AARP report: 6 Pillars of Brain Health – lifestyle changes and community policies

Published in RINewstoday on April 4, 2022

The Washington, DC-based AARP releases its latest Global Council on Brain Health (GCBH) report citing strong scientific evidence that behavior changes and lifestyle habits can positively impact one’s brain health – yet many adults struggle to implement such simple changes.

In a new report released last month, “How to Sustain Brain Healthy Behaviors: Applying Lessons of Public Health and Science to Drive Change,” GCBH outlines how individuals age 50 and over, communities, and policymakers can all take steps to support brain health.

The World Health Organization predicts that the number of people living with dementia is expected to grow to 82 million by 2030 and skyrocketing to 152 million by 2050. The GCBH report notes to lower this expected trajectory it will take “effective behavior and cultural changes, initiated and driven by all the pertinent actors working in concert at all levels of society.”

The 38-page report and its recommendations are based on a review of the current state of science and the consensus of 20 experts from across the world in an array of disciplines, notes the report. GCBH is an independent collaboration of scientists, health professionals, scholars and policy experts from all over the world who are working in the area of brain health related to human cognition to promote brain health.

GCBH’s 38-page report, released March 15, 2022, provides tips to support brain-healthy behavior. Over the past six years, the GCBH has issued reports on broad topics taking a look at whether adults’ behavior and lifestyle style habits could affect their brain health as they grow older.

“While we encourage people to make good decisions, the GCBH recognizes that an effective strategy to enhance brain health must be framed broadly, and that individual choices are made in a larger social and environmental context… Simply putting research findings forward and expecting people to change their behaviors and sustain healthy lifestyles accordingly is unrealistic,” say the report’s authors. 

Calls for Supporting Positive Brain Health

In the latest GCBH report, the authors share what they have learned about how to persuade and motivate people to maintain brain-healthy lifestyles, and how community policies can be shaped to promote this vital goal. 

“We know what works to support brain health – this report focuses on how to make that happen,” says Sarah Lenz Lock, GCBH’s Executive Director. “Our experts have identified specific, practical tips to help older adults, communities and policymakers support the habits that are good for brain health. We show that change is possible, and why supporting brain health for an aging population makes good health and economic sense for communities and society as well as individuals,” Lock says.

“We describe why implementing programs designed to promote brain health for older adults makes good health and economic sense for communities and societies as well as individuals. GCBH experts advise individuals to set specific goals, be realistic about what they choose, and approach their goals step by step,” says the report’s authors. 

“We encourage community-based organizations to create opportunities for peer-to-peer coaching. And we urge policymakers to raise public awareness that people can take steps to help themselves. These and many other recommendations along with a framework for achieving change for individuals, community organizations and policymakers are provided in the final report approved by the GCBH Governance Committee,” they add. 

The GCBH report also calls for addressing the disparities in health and access to care that undermine the cognitive well-being of underserved communities including many African Americans and Hispanics.

Hearing loss, high blood pressure, obesity, and depression are among the health issues that may be linked to cognitive decline and should be properly managed with access to health care.

The Six Pillars of Brain Health

After a careful analysis of scientific findings, GCBH’s report notes that “evidence continues to mount” that people may be able to lower their risks for cognitive decline by engaging in healthy lifestyle behaviors, referred to as the six pillars of brain health.

Specifically put:

“Be social” and continue to maintain and expand your social network.  Keep tabs on family and friends and don’t isolate yourself from others. 

  • Find new interests and hobbies to “engage your brain” and to stimulate your thinking. 
  • Meditate, relax, and maintain a consistent schedule to “manage stress.”
  • Don’t forget the importance of “ongoing” exercise” and schedule at least 2.5 hours of moderate to vigorous exercise a week.  
  • Achieve “restorative sleep” by at least getting 7-8 ours of restful sleep daily.
  • Finally, “eat right” by choosing a nutritious, heart healthy diet to limit high blood pressure, of fish, poultry, nuts, low-fat dairy, vegetables, whole grains, fruits, and vegetable oils. 

The GCBH recommendations urge people to avoid smoking and not drink alcohol.  But if you drink, limit alcohol to more than one drink a day for women and two drinks a day for men.

The Brain-Heart Connection is examined in GCBH’s report.  Hypertension is a serious risk to brain health that can lead to stroke, mild cognitive impairment, or dementia. With knowledge of this, the report notes that people can lower blood pressure by increasing physical activity and reduce overeating, excess drinking, smoking and even reducing sodium (salt) intake.

The GCBH report provides simple, easily obtainable steps to make successful behavioral changes to improve brain health.  Specifically, people can:

Set a goal, identify a specific action you want to take on.

Be thoughtful and realistic about the goals you choose.

Find something that is fun and choose what is enjoyable for you.

Re-purpose some of your free time.

Rethink your environment to reduce the temptations and encourage better choices.

Celebrate the wins.

Learn from the setbacks.

Involve friends and family with common goals to reinforce healthy choices; and

Pick a good start time. 

While brain health behavior changes can be achieved by individuals, these changes require the support health care providers, employers, and community organizations.  Health care providers can help their patients improve their lifestyle habits and make healthy choices to reduce risks and alleviate the symptoms of disease. Employers can promote healthy behaviors too by creating healthier work environments, offering wellness initiatives, health screenings, immunizations, supporting healthy sleep by minimizing shift work, not requiring employees to respond to emails 24/7 and respecting vacations and breaktimes.  These all can promote better brain and mental health, says the GCBH report.

Mission-driven organizations, like AARP, the Arthritis Foundation, and the Heart Association, can also provide individuals with needed information and tools to access their own wellness and motivate a person to make positive behavior changes.

Finally, policymakers can set goals to improve the public’s brain health with a focus on building equity, fighting the sigma of dementia, and implementing best practice to improve brain health from around the world. They can also become aware of how public policies in other areas, such as the built environment, nutrition, and education, can have a lifelong impact on brain health. Some specific examples of successful public health policies include seat-belt laws and smoking cessation requirements.

“A chasm remains between what researchers are discovering about brain health and how little this knowledge has been applied for the public good. Progress will require the combined actions of individuals and communities, reinforced by public policies that facilitate healthy lifestyles,” says the report’s authors. “By applying lessons of public health and science, we can improve brain health for the benefit of individuals, communities and countries around the world,” they say, noting that this report lays out the steps needed to achieve this goal.

The full report on “How to Sustain Brain Healthy Behaviors” is available by going to https://www.aarp.org/content/dam/aarp/health/brain_health/2022-03/gcbh-behavior-change-report-english.doi.10.26419-2Fpia.00106.001.pdf.

To obtain all of the GCBH’s past reports on brain health, go to https://www.aarp.org/health/brain-health/global-council-on-brain-health/resource-library/.

To see how staying socially active impacts brain health, go to https://thriveglobal.com/stories/spumoni-s-where-everybody-knows-your-name-study-says-being-socially-active-may-improve-cognitive-functioning-2/

Report Links Improved Brain Health to Sleep

Published in Pawtucket Times on January 16, 2017

Seven to eight hours of sleep per day may be key to maintaining your brain health as you age, says a newly released consensus report issued the Global Council on Brain Health (GCBH). The report’s recommendations, hammered out by scientists, health professionals, scholars and policy experts working on brain health issues at meeting convened by AARP with support of Age UK, in Toronto, Canada in late July 2016 Toronto, translates the scientific research evidence compiled on sleep and brain health into actionable recommendations for the public.

An AARP consumer survey released this month [in conjunction with GCBH’s report] found that 99 percent of age 50-plus respondents believe that their sleep is crucial to brain health, but over four in 10 (43 percent) say they don’t get enough sleep during the night. More than half (about 54 percent) say they tend to wake up too early in the morning and just can’t get back to sleep.

As to sleep habits, the adult respondents say that the most frequently cited activity that they engage in within an hour of bedtime are watching television and browsing the web. One-third keep a phone or electronic device by their bed. Nearly 88 percent of the adults think a cool bedroom temperature is effective in helping people sleep. Yet only two in five (41 percent) keep their room between 60 and 67 degrees. Finally, the most common reason people walk up during the night is to use the bathroom.

“Although sleep problems are a huge issue with older adults, it’s unfortunate the importance of sleep is often not taken seriously by health care professionals,” said Sarah Lock, AARP Senior Vice President for Policy, and GCBH Executive Director. “It’s normal for sleep to change as we age, but poor quality sleep is not normal. Our experts share [in GCBH’s report] the steps people can take to help maintain their brain health through better sleep habits,” said Lock, in a statement released with the report.

Sleep Vital to Brain Health

The new GCBH recommendations cover a wide range of sleep-related issues, including common factors that can disrupt sleep, symptoms of potential sleep disorders, and prescription medications and over-the-counter (OTC) sleep aids. The consensus report is jam-packed with tips from experts, from detailing ways to help a person fall asleep or even stay asleep, when to seek professional help for a possible sleep disorder, and the pros and cons of taking a quick nap.

Based on the scientific evidence, the GCBH report says that sleep is vital to brain health, including cognitive function, and sleeping on average 7-8 hours each day is related to better brain and physical health in older people.

The 16-page GCBH consensus report notes that the sleep-wake cycle is influenced by many different factors. A regular sleep-wake schedule is tied to better sleep and better brain health. Regular exposure to light and physical activity supports good sleep, says the report.

According to the GCBH report, people, at any age, can change their behavior to improve their sleep. Persistent, excessive daytime sleepiness is not a normal part of aging. Sleep disorders become more common with age, but can often be successfully treated. People with chronic inadequate sleep are at higher risk for and experience more severe health problems, including dementia, depression, heart disease, obesity and cancer.

“A 2015 consensus statement of the American Academy of Sleep Medicine and the Sleep Research Society mirrors the recently released GCBH report recommending that a person sleep at least 7 hours per night, notes Dr. Katherine M. Sharkey, MD, PhD, FAASM, Associate Professor of Medicine and Psychiatry and Human Behavior who also serves as Assistant Dean for Women in Medicine and Science. “Seven to eight hours seems to be a ‘sweet spot’ for sleep duration,” she says, noting that several studies indicate that sleeping too little or too much can increase risk of mortality.

More Sleep Not Always Better

Sharkey says that individuals with insomnia sometimes use a strategy of spending more time in bed, with the idea that if they give themselves more opportunity to sleep, they will get more sleep and feel better, but this can actually make sleep worse. “One of the most commonly used behavioral treatments for insomnia is sleep restriction, where patients work with their sleep clinician to decrease their time in bed to a time very close to the actual amount of sleep they are getting,” she says, noting that this deepens their sleep.

Sleep apnea, a medical disorder where the throat closes off during sleep, resulting in decreased oxygen levels, can reduce the quality of sleep and is often associated with stroke and other cardiovascular diseases, says Sharkey. While sleep apnea is often associated with men (24 percent), it also affects nine percent of woman and this gender gap narrows in older age, she notes.

Many older adults who were diagnosed with sleep apnea many years ago often times did not pursue medical treatment because the older CPAP devices were bulky and uncomfortable, says Sharkey, who acknowledges that this technology is much better today.

“We know how many questions adults have about how much sleep is enough, and the role that sleep plays in brain health and cognitive function,” said Marilyn Albert, Ph.D., GCBH Chair, Professor of Neurology and Director of the Division of Cognitive Neuroscience at Johns Hopkins University in Baltimore, Maryland. “This [GCBH] report answers a lot of these questions and we hope it will be a valuable source of information for people,” she says.

Simple Tips to Better Sleep

Getting a goodnights sleep may be as easy as following these tips detailed in the 16-page GCBH report.

Consider getting up at the same time every day, seven days a week. Restrict fluids and food three hours before going to bed to help avoid disrupting your sleep to use the bathroom. Avoid using OTC medications for sleep because they can have negative side-effects, including disrupted sleep quality and impaired cognitive functioning.
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The GCBH report notes that dietary supplements such as melatonin may have benefits for some people, but scientific evidence on their effectiveness is inconclusive. Be particularly cautious of melatonin use with dementia patients.

Naps are not always a cure to enhancing your sleep. Avoid long naps; if you must nap, limit to 30 minutes in the early afternoon.

“There has been such a steady stream of revealing brain-health reports that it would seem people would change their habits accordingly,” said AARP Rhode Island State Director Kathleen Connell. “Taking active steps is what’s important – and the earlier the better,” she added.

“The personal benefits are obvious, but we should be aware of the cost savings that better brain health can produce. If people in their
50s get on board, the impact on healthcare costs and a reduced burden of caregiving 20 years down the road could be significant,” Connell added. “At the very least, those savings could help cover other rising costs. We owe it to ourselves and to each other to assess and improve aspects of diet and exercise. And we should not overlook the importance of sleep.”

The full GCBH recommendations can be found here: http://www.globalcouncilonbrainhealth.org. The 2016 AARP Sleep and Brain Health Survey can be found here: http://www.aarp.org/sleepandbrainhealth.

Covering All the Aging Bases in 2017

Published in Pawtucket times on January 1, 2017

As an age beat columnist, it has been a very eventful year in covering aging, health care and medical issues that impact older Rhode Islanders. During 2017, over 42 “fresh” commentaries along with previous printed ones appeared in the Pawtucket Times and Woonsocket Call. Readers were kept abreast on a dazzling array of political issues, including a GOP President and Republican-controlled Congress attempting to whittle popular domestic entitlement programs like Social and Medicare programs, attempts to derail Obamacare, and the passage of the largest tax code changes in the past 30 years.

Throughout 2017, a few of my weekly commentaries drew attention to individuals who worked tirelessly on behalf of older Rhode Islanders. It is important to recognize volunteers who assist Rhode Island’s aging network provide programs and services to the state’s growing older population. One commentary noted Phil Zarlengo tireless efforts, and his receiving AARP’s most distinguished volunteer award. Another commentary gave kudos to the Rhode Island Minority Task Force’s 10 “Everyday Heroes.”

Meanwhile, other commentaries penned that year touched on a wide range of aging issues, from a Senate calling to better protect seniors during disasters, improving your cognitive health, enhancing communication at home, taking a look at how innovative companies help caregiver employees, to taking a look how a person made “lemonade out of life’s lemons” who shared her insight others.

Below are five article, providing you with the breadth and depth of this year’s commentaries. Over 300 commentaries including the below ones can be viewed on my blog, herbweiss.wordpress.com.

1. “Spumoni’s: “Where Everybody Knows Your Name”: Study Says Being Socially Active May Improve Cognitive Functioning,” published I the Feb. 26, 2017 issue of the Woonsocket Call, and one day later in the Pawtucket Times.

Mark and Nancy Shorrock, of Attleboro, Massachusetts, now in their seventies and married for 52 years, began dining at Spumonis twice a week with their children in the 1980s, and remember being drawn to the Italian-style restaurant because of its reputation of serving “good food.” Over the years, as the Shorrock’s three children became more independent and “doing things on their own,” the couple began increasing their trips daily to the Pawtucket resident for dinner since it was so close by. Of course, their network of friends increased, too.

What the Shorrocks know innately, a 24-page report, “The Brain and Social Connectedness: GCBH Recommendations on Social Engagement and Brain Health, “released by the Global Council on Brain Health in February 14, 2017, tells us that larger social networks may positively impact your health, wellbeing, even your cognitive functioning. This report is available at http://www.GlobalCouncilOnBrainHealth.org.

“It’s not uncommon for our social networks to shrink in size as we get older,” said Marilyn Albert, Ph.D., GCBH Chair, Professor of Neurology and Director of the Division of Cognitive Neuroscience at Johns Hopkins University in Baltimore, Maryland. “This report provides many helpful suggestions about the things we can do to improve the quality of our relationships with family and friends, which may be beneficial in maintaining our mental abilities.”

The Brain and Social Connectedness report addresses the social benefits of having pets, the role that age-friendly communities play in fostering social ties, and how close relationships promote both physical health and psychological well-being. The report also covers how social media like Facebook and Skype helps older adults maintain their social connections.

2. “Carvelli: Making Lemonade Out of Life’s Lemons,” published in the April 9, 2017 issue of the Woonsocket Call, and one day later in the Pawtucket Times.
Author and life coach Linda Carvelli believes that everything in life has a purpose and that resilience will get you through any obstacle in your path. She succinctly illustrates this philosophy in her 340 page memoir, “Perfectly Negative: How I Learned to Embrace Life’s Lemons Lessons.” The self-published book details how she faced personal and family tragedy (divorce, becoming unemployed, and caring for her mother and sister with breast cancer who ultimately died, and herself being diagnosed with breast cancer.)

Carvelli a Warren resident, dedicated over twenty years of her professional career to computer technology and project management before writing her first full-length memoir, published in 2016, that reveals how she ultimately came to terms with her life’s mission. That is helping people overcome and learn from the challenges in their daily lives. As a board certified life coach, she brings lessons from her book to people to help them regain control of their lives, discover new perspectives, create more options, and move forward with confidence and courage.

3. “Assistance to Employee Caregivers Good for Everyone’s Bottom Line,” published on June 11 issue of the Woonsocket Call, and one day later in the Pawtucket Times.

In 2017, AARP and the Respect a Caregiver’s Time Coalition (ReACT) released a report detailing innovative practices and policies of 14 organizations (including Fannie Mae, CBS Corporation, Allianz Life, and Emory University) to support their employees with caregiver responsibilities. With the graying of America, supporting caregiver employees should be considered “a potentially new weapon” to attract or retain talented employees, say the researchers, by flexible work arrangements and paid leave policies. And there will be a need for this support.

“Family caregivers juggle their loved one’s needs with their own personal and professional goals every day. AARP hopes this report will encourage more employers understand caregiving and support their employees’ success,” said Nancy LeaMond, executive vice president and chief advocacy and engagement officer in a statement. AARP sponsored the 49-page report.

`According to researchers, interviews with business and human resources executives from the profiled organizations in the report indicated that time and flexibility are what matter most to employees when it comes to balancing work and caregiving. Close to half of the employers interviewed provide paid time off for caregiving as well as emergency backup care and flexible work arrangements.

All offer employee caregivers a combination of information resources, referral services and advice by phone. Most provide resources online, typically through an employee assistance (EAP) or an intranet portal. More than half offer phone consultations or 24/7 expert hotlines. Several interviewees stressed the value of providing on-site, independent eldercare consultants, noting that employees appreciate both the convenience and the respect for their privacy.

4. “Save the Roses and Try These Tips: Six Ways to Improving Communication at Home,” published in the February 5, 2017 issue of the Woonsocket Call, and one day later in the Pawtucket Times

Effective Communication at home with your husband, wife, or partner is key to maintaining a meaningful, healthy, environment and thriving family. Author Donna Mac, a well-known corporate trainer, based in South Eastern, Massachusetts, with 25 years of experience in the broadcasting industry, translates effective corporate communication details tips in her book, “Six Pillars of Effective Communication” which can bring healthy energy into an ailing relationship and bring you closer together with your loved one.

According to Author Donna Mac, president of Rehoboth, MA-based DMacVoice Communications, sexual infidelity, commonly linked to divorce, is not the leading cause for couples separating. The corporate communications expert notes that a recent article in Psychology Today says that whether a partner’s communication “lifts you up or brings you down” is the single largest predictor of divorce.

Mac’s six pillars call for a person to: know and own who they are; understand the audience you are speaking to; master the topic of your conversation; anticipate the questions and reactions to your conversation; “speak to serve” by making sure the conversation is not about you; and be detach from the outcome of your discussion.

5. “Senate Aging Panel Calls for Improved Emergency Preparation and Response,” published in the October 8, 2017 of the Woonsocket Call, and one day later in the Pawtucket Times

In the wake of Hurricanes Irma and Harvey, after the death of at least nine nursing facility residents due to heat-related illness due to sweltering heat at a Hollywood, Florida-based facility that had lost power to run its air conditioner, the Senate Special Committee on Aging put the spotlight on the challenges facing seniors during natural disasters at a hearing on Sept. 20, 2017.

The expert panel detailed a variety of recommendations at this Senate panel hearing. One suggestion included creating registries to quickly locate were residents who are electricity-dependent live, for swift evacuations. Another called for fully funding the Federal Emergency Management Agency (FEMA) and investing in weather surveillance tools for better decision making.

Other recommendations included: requiring nursing and assisted living facilities have emergency evacuation plans; having support generators in the event of a power failure; gathering more research on what types of patients will benefit from evacuation or sheltering in; only allowing construction of facilities in places that minimize flooding risk; and litigation protection for facilities that abide by regulations and provide care during disaster scenarios.

If you like my weekly coverage of issues of interest to the aging network and older Rhode Islanders, a book compiling 79 of these commentaries is now available for purchase. To order “Taking Charge: Collected Stories on Aging Boldly,” go to http://www.herbweiss.com.