HEALTH AND FITNESS

Write about what works for you - and what does not?

Earlier this year the National Institute of Health (NIH) announced the approval of a special new test called MoCA-H which could lead to a more accurate diagnosis of dementia in people with a hearing impairment.

Why is this very important? There are several connected reasons.

First, it is important because the Montreal Cognitive Assessment (MoCA) is the most sensitive test available for detecting cognitive assessments such as dementia, leading to quicker diagnosis and patient care. The standard MoCA test consists of 30 questions, including three spoken questions. The researchers replaced the three spoken questions with three written questions. The new test was found to be accurate for people with a hearing impairment. 

Second, it is important because another recent study of Medicare beneficiaries showed that about 70% of people seventy and older have some degree of hearing loss. As of 2011, there were about 29 million men in the United States aged 70 or older. Only about 30%, or about 9 million olde goats. used hearing aids. 

Third, it is important because, yet another study shows that midlife hearing loss by itself, without any other risk factor, can cause dementia.

Fourth, about 8% of olde goats have been diagnosed with dementia.

Finally, it is important because the more questions you fail to answer correctly on any MoCA test, the more likely it is that your health care provider will diagnose dementia, leading to treatment and possibly side effects such as loss of self-worth, depression, or loneliness. 

It would be a shame if this was a false diagnosis based on your incorrect answers because your hearing impairment caused you to misunderstand the spoken questions.

How can I avoid this result?

If you have any sense that you are one of the 20 million olde goats whose hearing is not what it used to be, demand and insist that you be given a MoCA-H test. This test will not have any spoken questions. If you are given a MoCA with spoken questions, consider not completing the test and making sure that your medical records reflect your request of the M0CA-H.

   DIY SAGE Test to Catch Signs of Alzheimer’s or Dementia Early
The Self-Administered Gerocognitive Exam (SAGE) is designed to detect early signs of cognitive, memory, or thinking impairments. It evaluates your thinking abilities and helps physicians to know how well your brain is working.This well-regarded test can be taken in the privacy of your home without sharing the results with anyone. If the results concern you, you can ask your medical care provider to analyze them. The well-respected SAGE test was developed by a team led by neurologist Dr. Douglas Scharre at The Ohio State University Wexner Medical Center. More information about the test and its development can be found at https://wexnermedical.osu.edu/brain-spine-neuro/memory-disorders/sage#SAGETestbottomWhy take the SAGE test?“You may want to take SAGE if you are concerned that you might have cognitive issues. Or you may wish to have your family or friends take the test if they are having memory or thinking problems. The difficulties listed can be early signs of cognitive and brain dysfunction. While dementia or Alzheimer's disease can lead to these symptoms, there are many other treatable disorders that also may cause these signs.It is normal to experience some memory loss and to take longer to recall events as you age. But if the changes you are experiencing are worrying you or others around you, SAGE can be a helpful tool to assess if further evaluation is necessary.How to take the SAGE test“You don't need special equipment to take SAGE — just a pen and paper. There are four forms of the SAGE test. You only need to take one. It doesn't matter which one you take; they are all interchangeable.1. Download the test from  https://wexnermedical.osu.edu/brain-spine-neuro/memory-disorders/sage#SAGETestbottom2. Print it out and answer the questions in ink without the assistance of others.3. When you're done, take your answer sheet to your doctor so he or she can score it and talk to you about the results.Don't look at the clock or calendar while taking the test, and if you have questions about an item, just do the best you can. The average time to complete this four-page test is 10 to 15 minutes, but there is no time limit.Depending on your score, your doctor may schedule follow-up tests or simply keep it on file so he can see if there are any changes down the road.Unfortunately, many people do not seek help for these kinds of symptoms until they have experienced them for several years. There are many treatable causes of cognitive and thinking loss, and in some cases, medications or other treatments can be very effective-especially if provided when symptoms first begin.Remember that SAGE does not diagnose any specific condition. The results of SAGE will not tell you if you have Alzheimer's disease, mini-strokes or any number of other disorders. But the results can help your doctor know if further evaluation is necessary.” https://wexnermedical.osu.edu/brain-spine-neuro/memory-disorders/sage#SAGETestbottomTo begin, click the “Download the Test” button. After you consent to the Terms of Use, click on the “Download” button. The test form appears.  Note that you are not required to identify yourself or provide any personal information. If you cannot print a copy, ask a family member, friend, or health care provider to print a blank copy of the test for you.I took the test. The questions are straightforward. You must be honest with yourself in order to help yourself. If you explore this website further, you will find a digital version of the SAGE test offered at the bottom of the site. This is a commercial product. The first test is free but be aware of and be comfortable with the fact that the company requires you to provide payment information to cover the costs if you order subsequent tests,. 

  Article from the National Council on Aging 

Top 6 ways to deal with stress

The good news is, there are some really good stress management strategies anyone can use. Even better, you don’t have to try them all, or all of them at once. Choose one or two approaches that interest you and are realistic.

1. Remove the source

This isn’t always possible, but if you can, try to identify what’s causing your stress and do something to change that. Cliff, for example, got help paying for housing. Linda asked about applying for SNAP benefits. And Charlsie took steps to overcome her technophobia by seeking assistance at her local senior center.

2. Eat well

Following a healthy, balanced diet can boost the immune system, help combat the effects of inflammation, and fuel positive physical energy. And, filling up on bulky, good-for-you fruits and vegetables can prevent “stress-eating” a bag of potato chips or pint of ice cream.

3. Stay hydrated

Drinking enough water yields many health benefits, including improved brain performance. Adding a glass or two a day can help keep you mentally sharp and stabilize your emotions. Plus, keeping yourself hydrated leads to better digestion, eases headaches, and boosts your energy, too. 

4. Exercise

Regular physical activity helps reduce blood pressure, ease arthritis pain, combat chronic illness, and lift your mood. And you don’t have lace up a pair of running shoes and start training for a marathon to reap these benefits, either. Even gentle movement like tai chi can make a world of difference.

5. Get enough sleep

Sleep is essential to good physical and mental health. It’s the time when the body repairs itself and the mind takes a break. In particular, REM (deep) sleep helps regulate mood and memory. Establishing “sleep-friendly” routines can help both to reduce stress-related insomnia and other negative effects. Sleep quality can be improved with a comfortable mattress that fits your sleep preferences.

6. Meditate

Engaging in deep breathing, positive visualization, and other mindfulness practices can help calm racing thoughts, slow a rapid heart rate, relax tensed-up muscles, and create a sense of well-being. There are many different ways to meditate, so take time to explore some approaches and find one that works for you.

Remember: everyone experiences stress from time to time. Being proactive about managing yours can maintain your physical and mental health and well-being so you can age well.

____________________________________________________________________

6 Ways to  Manage Your Life

1. Adapt your home. Stairs, baths, and kitchens can present hazards for older people. Even if you don’t need to make changes now, do an annual safety review so you can make necessary updates if your needs change.
2. Prevent falls. Falls are a big deal for older people — they often result in fractures that can lead to disability, further health problems, or even death. Safety precautions are important, but so are exercises that can improve balance and strength.
3. Consider your housing options. You might consider investigating naturally occurring retirement communities (NORCs). These neighborhoods and housing complexes aren’t developed specifically to serve seniors — and, in fact, tend to host a mix of ages — but because they have plenty of coordinated care and support available, they are senior-friendly.
4. Think ahead  about how to get the help you may need. Meal preparation, transportation, home repair, housecleaning, and help with  financial tasks such as paying bills might be hired out if you can afford it, or shared among friends and family. Elder services offered in your      community might be another option.
5. Plan for emergencies.  Who would you call in an emergency? Is there  someone who can check in on you regularly?  What would you do if you fell and couldn’t reach the phone?  Keep emergency numbers near each phone or on speed dial. Carry a cellphone (preferably with large buttons and a bright screen), or consider investing in some type of personal alarm system.
6. Write advance care directives. Advance care directives, such as a living will, durable power of attorney for health care, or health care proxy, allow you  to explain the type of medical care you want if you’re too sick, confused,  or injured to voice your wishes.  Every adult should have these documents.

A Special Health Report from Harvard Medical School.