) and that the biggest effect was on executive processes, like planning and organization.

However, those who spent more time sleeping, sitting, or only moved a little instead of doing moderate to vigorous exercise had a 1% to 2% drop in cognition.

“Efforts should be made to preserve moderate and vigorous physical activity time, or reinforce it in place of other behaviors,” the researchers wrote in the conclusion.

Working out regularly can also lower your risk of cognitive decline and dementia. Exercise activates skeletal muscles that are thought to release hormones that communicate with your brain to influence the health and function of your neurons, i.e., cells that act as information messengers, Malin says.

“This could, in turn, promote growth and regeneration of brain cells that assist with memory and cognition,” he says.

The CDC recommends that most adults get at least 150 minutes a week of moderate-intensity exercise. You can walk your dog if you have one, as a study found that dog owners walk, on average, 22 minutes more every day than people who don’t own dogs.

However, the latest study suggests that more vigorous activities are best for your brain. Getting your heart rate up is key. That can include doing exercises like jogging, swimming, biking on an incline and dancing.

Reference: Prevention (Jan. 28, 2023) “These 5 Exercises Boost Brain Health and Improve Memory, Study Finds”

What’s the Latest on VA’s Coverage of New Alzheimer’s Drug?

The VA has announced that it will cover Leqembi, a monoclonal antibody therapy made by pharmaceutical companies Eisai and Biogen, for veterans in the disease’s early stages. This makes the VA the first and largest health program in the country to endorse the treatment, reports’ military.com in its recent article entitled, “VA to Cover New Drug for Early Stage Alzheimer’s Disease.”

In January, the FDA granted accelerated approval for Leqembi, also known as lecanemab, when research showed that the medication slowed the physical and mental decline in some patients with early Alzheimer’s by as much as 27%. Although research is ongoing on the treatment’s effectiveness, the drug is among the first to show that it reduces beta amyloid — the toxic protein that contributes to the development of Alzheimer’s — in the brain.

“This treatment option is the latest therapy to target and affect the underlying disease process of Alzheimer’s instead of only treating the symptoms of the disease,” said Dr. Billy Dunn, director of the Office of Neuroscience in the FDA’s Center for Drug Evaluation and Research, during the accelerated approval announcement.

The VA treats about 168,000 veterans with Alzheimer’s, some of whom are in the early stages. Leqembi has an estimated cost of $26,500 a year, and a two-milliliter dose at the VA will cost the department $194.63. A five-milliliter dose will cost $486.57, according to the department’s National Acquisition Center Contract Catalog.

According to VA Press Secretary Terrence Hayes, the drug will be available only at the request of a provider to vets who “most closely align with” patients who meet the selection criteria for clinical trials. This means that the VA patients must meet the same demographic and health history standards as those studied by the manufacturers.

“Each dose of the medication administered for each patient will be tracked and monitored for safety and appropriateness of use, in real-time, by VA’s Center for Medication Safety,” Hayes said in an email to Military.com. “VA will continue to monitor the clinical evidence and safety data for this agent and adjust the criteria for use as appropriate. VA also has capabilities and safeguards in place that are very different from the private sector, such as the ability to conduct real-time medication-use evaluations that will allow for continued safe use of the medication.”

Leqembi is approved for use only in patients with early Alzheimer’s with a “confirmed presence,” via a brain scan, of beta amyloid.

Reference: military.com (March 14, 2023) “VA to Cover New Drug for Early Stage Alzheimer’s Disease”

Use Estate Planning to Prepare for Cognitive Decline

Since 2000, the national median age in the U.S. has increased by 3.4 years, with the largest single year gain of 0.3 years in 2021, when the median age reached 38.8 years. This may seem young compared to the life expectancies of older Americans. However, the median age in 1960 was significantly lower, at 29.5 years, according to the article “Don’t Let Cognitive Decline Derail Well-Laid Financial Plans” from Think Advisor.

An aging population brings many challenges to estate planning attorneys, who are mindful of the challenges of aging, both mental, physical and financial. Experienced estate planning attorneys are in the best position to help clients prepare for these challenges by taking concrete steps to protect themselves.

Individuals with cognitive decline become more vulnerable to potentially negative influences at the same time their network of trusted friends and family members begins to shrink. As people become older, they are often more isolated, making them increasingly susceptible to scams. The current scam-rich environment is yet another reason to use estate planning.

When a person is diagnosed with Alzheimer’s or any other form of dementia, an estate plan must be put into place as soon as possible, as long as the person is still able express their wishes. A diagnosis can lead to profound distress. However, there is no time to delay.

While typically, the person may state they wish their spouse to be entrusted with everything, this has to be properly documented and is only part of the solution. This is especially the case if the couple is close in age. A secondary and even tertiary agent needs to be made part of the plan for incapacity.

The documents needed to protect the individual and the family are a will, financial power of attorney, durable power of attorney and health care documentation. In addition, for families with more sophisticated finances and legacy goals, trusts and other estate and tax planning strategies are needed.

A common challenge occurs when parents cannot entrust their children to be named as their primary or secondary agents. For example, suppose no immediate family members can be trusted to manage their affairs. In that case, it may be necessary to appoint a family friend or the child of a family friend known to be responsible and trustworthy.

The creation of power of attorney documents by an estate planning attorney is critical. This is because if no one is named, the court will need to step in and name a professional guardian. This person won’t know the person or their family dynamics and may not put their ward’s best interests first, even though they are legally bound to do so. There have been many reports of financial and emotional abuse by court-appointed guardians, so this is something to avoid if possible.

Reference: Think Advisor (April 21, 2023) “Don’t Let Cognitive Decline Derail Well-Laid Financial Plans”

Is Low Bone Mineral Density Linked to Dementia?

In a study of community-dwelling older adults, every standard deviation lower BMD at the femoral neck was linked with a 12% higher risk for developing all-cause dementia, says Mohammad Arfan Ikram, MD, PhD, of Erasmus University Medical Center in Rotterdam, The Netherlands, and colleagues.

MedPage Today’s recent article entitled, “Osteoporosis: Another Dementia Predictor?” says that each standard deviation lower for femoral neck BMD was also linked with a 14% higher risk for Alzheimer’s disease during the 11-year follow-up, the group wrote in Neurology.

When the researchers looked at only the first decade of follow-up, older adults falling into the lowest group of BMD in the femoral neck had a twofold higher risk for dementia than those in the highest tertile. In the first 10 years, those in the lowest tertile for trabecular bone score and total body BMD also saw a significantly higher risk for developing all-cause dementia. However, when expanding to the entire follow-up period, only low femoral neck BMD was still significantly connected with dementia onset.

“Low bone density and dementia are two conditions that commonly affect older people simultaneously, especially as bone loss often increases due to physical inactivity and poor nutrition during dementia,” noted Ikram. “However, little is known about bone loss that occurs in the period leading up to dementia. Our study found that bone loss indeed already occurs before dementia and thus is linked to a higher risk of dementia.”

“Previous research has found factors like diet and exercise may impact bones differently as well as the risk of dementia,” Ikram added. “Our research has found a link between bone loss and dementia, but further studies are needed to better understand this connection between bone density and memory loss.”

“It’s possible that bone loss may occur already in the earliest phases of dementia, years before any clinical symptoms manifest themselves,” he explained. “If that were the case, bone loss could be an indicator of risk for dementia and people with bone loss could be targeted for screening and improved care.”

The researchers also noted that prior data suggested a link between low femoral neck BMD with structural brain changes, which may be a major driver of elevated dementia risk. These changes include declined white matter volume, increased white matter hyperintensity volume, the occurrence of silent brain infarction and progression of parenchymal atrophy.

In addition, it’s possible that these individuals experienced some loss of cognition that subsequently lead to poorer dietary nutrition and lifestyle habits.

Reference: MedPage Today (March 22, 2023) “Osteoporosis: Another Dementia Predictor?”

Does Government Have Financial Assistance for Alzheimer’s?

Social Security Disability Insurance (SSDI) provides financial support to those who’ve worked and paid into the Social Security system and are now unable to work due to a disability, including dementia. To be eligible for SSDI, a person must have enough work history and their condition must meet the SSA’s definition of a disability.

Help! Dementia recent article entitled, “Financial Costs and Planning for Dementia and Alzheimer’s,” explains that Supplemental Security Income (SSI) provides financial support to those who have a limited income and assets and are aged, blind, or disabled. People with dementia may be eligible for SSI, if they satisfy the income and asset limits set by the Social Security Administration.

The Area Agency on Aging has information and resources on financial assistance for those suffering from dementia. However, financial assistance can vary depending on the location and the services offered by the agency. Some services that the aging agency may provide include:

  • Information on government benefits, such as Medicaid, may be available to individuals with dementia and their families to help cover the costs of care.
  • Assistance with long-term care planning, like resources on long-term care options, including assisted living facilities and in-home care. They can help individuals with dementia and their families plan for their future care needs.
  • Information on financial assistance programs, such as grants and loans, may be available to individuals with dementia and their families to help cover the costs of care.
  • Life resource planners and elder law lawyers can be helpful to those with dementia and their families who need assistance with financial and legal planning.

Life resource planners are professionals who specialize in helping individuals and families plan for their future, including financial and legal planning. They can provide guidance on government benefits, caregiving and long-term care planning.

Elder law lawyers specialize in legal issues affecting older adults, including government benefits and long-term care planning.

Reference: Help! Dementia (Feb. 12, 2023) “Financial Costs and Planning for Dementia and Alzheimer’s”

Can a Dementia Patient Sign Legal Documents?

Once a diagnosis of dementia has been received, families need to immediately begin advance care planning, as explained in a recent article titled “Can Someone With Dementia Sign Legal Documents” from Health News. Depending on their medical condition, some patients with dementia, particularly in early stages, may be capable of making their own decisions regarding legal decisions. However, discussions must begin early, so the person can be involved and understand the planning process.

When family members don’t know the wishes of their loved ones, they are more likely to experience distress and difficulties in making decisions. Families report feelings of guilt, self-doubt and stress while making advance care decisions with no input from their loved ones.

Laws concerning advance care vary from state to state. An elder law attorney can help older adults interpret state laws, plan how their wishes will be carried out and understand financial options.

Advance care planning focuses on both long-term care and planning for funeral arrangements. These documents typically include a durable power of attorney for healthcare, a living will and Do-Not Resuscitate orders, often called a DNR. Depending on state law, there may also be a MOLST document, short for Medical Orders for Life-Sustaining Treatment.

The durable power of attorney for healthcare names another person who can serve as a proxy for the person with dementia, if and when the person is not able to make informed healthcare decisions for themselves.

A living will states a person’s wishes for end-of-life treatment. This documents their views about specific medical procedures including but not limited to dialysis, tube feeding or blood transfusions. If the person should become unconscious, then families may make treatment decisions based on what their loved one wanted.

A Do-Not-Resuscitate order is placed in a patient’s medical chart if the person does not want to receive CPR (cardiopulmonary resuscitation) if their heart stops or breathing ceases. This must be signed by a doctor before it is placed in the chart.

Planning for a funeral is a difficult task. However, it will alleviate stress and possible guilt in the future. People with dementia can tell their loved ones in advance what they want regarding a funeral or memorial service, burial, or cremation. If any arrangements are already in place, such as the purchase of a burial plot, providing details to family members will make it easier to manage.

Advance care planning can be a sensitive topic but seeking legal advice early on is useful so the family can focus on making sure their loved one has the care they want. Involving the person with dementia in the process is respectful. An elder lawyer attorney will be able to guide the family to ensure planning is done properly.

Reference: Health News (Jan. 11, 2023) “Can Someone With Dementia Sign Legal Documents”

What Games are Best for Brain Health?

Researchers at Columbia University in New York City and Duke University in Durham, North Carolina, recently found that older participants — with an average age of 71 — who were trained to complete computerized crossword puzzles showed more of a cognitive improvement compared with those who were trained to use web-based cognitive video games, reports Money Talks News’ recent article entitled, “Crossword Puzzles or Video Games: Which Better Protects Your Brain?”

In a summary of the study’s findings, Dr. D.P. Devanand, professor of psychiatry and neurology at Columbia, remarked:

“This is the first study to document both short-term and longer-term benefits for home-based crossword puzzles training compared to another intervention. The results are important in light of difficulty in showing improvement with interventions in mild cognitive impairment.”

The researchers explain that mild cognitive impairment is a stage between the cognitive decline that is normal with aging and full-blown dementia. Those with mild cognitive impairment may struggle with memory, language, thinking or judgment.

The researchers went on to note that those with mild cognitive impairment are at a significant risk for dementia, including Alzheimer’s disease.

As part of the study, 107 participants with mild cognitive impairment were trained for 12 weeks in either crossword puzzles or cognitive games.

Follow-up “booster sessions” were then held for up to 78 weeks.

While both forms of training were equally effective early in the course of disease, crossword puzzles were better in the later stages. Those who used crossword puzzles showed less brain shrinkage at 78 weeks.

Dr. Devanand says the study results show that further research on developing a home-based digital therapeutic for delaying Alzheimer’s disease “should be a priority for the field.”

Reference: Money Talks News (Nov. 5, 2022) “Crossword Puzzles or Video Games: Which Better Protects Your Brain?”

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