How does Bitcoin work? – Bitcoin

Emboldened crypto industry seeks to cement political influence and mainstream acceptance

President Donald Trump listens to White House adviser David Sacks as he signs an executive order regarding cryptocurrency in the Oval Office of the White House, Thursday, Jan. 23, 2025, in Washington. (AP Photo/Ben Curtis, File)

BY  ALAN SUDERMAN

Updated 9:03 AM EST, February 17, 2025

When the Trump administration’s crypto czar, David Sacks, recently held a news conference to announce a new congressional working group to advance cryptocurrency regulation, many digital asset enthusiasts were unimpressed and underwhelmed.

“There were a lot of people on X who felt like this wasn’t, you know, a mind-blowing announcement,” Sacks said on a podcast a few days later, referring to the social media outlet formerly known as Twitter. But Sacks said having the White House and key members of Congress committed to passing key crypto legislation in the next year, possibly within six months, was worth celebrating. “We’ve never had that before, so that is pretty monumental,” he said.

Sacks’ defensiveness highlights a new reality in Washington: After spending heavily to help elect Trump and other crypto-friendly lawmakers, the industry is emboldened, impatient and eager to cement its influence in politics and mainstream financial systems.

“Time is critical,” Ji Hun Kim, president and acting CEO at the Crypto Council for Innovation said at a recent House committee hearing titled: “A Golden Age of Digital Assets: Charting a Path Forward.”

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The crypto industry has scored some early wins since Trump took office, including the repeal of an accounting rule by the U.S. Securities and Exchange Commission and an executive order by the president directing a working group to study and propose changes to crypto regulations as well as the possible formation of a strategic government reserve of cryptocurrencies within 180 days.

As the industry calls for more substantive action, some crypto companies are looking to exert their influence by trying to punish old enemies.

Tyler Winklevoss, co-founder of the crypto exchange Gemini, said his firm won’t hire any MIT graduates as punishment for the school rehiring former SEC Chairman Gary Gensler to teach classes. 

“Not even interns for our summer intern program,” Winklevoss said on X. The move came after Coinbase’s CEO announced his firm wouldn’t work with any law firms that hired any of Gensler’s former deputies who’d committed “bad deeds” toward the crypto industry. The Gensler SEC was the most aggressive financial regulator in trying to police the crypto industry.

Congress has held several hearings in recent weeks where crypto supporters have aired grievances over how they were treated during the Biden administration, particularly around how regulators allegedly forced banks to cut ties with crypto companies.

And new Republican leadership at the SEC has criticized the agency’s past performance under Gensler and promised a new day, while making it clear that day won’t be tomorrow.

“It took us a long time to get into this mess,” SEC Commissioner Hester Peirce, who is leading a new crypto task force, said in a lengthy statement on the agency’s website. “Please be patient.”

The SEC recently asked a federal court to pause ongoing litigation against Binance, the world’s largest cryptocurrency exchange, because leadership is now rethinking previous enforcement actions.  

Sacks and crypto-friendly lawmakers expect two pieces of legislation to become law. One would set regulations and reserve requirements for issuers of stablecoins, a type of crypto that’s exploded in popularity and whose value is typically tied to the dollar or other traditional currencies.

The other piece of legislation aims to set clear rules for how crypto exchanges and other companies operate, as well as decide which digital assets are regulated as securities, like stocks, and which should be considered commodities, like gold or oil. Securities generally face stricter regulations.

Similar legislation has stalled in past years but many in the crypto industry expect broad, bipartisan support for passage this time. That’s due in part to the heavy political spending by the crypto industry. Fairshake, the crypto super PAC that was one of the biggest spenders in last year’s election, said recently it has already amassed a huge war chest for next year’s midterms. One of the crypto industry’s biggest wins last year was helping knock off former Sen. Sherrod Brown, a Democrat from Ohio and crypto critic who led the Senate’s banking committee.  

“The Democrats have gotten the message,” said crypto investor Anthony Scaramucci, who briefly served as communications director during Trump’s first term, “They don’t want to be in the 2026 campaign having a crypto army against them.”

Just like crypto prices, the industry’s popularity and influence are prone to wild upswings and falls. A few years ago, the Super Bowl was packed with celebrities doing commercials for crypto companies and mogul Sam Bankman-Fried had easy access to the top halls of power.

That popularity and influence waned after Bankman-Fried’s company collapsed amid massive criminal fraud, a market meltdown and other scandals — before roaring back with Trump’s victory.  

But while showing a united front for the election, debates over the crypto legislation and other policy proposals risk exposing fault lines among the industry’s many different tribes and strong and eccentric personalities.

The CEO of Ripple, for example, caused waves when he said he’d like to see a U.S. government reserve of crypto include multiple digital assets rather than bitcoin, the world’s most popular cryptocurrency. The idea is a nonstarter for many bitcoin diehards.

And a new report from JPMorgan highlighted how some of the proposals in the stablecoin legislation related to how those coins hold reserves could pose a “significant challenge” to Tether, the world’s largest stablecoin.

The CEO of Tether, which recently relocated to crypto-friendly El Salvador, responded on social media by disputing the bank’s findings and calling its analysts “salty.”   Gold Wallet app – Search        Strike app – Search  

Digital Transformation in Financial Operations | U.S. Bank

How do you turn crypto into cash – Search Videos

When you’re buying low selling high better hope you find a buyer when you’re trying to sell when its high, converting your crypto into cash is a fantastic way to reap the rewards of your investments. If you’ve profited from your cryptocurrency trades, then why not cash out a fraction of it to enjoy as fiat currency?

Thankfully, converting crypto into cash is a straightforward and often fairly swift process. Traders have several options for doing this, with each method having its own advantages and disadvantages. Some methods are faster and more flexible, whilst others are more cost-effective.

Through this article, you’ll discover the five best ways to convert your cryptocurrency into cash. We’ll also cover the main consequences of cashing out crypto so you don’t encounter any surprises. So without further ado, let’s look at the main ways of converting crypto into cash!

Should I Cash Out My Crypto?

You may want to cash out Bitcoin and other crypto for numerous reasons. For a start, cashing out your crypto allows you to enjoy any gains you’ve made. In fact, the best time to cash out your crypto is when you have made optimal gains in your trading portfolio. This is typically the main reason traders convert their cryptocurrency assets into fiat currency or another digital currency.

However, if this is the case for you, then time will be your biggest issue. Since the crypto market is extremely unpredictable and each crypto coin is highly volatile, it’s important to cash out as fast as possible. Otherwise, those gains you’ve made may just vanish before your eyes!

Remember, you don’t have to cash out all your crypto at once. We actually advise against doing so if possible, as crypto coins always have a chance of rising in value, and you don’t want to deny yourself future gains. Your best option is cashing out fractions of your crypto portfolio. Trading experts recommend periodically cashing out 30-40% of your total profit. That is unless you’re in a situation where you need as much cash as possible.

The Five Best Ways to Convert Crypto Into Cash

Here are the five best ways to convert cryptocurrency into cash! The most suitable option for you will depend on how fast you want to cash out your crypto, your experience level, and how much fees you’re willing to pay.

Make a Peer-to-Peer Exchange

Pros:

• Highly cost-effective
• Most private option
• Able to negotiate fees

Cons:

• Very time-consuming
• Inexperienced traders may struggle

Peer-to-peer selling is a terrific option for more experienced traders who are looking for a private and cost-effective way to sell crypto and convert it into cash. Through a decentralised peer-to-peer (P2P) exchange, you can exchange your crypto assets for cash or other digital assets with another trader. Both parties can negotiate a price that suits them both, and there is no need for a third party’s involvement.

This method is a viable option for anyone looking for reduced fees when cashing out crypto and those who don’t want to pass various identification checks. But this option is most suited to those who already have experience with P2P platforms, as others may feel overwhelmed. Making a P2P trade can also be quite time-consuming, which may not be optimal for you if you’re looking for a quick cash-out option.

Sign-up for a Centralised Exchange

Pros:

• User-friendly
• Secure
• Plenty of crypto asset options

Cons:

• Higher crypto cash-out fees
• Identification checks needed

If you want a more regulated option, you can cash out your crypto through a centralised crypto exchange. A centralised exchange acts as an intermediary between buyers and sellers, as well as offering various other services. Crypto exchanges are one of the safest options on our list, but they require several identification checks that some traders may want to avoid.

However, if you want a wide range of options for cashing out your crypto, then this is your best bet. Most crypto exchanges, such as Kraken, support a wide range of cryptocurrencies, including Bitcoin (BTC), Ethereum (ETH), Bitcoin Cash (BCH), Dogecoin (DOGE), XRP (XRP), Tether (USDT), Cardano (ADA), and Litecoin (LTC). These exchanges are also very reliable and user-friendly, which makes them an appealing option for many traders.

Use a Crypto Broker

Pros:

• Highly suitable for beginners
• Plenty of flexibility
• Access to other trading-related services

Cons:

• Can be time-consuming
• Not the most convenient option

Crypto brokers assist traders as they learn to navigate the crypto market, refine their trading skills, and build up their trading portfolios. With a crypto broker, you can trade multiple digital currencies after connecting your bank account or using another payment method to make a deposit.

Furthermore, using a crypto broker is an excellent option for anyone who wants to cash out Bitcoin and other cryptocurrencies in a safe environment. If you’re new to the crypto world, this may be the most suitable method for you since brokers are experienced in offering assistance.

If you decide to opt for a broker, you can connect with one by registering on crypto platforms like https://coin-gpt.io/. You can swiftly sign up and get paired with a suitable broker based on your trading goals and individual preferences without wasting any unnecessary time.

Withdraw Funds From a Bitcoin ATM

Pros:

• Highly convenient
• Safe for traders
• Allows fast withdrawals

Cons:

• High transaction fees
• Limited availability

Using a Bitcoin ATM can be a fast and convenient way to withdraw cash using your crypto assets. There are already thousands of Bitcoin ATMs worldwide (around 34,000), and many more are expected to appear as countries continue to open their arms to the crypto sector.

A Bitcoin ATM will look just like a regular ATM you use to withdraw money from your bank account, but you’ll notice a few key differences. For example, unlike traditional ATMs, you cannot view your cash balance or manage your account funds. Instead, you’re limited to using the Bitcoin ATM to sell Bitcoin and withdraw your earnings as cash.

Most of these ATMs also allow users to withdraw other types of crypto, not just Bitcoin. Popular coins you can typically withdraw from a Bitcoin ATM include Bitcoin Cash, Litecoin, Dash, and Ethereum. Although, this method may not be viable for many since Bitcoin ATMs are generally limited to larger cities.

Get a Crypto Debit Card

Pros:

• The fastest way to cash out crypto
• Additional privacy
• Favourable exchange rates

Cons:

• Limited options
• Only select cryptocurrencies supported

Traders can use a crypto debit card similar to how they use their usual bank account debit card. With these cards, you can withdraw cash using your crypto funds. You can also use them to make various online transactions without needing to spend time converting your crypto to cash first.

This is a fast and reasonably cheap method that is suitable for both beginner and experienced traders. Even if you have limited knowledge of trading and crypto withdrawal, you should have no trouble using a crypto debit card. The most popular crypto debit card provider is BitPay. With BitPay, you can withdraw cash using multiple crypto coins, including Bitcoin, Ethereum, Bitcoin Cash, and Litecoin.

Additionally, many of these providers offer various rewards and cash bank options for users who withdraw fiat money using their crypto, making it a highly affordable and interesting option.

The Consequences of Converting Crypto Into Cash

Hold up! Before you begin cashing out your crypto using one of the methods we’ve listed above, there are a few things you need to be aware of. As with everything, cashing out your crypto results in several consequences. Although these consequences aren’t too serious, it’s still important that you understand them.

Tax Implications

Tax implications are the main consequences of cashing out your crypto holdings. In most countries, all traders must report any profit they’ve made on their crypto trades and pay capital gains tax. You may also have the opportunity to offset capital gains from alternate investments if you sell your crypto assets at a loss.

The amount of tax you have to pay and the process to do so will vary depending on which country you’re located in. It’s important to do adequate research and ensure you complete all necessary steps so that you don’t incur fines or other repercussions. You can refer to your country’s tax revenue service for more information about paying taxes for your crypto holdings.

If you’re struggling to calculate your capital gains tax, we strongly advise using crypto tax software such as Koinly. This software will help you record crypto transactions, preview capital gains, and generate tax reports.

Withdrawal Fees

You will likely encounter withdrawal and transaction fees when cashing out your crypto. This will vary depending on which method you opt for and which provider you choose.

For example, Bitcoin ATMs usually charge a transaction fee of up to 15% of the total amount. Centralised exchanges also have much higher withdrawal fees, which is one of their main disadvantages compared to using a broker or decentralised exchange.

If you want to save as much money as possible when converting your crypto into cash, then it’s best to choose a method with lower fees. Crypto debit cards and P2P exchanges are typically the most cost-effective way to cash out your crypto regarding these fees.

Additionally, other factors can affect how high your withdrawal and transaction fees will be. For instance, the type of bank account you own, the crypto coins you’re holding, and how much you want to withdraw at once will influence the fees you’ll need to pay. One way to reduce these fees is to make as few withdrawals as possible. This is because many providers calculate fees as a percentage of the transaction’s total value.

Scams

Another possible consequence of converting your crypto assets into cash is falling for a crypto scam. The cryptocurrency industry is ripe with scammers, each refining new ways to lure in and deceive victims. But don’t worry! It’s not as bad as it seems. These scams won’t be an issue for you if you’re aware of them and understand how to avoid them.

Most importantly, you should do extensive research before signing up for any platform or service. Your research should include reviewing user testimonials, thoroughly reading the company’s privacy policy, and using a scam-checking tool. Call us paranoid, but if you don’t want to risk losing all your assets, you should do this with any website or app before providing any of your financial information.

Summary

To summarise, there are five main ways to convert crypto into cash. The best method for you will depend on several factors, so it’s important to consider all your options before proceeding.

For instance, if you want to cash out your crypto as fast as possible, then your best option will be to use a Bitcoin ATM (if you have one nearby) or use a crypto debit card. On the other hand, if you want to avoid paying substantial transaction fees, then you’re better off converting your crypto into cash through a broker or making a trade through a P2P exchange.

It’s also crucial to make sure you’re aware of the tax implications and other consequences of converting your crypto assets into cash before doing so. Remember, if you do thorough research on each platform before providing sensitive information, then you’re much less likely to fall victim to a scam.

The Bitcoin Standard: The Decentralized Alternative to Central Banking

The Bitcoin Standard: The Decentralized Alternative to Central Banking 1st Edition

by Saifedean Ammous (Author)

A comprehensive and authoritative exploration of Bitcoin and its place in monetary history

When a pseudonymous programmer introduced “a new electronic cash system that’s fully peer-to-peer, with no trusted third party” to a small online mailing list in 2008, very few people paid attention.

Ten years later, and against all odds, this upstart autonomous decentralized software offers an unstoppable and globally accessible hard money alternative to modern central banks. The Bitcoin Standard analyzes the historical context to the rise of Bitcoin, the economic properties that have allowed it to grow quickly, and its likely economic, political, and social implications.

While Bitcoin is an invention of the digital age, the problem it purports to solve is as old as human society itself: transferring value across time and space. Author Saifedean Ammous takes the reader on an engaging journey through the history of technologies performing the functions of money, from primitive systems of trading limestones and seashells, to metals, coins, the gold standard, and modern government debt.

Exploring what gave these technologies their monetary role, and how most lost it, provides the reader with a good idea of what makes for sound money, and sets the stage for an economic discussion of its consequences for individual and societal future-orientation, capital accumulation, trade, peace, culture, and art. Compellingly, Ammous shows that it is no coincidence that the loftiest achievements of humanity have come in societies enjoying the benefits of sound monetary regimes, nor is it coincidental that monetary collapse has usually accompanied civilizational collapse.

With this background in place, the book moves on to explain the operation of Bitcoin in a functional and intuitive way. Bitcoin is a decentralized, distributed piece of software that converts electricity and processing power into indisputably accurate records, thus allowing its users to utilize the Internet to perform the traditional functions of money without having to rely on, or trust, any authorities or infrastructure in the physical world.

Bitcoin is thus best understood as the first successfully implemented form of digital cash and digital hard money. With an automated and perfectly predictable monetary policy, and the ability to perform final settlement of large sums across the world in a matter of minutes, Bitcoin’s real competitive edge might just be as a store of value and network for the final settlement of large payments―a digital form of gold with a built-in settlement infrastructure.

Ammous’ firm grasp of the technological possibilities as well as the historical realities of monetary evolution provides for a fascinating exploration of the ramifications of voluntary free market money. As it challenges the most sacred of government monopolies, Bitcoin shifts the pendulum of sovereignty away from governments in favor of individuals, offering us the tantalizing possibility of a world where money is fully extricated from politics and unrestrained by borders.

The final chapter of the book explores some of the most common questions surrounding Bitcoin: Is Bitcoin mining a waste of energy? Is Bitcoin for criminals? Who controls Bitcoin, and can they change it if they please? How can Bitcoin be killed? And what to make of all the thousands of Bitcoin knockoffs, and the many supposed applications of Bitcoin’s ‘block chain technology’? The Bitcoin Standard is the essential resource for a clear understanding of the rise of the Internet’s decentralized, apolitical, free-market alternative to national central banks.

What is blockchain technology – Search

The Bitcoin Standard: The Decentralized Alternative to Central Banking: Ammous, Saifedean: 9781119473862: Amazon.com: Books

The Bitcoin Standard: The Decentralized Alternative to Central Banking pdf

the bitcoin standard book – Search

To turn crypto into cash, you can: 

moneyunder30.com+1

• Use a crypto exchange, such as Coinbase, to sell your crypto and withdraw your cash balance. moneyunder30.com+1
• Use an online broker that supports crypto trading and cash out your profits. moneyunder30.com
• Use a Bitcoin ATM that allows you to sell your crypto and get cash. moneyunder30.com
• Use a crypto debit card that converts your crypto into fiat currency when you make a purchase. moneyunder30.com
• Use a peer-to-peer crypto trading platform that connects you with buyers who pay you in cash. moneyunder30.com
• Use a crypto wallet that has a built-in cash out feature. moneyunder30.com
• Use a money transfer app that supports crypto and send your cash to your bank account. moneyunder30.com
• Spend your crypto at a crypto-friendly business that accepts it as a payment method. moneyunder30.com

The Tsimané are an indigenous people of lowland Bolivia. AFP via Getty Images

A community in the heart of the jungle

As Americans race to unlock the secret to anti-aging, the answer could be tucked away in the depths of the Amazon rainforest.

The Tsimané people boast the “healthiest hearts on the planet” and brains that age far more slowly than their Western counterparts, with just 1% of the population showing signs of dementia.

Research suggests their pre-industrial lifestyle, marked by a unique balance of food consumption and physical activity, may hold the key.

“This ideal set of conditions for disease prevention prompts us to consider whether our industrialized lifestyles increase our risk of disease,” said Dr. Andrei Irimia, an associate professor at the University of Southern California’s Leonard Davis School of Gerontology who studies the tribe. 

There are an estimated 17,000 Tsimané living deep in the lowland Bolivian jungle. This isolated indigenous community stays physically active throughout their lives, fishing, hunting, farming and foraging from the tropical forest.

They live near the Mosetén people, who also reside in rural villages and rely on subsistence agriculture for their livelihoods. 

In 2022, an international research team discovered that among older Tsimané and Mosetén, only about 1% suffer from dementia. By comparison, 11% of Americans aged 65 and older have the memory-robbing disease, according to the Alzheimer’s Association.

“Something about the pre-industrial subsistence lifestyle appears to protect older Tsimané and Mosetén from dementia,” said Margaret Gatz, the lead study author and professor at the USC Dornsife College of Letters, Arts and Sciences.

Previous studies have shown that both the Tsimané and Mosetén experience significantly less brain atrophy than industrialized populations in the US and Europe. Brain atrophy is strongly linked to cognitive decline, functional impairment and dementia.

Greek island with almost no dementia — the two drinks they love

The Tsimané and Mosetén communities farm, hunt and gather for subsistence. AP

Greek island with almost no dementia follows a twist on the Mediterranean diet — the 2 drinks they love

But here’s the twist: The Tsimané and Mosetén, while both living traditional lifestyles, differ significantly in terms of modern exposure. Though they share similar languages and history, the Mosetén have more access to modern technology, medicine and education.

While the Mosetén are healthier than most Westerners, they don’t quite match the Tsimané’s extraordinary health.

In fact, researchers have found that among the Tsimané, a higher body mass index (BMI) and slightly elevated levels of “bad cholesterol” are associated with larger brain volumes for their age. 

This could be due to the Tsimané being generally more muscular than individuals in industrialized countries with similar BMIs — likely a result of their active, physically demanding lifestyle.

Even more surprising is the Tsimané’s high levels of inflammation, which is typically linked to brain atrophy in Western populations. However, studies suggest that high inflammation doesn’t have the same impact on their brains.

The Tsimané community first captured the attention of scientists when a 2017 study revealed their extraordinary heart health in older age.

Researchers discovered that the Tsimané have the lowest prevalence of coronary atherosclerosis — a condition marked by fatty deposits inside the arteries — of any known population. Additionally, they have remarkably few cardiovascular disease risk factors.

RELATED: Huaorani People of Tiguino River – Amazon’s Indigenous Tribe | Watch

Farming and foraging is mostly done by children and women. REUTERS

Scientists believe that the Tsimané’s low cardiovascular risks may outweigh the inflammation caused by infections, raising new questions about the true causes of dementia. While inflammation in Westerners is often linked to obesity and metabolic issues, in the Tsimane, it’s primarily driven by respiratory, gastrointestinal, and parasitic infections.

“This study demonstrates that the Tsimané stand out not only in terms of heart health but brain health as well,” said Hillard Kaplan, a professor at Chapman University who has studied the community for nearly two decades. “The findings suggest ample opportunities for interventions to improve brain health, even in populations with high levels of inflammation.”

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Diet and activity: a vital balance

While people in industrialized nations enjoy modern health care, we’ve grown accustomed to exercising less and eating more — especially diets rich in sugars and fats. 

By contrast, the Tsimané have little or no access to health care but remain extremely physically active and consume a high-fiber diet full of vegetables, fish and lean meats.

“Our sedentary lifestyle and diet rich in sugars and fats may be accelerating the loss of brain tissue with age and making us more vulnerable to diseases such as Alzheimer’s,” Kaplan said.

All-natural carbohydrates make up roughly 70% of the tribe’s diet.

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When CNN’s chief medical correspondent, Dr. Sanjay Gupta, visited the Tsimané in the Amazon rainforest, he was surprised to find that most of their calories come from carbohydrates.

The Tsimané’s diet is straightforward and unprocessed, free from added sugars and salts. Plantains, cassava, rice, and corn make up nearly 70% of their food intake, with 15% derived from fat and another 15% from protein.

Gupta noted that this carb-heavy approach is born out of necessity, as farmed food offers more predictability, especially during lean hunting seasons. The diet provides twice the fiber of the typical American diet and is rich in micronutrients like selenium, potassium and magnesium.

When Gupta visited the tribe, he also discovered that intermittent fasting was part of the Tsimané culture — not a trendy practice, but one born out of food scarcity. Experts say this is common in pre-industrialized societies.

Food scarcity is a staple of many pre-industrial societies. Courtesy of Tsimané Health and Life History Project Team

“The lives of our pre-industrial ancestors were punctured by limited food availability,” said Irimia. “Humans historically spent a lot of time exercising out of necessity to find food, and [the Tsimane]  brain aging profiles reflected this lifestyle.” 

Gupta observed that nearly all of the Tsimané’s waking hours involve standing or walking, with hunting and foraging lasting all day. On average, they take about 17,000 steps daily, while also getting ample rest at night.

Researchers suggest that the Tsimané’s unique balance of physical exertion and food availability could hold the key to healthy aging.

They point out that in societies with abundant food and little physical activity, people often struggle between what they know is best for their health and the cravings that evolved over time.

Dr. Sanjay Gupta, CNN’s chief medical correspondent, has indeed explored the lives of the Tsimané people in the Amazon rainforest. The Tsimané diet is fascinating because it primarily consists of carbohydrates, which is quite different from many Western diets. Their main sources of calories include plantains, rice, corn, and manioc2.

Dr. Gupta’s observations highlight how the Tsimané people maintain remarkable heart health despite their high carbohydrate intake. This has intrigued researchers and health experts, as it challenges some common assumptions about diet and heart health2.

If you’re interested in learning more about Dr. Gupta’s findings and the Tsimané lifestyle, you can check out his podcast, Chasing Life.

What do you find most intriguing about the Tsimané diet?’

The Tsimané diet is quite unique and contributes to their heart health in several ways:

1. High in Complex Carbohydrates: About 70% of their diet consists of complex carbohydrates like plantains, rice, corn, and manioc. These foods are rich in fiber, which helps maintain healthy cholesterol levels and supports overall heart health2.
2. Low in Processed Foods: The Tsimané diet lacks processed foods, trans fats, and refined sugars, which are common in many Western diets. This absence of unhealthy fats and sugars reduces the risk of heart disease2.
3. Rich in Micronutrients: Their diet is rich in essential micronutrients like potassium, magnesium, and selenium, which are linked to heart health. These nutrients help regulate blood pressure and support cardiovascular function2.
4. Lean Protein Sources: While they do consume meat, it comes from wild game, which is leaner compared to the meat commonly consumed in industrialized societies. This helps in maintaining lower levels of unhealthy fats in their diet3.
5. Active Lifestyle: The Tsimané people lead a physically active lifestyle, which complements their diet and contributes to their overall heart health. Regular physical activity is known to reduce the risk of heart disease3.

The combination of these dietary habits and their active lifestyle results in remarkably low levels of atherosclerosis (plaque buildup in the arteries) among the Tsimané people3.

Is there anything specific you’d like to know more about regarding their diet or lifestyle?

How does the Tsimané diet compare to the Mediterranean diet?

The Tsimané and Mediterranean diets both promote heart health, but they have some key differences and similarities:

Similarities:

1. High in Fiber: Both diets are rich in fiber, which helps maintain healthy cholesterol levels and supports overall heart health.
2. Low in Processed Foods: Both diets emphasize whole, unprocessed foods, reducing the intake of unhealthy fats and sugars.
3. Rich in Micronutrients: Both diets provide essential micronutrients like potassium, magnesium, and antioxidants, which are beneficial for heart health.

Differences:

1. Primary Food Sources:
   • Tsimané Diet: Primarily consists of complex carbohydrates like plantains, rice, corn, and manioc, with lean protein from wild game and fish.
   • Mediterranean Diet: Emphasizes fruits, vegetables, whole grains, legumes, nuts, and seeds, with healthy fats from olive oil and moderate consumption of fish and poultry.
2. Fat Content:
   • Tsimané Diet: Lower in overall fat content, with minimal intake of unhealthy fats.
   • Mediterranean Diet: Includes healthy fats, particularly from olive oil, which is a staple in the diet.
3. Protein Sources:
   • Tsimané Diet: Protein comes mainly from wild-caught animal meat and fish.
   • Mediterranean Diet: Protein sources include fish, poultry, legumes, and occasionally red meat.
4. Lifestyle Factors:
   • Tsimané: Lead a physically active lifestyle, which complements their diet and contributes to their overall heart health.
   • Mediterranean: Also promotes an active lifestyle, but the level of physical activity may vary depending on individual habits.

Both diets offer valuable insights into maintaining heart health through natural, whole foods and an active lifestyle. If you’re considering adopting elements from either diet, it’s essential to find a balance that works best for your individual needs and preferences.

The Tsimané diet is rich in micronutrients like selenium, potassium and magnesium. AP

Is there a specific aspect of these diets you’d like to explore further?

“During our evolutionary past, more food and less calories spent in getting it resulted in improved health, well-being and ultimately higher reproductive success or Darwinian fitness,” Kaplan said.

“This evolutionary history selected for psychological and physiological traits that made us desirous of extra food and less physical work, and with industrialization, those traits lead us to overshoot the mark.”

According to Irimia, the ideal scenario for brain health and disease risk is the “sweet spot” — a place where the brain is provided with neither too little nor too much food and nutrients, while also getting a healthy dose of exercise.

With the global population aging, along with rising risk factors, researchers predict the number of people with dementia will triple to more than 152 million worldwide by 2050.

“We’re in a race for solutions to the growing prevalence of Alzheimer’s disease and related dementias,” Kaplan said. “Looking at these diverse populations augments and accelerates our understanding of these diseases and generates new insights.”

Bolivian community’s diet linked to heart health, no dementia

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Life Expectancy By State 2025

Life expectancy is a crucial measure that reflects the average lifespan of individuals in a given population. In the United States, life expectancy can vary significantly from state to state, influenced by various factors such as access to healthcare, lifestyle choices, socioeconomic status, and environmental conditions. In this comprehensive guide, we will explore the variations in life expectancy by state, shedding light on the states with the highest and lowest life expectancies.

Life Expectancy By State

What is Life Expectancy?

Life expectancy, also known as the average life span, is a statistical measure that estimates the number of years an individual is expected to live, based on various demographic factors. It represents the average age at which individuals in a population are likely to die. Life expectancy is typically calculated at birth, but it can also be measured at different stages of life, such as at age 65 or 75.

It is important to note that life expectancy is influenced by a wide range of factors, including genetics, lifestyle choices, access to healthcare, socioeconomic status, and environmental conditions. These factors contribute to the overall health and well-being of individuals, influencing their longevity.

The Impact of Geography on Life Expectancy

Geography plays a significant role in determining life expectancy. Different states within the United States exhibit variations in healthcare systems, socioeconomic conditions, educational opportunities, and environmental factors, which can significantly impact the health and well-being of their populations. As a result, life expectancy can vary widely from state to state.

To provide a comprehensive overview, let’s explore the states with the highest and lowest life expectancies in the United States, based on the latest available data.

States with the Highest Life Expectancies

1. Hawaii: Hawaii boasts the highest life expectancy among all states, with an average of 82.4 years. This beautiful island state offers a unique combination of natural beauty, a healthy lifestyle, and access to quality healthcare.
2. California: With a life expectancy of 81.6 years, California secures the second spot on the list. The state’s commitment to health and wellness, coupled with its diverse population and access to cutting-edge healthcare facilities, contributes to its high life expectancy.
3. New York proudly claims the third spot, with a remarkable life expectancy of 81.2 years. The state’s dedication to healthcare accessibility, education, and overall well-being ensures a high life expectancy for its residents.
4. Minnesota: Known for its excellent healthcare system and emphasis on healthy living, Minnesota enjoys a life expectancy of 81 years. The state’s commitment to promoting physical activity and access to quality healthcare services contribute to its residents’ longevity.

States with the Lowest Life Expectancies

1. West Virginia: Having the lowest life expectancy in the US at 74.1 years, the state grapples with high obesity rates, limited healthcare access, and socioeconomic challenges that adversely impact its average life expectancy.
2. Mississippi: Unfortunately, Mississippi has the second lowest life expectancy among all states, with an average of 74.8 years. The state faces numerous challenges, including high poverty rates, limited access to healthcare services, and higher rates of chronic diseases.
3. Louisiana: Louisiana follows closely with a life expectancy of 75.3 years. The state struggles with high rates of poverty, limited education opportunities, and higher rates of chronic diseases, all of which contribute to the lower life expectancy among its residents.
4. Alabama: life expectancy at birth in is 75.4 years as of 2025. This is lower than the national average in the United States. Factors such as healthcare access, lifestyle, and socioeconomic conditions can influence life expectancy.

It is worth mentioning that several other factors, such as race, ethnicity, income levels, and education, can also influence life expectancy within each state. Disparities in healthcare access and socioeconomic conditions can further exacerbate variations in life expectancy among different populations. 

Every State’s Life Expectancy At Birth

Hawaii	82.4 years
California	81.6 years
New York	81.2 years
Minnesota	81.0 years
Connecticut	80.9 years
Massachusetts	80.8 years
New Jersey	80.6 years
Colorado	80.5 years
Vermont	80.5 years
Utah	80.4 years
Washington	80.2 years
New Hampshire	80.1 years
Maryland	79.9 years
Rhode Island	79.9 years
South Dakota	79.9 years
Florida	79.8 years
Oregon	79.6 years
Maine	79.5 years
North Dakota	79.5 years
Virginia	79.4 years
Wisconsin	79.4 years
Iowa	79.3 years
Nebraska	79.2 years
Arizona	79.1 years
Idaho	79.1 years
Illinois	79.0 years
Kansas	78.9 years
Alaska	78.7 years
Delaware	78.7 years
Montana	78.7 years
Pennsylvania	78.6 years
Michigan	78.5 years
Texas	78.5 years
Nevada	78.4 years
New Mexico	78.4 years
North Carolina	78.0 years
Wyoming	78.0 years
Ohio	77.6 years
Missouri	77.3 years
Georgia	77.2 years
South Carolina	77.0 years
Indiana	76.8 years
Tennessee	76.5 years
Arkansas	75.8 years
Oklahoma	75.7 years
Kentucky	75.6 years
Alabama	75.4 years
Louisiana	75.3 years
Mississippi	74.8 years
West Virginia	74.1 years

Factors Affecting Life Expectancy by State

Numerous factors contribute to the variations in life expectancy by state. Let’s delve deeper into these factors to gain a comprehensive understanding.

Access to Quality Healthcare

Access to quality healthcare services is a critical determinant of life expectancy. States with robust healthcare systems, including accessible primary care, preventive services, and specialized treatments, tend to have higher life expectancies. Conversely, limited access to healthcare services can result in delayed diagnosis, inadequate treatment, and poorer health outcomes, ultimately leading to lower life expectancies.

Socioeconomic Status

Socioeconomic factors, such as income levels, education, and employment opportunities, significantly influence life expectancy. Higher socioeconomic status is generally associated with better access to healthcare, improved living conditions, and healthier lifestyle choices, which contribute to longer life expectancies. Conversely, individuals with lower socioeconomic status often face barriers to healthcare, limited resources, and challenging living conditions, leading to reduced life expectancies.

Lifestyle Choices

Individual lifestyle choices, including diet, exercise, smoking, alcohol consumption, and substance abuse, play a crucial role in determining life expectancy. States that prioritize public health initiatives, promote healthy behaviors, and offer resources for disease prevention and management tend to have higher life expectancies. On the other hand, states with higher rates of unhealthy behaviors and limited public health interventions may experience lower life expectancies.

Environmental Factors

Environmental conditions, including air and water quality, access to green spaces, exposure to pollutants, and natural disaster risks, can impact life expectancy. States with cleaner environments, well-maintained infrastructure, and effective disaster preparedness tend to have higher life expectancies. Conversely, states facing environmental challenges, such as pollution, inadequate infrastructure, and higher risks of natural disasters, may experience lower life expectancies.

Demographic Factors

Demographic factors, such as age, gender, and racial or ethnic background, can contribute to variations in life expectancy. Women generally have longer life expectancies compared to men, reflecting biological differences and variations in health behaviors. Moreover, racial and ethnic disparities in healthcare access, socioeconomic conditions, and health outcomes can result in variations in life expectancy among different populations.

Promoting Health Equity and Improving Life Expectancy

Understanding the variations in life expectancy by state is crucial for policymakers, healthcare providers, and communities to address disparities and promote health equity. Efforts to improve healthcare access, socioeconomic conditions, public health initiatives, and environmental factors can contribute to raising life expectancies in states with lower averages.

By investing in comprehensive healthcare systems, promoting healthier lifestyles, addressing socioeconomic inequalities, and prioritizing public health interventions, states can work towards improving the well-being and longevity of their populations. Collaboration between government agencies, healthcare providers, community organizations, and individuals is essential to achieve these goals.

In conclusion, life expectancy by state in the United States varies significantly due to multiple factors, including access to healthcare, socioeconomic conditions, lifestyle choices, and environmental factors. By identifying these determinants and implementing targeted interventions, states can strive towards achieving health equity and improving the overall well-being and life expectancy of their residents.

List of U.S. states and territories by life expectancy – Wikipedia 

Mapped: The states with the highest (and lowest) life expectancy

Comparing The American States With The Lowest & Highest Life Expectancy

In recent years, life expectancy in the United States has been declining. According to the American Medica Association, this trend is influenced by factors such as rising rates of chronic diseases, drug overdoses, and disparities in healthcare access.

But even as the national average decreases, the gap between the states with the highest and lowest life expectancies remains stark, driven by socio-economic, environmental, and cultural differences.

For instance, Mississippi has the lowest life expectancy in America and continues to face health challenges with some of the worst health indicators, including chronic diseases, women’s health, obesity, infant and maternal mortality, and more.

COMMENTS

Life expectations have to do with individual life choices. Bad and good habits are the major reasons for differences in life expectations in different areas. None of the government’s business how one lives their lives. A slave in a gilded cage is still a slave. Freedom is the answer.

“Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.” ~ C. S. Lewis

So, poverty, lack of affordable healthcare, and higher rates of people who have no health insurance do not factor in?

Health insurance is something most responsible people have. Healthcare is expensive because of government interference in healthcare.

A free market would give us the lower cost and highest standards of healthcare.

“When a man spends his own money to buy something for himself, he is very careful about how much he spends and how he spends it. When a man spends his own money to buy something for someone else, he is still very careful about how much he spends, but somewhat less what he spends it on.

When a man spends someone else’s money to buy something for himself, he is very careful about what he buys, but doesn’t care at all how much he spends. And when a man spends someone else’s money on someone else, he doesn’t care how much he spends or what he spends it on. And that’s the government for you.” ~ Milton Friedman

Poverty is often caused by poor habits. Dropping out of school, drug use, and so on,
To be successful in the United States you need to keep eight rules in mind. It doesn’t matter who your parents were or where you live, the color of your skin, or what religion you are.

Don’t become addicted to drugs, alcohol, gambling, or any other wasteful habit.
Do not have a child until you are married and can afford to.
Get your high school diploma or GED. The more the education you get the better.
Do not get married until you are 21 and can afford it.

Do not commit a felony.

Take work when offered and do your best.
Avoid debt. Debt can drag you down.

Take promotions when offered.

You may not become a millionaire, but you will be able to feed and house your family. Of course, you need to take time for yourself, family, exercise and so on. No guarantee in life. A well-rounded life is important. If one cannot follow these rules, they probably have bad health habits too. 

Comes down to Smoking, Obesity, and limited quality access to good medical care. No education, dumb people, low life expectancy, Very simple in themselves not as much as personal habits. Get a good job, spend your money on healthy food and exercise and move closer to good medical care as you age.

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Map Shows States With the Highest Alzheimer’s Disease Deaths

Story by Marni Rose McFall

Alzheimer’s disease is a devastating neurodegenerative disorder affecting millions of Americans, and its impact varies significantly across the country.

While the disease is a nationwide concern, certain areas, particularly in the South and the Pacific Northwest, experience significantly higher mortality rates, according to data from 2022 released by the Centers for Disease Control and Prevention. Factors such as healthcare access, lifestyle, and underlying health conditions may contribute to these variations.

The CDC researchers also looked at where people with Alzheimer’s were living when they died of the disease. They found that although most deaths in 2014 occurred in nursing homes or other long-term care facilities, more patients with the disease were dying at home than they were 16 years earlier.

In 1999, only 13.9 percent of people with Alzheimer’s were living at home when they died. That number rose to 24.9 percent in 2014. Another 6.1 percent died in a hospice facility.

Possible reasons for increase

“The number of Alzheimer’s deaths has increased, in part, because of a growing population of older adults,” write the CDC researchers. They also point out that the rise in deaths from Alzheimer’s disease may be the result of fewer “competing” deaths from heart disease and stroke.

In addition, Alzheimer’s is now much more likely to be correctly diagnosed — and cited on death certificates as the direct cause of death — than in past decades.

Whatever the reasons for the increase in the nation’s Alzheimer’s death rate, the growing burden of the disease on American families is clear.

“In 2015, caregivers of persons with dementia, including Alzheimer’s, provided 18.2 billion hours of unpaid assistance,” write the researchers. “These caregiving hours might correspond to increased financial costs for caregivers and decreased work productivity, as caregivers might take leave from work to ensure adequate care is provided.”

“As Alzheimer’s disease progresses, caregiving becomes very important,” explained Christopher Taylor, a CDC epidemiologist who led the study, in the released statement. “Caregivers and patients can benefit from programs that include education about Alzheimer’s disease, how to take care of themselves and their loved one, and case management to lessen the burden of care.”

“Supportive interventions can lessen the burden for caregivers and improve the quality of care for people with Alzheimer’s disease,” he added.

What Is Alzheimer’s Disease?

The National Institute on Aging defines Alzheimer‘s disease as a progressive brain disorder that gradually destroys memory, thinking skills, and the ability to perform simple tasks.

Stock image shows an elderly woman wearing a blue sweater, track pants and sneakers slowly walking in parks with a rollator walker. It is a sunny autumn day in Frederick, Maryland. Data from the CDC shows how the mortality rate of Alzheimer’s changes from state to state. Grandbrothers/Getty Images© 

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It is most common in people over 65, with late-onset Alzheimer’s being the predominant form. In rare cases, early-onset Alzheimer’s can occur between a person’s 30s and mid-60s. The disease is the leading cause of dementia among older adults.

Named after Dr. Alois Alzheimer, who first observed abnormal clumps (amyloid plaques) and tangled fibers (tau tangles) in the brain of a woman with memory loss and erratic behavior, these features remain key indicators of the disease today.

Alzheimer’s is marked by the buildup of plaques and tangles, as well as the loss of connections between neurons that transmit messages within the brain and to other parts of the body. The damage initially impacts areas critical to memory, such as the entorhinal cortex and hippocampus, before spreading to regions responsible for language, reasoning, and social behavior.

Over time, this widespread brain deterioration severely impairs cognitive and physical abilities, leading to the loss of independence in those affected. While scientists continue to investigate other complex brain changes that may contribute to Alzheimer’s, plaques, tangles, and neuronal damage remain central to understanding the disease. Alzheimer’s Risk Higher If Mom Had Memory Problems

Delayed REM sleep phase linked to increased Alzheimer’s risk, research finds

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Which State Has the Highest Alzheimer’s Mortality Rate?

Stats of the States – Alzheimer’s Disease Mortality

The top five states with the highest Alzheimer’s mortality rates are:

1. Mississippi
2. Washington
3. Alabama
4. Arkansas
5. Louisiana 
6. Idaho
7. Utah
8. Georgia
9. Texas
10. California

What Causes the State Differences?

According to research from the University of Alabama, Alzheimer’s disease disproportionately affects the Deep South, where states like Alabama, Georgia, Louisiana,  Mississippi, and South Carolina see significantly higher rates of dementia.

People born in this region have a 20–30 percent greater risk of developing Alzheimer’s or other forms of dementia, largely due to underlying health disparities. Factors such as high rates of hypertension, diabetes, obesity, and vascular disease in the region contribute to cognitive decline and increase dementia risk. These conditions are particularly prevalent among African Americans, who make up over 20 percent of the population in the Deep South, and face twice the risk of late-onset Alzheimer’s compared to other groups.

A key issue in addressing Alzheimer’s disparities is the underrepresentation of African Americans in Alzheimer’s-related research. Although African Americans make up around 10 percent of the U.S. population over 55, few clinical studies have included a proportionate number of African American participants.

The Deep South is also a hotspot for other health conditions that heighten the risk of Alzheimer’s, including cerebrovascular disease, diabetes, and obesity. The so-called “Stroke Belt” – Search and “Diabetes Belt” – Search—areas in the region where those diseases are prevalent—contribute to widespread vascular problems and cognitive decline, while obesity is linked to inflammation that could exacerbate dementia.

A spokesperson for UsAgainstAlzheimer’s said, “There are a number of comorbidities that can increase a person’s risk of developing Alzheimer’s or related dementias and controlling these can reduce a person’s risk of developing Alzheimer’s. We should be clear that hypertension and diabetes are not really “lifestyle factors” but diseases that can be treated—and they should be treated.”

“One of the things we are focused on is making sure the public knows there are things people can do to reduce their risk of Alzheimer’s. Hypertension, diabetes, social isolation, and tobacco use, to name a few, are examples of the risk factors. But people can make simple lifestyle changes to reduce their risk.  Exercise, sleep, eating a healthy diet, and even wearing hearing aids if you have hearing loss are just some of the actions people can take to reduce the risk of developing Alzheimer’s.”

“Access to information and healthcare are two of the biggest challenges,” the spokesperson said.

“Working with the Centers for Disease Control, we are working very hard to reach these very communities so we can raise Alzheimer’s awareness and encourage people to talk about it. But you still have the issue of access to healthcare and adequate treatment – not only for dementia but to address the other factors that increase the risk for Black and Latino people, in particular. We need a healthcare system that works for everyone; getting there is a major priority for ‘UsAgainstAlzheimer’s.” – Search

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Update, 17/10/24, 12:01 p.m. ET: This article was updated with comment from UsAgainstAlzheimer’s.

Estimate of U.S. prevalence of adults aged 18 and over with any serious medical condition, as of 2018. (CDC map)

A new report from the Centers for Disease Control and Prevention has a map showing which counties have populations with an increased risk of severe outcomes from covid-19. Many are rural, since rural populations tend to be older, more obese, and are more likely to have underlying medical conditions.

Read more here: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6929a1-H.pdf from The Rural Blog https://ift.tt/2ZUVyZA Map shows which states have adults at higher risk of serious illness with covid-19 – Entrepreneur Generations

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<<<<<<<<<<<< >>>>>>>>>>>>

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Neurologist, Dr. Daniel Gibbs, Reveals His Personal Story in A Tattoo on my Brain – AlzAuthors: Your Compassionate Guide through Alzheimer’s and Dementia

As a doctor, here’s what I have learned from my own Alzheimer’s disease 

Story by Daniel Gibbs – Search Videos

I have a special interest in Alzheimer’s disease. For nearly 25 years, I practiced general neurology in Portland, Oregon, and some of my patients had dementia. In 2012, while doing a genealogical DNA search, I inadvertently discovered that I have two copies of the APOE-4 allele, meaning I had a very good chance of getting Alzheimer’s-caused dementia by age 80.

I felt Gobsmacked.

I remember walking down the stairs in a daze after reading the report from the genetic testing service and telling my wife, Lois, “I think I am screwed.”

A year later, I retired at age 62 even though I had no symptoms of cognitive impairment. If I had almost any other job, I could have continued working for a few more years, but in medicine, forgetfulness could have fatal consequences. I suddenly wore two hats — that of a retired physician who had cared for a lot of people with Alzheimer’s disease and now a person living with the same disorder.

I had been taught, in medical school in the 1970s and even during my neurology residency in the 1980s, that Alzheimer’s disease progresses from onset to death in about three to five years, and nothing can be done about it. Neither statement is true.

In hindsight, my first symptom of Alzheimer’s disease was a gradual loss of smell that I first noticed in 2006. This was accompanied by odd olfactory hallucinations that smelled like baking bread mixed with perfume. I didn’t have any measurable cognitive impairment until 2015, when I had significant trouble remembering words, including the names of friends and colleagues.

  Related video: What Is Alzheimer’s Disease? (Newsweek) – Search

I had a PET scan as part of a research study, which showed my brain had the beginning of abnormal tau protein, a key part of diagnosing Alzheimer’s. When the scans were repeated in 2018 and 2022, the tau protein can be seen spreading through my brain.

We now know that the first signs of Alzheimer’s disease, beta-amyloid plaques, can be seen in the brain up to 20 years before any cognitive changes. Tau-containing tangles start to form later, about two or three years before the onset of mild cognitive impairment. There is a variation in the speed of progression from mild impairment to full-blown dementia to death, probably about eight to 12 years on average.

I am now 73, and I have had mild cognitive impairment for roughly five years, followed by mild dementia for about four years. We don’t yet have a way to stop this progression, but what have I been doing to slow it?

There are lifestyle modifications that help, and they also decrease the likelihood of getting it in the first place.

Top among them is aerobic exercise. 

Multiple studies have shown up to a 50 percent reduction in the chance of getting Alzheimer’s disease for people who exercise regularly. The only group that doesn’t seem to benefit from exercise are those who already have dementia. The sooner you start, the better.

I started exercising daily in 2012 as soon as I learned that I was on the Alzheimer’s trajectory. Recent evidence shows that tai chi can help people who already are experiencing cognitive impairment.

The data for adopting a plant-based diet are almost as strong as exercise. I follow a variant of the Mediterranean diet called the MIND diet that includes eating foods with increased flavonols such as nuts and certain vegetables. Many experts now recommend avoiding alcohol, especially for people with a family history of dementia. Recently, I gave up my daily glass of beer or wine. Frankly, I have been surprised that nonalcoholic beer tastes quite good.

Staying mentally active is very important. For me, my most important brain exercise is reading and writing. I do a crossword puzzle every day while eating lunch, and I enhance the brain benefit by looking up words I don’t know. Staying socially engaged is important but increasingly difficult as dementia progresses. It’s best for me to socialize with just one or two people at a time. Getting at least 7½ hours of sleep each night appears to reduce the chance of getting dementia.

What about drugs? 

We now have two FDA-approved drugs, lecanemab and donanemab, that are effective in removing beta-amyloid from the brain, but they only slow cognitive decline by about 35 percent. They can also have lethal side effects in patients with two copies of the APOE-4 allele, like me. After only four monthly injections of aducanumab (a cousin of lecanemab) during the phase 3 trial, I developed swelling and bleeding in my brain requiring a stay in an intensive care unit and about four months to recover. The drug has since been discontinued by its manufacturer.

These treatments represent an important step forward in understanding the neurobiology of Alzheimer’s disease, but they should not be used by everyone. So I have learned that Alzheimer’s disease is not the rapidly progressive dementia I was taught about in medical school. It is a slowly progressive disease that is asymptomatic for up to 20 years. Mild symptoms of cognitive impairment may be annoying but usually can allow normal activities for another five years or so. 

Even work may be possible with accommodations. Once someone has dementia, unable to live independently, lifestyle modifications and medications do not seem to be as effective. In my experience, it is critical to manage Alzheimer’s disease in the early stages to postpone the onset of dementia. Don’t wait for the horses to get out of the barn.

Daniel Gibbs has published two books about his experiences with Alzheimer’s disease, “Dispatches From the Land of Alzheimer’s” and “A Tattoo on My Brain: A Neurologist’s Personal Battle against Alzheimer’s Disease,” which was made into a documentary film that can be streamed on Paramount Plus. Gibbs also has a blog. 

About the book – A Tattoo On My Brain

FILE – A doctor checks the blood pressure of A 94-year-old woman in Sant Sadurní d’Anoia, Catalonia region, Spain, Friday, July 31, 2020.© Felipe Dana/AP Photo

How to lower your dementia risk as cases expected to rise by 2060

Research shows that dementia cases are going up, with a study released this week estimating that cases in the United States, for instance, will double by 2060.

The study, published in the journal Nature Medicine on Monday, found that the risk of developing dementia after age 55 is double that reported by previous studies, estimating it at 42 per cent. They said this was tied to population ageing.

Previous research has estimated that global cases of dementia will rise due to population ageing and growth including a 2022 study that estimated global cases could rise from 57.4 million cases in 2019 to nearly 153 million in 2050.

Western Europe would see an estimated 74 per cent increase in cases by 2050, central Europe would have an 82 percent increase, and eastern Europe would see a 92 per cent increase, according to the study.

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But people can take steps to reduce their risk of dementia, such as controlling high blood pressure and other bad-for-the-brain health problems, and it’s not too late to try even in middle age.

“All of our research suggests what you do in midlife really matters,” said Dr Josef Coresh, the study’s co-author from New York University (NYU) Langone Health in the US.  

Dementia isn’t only Alzheimer’s

Dementia is the progressive loss of memory, language, and other cognitive functions.

Alzheimer’s is the most common form, and silent brain changes that eventually lead to it can begin two decades before symptoms appear. Other types include vascular dementia when heart disease or small strokes impair blood flow to the brain.

Many people have mixed causes, meaning vascular problems could exacerbate brewing Alzheimer’s symptoms.

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Measuring the risk from a certain age over the potential remaining life span can guide public health recommendations and medical research.

“It’s not a guarantee that someone will develop dementia,” said Dr James Galvin, a University of Miami Alzheimer’s specialist. He wasn’t involved with the new study but said the findings fit with other research. 

Dementia risk is different by age

Prior studies estimated about 14 percent of men and 23 percent of women would develop some form of dementia during their lifetime.

Coresh’s team analysed more recent data from a US study that has tracked the heart health and cognitive function of about 15,000 older adults for several decades. Importantly, they found the risk changes with the decades.

Only 4 percent of people developed dementia between the ages of 55 and 75, what Coresh calls a key 20-year window for protecting brain health.

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For people who survive common health threats until 75, the dementia risk then jumps to 20 per cent by age 85 and 42 per cent between ages 85 and 95.

Overall, the lifetime dementia risk after age 55 was 35 per cent for men and 48 per cent for women, the researchers concluded.

Women generally live longer than men, a main reason for that difference, Coresh noted. Black Americans had a slightly higher risk, 44 per cent, than white people at 41 per cent.

Ways to lower dementia risk

There are some risk factors people can’t control, including age and whether you inherited a gene variant called APOE4 that raises the chances of late-in-life Alzheimer’s.

But people can try to avert or at least delay health problems that contribute to later dementia.

Coresh, for example, wears a helmet when biking because repeated or severe brain injuries from crashes or falls increase the risk of later-in-life dementia.

Especially important: “What’s good for your heart is good for your brain,” added Miami’s Galvin. He urges people to exercise, avoid obesity, and control blood pressure, diabetes and cholesterol.

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For example, high blood pressure can impair blood flow to the brain, a risk not just for vascular dementia but also linked to some hallmarks of Alzheimer’s.

Similarly, the high blood sugar of poorly controlled diabetes is linked to cognitive decline and damaging inflammation in the brain.

Stay socially and cognitively active, too, Galvin said. He urges people to try hearing aids if age brings hearing loss, which can spur social isolation.

“There are things that we have control over, and those things I think would be really, really important to build a better brain as we age,” he said. 

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“To the world, you might be one person, but to one person, you might be the world”

Genetic risk for Alzheimer’s disease and dementia appeared to be partly offset by high levels of cardiorespiratory fitness, U.K. Biobank data suggested.

Overall, high cardiorespiratory fitness was associated with better global and domain-specific cognitive functions and lower risk of dementia in both middle-age and older adults, reported Weili Xu, PhD, of the Karolinska Institute in Stockholm, and co-authors.

The incidence rate ratio (IRR) of all-cause dementia was 0.60 (95% CI 0.48-0.76) for high versus low cardiorespiratory fitness.

 Dementia onset was delayed by 1.48 years (95% CI 0.58- 2.39) in the high fitness group.

Among people with moderate or high genetic dementia risk scores, high cardiorespiratory fitness attenuated dementia risk by 35% (IRR 0.65, 95% CI 0.52-0.83) compared with low fitness, Xu and colleagues said in the British Journal of Sports Medicine.

“Cardiorespiratory fitness may be used as a predictor of cognitive health,” the researchers stated. “Enhancing cardiorespiratory fitness could be a strategy for the prevention of dementia, even among people with a high genetic predisposition for Alzheimer’s disease.”

No study to date has explored the combined effect of cardiorespiratory fitness and genetic risk on dementia, Xu and colleagues pointed out. “Open questions remain regarding whether and to what extent favorable cardiorespiratory fitness may reduce dementia risk, even in those with a high genetic predisposition for dementia,” they noted.

In this analysis, the researchers followed 61,214 dementia-free U.K. Biobank participants ages 39-70 for a median of 11.72 years. 

Mean baseline age was 56 and 52% of participants were female.

A 6-minute submaximal exercise test on a stationary bike was completed at study enrollment (from 2006 through 2010) to estimate cardiorespiratory fitness. Fitness scores were divided into low, moderate, and high tertiles, standardized by age and sex.

Global and domain-specific cognitive function was evaluated at baseline. Dementia was identified over the follow-up period using medical history and medical records. Genetic predisposition for dementia was estimated using polygenic risk scores for Alzheimer’s disease derived from genome-wide association studies.

During the follow-up period which spanned to 12 years, 553 people (0.9%) received a diagnosis of dementia. High cardiorespiratory fitness was associated with a lower risk of dementia and a delay in the onset of dementia across middle and older ages.

In multi-adjusted linear regression models, higher cardiorespiratory fitness was associated with better global cognitive function, prospective memory, verbal/numeric memory, and processing speed in all participants. The association between cardiorespiratory fitness and cognitive function was consistent in different age and genetic risk groups.

“Future research on the relationship between cardiorespiratory fitness and brain health, especially in older adults, is warranted, and the mechanisms by which cardiorespiratory fitness modifies the relationship between genetic risk and dementia deserve further investigation,” Xu and colleagues observed.

“As the measurement of cardiorespiratory fitness in clinical settings becomes both important and feasible, cardiorespiratory fitness may be used as a routine health monitoring tool or an indicator of health conditions,” they added.

The study was observational and cannot determine causality. Also, U.K. Biobank participants often are healthier than the general population, the researchers acknowledged.

U.K. Biobank participants with certain health conditions — such as chest pain at rest, high weight, high blood pressure, or a pacemaker — were excluded from the exercise test, which may have influenced outcomes. The submaximal exercise test used in this study is considered less accurate than maximal exercise testing which requires participants to exercise to exhaustion, Xu and co-authors said.

In addition, incident dementia cases were determined through register information, which might have led to an underestimation. Most participants did not have repeated cardiorespiratory fitness measurements, and relationships between changes in cardiorespiratory fitness and dementia risk could not be determined.

This research was supported by the Swedish Research Council, the Swedish Council for Health Working Life and Welfare, and the Karolinska Institutet Research Foundation.

Xu and co-authors reported no conflicts of interest.

Related video: Dementia Prevention: Middle Age Habits That Pay Off (Money Talks News) – Search

People who have a genetic predisposition to Alzheimer’s disease may lower their risk of developing the illness with a workout routine, according to a new report. The study found that men and women with high levels of cardiorespiratory fitness in middle age and beyond were 35 percent less likely to develop Alzheimer’s disease or other forms of dementia in old age compared to their less fit peers. The benefits of exercise were particularly pronounced in those at increased genetic risk of Alzheimer’s because they carried the APOE-E4 gene variant or other genetic factors that predispose to the disease.

“Enhancing cardiorespiratory fitness could be a strategy for the prevention of dementia, even among people with a high genetic predisposition for Alzheimer’s disease,” the authors stated. The findings were published in the British Journal of Sports Medicine.

For the study, researchers from the Karolinska Institute in Stockholm and other medical centers analyzed health records from 61,214 men and women who were part of the UK Biobank, a database containing in-depth genetic and medical information from half a million British citizens over many years. They ranged in age from 39 to 70 at the start of the study period, from 2006 to 2010.

At the beginning of the study period, participants underwent a six-minute fitness test on a stationary bicycle to assess their cardiorespiratory fitness, a measure of the ability of the heart, blood and lungs to supply oxygen to muscles during physical exertion. They were grouped into low, medium or high levels of cardiorespiratory fitness, standardized according to their age and sex.

Researchers assessed individuals’ genetic risk for Alzheimer’s disease, according to standard research-based DNA analyses of genes linked to the disease. Participants also underwent tests of memory and thinking skills to assess their cognitive health. All were free of Alzheimer’s disease or other forms of dementia when the study began.

Participants were followed for about 12 years, including with follow-up cognitive tests. During that time, 553 of them developed Alzheimer’s disease or another form of dementia.

The researchers found that overall, the more aerobically fit someone was in middle age, the better their cognitive health was more than a decade later. Cardiorespiratory fitness seemed to benefit multiple facets of memory, such as recalling specific words, names and numbers or remembering specific tasks, such as making an appointment.

The greatest benefits were observed in individuals with a genetic predisposition for Alzheimer’s. Those with the highest levels of cardiorespiratory fitness had a 35 percent lower relative risk of developing the disease compared to their least fit peers. Aerobic fitness delayed the onset of dementia by the equivalent of about one-and-a-half years, the researchers found.

“Our study shows that higher cardiorespiratory fitness is associated with better cognitive function and decreased dementia risk,” the authors concluded. “Moreover, high cardiorespiratory fitness may buffer the impact of genetic risk of all dementia by 35 percent”

The study was observational and cannot prove cause and effect. But it involved a large study population, and earlier research has shown that greater cardiorespiratory fitness is linked to a lower risk of serious diseases such as heart disease, stroke or cancer and a lower risk of dying young.

Cardiorespiratory fitness declines by around 3 percent to 6 percent per decade when we are in our 20s and 30s, but the decline accelerates to more than 20 percent per decade by the time we reach our70s.

Experts say the best way to help minimize cardiorespiratory decline as we age is by choosing an activity you enjoy, such as walking, running, biking or a dance or spin class, and to do it regularly for at least half an hour several days a week. Aim to perform the activity at a fairly rigorous level, in which it would be difficult to hold a conversation with a friend. You can also mix it up, aiming for brief periods of high-intensity exercise amid longer periods of lower intensity exertion.

If you’re just getting started, see your doctor to make sure the exercise plan is right for you. And don’t forget other lifestyle factors that can promote brain health, including a heart-healthy diet and a good night’s sleep.

By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Eric Schmidt, Ph.D. Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University. 

Source: Shuqi Wang, Liuao Xu, Wenzhe Yang, et al: “Association of cardiorespiratory fitness with dementia risk across different levels of genetic predisposition: a large community-based longitudinal study” British Journal of Sports Medicine, November 19, 2024

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RELATIONSHIP STRESS AND DEMENTIA – Search Videos

As the mind’s delicate gears interlock and whirl, anxiety and stress lurk like saboteurs, potentially hastening the onset of dementia’s fog. This poignant imagery encapsulates the complex interplay between mental health and cognitive decline, a relationship that has garnered increasing attention from researchers and healthcare professionals alike. The connection between anxiety, stress, and dementia is not merely coincidental but represents an intricate web of neurological and physiological processes that can significantly impact an individual’s cognitive health over time.

Anxiety and dementia, while distinct conditions, often intertwine in ways that can profoundly affect a person’s quality of life. Anxiety, characterized by persistent worry and fear, is a common mental health disorder that affects millions worldwide. Dementia, on the other hand, is a broad term encompassing various neurodegenerative disorders that lead to cognitive decline, with Alzheimer’s disease being the most prevalent form. The prevalence of anxiety in dementia patients is strikingly high, with studies suggesting that up to 71% of individuals with dementia experience significant anxiety symptoms.

Understanding the relationship between anxiety, stress, and dementia is crucial for several reasons. First, it can help in early identification of individuals at higher risk of developing dementia. Second, it opens up new avenues for potential interventions that could slow down or even prevent cognitive decline. Lastly, it underscores the importance of mental health in overall brain health, challenging the traditional view that cognitive decline is an inevitable part of aging.

The Link Between Anxiety and Dementia

The connection between anxiety and dementia is multifaceted, involving various physiological and psychological mechanisms. Understanding anxiety and its effects on cognitive function is crucial to grasping this relationship. Anxiety can impact cognitive performance in several ways, including:

1. Impaired attention and concentration
2. Reduced working memory capacity
3. Slower processing speed
4. Difficulties in decision-making

These cognitive effects, when persistent over time, may contribute to an increased risk of developing dementia. Several studies have shown a correlation between anxiety and dementia risk. For instance, a meta-analysis published in the journal Alzheimer’s Research & Therapy found that individuals with anxiety had a 57% higher risk of developing dementia compared to those without anxiety.

The potential mechanisms connecting anxiety and dementia are still being investigated, but several theories have emerged:

1. Chronic stress response: Anxiety triggers a prolonged stress response, leading to elevated cortisol levels that can damage brain cells over time.

2. Inflammation: Anxiety is associated with increased inflammation in the body, including the brain, which is a known risk factor for dementia.

3. Vascular changes: Anxiety can affect cardiovascular health, potentially leading to reduced blood flow to the brain and increasing the risk of vascular dementia.

4. Sleep disruption: Anxiety often interferes with sleep quality, and poor sleep has been linked to an increased risk of cognitive decline.

5. Neuroplasticity: Chronic anxiety may impair the brain’s ability to form new neural connections, a process crucial for maintaining cognitive health.

Can Stress Make Dementia Worse?

To understand how stress impacts dementia, it’s essential to first define stress and its effects on the brain. Stress is the body’s response to any demand or challenge, triggering a cascade of physiological changes. While acute stress can be beneficial in certain situations, chronic stress can have detrimental effects on brain health.

Research has shown that stress can indeed exacerbate dementia symptoms. The hidden link between stress and memory loss becomes more apparent in individuals with dementia. Stress can worsen cognitive symptoms such as memory loss, confusion, and difficulty with problem-solving. Moreover, it can amplify behavioral symptoms like agitation, anxiety, and depression in dementia patients.

The physiological changes in the brain due to chronic stress are significant and can contribute to the progression of dementia:

1. Hippocampal atrophy: Chronic stress can lead to shrinkage of the hippocampus, a brain region crucial for memory formation and already vulnerable in dementia.

2. Amyloid-beta accumulation: Stress has been shown to increase the production of amyloid-beta, a protein associated with Alzheimer’s disease.

3. Tau protein aggregation: Stress can accelerate the formation of tau tangles, another hallmark of Alzheimer’s disease.

4. Oxidative stress: Chronic stress increases oxidative stress in the brain, leading to cellular damage and potentially accelerating cognitive decline.

5. Neuroinflammation: Stress triggers inflammatory responses in the brain, which can exacerbate neurodegenerative processes.

The Impact of Stress on Dementia Progression

The effects of stress on cognitive decline in dementia patients are profound and multifaceted. The complex relationship between stress and Alzheimer’s disease reveals that stress can accelerate the rate of cognitive decline in individuals already diagnosed with dementia. This acceleration is thought to occur through various mechanisms:

1. Exacerbation of existing pathology: Stress can worsen the underlying neurodegenerative processes in dementia.

2. Cognitive reserve depletion: Stress may deplete cognitive reserve, reducing the brain’s ability to compensate for damage.

3. Behavioral changes: Stress-induced behavioral changes can interfere with daily functioning and quality of life.

Stress-induced inflammation plays a significant role in dementia progression. Chronic stress activates the body’s inflammatory response, leading to the release of pro-inflammatory cytokines. These inflammatory molecules can cross the blood-brain barrier and contribute to neuroinflammation, a key factor in the progression of neurodegenerative diseases.

Several case studies have demonstrated the effects of stress on dementia. For example, a study published in the journal Neurology followed a group of dementia patients over two years and found that those experiencing high levels of stress showed a more rapid cognitive decline compared to those with lower stress levels. Another study in the American Journal of Geriatric Psychiatry reported that dementia patients exposed to acute stressors, such as hospitalization or the death of a spouse, experienced significant worsening of cognitive symptoms in the following months.

Managing Anxiety and Stress in Dementia Patients

Given the significant impact of anxiety and stress on dementia, managing these factors is crucial in dementia care. Non-pharmacological interventions for anxiety reduction in dementia patients have shown promising results and include:

1. Cognitive Behavioral Therapy (CBT): Adapted for individuals with cognitive impairment, CBT can help manage anxiety symptoms.

2. Mindfulness and relaxation techniques: These practices can help reduce stress and improve overall well-being.

3. Music therapy: Listening to familiar music can reduce anxiety and improve mood in dementia patients. 

4. Art therapy: Engaging in creative activities can provide a sense of accomplishment and reduce stress.

5. Pet therapy: Interaction with animals has been shown to reduce anxiety and improve mood in dementia patients.

Lifestyle changes to minimize stress are equally important for both dementia patients and their caregivers:

1. Establishing routines: Predictable daily schedules can reduce anxiety and confusion.

2. Regular physical exercise: Exercise has been shown to reduce stress and improve cognitive function.

3. Maintaining social connections: Social engagement can provide emotional support and cognitive stimulation.

4. Engaging in enjoyable activities: Participating in hobbies and pleasant activities can reduce stress and improve quality of life.

5. Ensuring adequate sleep: Good sleep hygiene is crucial for managing stress and supporting cognitive health.

The importance of support systems for patients and caregivers cannot be overstated. Understanding the link between stress and dementia is crucial for caregivers to provide effective support. Support groups, respite care, and educational resources can help both patients and caregivers manage stress and anxiety more effectively.

Prevention Strategies: Reducing Anxiety and Stress to Lower Dementia Risk

While managing anxiety and stress in dementia patients is crucial, prevention strategies aimed at reducing these factors in the general population may help lower the risk of developing dementia. Early intervention for anxiety disorders is key. Treating anxiety early in life may potentially reduce the risk of cognitive decline later on. This can involve:

1. Psychotherapy: Cognitive Behavioral Therapy (CBT) and other forms of talk therapy can effectively manage anxiety.

2. Medication: When necessary, anti-anxiety medications can be used under medical supervision.

3. Lifestyle modifications: Incorporating stress-reduction techniques into daily life from an early age.

Stress management techniques for long-term brain health are essential for everyone, regardless of their current cognitive status. These techniques include:

1. Mindfulness meditation: Regular practice can reduce stress and improve cognitive function.

2. Physical exercise: Regular aerobic exercise has been shown to reduce stress and support brain health.

3. Healthy diet: A balanced diet rich in antioxidants and omega-3 fatty acids can support brain health and reduce inflammation.

4. Adequate sleep: Prioritizing good sleep hygiene is crucial for stress management and cognitive health.

5. Time management: Effective time management can reduce daily stress and improve overall well-being.

The role of cognitive stimulation in preventing dementia should not be underestimated. Engaging in mentally stimulating activities throughout life can build cognitive reserve, potentially delaying the onset of dementia symptoms. Such activities include:

1. Learning new skills or languages
2. Engaging in challenging puzzles or games
3. Reading and writing
4. Participating in social activities and discussions
5. Pursuing creative hobbies

Conclusion

The relationship between anxiety, stress, and dementia is complex and multifaceted. Understanding stress-induced anxiety and its potential long-term consequences on cognitive health is crucial for both prevention and management of dementia. Anxiety and chronic stress can significantly impact cognitive function, potentially increasing the risk of developing dementia and accelerating its progression in those already diagnosed.

Addressing anxiety and stress in dementia care is of paramount importance. By implementing strategies to manage these factors, we may be able to improve the quality of life for dementia patients and potentially slow the rate of cognitive decline. Moreover, focusing on anxiety and stress reduction in the general population could serve as a preventive measure against dementia.

Future research directions in this field are promising and may lead to better treatments and preventive strategies. Areas of interest include:

1. Developing more targeted interventions for anxiety in dementia patients
2. Investigating the long-term effects of early anxiety treatment on dementia risk
3. Exploring the potential of stress-reduction techniques in slowing cognitive decline
4. Studying the genetic and epigenetic links between anxiety, stress, and dementia

As our understanding of the intricate relationship between mental health and cognitive decline continues to grow, there is hope for better treatments and prevention strategies. By addressing anxiety and stress throughout the lifespan, we may be able to support better brain health and reduce the global burden of dementia.

Learning how to deal with anxiety and manage stress effectively is not just about improving current quality of life, but also about investing in long-term cognitive health. As research progresses, the importance of mental health in maintaining cognitive function becomes increasingly clear, offering new avenues for intervention and prevention in the fight against dementia.

Anxiety, Stress, and Dementia Explained

References

1. Gimson, A., Schlosser, M., Huntley, J. D., & Marchant, N. L. (2018). Support for midlife anxiety diagnosis as an independent risk factor for dementia: a systematic review. BMJ Open, 8(4), e019399.

2. Gulpers, B., Ramakers, I., Hamel, R., Köhler, S., Oude Voshaar, R., & Verhey, F. (2016). Anxiety as a Predictor for Cognitive Decline and Dementia: A Systematic Review and Meta-Analysis. The American Journal of Geriatric Psychiatry, 24(10), 823-842.

3. Justice, N. J. (2018). The relationship between stress and Alzheimer’s disease. Neurobiology of Stress, 8, 127-133.

4. Machado, A., Herrera, A. J., de Pablos, R. M., Espinosa-Oliva, A. M., Sarmiento, M., Ayala, A., … & Cano, J. (2014). Chronic stress as a risk factor for Alzheimer’s disease. Reviews in the Neurosciences, 25(6), 785-804.

5. Mah, L., Binns, M. A., & Steffens, D. C. (2015). Anxiety symptoms in amnestic mild cognitive impairment are associated with medial temporal atrophy and predict conversion to Alzheimer’s disease. The American Journal of Geriatric Psychiatry, 23(5), 466-476.

6. Orgeta, V., Qazi, A., Spector, A. E., & Orrell, M. (2014). Psychological treatments for depression and anxiety in dementia and mild cognitive impairment. Cochrane Database of Systematic Reviews, (1).

7. Sindi, S., Kåreholt, I., Johansson, L., Skoog, J., Sjöberg, L., Wang, H. X., … & Kivipelto, M. (2018). Sleep disturbances and dementia risk: A multicenter study. Alzheimer’s & Dementia, 14(10), 1235-1242.

8. Terracciano, A., Sutin, A. R., An, Y., O’Brien, R. J., Ferrucci, L., Zonderman, A. B., & Resnick, S. M. (2014). Personality and risk of Alzheimer’s disease: New data and meta-analysis. Alzheimer’s & Dementia, 10(2), 179-186.

9. Wilson, R. S., Begeny, C. T., Boyle, P. A., Schneider, J. A., & Bennett, D. A. (2011). Vulnerability to stress, anxiety, and development of dementia in old age. The American Journal of Geriatric Psychiatry, 19(4), 327-334.

10. Yaffe, K., Vittinghoff, E., Lindquist, K., Barnes, D., Covinsky, K. E., Neylan, T., … & Marmar, C. (2010). Posttraumatic stress disorder and risk of dementia among US veterans. Archives of General Psychiatry, 67(6), 608-613.

Caring for someone with Alzheimer’s is one of the toughest jobs 
in the world. “It is stressful, physically and emotionally draining, and very expensive, as almost 15 million unpaid caregivers for people with Alzheimer’s and other dementias can attest,” says Dr. Scott McGinnis, medical editor of the Harvard Special Health Report A Guide to Coping with Alzheimer’s Disease.

How to take care of a person with dementia

Learning how to take care of a person with dementia can be a trial-and-error process. Every person with dementia and every caregiver is unique, and so is their relationship. However, the following general tips may be useful in helping people with dementia remain physically healthy and connected to the world.

• Help people with dementia by speaking simply and patiently. To get the person’s attention, begin by using his or her name. Use simple phrasing and short sentences, but be careful to avoid talking to the person as if he or she were a child. Give someone with Alzheimer’s time to complete a sentence or thought, and try not to interrupt. 

• Make mealtimes less stressful. Reduce sensory confusion at meals. See that the dining area is well lit. Make sure the person is comfortably seated and doesn’t need to use the bathroom. Keep items that may be mistaken for food, like dog biscuits or flower bulbs, out of sight.

• Serve nourishing, manageable meals. Use a plate color that contrasts with the food. Remove condiments from the table. Limit choices by putting only one food on the plate at a time and offering only one utensil. (Curved spoons, divided plates, and straws can make it easier for people to feed themselves.)  Don’t serve food or drink that is too hot. Cut food into small pieces. Remind the person to eat slowly and chew each bite thoroughly. If he or she chokes easily, switch to soft foods. Serve foods containing fiber to help prevent constipation.
• Reduce resistance to bathing. Avoid discussing whether a bath is needed. Prepare everything in advance. Lay out towels, soap, shampoo, and clothes. Have the water ready and at the right temperature before bringing him or her into the bathroom. Be calm, gentle, and reassuring. If the person seems disturbed at this invasion of privacy, cover portions of his or her body with a towel. Encourage him or her to do as much as possible without hands-on help. Talk through each step. If the person refuses to get into the tub or shower, be flexible and suggest an alternative. If all else fails, try again later. 

• Accident-proof the bathroom. Use rubber tub mats, tub seats, grab bars, nonslip bath mats, etc. Do not use bath oil or products that make the tub slippery. Put razors and electrical appliances out of reach. Take the lock off the bathroom door.
• Incorporate skin care into bath time. Check the skin for rashes and sores. Use powder or cornstarch to prevent chafing, and apply body lotion to dry skin.
• Simplify dental care. Prepare the toothbrush and demonstrate how to brush. If the person will not brush and refuses assistance, give him or her a cloth moistened with mouthwash and tell the person to rub it over his or her teeth. 


Dementia is a disease that affects millions of people across the globe every year. It is often a highly misunderstood condition that is marred by numerous misconceptions, which make the condition difficult to understand and study.

You should know that dementia is not a name for an illness, rather it is a collective term that describes a broad range of symptoms that relate to declining thinking, memory, and cognitive skills. These symptoms have deteriorating effects that usually affect how a patient acts and engages in the day-to-day activities.

In advanced dementia stages, affected persons may experience symptoms that bring out a decline in rational thought, intellect, social skills, memory, and normal emotional reactivity. It is something that can make them powerless when it comes to living normal, healthy lives.

Relatives, caregivers, spouses, siblings, children and anyone close to a person who has dementia need to know how to deal with behavioral problems that surface because of the illness. Examples of dementia problems may include aggressiveness, violence and oppositional behaviors. Find out some of the vital Do and Don’ts when dealing with a dementia patient.

Dealing with Dementia Behavior: Do’s

We have identified a list of 9 Do’s that you should keep in mind when dealing with behavior problems associated with dementia. They are as follows:

Do Try and Identify the Trigger that Causes Behavior Change

After spending some time with a patient who has dementia, caregivers may be in a position to identify some of the things that make dementia sufferers yell, get physical, or change their mood. For some, it may be something simple such as taking a bath or even getting dressed.

The best approach to handle this is not to force the patient to do something that they do not want to do. Try and distract them with something else that allows them to relax and calm down. Once they are not a danger to themselves or anyone around them, try going back to the subject, but this time reassuringly and calmly.

Do Keep Eye Contact When Speaking

Communicating with a dementia patient requires a lot of patience, especially during later stages of dementia. It is vital to ensure that you talk in a place that has good lighting, a place that is quiet and without too many distractions. Do not try to stand over the person you are talking to, but rather try to be at their level and keep eye contact at all times. Take care to make sure that body language is relaxed and open. Prepare to spend quality time with the person so that they do not feel rushed or like they are a bother.

Do Introduce Yourself

It does not matter how many times you have to do it. Dementia comes with memory loss which means that the patient may forget your name. When starting a conversation, always remind them your name and tell them something nice that will make them smile.

Do Stick to Routine

Scientists state that habits belong to their own memory structure, which remains intact for long periods even when the patient loses their most recent memory skills. Routine helps dementia patients to know what to do on a daily basis. Caregivers should strive to include meaningful activities in the routine for as long as possible as a way of ensuring that the person with the condition has a sense of independence and purpose in life.

Remember to continually re-examine the routine to remove things that may agitate, depress or make the dementia patient feel unsettled. Sadly, it may reach a point where people with dementia may not be able to keep up with a basic routine. However, as long as they still can, be sure that they do things every day that make them happy.

Do Offer Assurance Often

Many times, people with dementia may experience feelings of isolation, fear, loneliness or confusion. They may not be able to express this in the right way and thus may wander off or keep saying that they want to go back home, especially if they are in a senior living facility. This is not the time to shut them out. It’s a good idea to assure them that they are safe and in a good place.

If you are close enough, provide a comforting hug every once in a while and remind them that they are in a place that has their best interest at heart. Where possible, engage in exercise or take a walk as even light physical activity may help to reduce agitation, restlessness and anxiety.

Do Make Sure That the Dementia Patient Gets Enough Rest, Food and Water

Fatigue, hunger and thirst may cause combativeness. Ensure that the person with dementia is well fed, hydrates enough, and gets adequate sleep and rest. In line with this, they should also have enough bathroom breaks. Research also shows that it may help to reduce loud noises as well as clutter in the space where the patient spends most of his/her time, as both loud noises and clutter tend to over-stimulate people with dementia.

Do Share Photos

At times, the behavior that dementia patients exhibit is because they are missing a person or place they love. Experts suggest for caregivers to go through as many photos as possible with the person with the illness. It is a tool that helps to stimulate happy memories while the dementia sufferer goes down the memory lane.

Going through family photos has been known to play a significant role when it comes to the patients remembering the pleasant times they had. Family photos also help people with dementia to remember special people in their lives. It is best to use large pictures that have clear labels because many people who have dementia often have declining or poor eyesight. Try and select meaningful moments, and you can also make it an activity where patients can create scrapbooks with the people they love.

Do Try to be Pleasant

Caregivers are also humans who are prone to emotions like anger, stress, impatience, and irritation. Even when one goes through caregiver burnout, it is best that the patient does not get wind of it. It is better to step out of the room and try some breathing exercises to calm down before going back to deal with the dementia patient. Where possible, shelve the “bad” feelings and try to deal with them later. Dementia patients deal with a lot and they do not need more on their plate if they are to lead fulfilling and happy lives.

Do try to be Forgiving and Patient

Do not forget that dementia is the condition that results in irrational behavior and causes dementia sufferers to act the way they do. The patients demand plenty of patience and forgiveness from the people looking after them. Have the heart to let things go instead of carrying grudges around for something that the patient may not be in control of.

Dealing with Dementia Behavior: Don’ts

There are certain actions you should not take and certain things you should not do when you are dealing with dementia behavior problems. We have identified a list of 10 such Don’ts, and they are:

Do Not Engage in Arguments

One of the worst things a person can do to an individual who has dementia is to start an argument or even force them to do something that makes them upset or angry. When the discussion or argument is too heated, it may be better to walk away to create an environment where everyone can remain calm. Experts agree that one of the ways that can yield results when it comes to dementia behavior problems is to get rid of the word no when dealing with patients. Avoid forcibly restraining a dementia sufferer at all costs.

Do Not Be Impolite

Communication and language often become difficult over time for individuals who have dementia. It is therefore very important to use polite language when speaking with someone who has dementia. Do not use sharp or threatening voices. Do not feel frustrated when you have to repeat words or phrases several times because the person you are conversing with does not catch them or understand as fast as they should. Restrain from ridiculing or patronizing the patients about what they say.

Do Not Keep Correcting the Patient

People with dementia do not like it when someone keeps correcting them every time they say something that may not be right. It makes them feel bad about themselves and can make them drift out of the conversation. Discussions should be humorous and light and one should always speak slowly and clearly using simple and short sentences to capture and keep the interest of the dementia patients.

Do Not Get Angry or Upset

When looking after persons with dementia, practicing self-control is of utter importance. Learn how to breathe in and just relax without taking things personally or getting angry and upset. Remember that dementia patients do not act the way they do out of their own accord. It is the illness that makes them behave the way they do.

Do Not Try and Alter Undesirable Behavior

Lack of understanding may push one to try and change or stop any undesirable behavior from patients who have dementia. Keep in mind that it is almost impossible to teach new skills or even reason with the patient. Try instead to decrease frequency or intensity of the behavior. For instance, respond to emotion and not the changes in behavior. If a patient insists on always asking about a particular family member reassure them that he or she is safe and healthy as a way of keeping them calm and happy.

Do Not Try to Stop a Person Who Wants to Leave a Room

Staying in one place for long periods may result in behavior problems in the dementia patient. It is essential to have a safe environment where they can enjoy the outdoors without any problem. When someone tries to leave a room, do not force them to stop. Doing this may result in an extreme reaction such as severe distress or injuries.

Instead, it is best to accompany the patient so that they are safe. You can even suggest going for a drive around the block so that they can experience a new environment for a short period. If they do not want company, just let them go but stay close by to make sure that the patient is safe at all times.

Do Not Expect Too Much

It helps to have an open mind when dealing with an individual who has dementia. Try and keep up with their pace without having to rush them too much. It is advisable to avoid trying to teach new information or ask the affected individuals to do something that they have not previously done.

Do Not Shy Away From Asking For Help

No one may have all the answers especially when it comes to taking care of a person with dementia. Try doing research on how their behavior changes and what needs to be done to help them live their lives without too many complications. Hire help when it becomes too much as it also ensures that you do not become too frustrated or drained.

When you have multiple family members who can help, ask everyone to pitch in and look after the patient so that you can get some personal space to breathe and re-energize when it is your time to look after the patient. When you feel like you can no longer look after your loved one at your own home, it may be time to consider assisted living. In such cases, look into dementia care homes that can provide specially trained professionals.

Do Not Panic

When a dementia patient becomes aggressive or agitated, try to remain in control without breaking down, panicking and using physical force. Try other approaches that may help to make them calm. These can include holding their hand firmly but gently, singing them their favorite song, or patting their pack gently. Note that some people do not like to be touched; thus, it is best to give them some space by sitting away from them or leaving the room until they calm down.

Do Not Ignore Physical Abuse

As much as one needs to be tolerant, kind, forgiving, and patient with older adults who have dementia, it does not mean that they have to excuse the patients when they become physically aggressive and allow the abuse to continue. It is not to be accepted, and if it happens, it is best to alert your doctor who will work on the solution to make sure it stops. It will keep both the patient and caregiver in safety.

From physical manifestations to angry outbursts, taking care of an individual with dementia may not be easy. However, working with the tips above can help caregivers and loved ones to get through it. Remember that there are plenty of treatments, interventions and special care providers who can help; therefore, you should never be shy about getting help when you need it. 

Infographic: Do’s and Don’ts: Communicating With a Person Who Has Alzheimer’s Disease

People with Alzheimer’s disease may have trouble finding the right words or remembering what they want to say. This can make communication difficult. Use the tips below to better communicate with a person who has Alzheimer’s.

To share the image, right-click on it and select “save image as” to save the file to your computer. We encourage you to use the hashtag #NIAHealth in your social media posts to connect with people and organizations with similar goals.

You may also be interested in

• Reading more about communication changes in Alzheimer’s disease
• Downloading or ordering a tip sheet about how to deal with agitation, aggression, and sundowning
• Finding out more about managing personality and behavior changes in Alzheimer’s
• If you don’t give someone attention with dementia they will act out. – Search
• Exercise can boost your memory and thinking skills – Harvard Health
• Anxiety, Stress, and Dementia Explained

Story by Anne E. White  © Eli Lilly and Company

Alzheimer’s made my mom unable to recognize her grandkids. Breakthroughs too late for her can change the disease’s trajectory—if diagnosis and treatment start early

My mother, Margaret, was the heart of our family. When my twins were born prematurely, she moved in with us to help care for them. Her support allowed me to take on being a new mom of two and a busy career during a challenging time. And her selflessness stayed with me as I helped care for her later in life when she needed it most. gns of cognitive impairment. Within a few years, Alzheimer’s disease stole her joy for cooking, love of music, and ability to recognize her grandchildren.   

My father, sisters, and I shared caregiver duties, watching her with vigilance, and balancing a new dynamic in our family. I found myself sleeping on my mother’s bedroom floor to prevent her from wandering in the night. We were a private family and did not discuss my mom’s illness very much outside our immediate circle. When caring for her, our world became small, our routine focused on keeping her safe. My sisters and I wondered, Will we be next?

It would be different if my mom were diagnosed today. Nearly two decades later, we know so much more about this disease. Improvements in detection, diagnosis, and medicines are offering new hope for slowing its progression. 

 Related video: The Doctor Is In: Recognizing the difference between Alzheimer’s and other forms of dementia and daily habits that can impact long-term brain health (FOX 2 Detroit) – Search

Studies have confirmed we have the greatest opportunity to impact this disease in its earliest stages, when some people may initially show only subtle changes in memory and thinking that differ from normal aging. People in this state, often with mild cognitive impairment, may encounter minor challenges in everyday living, and may be younger and appear healthier than society has traditionally portrayed.

Innovations in diagnostics are now able to identify underlying disease pathology—clumps of amyloid plaques in the brain. And emerging blood tests hold promise to speed and simplify diagnosis with remarkable accuracy. Just years ago, for patients like my mom, a confirmed diagnosis wasn’t even possible until after death.

Changing perceptions of Alzheimer’s disease

Moving forward, it will take all of us—people with Alzheimer’s disease, providers, and families—to change how we view this disease and how we treat it.

More people need to be aware about the importance of the early detection of symptoms, often in the primary care setting, and reducing the stigma surrounding the disease so that more people are diagnosed.

Today it can take more than two years on average to diagnose Alzheimer’s after the first symptom is detected. We need health care providers to include cognitive assessments and advanced diagnostics routinely in their clinical practice when Alzheimer’s disease is suspected. And we must advocate for access and reimbursement for diagnostic tests as well as treatments. 

We need greater equity across disease states, races, genders, and generations. Promoting available and affordable options across geographic and socioeconomic boundaries and allowing care close to home should be a priority. As a new generation of caregivers begin to take responsibility for their mothers, fathers, and families, we should make sure these newly diagnosed individuals are helped as early in their disease as possible.

The progress we are now realizing will lead to more investment and research in Alzheimer’s disease that will unlock further understanding and open the door to address other neurodegenerative conditions. This moment will be a catalyst to drive progress toward understanding diseases such as ALS, Parkinson’s, and multiple sclerosis.

This is all within our reach: What were breakthroughs in science and care in cancer and cardiovascular disease in previous decades are now routine in how we treat these patients today. The same can be true in neurodegenerative disease.

Looking back on my mom’s experience, I remain deeply grateful that she continued to recognize my dad, my sisters, and me through the end of her life. When I held her hand and looked into her eyes as she passed away, I found comfort in knowing that she did not see a stranger, but a loving daughter who had felt a lifetime of love and care.

Scientific breakthroughs came too late for my mom. but they are not too late for people diagnosed today. The story of Alzheimer’s is now being rewritten. We have the chance to truly change the trajectory of this disease for many people, and we need to act with urgency to help them and those that love them.

I would have given so much to have more time with my mom, and I am so glad that many families now have that chance for more time.   

More must-read commentary published by Fortune:

• I’m nearing 65 and am better than ever at my job. With more boomers opting not to retire, I’m not alone
• I’ve been practicing medicine at a renowned institution for 40 years. Society isn’t ready for us to reverse the aging process across an entire population
• My 2-year-old daughter needed a pacemaker. That spurred me to engineer a virtual heart, and now customized 3D simulations are saving lives
• I cared for my dad under ‘hospital at home’ in his final weeks. The program is missing one big piece
• For Your Patients: The Stages of Alzheimer’s Disease

The opinions expressed in Fortune.com commentary pieces are solely the views of their authors and do not necessarily reflect the opinions and beliefs of Fortune.

Learn its history and what Alzheimer’s research has discovered so far.

Also, consider investigating an Alzheimer’s clinical trial here.

Minor abnormalities, so-called amyloid plaques, and tau tangles that form in the brain and are found in specific locations throughout are two distinguishing hallmarks of Alzheimer’s Disease Dementia. Advanced testing, such as PET scans, MRI, DNA, and spinal fluid analysis, can shed invaluable light on the probability of Alzheimer’s.

Alois Alzheimer was a German psychiatrist who discovered the pathological condition of Dementia and diagnosed the disease that bears his name. Alois was born in Marktbreit, Germany, in 1864 and showed an early aptitude for science.

After obtaining his medical degree, he worked in hospitals in Frankfurt, where he met Auguste Deter, a 51-year-old woman suffering from progressive short-term memory loss. He was eventually able to isolate the pathological causes of severe Dementia, work so extensive that the condition became known as Alzheimer’s disease.

Source: click here.

Today, it is believed that “Alzheimer’s disease (AD) is the most common form of Dementia among older people. Dementia is a brain disorder that seriously affects a person’s ability to carry out daily activities.

AD begins slowly. It first involves the parts of the brain that control thought, memory, and language. People with AD may have trouble remembering recent events or the names of people they know. A related problem, mild cognitive impairment (MCI), causes more memory problems than usual for people of the same age. Many, but not all, people with MCI will develop AD.

In AD, symptoms get worse over time. People may not recognize family members or have trouble speaking, reading, or writing. They may forget how to brush their teeth or comb their hair. Later, they may become anxious or aggressive or wander away from home. Eventually, they need total care, which can cause great stress for family members who must care for them.

AD usually begins after age 60. The risk goes up as you get older. Your risk is also higher if a family member has had the disease. No treatment can stop the disease. However, some drugs may help keep symptoms from worsening for a limited time.”

Source: click here.

You may also be interested to read about the IDEA Study and how the results suggested that about a third of those diagnosed with Alzheimer’s disease in the past, now, due to recent advancements in imaging, were found not to have Alzheimer’s disease. Yes, they may have had significant cognitive impairments, but their cause was not necessarily Alzheimer’s disease, and the treatment plan was altered accordingly.

Source: click here.

Lastly, a well-known study of nuns, lasting decades, has indicated that some individuals can live cognitively intact, showing no signs or clues to significant degenerative changes, despite having the hallmarks of a Dementia pathology seen at their autopsy.

Source: click here.

Alzheimer’s Disease Dementia

Mild Cognitive Impairment

Mixed Dementia | Dementia Society of America®

Dementia Like Conditions

Vascular Dementia

Young Onset Dementia

Lewy Body Disease | Dementia Society of America®

Frontotemporal Dementia | Dementia Society of America

AIDS Dementia Complex

Huntington’s Disease With Dementia

Multiple Sclerosis

Parkinson’s Disease Dementia

Chronic Traumatic Encephalopathy

Traumatic Brain Injury

Down Syndrome Dementia | Dementia Society of America

Posterior Cortical Atrophy | Dementia Society of America

Primary Progressive Aphasia | Dementia Society of America

Alzheimer’s Disease Information: Facts, Causes, Definition, and More

Creutzfeldt Jakob Disease

Corticobasal Degeneration | Dementia Society of America

Progressive Supranuclear Palsy

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy: MedlinePlus Genetics

Sanfilippo Children’s Foundation

Batten Disease: What It Is, Causes, Symptoms & Treatment

Dementias | National Institute of Neurological Disorders and Stroke

Cerebral amyloid angiopathy: MedlinePlus Medical Encyclopedia

Types of Childhood Dementia Disorders

Scientist Discover Key Longevity Difference in Blood of Those Who Live Past 90

Discover the Countries With the Longest Life Expectancy | Watch

Tammy and Paul Maida go on frequent bike rides. – © Provided by CNN

November is Alzheimer’s Awareness Month, a time to also heighten awareness about Alzheimer’s disease and show support for the more than 6.2 million Americans living with it. There are a number of quick and easy ways you can help raise awareness, show support, and fight Alzheimer’s disease!

Why Teal?

Teal is the Alzheimer’s Awareness color of the Alzheimer’s Foundation of America (AFA). AFA uses teal because it has been shown in color psychology studies to be a calming color. This is helpful when designing and decorating spaces and events to be welcoming and comforting to those living with Alzheimer’s. So, next time you see someone dressed in teal, remember the more than 6 million people living with Alzheimer’s and the help they need.

‘A study to give us hope’: Lifestyle changes improve Alzheimer’s symptoms for some

Story by Sandee LaMotte and A. Chris Gajilan, CNN

Editor’s note: CNN Chief Medical Correspondent Dr. Sanjay Gupta’s documentary“ CNN original series – The last Alzheimer patient documentary as part of  “The Whole Story With Anderson Cooper.” – Search Videos

Looking back, Tammy Maida, 67, said things started to change in her late 50s. At first, she would lose track of her belongings: her keys multiple times a day, a ring, eyeglasses, her purse.

She would drive to the grocery store in her hometown of San Jose, California, and forget where she parked the car. At home, she couldn’t remember where she had put the groceries. Her husband, Paul, would sometimes find them in the garage.

A lifelong, avid reader, Maida stopped picking up books because she couldn’t remember the last chapter she had read or the major characters.

“I honestly thought I was losing my mind, and the fear of losing my mind was frightening,” she told CNN Chief Medical Correspondent Dr. Sanjay Gupta for the CNN documentary “The Last Alzheimer’s Patient.”

Today, Maida is back to devouring short novels and helping with the family finances.

Another patient, Mike Carver, 71, was diagnosed with early-onset Alzheimer’s at age 64 while working as a business executive. Doctors told him to put his affairs in order with little hope for the future. Carver eventually learned that he was a carrier of both copies of the APOE4 gene, which carries the highest-known genetic risk for Alzheimer’s.

Now, however, Carver is back to reconciling the family finances and keeping track of investments. “It’s kind of like doing a happy dance,” he said with a laugh. “It was kind of hard saying that part of me was just gone. And so a lot of self-worth has come back.”

How did Maida and Carver gain back what dementia had stolen from them?

By participating in what researchers call the first randomized controlled clinical trial to use lifestyle interventions and show cognitive improvement in people with mild cognitive impairment or early dementia due to Alzheimer’s disease.

CNN Chief Medical Correspondent Dr. Sanjay Gupta, left, talks to Mike Carver, right and his wife, Pat. –   © Provided by CNN

‘A study to give us hope’

The study, published Friday in the journal Alzheimer’s Research and Therapy, was small, with only two dozen people receiving treatment and a similar number serving as controls over a short, five-month period. Not everyone showed improvement. Still, for some participants and their families, there were remarkable changes.

The thinking skills of a majority of people in the intervention group stayed the same, a boon since most in the control group declined. Ten people saw their cognition actually improve, while a blood test found levels of amyloid, a hallmark of Alzheimer’s disease, were retreating, said lead study author Dr. Dean Ornish, a clinical professor of medicine at the University of California, San Francisco.

“This is a study to give us hope,” said journalist and former California first lady Maria Shriver, founder of the Women’s Alzheimer’s Movement at Cleveland Clinic in Ohio, which provided early seed funding for the new research.

“This study finally gives us scientific data to support what many of us in this field have believed instinctively for years, that lifestyle interventions may determine the trajectory of people’s Alzheimer’s journeys,” Shriver said in a statement.

Because the clinical trial was only five months long, the results were “astounding,” said co-senior study author Rudy Tanzi, an Alzheimer’s researcher and professor of neurology at Harvard Medical School in Boston.

“If you picture a brain full of damage as a sink full of water, when you just turn off the tap, it takes a long time for that sink to slowly drain, right?” said Tanzi, director of the McCance Center for Brain Health at Massachusetts General Hospital in Boston.

“If you want the amyloid to go down in 20 weeks, as we found on one blood test, you’re going to need a Roto-Rooter.”

That’s exactly what the study did — provide people with a carefully constructed, multipart, intensive lifestyle intervention that targets multiple contributors to cognitive decline. And those who put in the most effort saw the best results.

“There was a statistically significant dose-response relationship between the degree of adherence to our lifestyle changes and the degree of improvement we saw on measures of cognition,” said Ornish, creator of the Ornish diet and lifestyle medicine program, founder and president of the nonprofit Preventive Medicine Research Institute and coauthor of “Undo It!: How Simple Lifestyle Changes Can Reverse Most Chronic Diseases.”

Dr. Dean Ornish speaks to CNN Chief Medical Correspondent Dr. Sanjay Gupta in the documentary “  The Last Alzheimer’s Patient,” streaming June 18 on MAX. – © A. Chris Gajilan/CNN  

“I would describe this as a really positive, small pilot study, a starting point for additional research,” said Dr. Suzanne Schindler, an associate professor of neurology at Washington University School of Medicine in St. Louis.

“I wish we could do a program like this for everyone, not just people with mild cognitive impairment or early stage Alzheimer’s,” said Schindler, who was not involved in the study.

‘Eat well, move more, stress less and love more’

The lifestyle intervention Ornish created — “eat well, move more, stress less and love more” — has been tested before. In 1990, Ornish showed for the first time in a randomized clinical trial that coronary artery disease could often be reversed with nothing more than diet, exercise, stress reduction and social support.

Since then, research has shown the same four-part program can lower blood sugars and heart disease risk in patients with diabetes, reduce prostate cancer cell growth, improve depression and reduce “bad cholesterol.”

“How is it that these same four lifestyle changes stop, and often reverse, the progression of such a wide spectrum of the most common and costly chronic diseases?” Ornish asked.

“It’s because they all share many of the same underlying biological mechanisms: chronic inflammation, oxidative stress, changes in the microbiome, changes in gene expression, changes in immune function and so on,” he said.

“And the lifestyle choices we make every day — what we eat, how we respond to stress, how much exercise we get, how much love and social support we have — can activate or downregulate these different mechanisms.”

Taking care of the heart and the brain

Since what’s good for the heart is good for the brain, Ornish asked, why couldn’t this intervention also work on early Alzheimer’s or other forms of dementia?

“If we found patients didn’t improve at all, that would be disappointing but an important finding — people need to know that,” Ornish said. “But if we found that we could slow, stop or even reverse the progression of Alzheimer’s disease, that would be an important finding as well.”

To find out, Ornish and professors from other leading academic centers began recruiting patients into a new study. Covid-19 hit, which stalled progress until the team realized it could offer the intervention via video conference calls.

“That was a game changer because before you had to live near a hospital or clinic that we trained in our program, and most people don’t,” Ornish said. “Now you can live anywhere, even a food desert or rural area.”

Fifty-one people were selected for the study, then randomized into two groups: One group would consume a vegan diet, do daily aerobic exercise, practice stress reduction and engage in online support groups for 20 weeks, while the control group would not.

A nutritionist held hour-long video classes on diet, while a therapist led equally lengthy group sessions three times a week in which participants shared their feelings and received support.

Each day a fitness instructor led online strength training exercises and encouraged 30-minute daily walks. Meditation, deep breathing, yoga and other ways to reduce stress took up another hour every day. The program also encouraged participants to prioritize good quality sleep.

Omega 3 Fatty Acids to Fight Dementia – Search

Supplements were provided to everyone in the intervention group. They took a daily multivitamin, omega-3 fatty acids with curcumin, coenzyme Q10, vitamin C and B12, magnesium, a probiotic and Lion’s mane mushroom (Hericium erinaceus).

Omega 3 fatty acids to fight metastatic cancer – Search

To be sure the vegan diet was followed, all meals and snacks for both the participant and spouse were delivered to their homes. Calories were unrestricted, but protein and total fat were about 18% of the daily caloric intake — experts say the average American eats twice the amount of protein they need and obtains 36% of daily calories from total fat.

Complex carbs found in whole grains, vegetables, fruits, tofu, nuts and seeds made up most of the diet. 

Sugar, alcohol and refined carbs found in processed and ultra processed foods were taboo.

“A minimally processed diet is key,” said Tanzi, who tests potential treatments for dementia on tiny organoids composed of human brain cells that develop signs of Alzheimer’s.

“The gut microbiome loves all the fiber from the whole grains, fruits and vegetables,” Tanzi said. “My lab has shown in animals that a happy gut can trigger metabolites to the brain, which induce microglial cells to eat more of the amyloid in the brain.”

Microglial cells are the brain’s housekeepers, responsible for tidying up synapses, taking out cellular trash and gobbling up nasties such as amyloid. They do most of their work at night during key stages of sleep.

But when neurons die due to injury, age or a disease such as Alzheimer’s, microglia become sidetracked, turning into killers to fend off whatever seems to be damaging the brain, Tanzi said. Doing so can unleash a cytokine storm, ramping up inflammation and causing further brain injury.

Lifestyle changes can help microglia get back on track, Tanzi said. Besides a high-fiber diet, aerobic exercise and plenty of good quality sleep also encourage microglial cells and other amyloid-clearing enzymes to do their jobs.

“Exercise and sleep induce clearance of amyloid in different ways than the gut microbiome,” Tanzi said. “Combining them is a powerful tool.”

In fact, microbiome tests of the study participants found two of the organisms that increase the risk of Alzheimer’s went down in the intervention group and up in the control group, Ornish said.

“At the same time, microorganisms believed to be protective against Alzheimer’s went up in the intervention group and down in the control group,” he added.

Improvement for some but not all

Five months into the program, the rest of the results were in. For some, such as Mike Carver and Tammy Maida, the program was life-changing.

In addition to an improvement in his cognition, Carver and his wife, Pat, lost weight and reduced their cholesterol numbers and resting heart rates. Mike’s PSA levels, a test for prostate cancer, looked better than ever before.

Mike Carver told Gupta that he is able to think more clearly and his physical health has improved. – ©  A. Chris Gajilan/CNN

Maida is sleeping better and back to accomplishing the tasks she thought she had to give up due to Alzheimer’s: doing laundry, cooking, voraciously reading books, keeping track of household finances and small business bookkeeping.

“The cloud of the Alzheimer’s diagnosis slowly started to lift,” she told CNN’s Gupta. “Honestly, I am more me than I had been for the years prior to starting Dr. Ornish’s program.”

However, not everyone in the intervention improved. Two people dropped out — one couldn’t give up McDonald’s on the way home from his daily walks.

“It was only a 20-week intervention period with a small sample size of just 24 people,” said John Morris, distinguished professor of neurology and codirector of the Knight Alzheimer’s Disease Research Center at Washington University School of Medicine.

“Only 10 out of 24 people in the intervention group seemed to improve and that meant 14 did not,” said Morris, who was not involved in the study. “Overall, it’s interesting, but it would need to be a larger study, with a more representative sample and a longer treatment period to draw any definite conclusions.”

For people who did the intervention, a blood test called plasma Aβ42/40 showed an “extremely” significant improvement, the study found. The test measures the level of amyloid in the blood, a sign that the microglia in the brain are doing their job. Tests that measure amyloid in different ways did not show improvement, however.

“Unfortunately, not all the biomarkers were showing consistent effects,” said Washington University’s Schindler, who specializes in blood biomarkers.

There was no significant change in a test for amyloid called p-tau 181, considered to be a superior measure of Alzheimer’s risk, Schindler said. Nor was there any change in glial fibrillary acidic protein, or GFAP, another blood biomarker that seems to correlate reasonably well with Alzheimer’s disease.

“If one of these markers improves, you typically see all of them improve, so the fact they did not makes me wonder whether this effect is real,” she said. “If they were to repeat the study with a much larger population for a longer period of time, perhaps more change could be seen.”

Need for empowerment

One of the earliest patients recruited to the study was Cici Zerbe, now in her mid-80s. Six years ago, a neurologist diagnosed her with mild cognitive impairment and dementia due to Alzheimer’s. She knew what that meant.

“My grandmother, she would sit forever and just twiddle her thumbs and stare into space and wouldn’t talk too much,” Zerbe told Gupta, who tracked her progress for five years in the documentary.

“Her mother, they finally put her in a home because her father couldn’t take care of her,” said Zerbe’s husband, John. “My greatest fear was she would end up like her mother and grandmother, where I couldn’t take care of her.”

A lifelong runner, retired educator and matriarch of a large family, Zerbe joined Ornish’s study in 2019. Nearly 5 years later, Zerbe and her husband, who live in Novato, California, are still doing the program, and believe the intervention has turned her life around.

“It’s really helped. I think it’s slowed it down,” her daughter Alicia Manzoni told Gupta.

“I think she’s doing very well,” her husband added. “I was afraid by this time she would be in a home or something.”

After all, it’s the improvement in daily life, not blood or cognitive tests, that is most meaningful to a person with Alzheimer’s and their family, said Washington University’s Morris.

Dr. Sanjay Gupta speaks to CiCi and John Zerbe’s entire family. CiCi is shown wearing white. – 

© A. Chris Gajilan/CNN  

“What matters to the patient in the family is whether they’re able to do the things they normally do,” Morris said. “If they couldn’t read and now, they can read, that’s great. That’s an outstanding achievement.”

For Ornish, who has watched members of his family die from Alzheimer’s, the study’s results are important for one key reason — hope.

“So often when people get a diagnosis of dementia or Alzheimer’s, they are told by their doctors that there is no future, ‘It’s only going to get worse, get your affairs in order.’ That’s horrible news and is almost self-fulfilling,” Ornish said.

“I’m not about false hope, and I’m not saying that everyone will get better,” he added. “I’m here to empower people with the knowledge that if you do change, there is a reasonably good chance that you may slow the progression of the disease and often improve it.”

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