People whose brains have less myelin — the fatty tissue that insulates nerve cells — experience steeper declines in cognition over time, according to an NIA study published in Alzheimer’s & Dementia. The findings show the impact of myelin content as healthy people age and underscore myelin as a potential therapeutic target for neurodegenerative diseases, such as Alzheimer’s and mild cognitive impairment.

Myelin is an insulating layer that forms around nerves, including those in the brain. It helps neurons communicate more efficiently, maintain a healthy water balance, and respond to signals involved in memory formation and other cognitive functions. Previous studies have shown that myelin production slows as people age, but whether changes in myelin are linked to age-related changes in cognition remained unknown. However, some animal study evidence suggests changes in myelin may be responsible for cognitive deficits in neurodegenerative diseases.

For this study, the team of NIA scientists gathered data from 123 cognitively unimpaired adults enrolled in the Baltimore Longitudinal Study of Aging and from the Genetic and Epigenetic Signatures of Translational Aging Laboratory Testing study. The researchers tested several different types of cognition and used magnetic resonance imaging (MRI) brain scans to measure myelin content in the brain. They looked at two different MRI-based measurements to estimate the amount of myelin: myelin water fraction (MWF) and longitudinal relaxation rate (R1).

For both measurements, lower myelin was linked to greater cognitive decline over time. Lower myelin, as measured with MWF, was associated with a steeper decline in executive function, which includes skills such as planning, problem-solving, organization, and multitasking. Lower myelin as measured with R1 was associated with a faster decline in verbal fluency, which measures the ability to retrieve information from memory. These findings contribute to a foundation for further studies that explore how age-related changes in myelin are different in people who develop neurodegenerative diseases.

While, overall, this study establishes a meaningful relationship between myelin content and cognition, the authors noted some limitations, mainly that the cohort size was relatively small and included a higher proportion of men and White participants. Future research should reexamine the link in a larger, more diverse study cohort; explore the link between myelin and cognition in people with neurodegenerative diseases; and test whether promoting myelin production could be an effective strategy to prevent disease.

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The MIND and Mediterranean diets — both of which are rich in vegetables, fruits, whole grains, olive oil, beans, and fish — are associated with fewer signs of Alzheimer’s disease in the brains of older adults. Green leafy vegetables in particular were associated with less Alzheimer’s brain pathology. This NIA-funded study, published in Neurology, suggests these diets may help protect the brain from damage caused by Alzheimer’s.

Primarily plant-based, the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) and Mediterranean diets are rich in nutrients important for brain health. The MIND diet features vegetables, especially green leafy vegetables such as spinach, romaine lettuce, and kale; berries over other fruit; and beans, nuts, and one or more weekly servings of fish. The Mediterranean diet consists of vegetables, fruit, legumes, nuts, and at least three servings of fish each week. Both diets also include olive oil, whole grains, and small amounts of wine; and limit red meat.

Previous research has shown these diets may slow cognitive decline and reduce the risk of Alzheimer’s. In this study, researchers at Rush University Medical Center examined the association of these diets with brain changes linked with Alzheimer’s.

The study involved 581 participants who agreed to donate their brains at death for dementia research. On average, the participants began the study with a first dietary assessment at an average age of 84 years. Annually, for more than a decade, they completed questionnaires about the food they ate in various categories. After the participants’ deaths, the researchers examined the donated brains for amyloid plaques and tau tangles, two protein hallmarks of Alzheimer’s.

The researchers also used the questionnaire information to score adherence to the two diets. Higher scores were given to participants who reported eating foods that each diet defined as healthy and reduced scores for unhealthy foods, such as red meat, and high-sugar and high-fat foods.

The brains of participants who had higher diet scores showed fewer signs of Alzheimer’s. This was primarily due to lower levels of amyloid plaques. This trend was not influenced by other lifestyle factors, including physical activity and smoking, or vascular health. There was no correlation between the diet scores and the presence of tangles.

The study’s participants were mostly White, non-Hispanic, and older. Future studies are needed with more diverse populations to examine how different foods affect the brain and the cellular processes involved, such as inflammation. Nonetheless, the findings suggest that diet is an important lifestyle factor that needs further research as an Alzheimer’s prevention strategy.

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What is the difference between Alzheimer’s disease and dementia?

Alzheimer’s disease is a type of dementia. Dementia is a loss of thinking, remembering, and reasoning skills that interfere with a person’s daily life and activities. Alzheimer’s disease is the most common cause of dementia among older people. Other types of dementia include frontotemporal disorders, Lewy body dementia, and vascular dementia.

What are the early signs of Alzheimer’s disease?

Memory problems are typically one of the first signs of Alzheimer’s disease, though different people may have different initial symptoms. A decline in other aspects of thinking, such as finding the right words, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimer’s disease.

What are the stages of Alzheimer’s disease?

Alzheimer’s disease progresses in several stages: preclinical, early (also called mild), middle (moderate), and late (severe). During the preclinical stage of Alzheimer’s disease, people seem to be symptom-free, but toxic changes are taking place in the brain. A person in the early stage of Alzheimer’s may exhibit the signs listed above.

What are the causes of Alzheimer’s disease?

Scientists do not yet fully understand what causes Alzheimer’s disease in most people. In early-onset Alzheimer’s, which occurs between a person’s 30s and mid-60s, there may be a genetic component. Late-onset Alzheimer’s, which usually develops in a person’s mid-60s, arises from a complex series of age-related brain changes that occur over decades. The causes probably include a mix of these changes, along with genetic, environmental, and lifestyle factors. These factors affect each person differently.

Is Alzheimer’s disease hereditary?

Just because a family member has Alzheimer’s disease does not mean that you will get it, too. Most cases of Alzheimer’s are late-onset. This form of the disease occurs in a person’s mid-60s and is not linked to a specific change in genes. However, genetic factors appear to increase a person’s risk of developing late-onset Alzheimer’s.

Is there a cure for Alzheimer’s disease?

Currently, there is no cure for Alzheimer’s disease. Some sources claim that products such as coconut oil or dietary supplements can cure or delay Alzheimer’s. However, there is no scientific evidence to support these claims.

The U.S. Food and Drug Administration (FDA) has approved several drugs to treat people with Alzheimer’s disease, and certain medicines and interventions may help control behavioral symptoms.

Is there a way to prevent Alzheimer’s disease?

Currently, there is no definitive evidence about what can prevent Alzheimer’s disease or age-related cognitive decline. What we do know is that a healthy lifestyle — one that includes a healthy diet, physical activity, appropriate weight, and control of high blood pressure — can lower the risk of certain chronic diseases and boost overall health and well-being. Scientists are very interested in the possibility that a healthy lifestyle might delay, slow down, or even prevent Alzheimer’s. They are also studying the role of social activity and intellectual stimulation in Alzheimer’s disease risk.

Where can I find financial help for people with Alzheimer’s disease or their caregivers?

There are several possible sources of financial help, depending on your situation. Looking into programs offered by the government is a great place to start. Several federal and state programs provide help with healthcare-related costs.

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It’s important to spend meaningful time with a family member or friend who has Alzheimer’s disease or related dementia. Participating together in activities your loved one enjoys can help improve their quality of life and manage behavior changes that may come with the disease, such as sleep problems, aggression, and agitation. It can also help grow and strengthen your connection. However, it may be difficult to know what activities you can safely do with your loved one.

Activities to do around the house

• Make a memory book — look through old pictures together and create a scrapbook.
• Water house and garden plants.
• Listen to their favorite music.
• Watch their favorite show or movie.
• Do an arts and crafts project such as painting or drawing.
• Knit or crochet together.
• Cuddle, feed, or brush a household pet.
• Present an instrument the person used to play such as a piano or guitar. Play, whistle, or sing along.
• Sweep or vacuum.

Activities to keep moving

• Go for a walk on a safe path clear of branches or other obstacles.
• Dance to music the person likes or tap your feet.
• Go to the gym — try walking next to each other on the treadmill or using a stationary bike.
• Lift weights or household items such as filled water bottles.
• Plant flowers.
• Stretch or do yoga.
• Go to a local museum.
• Participate in a water aerobics class.

Activities to engage the mind

• Play a board or card game.
• Work on a puzzle together.
• Read poems or a book together.
• Write cards to other family members and friends.
• Play a computer game.

Activities that promote healthy eating

• Cook together — ask the person about their favorite meal and work together to make it. Or look up healthy cooking videos online and try to make them yourselves.
• Plant vegetables together in the garden or in pots.
• Have a picnic together — bring healthy food options the person likes. Bring a portable or camping chair if the person has trouble sitting on the ground

Activities to stay socially engaged

• Join a dementia-friendly exercise class.
• Invite friends over for tea or snacks.
• See if there is a memory café in your community.
• Plan a video call with a group of friends.
• Join a book club together or start your own with friends and family.
• Host a family game night.

Activities to do with children

• Look through a photo album.
• Paint with watercolors or draw a picture.
• Play with building blocks.
• Listen to music or sing.
• Make tie-dye shirts.

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Published by: AARP

It’s not unusual to have occasional trouble finding the right word or remembering where you put things. But the persistent difficulty with memory, cognition, and ability to perform everyday tasks might be signs of something more serious.

Here are some symptoms to watch for:

1. Difficulty with everyday tasks. Everyone makes mistakes, but people with dementia may find it increasingly difficult to do things like keep track of monthly bills or follow a recipe while cooking, the Alzheimer’s Association says. They may also find it hard to concentrate on tasks, take much longer to do them, or have trouble finishing them.

2. Repetition. Asking a question over and over or telling the same story about a recent event multiple times are common indicators of mild or moderate Alzheimer’s, according to the Cleveland Clinic.

3. Communication problems. Observe if a loved one has trouble joining in conversations or following along with them, stops abruptly in the middle of a thought, or struggles to think of words or the name of objects.

4. Getting lost. People with dementia may have difficulty with visual and spatial abilities. That can manifest itself in problems like getting lost while driving, according to the Mayo Clinic.

5. Personality changes. A loved one who begins acting unusually anxious, confused, fearful, or suspicious, or who becomes upset easily and seems depressed is cause for concern.

6. Confusion about time and place. If someone forgets where they are or can’t remember how they got there, that’s a red flag. Another worrisome sign is disorientation about time — for example, routinely forgetting what day of the week it is, says Jason Karlawish, M.D., a neurologist and professor of medicine at the University of Pennsylvania Perelman School of Medicine and co-director of the Penn Memory Center.

7. Misplacing things. Someone with dementia may put things in unusual places and may have difficulty retracing their steps to find misplaced items, the Alzheimer’s Association notes.

8. Troubling behavior. If your family member seems to have increasingly poor judgment when handling money or neglects grooming and cleanliness, pay attention. 

9. Loss of interest, or apathy. Not feeling especially social from time to time is one thing, but a sudden and routine loss of interest in family, friends, work, and social events is a warning sign of dementia. A new study published in the Journal of Alzheimer’s Disease found that apathy may even be a sign that someone is progressing from mild cognitive impairment (MCI) — symptoms of memory loss or thinking problems that are not as severe as dementia — to Alzheimer’s disease. People with MCI are at an increased risk of developing dementia.

10. Forgetting old memories. Memory loss which becomes more persistent is often one of the first signs of dementia.

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One donated brain can make a huge impact, potentially providing information for hundreds of studies on brain disorders, such as Alzheimer’s and related dementias. Learn about the brain donation process and how to get started.

Why is brain donation important?

Brain donation helps researchers better understand the causes and potential treatments for brain disorders that affect millions of people.

Who can donate?

Anyone over age 18 who has a brain disorder or a healthy brain can donate. Many brains are needed from diverse populations and ages.

What happens to the brain after donation?

A specialist carefully removes the brain through the back of the head in a way that does not affect a person’s appearance. The brain is sent to a brain bank, which distributes tissue samples to qualified researchers. The body is returned to the family for burial or cremation and related ceremonies.

Are there any fees for me or my family?

No, when donating as part of a study or to the brain banks of the National Institutes of Health, there is no cost to the family for the donation procedure.

How do I donate?

Brain donation is different from other organ donations. You can donate by enrolling in a brain donation program or a research study.

What do my family and friends need to do?

Agree on who will contact the brain donation center at the time of death.

How do I talk with my family and friends about brain donation?

Tell them why you want to donate your brain and share what you’ve learned. Talk with them early in your decision-making process. Contact a brain donation center to help answer questions.

Ready to take the next step?

To become a brain donor, consider enrolling in a study that leads to brain donation, such as through the Alzheimer’s Disease Research Centers at www.nia.nih.gov/health/alzheimers-disease-research-centers, or enrolling to donate to the brain banks of the NIH by going to www.braindonorproject.org.

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Published by: AARP

You already know that a bad diet and a permanent indentation on the couch aren’t good for your brain. But there are some lesser-known daily routines that could be undermining your cognition, says Jessica Caldwell, a neuropsychologist and director of the Women’s Alzheimer’s Movement Prevention Center at the Cleveland Clinic. Altering just one of these habits could change how your brain works — and help you age healthier and better. And it’s never too late to start. Even people with memory issues can benefit from altering harmful behaviors.

1. You accentuate the negative

Ruminating on grudges, resentments, and negative thoughts won’t just keep you in a pessimistic mood; it has also been linked to a decline in cognition and memory in people 55 and older, according to a study in the journal. Participants who repeatedly dwelled on negative thoughts had more amyloid and tau deposits in their brains, the biological markers of Alzheimer’s disease.

Next time you’re overtaken by negative thoughts; do the following:

• Make a list of five specific things that you are grateful for and focus on those.
• Take some deep belly breaths, try a new task, or change your focus to something in your environment.
• When a negative thought pops up, greet it with “Hello,” then tell it “Goodbye.”

2. You skip your vaccines

It’s estimated that more than half of Americans blew off the flu shot during the 2021 flu season, and we know that today many people are hesitant about keeping up with COVID-19 boosters. But opting out of vaccinations may be a missed opportunity in the fight against dementia.

3. You drink sugary beverages

If your usual breakfast includes a tall glass of orange juice, take note. A 2017 study associated sugary beverage consumption with poorer episodic memory as well as lower total brain volume and hippocampal volume. And 2022 research found that sugar-sweetened beverages like soft drinks, sweetened tea, fruit drinks, sports drinks, and energy drinks were all significantly linked to 4. You have unhealthy sleep habits

Quality sleep is crucial to a sharp and productive mind, according to the Global Council on Brain Health.

Consistency is one important marker of good quality sleep: Go to bed and wake up at the same time every day. Shift work, changing time zones, chronic stress, and too much caffeine or alcohol can all throw off your rhythm. So, too, can sleeping in a room that’s not cool or dark enough. And if you have symptoms of sleep apnea, such as snoring or daytime sleepiness, see a doctor for declined cognitive function.

5. You crank up your headphones

If it’s bad for your ears, it could very well be bad for your brain. In a study of 639 adults ages 36 to 90, mild hearing loss was associated with a nearly twofold likelihood of dementia.

As a rule, if someone else can hear sound from your earbuds, they’re too loud, says Nicholas Reed, assistant professor at the Johns Hopkins Bloomberg School of Public Health. He also recommends carrying a pair of foam earplugs with you and using them at concerts or sporting events, and removing yourself from loud environments when possible.

6. You regularly take this type of medicine

A wide array of drugs — including tricyclic antidepressants, some overactive bladder medications, and some over-the-counter antihistamines — can block the actions of acetylcholine, a brain chemical important for learning and memory. A study found that higher cumulative use of these drugs was associated with an increased incidence of dementia.

7. You don’t have a sense of purpose

Bosses, kids, spouses — when we’re younger, it seems like everyone is relying on us. But when we get older, freedom from those responsibilities can have a darker side.

“Having a reason to get up in the morning, knowing that people are depending upon you, feeling that you are making important contributions can contribute to healthy aging,” explains Scott Kaiser, M.D., director of Geriatric Cognitive Health at the Pacific Neuroscience Institute.

8. You’re not a fan of flossing

Do you roll your eyes when your dentist tells you to floss? You may want to give it a whirl. “Poor oral hygiene can lead to the buildup of bacteria in the mouth, leading to inflammation of the gums [gingivitis], which if left untreated can lead to a chronic infection called periodontitis,” says Hara. A 2022 study found that poor periodontal health and tooth loss appear to increase the risk of both cognitive decline and dementia.

9. You have a few drinks per week

Even light to moderate drinking can cause reduced brain volume, according to a 2022 study by the University of Pennsylvania. The researchers found that half a beer per day was enough to trigger these changes — and that the link grew stronger the greater the level of alcohol consumption.

So, a 50-year-old who went from one drink a day to two experienced associated changes in the brain equivalent to age two years. And increasing from two to three drinks at that age was like aging the brain by three and a half years.

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Published by: National Institute on Aging

Learn about Alzheimer’s disease

Being informed will help you know what to expect as the disease progresses. Here are some resources:

• Alzheimer’s and Related Dementias Education and Referral (ADEAR) Center:  800-438-4380
• Alzheimer’s Association:  800-272-3900
• Alzheimer’s Foundation of America:  866-232-8484

Local hospitals and community centers may have educational programs about Alzheimer’s disease and related dementias

Get regular medical care

• Make regular appointments with your primary care doctor or specialist (neurologist, neuropsychiatrist, geriatric psychiatrist).
• Consider going to a memory disorders clinic. Ask your doctor for a referral if desired.

Find local services and support

• Find local services by contacting Eldercare Locator: 800-677-1116
• Find local chapters, organizations, and support groups through the Alzheimer’s Association (800-272-3900) or the Alzheimer’s Foundation of America (866-232-8484)
• Contact your local Alzheimer’s Disease Research Center

Do some legal, financial, and long-term care planning

• Get information to help you plan.
• Prepare or update your will, living will, health care power of attorney, and financial power of attorney. To find a lawyer, contact your local bar association or the National Academy of Elder Law Attorneys.
• Learn about the care you may need in the future and how to pay for it.
• Explore getting help to pay for medicines, housing, transportation, and more.

Get help as needed with day-to-day tasks

• Use simple memory aids like a notepad or sticky notes to jot down reminders, a pillbox to keep medications organized, and a calendar to record appointments.
• Ask family members or friends or find local services to help with routine tasks, such as cooking, paying bills, transportation, or shopping.
• Consider using technology solutions for medication management, safety (e.g., emergency response, door alarms), and other care.
• See tips about coping daily, changes in relationships, and more.

Be safe at home

• Get home-safety tips.
• Ask your doctor to order a home-safety evaluation and recommend a home healthcare agency to conduct it. Medicare may cover the cost.
• Consider wearing a medical ID bracelet or necklace in case you get lost or need help, or joining the MedicAlert and Alzheimer’s Association’s Wandering Support program.

Stay safe on the road

• Talk with your doctor if you become confused, get lost, or need lots of help with directions, or if others worry about your driving.
• Get a driving evaluation. Ask your doctor for names of driving evaluators, or visit the American Occupational Therapy Association.
• Learn about driving safety.

Consider participating in a clinical trial

• Ask your doctor about trials or studies.
• Contact an Alzheimer’s Disease Research Center for assessment and potential research opportunities.
• Search for a clinical trial or study near you:
• The Alzheimers.gov Clinical Trials Finder
• Learn more about clinical trials:
• NIA Clinical Trials Information
• National Institutes of Health

Stay healthy

• Be active! Getting exercise helps people with Alzheimer’s feel better and helps keep their muscles, joints, and heart in good shape.
• Eat a well-balanced diet that includes fruits, vegetables, and whole grains.
• Continue to enjoy visits with family and friends, hobbies, and outings.

If you live alone

• Identify someone who can visit you regularly and be an emergency contact.
• If you are at risk of falling, order an emergency response system. A special pendant or bracelet lets you summon help if you fall and can’t reach the phone.
• Consider working with an occupational therapist. This person can teach you ways to stay independent. Ask your doctor for more information.
• Stick with familiar places, people, and routines. Simplify your life.
• Get tips about self-care, safety, staying connected, and more.

If you are working

• If you have problems performing your job, consider reducing your hours or switching to a less demanding position.
• Consider consulting your employer’s HR department or employee assistance program about family leave, disability benefits, and other employee benefits.
• Find out if you qualify for Social Security disability benefits through “compassionate allowances.” Call 800-772-1213.

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