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/

Calls for Rhode Island to become more “Age Friendly”

Published in RINewsToday on January 24, 2022

On Aug. 3, 2020, The Decade of Healthy Aging 2020-2030 proposal was endorsed by the 73rd World Health Assembly. It was presented to the U.N. General Assembly Dec. 14, 2020, (Resolution 75/131), leading to the proclamation of a U.N. Decade of Healthy Aging (2021-2030).

The four-page Resolution expressed concern that, despite the predictability of population aging and its accelerating pace, the world is not sufficiently prepared to respond to the rights and needs of older people. It acknowledges that the aging of the population impacts our health systems but also many other aspects of society, including labor and financial markets and the demand for goods and services, such as education, housing, long-term care, social protection and information. It thus requires a total whole-of-society approach to make changes.

The passed Resolution called on the World Health Organization (WHO) to lead the implementation of the decade, in collaboration with the other U.N. organizations. Governments, international and regional organizations, civil society, the private sector, academia and the media are urged to actively support the decade’s goals.

According to WHO,  the world’s population is aging at a swifter pace than any time in the past and this will have an impact on all aspects of society.  There are more than 1 billion people aged 60 years or older, most of these individuals living in low- and middle-income countries. “Many do not have access to even the basic resources necessary for a life of meaning and of dignity. Many others confront multiple barriers that prevent their full participation in society,” says WHO.  

In a December 14, 2020, statement announcing the passage of Resolution 75/131, Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, stated that it “sends a clear signal that it is only by working as one, within the United Nations system and with governments, civil society and the private sector that we will be able to not only add years to life, but also life to years.”

“By adopting a U.N.-wide approach in support of healthy aging, we will be able to galvanize international action to improve the lives of older people, their families and communities, both during the COVID-19 pandemic and beyond,” Dr Etienne Krug, Director of the Department of Social Determinants of Health at added World Health Organization (WHO).

The WHO says that the ongoing COVID-19 pandemic highlights the seriousness of existing gaps in policies, systems and services and a decade of concerted global action is urgently needed to ensure that older people can fulfil their potential in dignity and equality and in a healthy environment.  

WHO’s worldwide initiatives would seek to change “how we think, feel and act toward age and aging; facilitate the ability of older people to participate in and contribute to their communities and society; deliver integrated care and primary health services that are responsive to the needs of the individual; and provide access to long-term care for older people who need it.” 

Healthy Aging Baseline Data Released

Just days ago, WHO released, “Decade of Healthy Ageing: Baseline Report,” in all official U.N. languages, to support member states, academia, civil society, U.N. partners and others to aid in evidence-based decision making on the policies, programmes and services needed to support all people, in particular older persons, to live long and healthy lives.

The Baseline report, released January 20, 2021, brings together data available for measuring healthy aging, defined by WHO as “the process of developing and maintaining the functional ability that enables well-being in older age.”

According to WHO, optimizing “functional ability” is the goal of the Decade of Healthy Aging, which began in 2021 and addresses five interrelated abilities that all older people should enjoy:  the ability to meet basic needs; to continue to learn and make decisions; to be mobile; to build and maintain relationships; and to contribute to society. The report also takes a look at people’s capacities (including physical and mental) and the environments (spanning attitudes, services, natural and built) in which people live, which contribute to functional ability.

The 203-page baseline report, now available in Arabic, Chinese, English, French, Russian and Spanish, introduces the concepts of health aging and strategies for achieving the initiatives goals by 2030. It provides a first-time baseline (in 2020) for healthy aging worldwide and takes a look at what improvements that can be made by 2030.  It documents progress and scenarios for improvement. The report addresses how stakeholders can work together and impact the functional abilities of older people. Finally, it outlines next steps detailing opportunities that can increase collaboration and impact by 2023, the next reporting period.

Is Rhode Island Becoming Age Friendly?   

Maureen Maigret, policy consultant and chair of the Aging in Community Subcommittee of Rhode Island’s Long-Term Care Coordinating Council, says that many Rhode Island communities are involved to 1 degree or another in what we consider age-friendly activities. “The initiative is usually led by the local senior center and in some instances volunteer programs such as RSVP and AARP and The Village Common of RI,” she says.

According to Maigret, over the last five years the state’s Long-Term Care Coordinating Council Aging (LTCCC) in Community Subcommittee has adopted and continues to work to support WHO’s decadelong initiative, adding the domains of Food & Nutrition and Economic Security and Supports to Remain at Home.

Maigret noted that Newport was the first community to join the AARP age-friendly network; Cranston, Providence and Westerly following. The state’s Office of Healthy Aging has adopted its State Plan on Aging, calling for Rhode Island to become an age-friendly state.

Governor Dan McKee’s proposed budget for FY2023 includes an additional $200,000 for local senior programs increasing the total amount to $1 million. Maigret calls for adding an additional  $800,000 so each municipality would be allocated $10 per person aged 65 and over to support local senior programs. Advocates had promoted this since at least 2018 to make up for prior budget cuts and inflation, she says.

Don’t forget improving and expanding the state’s transportation options for older Rhode Islanders who have mobility needs and are no longer able to drive. “This could be accomplished by adding trip types to the state funded Elderly Transportation Program,” she says, noting that trips are now limited for trips to medical appointments, adult day care services, meal sites and Insight. Why not provide trips for older adults to access volunteer activities, she adds.

“We also need to adequately fund our subsidized home care programs by providing realistic reimbursement to address the huge workforce challenges we face,” warns Maigret, noting that seniors are waiting over two months to get service. “This is a travesty,” she says.

“It is tragic that the state’s Office of Healthy Aging is so under resourced in so many areas,” says Maigret, putting the spotlight on the lack of affordable home maintenance and chore services to keep people in their homes. “There is also a need to provide greater supports for our family caregivers who provide the vast majority of caregiving in our state and nation,” she adds. 

Getting Municipalities Involved

Maigret suggests that Rhode Island’s cities and towns review their community’s Comprehensive Plans to see how age-friendliness is addressed. “This is what Newport did. They can also form local Steering Committees to identify local needs and develop recommendations to address them both at the local and state level,” she says.

Governor Dan McKee can also issue an Executive Order directing all state departments and agencies to review programs and policies for age-friendliness and provide incentive funding for local communities to assess their communities. Several states have done this. NY, MA, CO, FL, MI, ME, CA, she says. 

While aging advocates pushed for McKee and lawmakers to allocate ARPA COVID-19 federal funds to make Rhode Island a more age friendly, it’s gotten little attention, says West Warwick resident Vin Marzullo. “Quite frankly its shocking — that there is yet an explicit acknowledgement that the aging community needs resources, support, more collaborative arrangements, to extend living in-place. There seems not to be any sensitivity to the fact that 90% of the COVID deaths were adults 60 and over – and 53% were in congregate care,” says Marzullo, a  well-known aging advocate who served as a federal civil rights and national service administrator.

“The ARPA funds were authorized to be used to ameliorate the impact on the populations, communities, sectors, etc. that were adversely impacted. Our older adults must be in the conversation and not neglected,” says Marzullo.

Maigret agrees. “It is tragic that neither the McKee-Matos’ “Rhode Island 2030 Plan” nor the Rhode Island Foundation report outlining the use of ARPA funds gave sufficient attention to the needs of our state’s older population, she says, warning that this population is increasing, and getting more economically insecure and diverse,” she says.

“When we look at the exceedingly high cost of residential institutional care,  much of which is paid for taxpayers through government programs, we can make a strong case that funding programs helping older persons remain healthy and living in their homes and communities are important investments,” says Maigret. 

To obtain a copy of WHO’s “Decade of Healthy Ageing: Baseline Report,” go to:

https://www.who.int/publications/i/item/9789240017900.

One Year Later – Two Surveys Examine Impact of COVID-19

Published in RINewsToday on May24, 2021

Over the year the raging pandemic has impacted on the physical and mental health of Americans. With daily COVID case counts now the lowest since last year and hospitals seeing less coronavirus hospitalizations, most states, including Rhode Island, are now opening up.

According to the American Psychological Association’s (APA) latest Stress in AmericaTM poll (findings released on March 11, 2021), the nation’s health crisis is far from over. Just one year after the World Health Organization declared COVID-19 a global pandemic, many adults report increased negative behaviors, such as undesired changes to their weight and increased drinking, that may be related to their inability to cope with prolonged stress.

APA’s survey of U.S. adults, conducted in late February 2021 by The Harris Poll, shows that a majority of adults (61 percent) experienced undesired weight changes—weight gain or loss—since the pandemic started, with 42 percent reporting they gained more weight than they intended. Of these individuals, they gained an average of 29 pounds (the median amount gained was 15 pounds) and 10 percent stated they gained more than 50 pounds, noted the poll’s findings.

Gaining Weight Bad for Your Health

Weight changes come with significant health risks, including higher vulnerability to serious illness from COVID-19.  According to the National Institute of Health, people who gain more than 11 pounds are at higher risk of developing Type II diabetes mellitus and coronary heart disease, and people who gain more than 24 pounds are at higher risk of developing ischemic stroke. 

For the 18 percent of Americans who said they lost more weight than they wanted to, the average amount of weight lost was 26 pounds (median amount lost was 12 pounds). Adult respondents also reported unwanted changes in sleep patterns and increased alcohol consumption. Two in 3 (67 percent) said they have been sleeping more or less than desired since the pandemic started. Nearly 1 in 4 adults (or 23 percent) reported drinking more alcohol to cope with their stress.

“We’ve been concerned throughout this pandemic about the level of prolonged stress, exacerbated by the grief, trauma and isolation that Americans are experiencing. This survey reveals a secondary crisis that is likely to have persistent, serious mental and physical health consequences for years to come,” said Arthur C. Evans Jr, PhD, APA’s chief executive officer, in a March 21st statement announcing the results of the study’s findings. 

Evans calls on health and policy leaders to come together quickly to provide additional behavioral health supports as part of any national recovery plan.

The researchers found that the pandemic took a particularly heavy toll on parents of children under 18-years old. While slightly more than 3 in 10 adults (31 percent) reported their mental health has worsened compared with before the pandemic, nearly half of mothers who still have children home for remote learning (47 percent) say that their mental health has worsened; 30 percent of the fathers who still have children home said the same. 

APA’s study also found that parents were more likely than those without children to have received treatment from a mental health professional (32 percent vs. 12 percent) and to have been diagnosed with a mental health disorder since the coronavirus pandemic began (24 percent vs. 9 percent). More than half of fathers (55 percent) reported gaining weight, and nearly half (48 percent) said they are drinking more alcohol to cope with stress.

As to essential workers, (either persons working in health care or law enforcement), the majority said that they relied on a lot of unhealthy habits to get through the year-long pandemic. Nearly 3 in 10 (29 percent said their mental health has worsened, while 3 in 4 (75 percent) said they could have used more emotional support than they received since the pandemic began. Essential workers were more than twice as likely as adults who were not essential workers to have received treatment from a mental health professional (34 percent vs. 12 percent) and to have been diagnosed with a mental health disorder since the coronavirus pandemic started (25 percent vs. 9 percent).

Furthermore, people of color noted that unintended physical changes occurred during the pandemic. Hispanic adults were most likely to report undesired changes to sleep (78 percent Hispanic vs. 76 percent Black, 63 percent white and 61 percent Asian), physical activity levels (87 percent Hispanic vs. 84 percent Black, 81 percent Asian and 79 percent white) and weight (71 percent Hispanic vs. 64 percent Black, 58 percent white and 54 percent Asian) since the beginning of the pandemic.

Black Americans were most likely to report feelings of concern about the future, say the researchers, noting that more than half said they do not feel comfortable going back to living life like they used to before the pandemic (54 percent Black vs. 48 percent Hispanic, 45 percent Asian and 44 percent white).  They also feel uneasy about adjusting to in-person interaction once the pandemic ends (57 percent Black vs. 51 percent Asian, 50 percent Hispanic and 47 percent white).

“It’s clear that the pandemic is continuing to have a disproportionate effect on certain groups,” said APA President Jennifer Kelly, PhD. “We must do more to support communities of color, essential workers and parents as they continue to cope with the demands of the pandemic and start to show the physical consequences of prolonged stress,” says Kelly.

COVID-19’s Impact on Seniors

A newly released AARP study, released on May 10, 2021, has found that more than a year into the coronavirus pandemic, most adults age 50 and older say that it has had a negative impact on their mental health. Researchers found that seven in 10 older adults reported an increase in sadness or depression due to the COVID-19 pandemic, and nearly 8 in 10 said they had increased concern about the future, worry or anxiety. Half of adults 50 and older reported feelings of anxiety in the last two weeks, and 56% noted difficulties falling asleep or staying asleep, say the study’s findings.

“If you are feeling stressed and anxious after the last year, you are far from alone!” said Alison Bryant, Senior Vice President of Research at AARP in a statement announcing the survey results. “As our survey highlights, most older adults’ mental health and wellbeing was affected by the pandemic—and some of the ways we coped might not have been great for our health, either. With many communities returning to normal, we hope older adults will consider taking steps to reclaim their health this spring and summer,” she said.

Coping with the COVID-19 pandemic

According to the AARP study findings, seniors are responding to the increased stress in a variety of ways. About one in four of the respondents reported they are eating comfort foods or “unhealthy foods” like chips and candy more often than before the pandemic. And 27 percent of people 50 and over have increased the time they spend praying or meditating. One in 10 survey respondents reported seeking mental health care in the last year, a third of whom did so specifically because of the pandemic. Overall, 15 percent of older adults said that experiencing the pandemic made them more likely to seek help from a mental health provider if they had concerns.

AARP’s survey also highlighted how the pandemic increased loneliness and isolation among those age 50 and over.  Among older adults, 58 percent reported feeling increased loneliness, and 62 percent were less likely to socialize with friends and family compared to before the pandemic.