In Japan, Driving Skill Training for Older Drivers Enhances Safety

Journal of the American Geriatrics Society Research Summary

More older adults in the US are driving than ever before, according to the Centers for Disease Control and Prevention (CDC). In fact, 56 percent more older adults were on the road in 2016 than in 1999. But as age increases, so do the risks for having a crash while driving. In 2016 (the last year for which statistics are available), motor vehicle crashes killed about 7,700 people over the age of 65 in this country, and 290,000 more were injured.

According to the CDC< fatal automobile crash rates spike between ages 70 to 74, and are highest among drivers 85 and older. These older drivers’ deaths are caused as much by their increased frailty and medical complications as by their increased risk of crashes. Age-related vision problems, the ability to think and make decisions, and age-related physical changes such as arthritis pain may also affect the ability of older adults to safely operate a motor vehicle.

As in the U.S., Japan’s population of older drivers has also grown. A national traffic safety report noted that over five million people in Japan aged 75 years or older — one in three people — had a driver’s license. The rate of fatal crashes for those aged 75 or older gradually increased from 7.4 percent in 2006 to 13.5 percent in 2016. Continue reading

Healthy Lifestyle Habits May Lower the Risk for Developing Dementia

Journal of the American Geriatrics Society Research Summary

Can your eating habits and physical and mental activity lower your risk for developing dementia as you age? Obviously, it is important to learn all we can about how health habits affect the risks for developing dementia, a debilitating decline in memory and other mental abilities. Experts say that the number of people with dementia worldwide is expected to rise to 82 million by 2030 and to over 152 million by 2050.

A team of researchers designed a study to learn more about whether adopting healthier lifestyle habits can help prevent or slow the onset of dementia. Their study was published in the Journal of the American Geriatrics Society.

The researchers suggest that prevention strategies should focus on lowering dementia risk for people who are starting to experience cognitive decline, specifically subjective cognitive decline (SCD) and mild cognitive impairment (MCI). Continue reading

Aerobic Exercise and Heart-Healthy Diet May Slow Development of Memory Problems

Journal of the American Geriatrics Society Research Summary

Cognitive impairment without dementia (CIND), or mild cognitive impairment, is a condition that affects your memory and may put you at risk for Alzheimer’s disease and dementia. According to the U.S. National Library for Medicine, signs of mild cognitive impairment may include frequently losing things, forgetting to go to events and appointments, and having more trouble coming up with words than other people of your age.

Sine experts believe that risk factors for heart disease also are risk factors for dementia and late-life cognitive decline and dementia. Recently, researchers examined two potential ways to slow the development of CIND based on what we know about preventing heart disease. They published the results of their study in the Journal of the American Geriatrics Society.

The research team had a theory: That the healthy lifestyle behaviors that slow the development of heart disease could reduce heart disease risk and also slow cognitive decline in older adults with CIND. These behaviors include regular exercise and a heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet.

In order to investigate their theory, the researchers designed a study titled “Exercise and NutritionaL Interventions for coGnitive and Cardiovascular HealTh EnhaNcement” (or ENLIGHTEN for short). The goal of the study was to examine the effects of aerobic exercise (sometimes known as “cardio” or “cardiovascular” exercise because it involves activities that increase the circulation of oxygen through the blood) and the DASH diet on cognitive functioning in older adults with CIND.

The ENLIGHTEN study examined 160 adults 55-years-old or older. The study participants were older adults who didn’t exercise and had memory problems, difficulty thinking, and making decisions. They also had at least one additional risk factor for heart disease, such as high blood pressure (also known as hypertension), high cholesterol, diabetes, or other chronic conditions.

Participants took a number of tests to measure their heart disease risk factors and cognitive ability. Researchers also assessed participants’ dietary habits and ability to perform daily activities. The participants were then randomly assigned to one of four groups: a group doing aerobic exercise alone, a group following the DASH diet alone, a group doing aerobic exercise and following the DASH diet combined, or a group receiving standard health education.

People in the exercise group did 35 minutes of moderate intensity aerobic exercise (including walking or stationary biking) three times per week for six months. They were supervised for three months and then exercised unsupervised at home for three months. Participants in the exercise group did not receive any counseling in the DASH diet and were encouraged to follow their usual diets for six months.

People in the DASH eating plan group received instruction about how to meet DASH guidelines in a series of weekly sessions for three months and then bi-weekly for the remaining three months. Participants in the DASH group were asked not to engage in regular exercise until the completion of the six-month study.

People in the exercise and DASH group followed the exercise and DASH programs for six months. The participants who were enrolled in the health education group received weekly educational phone calls for three months and then bi-weekly calls for three months. Phone calls were conducted by a health educator on health topics related to heart disease. Participants were asked to maintain their usual dietary and exercise habits for six months until they were re-evaluated.

At the conclusion of the six-month intervention and assessment, participants were free to engage in whatever activity and dietary habits they desired, with no restrictions.

The results of the research team’s study showed that exercise improved the participants’ ability to think, remember, and make decisions compared to non-exercisers, and that combining exercise with the DASH diet improved the ability to think, remember, and make decisions, compared to people who didn’t exercise or follow the diet—even though they didn’t perfectly follow the programs they were assigned to during the six-month interventions.

The researchers concluded that their findings are promising proof that improved ability to think, remember, and make decisions can last one year after completing a six-month exercise intervention. They suggested that further studies would be needed to learn more.

This summary is from “Longer Term Effects of Diet and Exercise on Neurocognition: One Year Follow-Up of the ENLIGHTEN Trial.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are: James A. Blumenthal, PhD; Patrick J. Smith, PhD; Stephanie Mabe, MS; Alan Hinderliter, MD; Kathleen Welsh-Bohmer, PhD; Jeffrey N. Browndyke, PhD; P. Murali Doraiswamy, MBBS, FRCP; Pao-Hwa Lin, PhD; William E. Kraus, MD; James R. Burke, MD; and Andrew Sherwood, PhD.

Have Sleep Apnea? Using Your CPAP Device Consistently May Slow Memory Loss

Journal of the American Geriatrics Society Research Summary

Mild cognitive impairment (MCI) refers to having problems with your memory and decision-making abilities. Usually, people with MCI experience few if any problems with performing their daily activities. Experts say that MCI could be a stage between normal aging and Alzheimer’s disease.

A growing number of studies suggest that obstructive sleep apnea (OSA), or “sleep-disordered breathing,” is associated with a higher risk for memory problems and for problems with thinking and making decisions. OSA is a common condition in older adults who have MCI. Symptoms include disturbed sleep due to reduced or momentarily stopped breathing at night.

If your healthcare practitioner diagnoses you with OSA, she may recommend treatment with continuous positive airway pressure (CPAP), a pressurized mask worn during sleep. CPAP treatment eliminates obstructive sleep apnea. However, to be effective, people must use the CPAP machine regularly for at least four hours per night. Only 30 to 60 percent of people who are prescribed CPAP therapy use the machine regularly as prescribed. Additionally, few studies have confirmed whether or not CPAP treatment delays cognitive decline. Now researchers in a new study examined whether using CPAP treatment had an effect on slowing cognitive decline. Their study was published in the Journal of the American Geriatrics Society. Continue reading

Helping Prevent Falls in Older Adults with Dementia

Journal of the American Geriatrics Society Research Summary

Annually, about one-third of all American adults aged 65 or older experience a fall. Falls are a major cause of medical problems, especially among those who have dementia. In fact, twice the number of older adults with dementia experience falls, compared to people without dementia.

What’s more, older adults with dementia or other cognitive problems who fall are five times more likely to be admitted to long-term care facilities, and are at higher risk for fractures, head injuries, and even death, compared to older adults without dementia who experience a fall.

Researchers have recently focused on the role that dementia and other cognitive problems may play in falling, in hopes of discovering ways to manage and prevent falls. They published their study in the Journal of the American Geriatrics Society. Continue reading