DANCING MAKES YOU SMARTER

By Richard Powers: Richard has been teaching historic and contemporary social Senior_dancesdance for 40 years. He leads workshops around the world and is currently a full-time instructor at Stanford University’s Dance Division.

For centuries, dance manuals and other writings have lauded the health benefits of dancing, usually as physical exercise. More recently we’ve seen research on further health benefits of dancing, such as stress reduction and increased serotonin level, with its sense of well-being. More recently we’ve heard of another benefit: Frequent dancing apparently makes us smarter.

A major study added to the growing evidence that stimulating one’s mind by dancing can ward off Alzheimer’s disease and other dementia, much as physical exercise can keep the body fit. Dancing also increases cognitive acuity at all ages.

You may have heard about the New England Journal of Medicine report on the effects of recreational activities on mental acuity in aging. Here it is in a nutshell:

The 21-year study of senior citizens, 75 and older, was led by the Albert Einstein College of Medicine in New York City, funded by the National Institute on Aging, and published in the New England Journal of Medicine. Their method for objectively measuring mental acuity in aging was to monitor rates of dementia, including Alzheimer’s disease.

The study wanted to see if any physical or cognitive recreational activities influenced mental acuity and discovered that some activities had a significant beneficial effect while others had none.
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Cognitive activities such as reading books, writing for pleasure, doing crossword puzzles, playing cards and playing musical instruments were studied; as were physical activities like playing tennis or golf, swimming, bicycling, dancing, walking for exercise and doing housework.

One of the surprises of the study was that almost none of the physical activities appeared to offer any protection against dementia. There can be cardiovascular benefits of course, but the focus of this study was the mind. There was one important exception: the only physical activity to offer protection against dementia was frequent dancing:

Reading – 35% reduced risk of dementia
Bicycling and swimming – 0%
Doing crossword puzzles at least four days a week – 47%
Playing golf – 0%
Dancing frequently – 76%, the greatest risk reduction of any activity studied, cognitive or physical.

NEUROPLASTICITY
What could cause these significant cognitive benefits? Neurologist Dr. Robert Katzman proposed these persons are more resistant to the effects of dementia as a result of having greater cognitive reserve and increased complexity of neuronal synapses. Like education, participation in mentally engaging activities lowers the risk of dementia by improving these neural qualities.

As Harvard Medical School psychiatrist Dr. Joseph Coyle explains in an accompanying commentary: “The cerebral cortex and hippocampus, which are critical to these activities, are remarkably plastic, and they rewire themselves based upon their use.”

Our brain constantly rewires its neural pathways, as needed. If it doesn’t need to, then it won’t.

AGING AND MEMORY
When brain cells die and synapses weaken with aging, our nouns go first, like names of people, because there’s only one neural pathway connecting to that stored information. If the single neural connection to that name fades, we lose access to it. As people age, some of them learn to parallel process, to come up with synonyms to go around these roadblocks.

The key here is Dr. Katzman’s emphasis on the complexity of our neuronal synapses. More is better. Do whatever you can to create new neural paths. The opposite of this is taking the same old well-worn path over and over again, with habitual patterns of thinking and living. . . We need to keep as many of those paths active as we can, while also generating new paths, to maintain the complexity of our neuronal connections. In other words: Intelligence — use it or lose it.

WHY DANCING?
We immediately ask two questions: 1) Why is dancing better than other activities for improving mental capabilities? 2) Does this mean all kinds of dancing, or is one kind of dancing better than another?

. . .The essence of intelligence is making decisions. The best advice, when it comes to improving your mental acuity, is to involve yourself in activities that require split-second rapid-fire decision-making, as opposed to rote memory (retracing the same well-worn paths), or just working on your physical style.

One way to do that is to learn something new. Not just dancing, but anything new. Don’t worry about the probability that you’ll never use it in the future. Take a class to challenge your mind. It will stimulate the connectivity of your brain by generating the need for new pathways. Difficult classes are better for you, as they will create a greater need for new neural pathways.

Then take a dance class, which can be even more effective. Dancing integrates several brain functions at once — kinesthetic, rational, musical, and emotional — further increasing your neural connectivity.

WHO BENEFITS MORE, WOMEN OR MEN?
In social dancing, the Follow role automatically gains a benefit, by making hundreds of split-second decisions as to what to do next, sometimes unconsciously so. As I mentioned on this page, women don’t “follow”, they interpret the signals their partners are giving them, and this requires intelligence and decision-making, which is active, not passive.

This benefit is greatly enhanced by dancing with different partners, not always with the same fellow. With different dance partners, you have to adjust much more and be aware of more variables. This is great for staying smarter longer.

DANCE OFTEN
The study made another important suggestion: do it often. Seniors who did crossword puzzles four days a week had a measurably lower risk of dementia than those who did the puzzles once a week. If you can’t take classes or go out dancing four times a week, then dance as much as you can. More is better. And do it now, the sooner the better. It’s essential to start building your cognitive reserve now. Some day you’ll need as many of those stepping-stones across the creek as possible. Don’t wait — start building them now.

Robin Williams & Lewy Body Dementia

By Lewy Body Dementia Association:Robin Williams

ATLANTA (November 10, 2014) — The recent release of the autopsy and coroner reports on Robin Williams has raised questions about his state of health at the time of his tragic suicide earlier this year.  Some news reports indicate that Mr. Williams had dementia at the time of his death.

The Lewy Body Dementia Association (LBDA) provides information about what can – and cannot – be concluded from these reports.  The autopsy indicated the presence of ‘diffuse Lewy body dementia’ in the brain of Mr. Williams. This is more commonly called ‘diffuse Lewy body disease’ which reflects the biological disease process in the brain.

“The use of the term dementia in the neuropathology report should not be inferred to mean that dementia was observed during life,” warns Dennis Dickson, M.D., Mayo Clinic in Jacksonville, Fla. and member of the LBDA Scientific Advisory Council.

Lewy bodies are mis-folded protein deposits found in the brains of individuals with several different disorders including Parkinson’s disease (PD) and dementia with Lewy bodies (DLB).

According to his wife, Robin Williams was battling “the early stages of Parkinson’s disease” before his death. In early PD, Lewy bodies are generally limited in distribution, but in DLB, the Lewy bodies are spread widely throughout the brain, as was the case with Robin Williams.

Dr. Dickson, who has reviewed the autopsy and coroner’s report, further states, “Mr. Williams was given a clinical diagnosis of PD and treated for motor symptoms. The report confirms he experienced depression, anxiety and paranoia, which may occur in either Parkinson’s disease or dementia with Lewy bodies.”

Both Parkinson’s disease with dementia and DLB are considered Lewy body dementias because of the presence of Lewy bodies in the brain. Collectively, Lewy body dementias are the second most common form of dementia and affect an estimated 1.4 million Americans.

To receive a diagnosis of dementia with Lewy bodies, a person must have significant problems with thinking and memory that interfere with everyday life. There is no mention in the media or in the autopsy report that Robin Williams exhibited these symptoms.  It is not uncommon, however, for early signs of dementia to go undetected. The Mini Mental Status Exam – a common screening test for cognitive impairment and dementia used by many physicians – is not able to detect cognitive impairment in early DLB.

“Further research is needed to better understand why some individuals with diffuse Lewy body disease do not show symptoms of dementia,” according to Dr. Dickson. “In particular, we need to learn how dementia with Lewy bodies differs clinically from Parkinson’s disease when they both share the same underlying disease process.”

DLB and PD share many symptoms, but have different patterns of onset, progression and symptom severity. The most prominent and problematic clinical symptoms in early PD are related to movement, while in DLB they are more likely to be cognitive and psychiatric. However, over the course of both disorders, the symptoms become more and more alike.

A Plea for Better End of Life Care

Dr. Atul Gawande, bestselling author of Being Mortal: Medicine and What Matters in the End.
Atul-Gawande
In order to provide better medical care to the seriously ill, physicians must ask patients about their goals of care and end of life wishes.

Gawande, a general surgeon at Brigham and Women’s Hospital in Boston, addressed hundreds of medical students and physicians at the University of Chicago Medical School… He asked that they listen to patients’ concerns and recognize that prolonging life may not always be the best medical option for the dying.

“We have failed to recognize in medicine and society that people have priorities besides just living longer, that they have aims and goals,” he said. “The most effective way to find peoples’ priorities is to ask. But we don’t ask.” In the hospital setting, the physician often speaks more than the patient, Gawande added.

Some terminally ill patients wish to remain mobile or mentally competent enough to walk their dog or eat at a favorite restaurant; others wish for enough time to say goodbye to loved ones.

“At the end of life, people want to still participate, have a role and make memories,” he said. Because aggressive, often unnecessary, treatments can stymie mobility and cognitive ability, Gawande recommends that doctors familiarize themselves with the benefits of hospice and palliative medicine.

We have failed to recognize in medicine and society that people have priorities besides just living longer, that they have aims and goals.

Gawande urged physicians and nurses to ask their patients if they truly understand the nature of their disease. Only with this understanding can a physician begin to provide guidance, he added. Patients and families would be more comfortable enrolling in earlier palliative treatments if they are told about the benefits soon after diagnosis.

Throughout his new book, Being Mortal, Gawande tackles the negative impacts of some relatively new life-prolonging treatments on the seriously ill.

“I never expected that among the most meaningful experiences I’d have as a doctor — and, really, as a human being — would come from helping others deal with what medicine cannot do as well as what it can,” he writes.

Unfortunately, many medical students avoid pursuing careers in geriatrics – care for the aged and ill – often due to the lower pay and the difficult, often emotional, nature of the work.

The Burden of Stigma

by Ken Clasper, individual living with Lewy Body Dementia
KenClasper
Stigma is a terrible thing, but it’s not something which is new,it has been around for many years.

We have seen stigma in many illnesses,like cancer in the 1950-60s. It has also been attached to Aids, and recently Ebola, yet much of it is caused by old stories and myths, which do not seem to go away; possibly because many people simply believe they are true.

I have been asked on many occasions whether dementia us contagious, something which has left me staggered. Some think you can catch it if someone who has dementia sneezes.

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But I believe much of this stems from the fact that it sometimes seems to run in families; but most of it seems to come from the fact that some forms are called disease, like Lewy Body Dementia, which in some cases is called Lewy Body Disease; just one case in many.

Some charities sometimes call themselves “Alzheimer’s Disease” or “Dementia Disease”, and this also helps keep the stigma going. I suppose this is because professionals cannot decide what to call illnesses; or people call things by different terms and names.But I feel that much of this could be stopped if everyone was educated properly about this illness, rather than picking up odd pieces and trying to find the truth their own way

To educate everyone we should be starting with school children, who are already learning about someone in their families who has the illness. Many of these children want to learn more about what is happening to granny or grand dad, and it’s now time to start helping them understand just what is going on. These are the people who will shape the future in stopping this stigma, and therefore we must help them to help us.

Years ago parents kept their children out of the way, when someone had dementia, but now things have changed for the best, and it would be much better without the stigma. I have also heard stories of people crossing the road, so they did not come into contact with someone who had dementia in their families. This usually happened in very close communities like small villages.

So it’s time to find a way of getting into all schools, to teach all children that stigma, is not a nice thing, no matter which illness it’s attached to. Teachers should allow people with illnesses into schools to help educate those who are our future support.

The Government says that they are dementia friendly, so it’s time they factored this into education. It does not need to be an examination study, just allow us in during free time to speak to children and explain our problems and the stigma which is attached to it.

Let us hope that sometime soon things will change and change for the best. Let us all work to remove all stigma once and for all

Her Name Is Rose

the rose
The first day of school our professor introduced himself and challenged us to get to know someone we didn’t already know. I stood up to look around when a gentle hand touched my shoulder. I turned around to find a wrinkled, little old lady beaming up at me with a smile that lit up her entire being.

She said, ‘Hi handsome. My name is Rose. I’m eighty-seven years old. Can I give you a hug?’

I laughed and enthusiastically responded, ‘Of course you may!’ and she gave me a giant squeeze.

‘Why are you in college at such a young, innocent age?’ I asked.

She jokingly replied, ‘I’m here to meet a rich husband, get married, and have a couple of kids…’

‘No seriously,’ I asked. I was curious what may have motivated her to be taking on this challenge at her age.

‘I always dreamed of having a college education and now I’m getting one!’ she told me.

After class we walked to the student union building and shared a chocolate milkshake. We became instant friends. Every day for the next three months we would leave class together and talk nonstop. I was always mesmerized listening to this ‘time machine’ as she shared her wisdom and experience with me…

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Over the course of the year, Rose became a campus icon and she easily made friends wherever she went. She loved to dress up and she reveled in the attention bestowed upon her from the other students. She was living it up.

At the end of the semester we invited Rose to speak at our football banquet. I’ll never forget what she taught us. She was introduced and stepped up to the podium. As she began to deliver her prepared speech, she dropped her three by five cards on the floor. 
Frustrated and a little embarrassed she leaned into the microphone and simply said, ‘I’m sorry I’m so jittery. I gave up beer for Lent and this whiskey is killing me! I’ll never get my speech back in order so let me just tell you what I know.’

As we laughed she cleared her throat and began, ‘ we do not stop playing because we are old; we grow old because we stop playing. There are only four secrets to staying young, being happy, and achieving success. You have to laugh and find humor every day. You’ve got to have a dream. When you lose your dreams, you die. We have so many people walking around who are dead and don’t even know it! There is a huge difference between growing older and growing up.

If you are nineteen years old and lie in bed for one full year and don’t do one productive thing, you will turn twenty years old. If I am eighty-seven years old and stay in bed for a year and never do anything I will turn eighty-eight. Anybody! Can grow older. That doesn’t take any talent or ability. The idea is to grow up by always finding opportunity in change. Have no regrets. The elderly usually don’t have regrets for what we did, but rather for things we did not do. The only people who fear death are those with regrets.’

She concluded her speech by courageously singing ‘The Rose..’ She challenged each of us to study the lyrics and live them out in our daily lives. At the year’s end Rose finished the college degree she had begun all those years ago.

One week after graduation Rose died peacefully in her sleep. Over two thousand college students attended her funeral in tribute to the wonderful woman who taught by example that it’s never too late to be all you can possibly be.

REMEMBER, GROWING OLDER IS MANDATORY. GROWING UP IS OPTIONAL. We make a Living by what we get. We make a Life by what we give.

Alzheimer’s Claims One Half of Click & Clack

Click & ClackOn Monday, November 3rd, Tom Magliozzi, one half of Car Talk’s Click and Clack, succumbed to complications due to Alzheimer’s. Tom and his brother Ray were experts in soul-cleansing, captivating humor. In honor of what they have brought us for over 35 years, we dedicate this “Featured Expert” space to the joy they brought.  Click on their photo and enjoy.

Staying One Step Ahead of the Mortician

Martin Bayneby: Martin Bayne a journalist, Buddhist monk, MIT graduate, and well-known advocate for the aging. In the nineties, at the peak of his professional career and personal eldercare advocacy, Bayne was diagnosed with Parkinson’s Disease. For the past ten years he has lived in an assisted living facility.

Prior to my diagnosis of Young Onset Parkinson’s Disease in 1994, just before my 44th birthday, the concepts of morbidity and mortality were statistical anomalies; ignored, for the most part, like unwanted relatives. That would change, however, in ways I could not fathom.

Three weeks ago I was taken by ambulance from the Assisted Living Facility (ALF) I now call home, to an acute care hospital ER where I presented with a 103o fever, delirium and difficulty breathing. After eight hours of poking, prodding, blood work and X-rays, I was diagnosed with pneumonia and exacerbation of congestive heart failure. I waited for a bed on an ICU step-down unit to open, and three hours later was admitted to the sixth-floor unit, where a broad-spectrum antibiotic (the first of sixteen IVs) was started in my left antecubital vein.

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A week later and pneumonia-free, I was transferred to a Skilled Nursing Facility for rehab – a move mandated by my ALF. Finally, after two weeks of physical and occupational therapy, I returned home yesterday, closing the circle, and once again cheating the Grim Reaper.

After twelve years of life in an ALF, I’d like to report that going toe-to-toe with death has become just another fact of life. But it hasn’t. In fact, the older I get (now 64), the more I dig in with all the tenacity I can muster to stave off what I know is natural and inevitable.

Americans rarely talk openly about death — the hospice movement is trying to change that, but the chronology of genuine change is more likely to be measured in generations than years.

According to The National Hospice and Palliative Care Organization (NHPCO), the name “hospice” was first applied to specialized care for dying patients by physician Dame Cicely Saunders, who began her work with the terminally ill in 1948 and eventually went on to create the first modern hospice—St. Christopher’s Hospice—in a residential suburb of London. Considered the model for quality compassionate care for people facing a life-limiting illness, hospice provides expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s needs and wishes. Support is provided to the patient’s loved ones as well.

I’ve witnessed a significant number of my fellow residents — in three ALFs, over a twelve year period — drop their bodies and move on. Some transitioned quickly, with no fanfare or goodbyes; often in their sleep, while still others appeared to slowly enter a deep and silent hibernation.

When possible, and the family deemed it appropriate, I would spend time with the dying resident, often holding their hand and reading from an inspirational book or web page (http://DynamicKindess.com) Other times I would merely sit quietly next to their bed, in meditation – never a “pity party,” just a proper Bon Voyage from a fellow human being.Holding Hands 300×195 Staying One Step Ahead of the Mortician

I was particularly moved by “Charles,” a man in his mid-nineties who sat by himself in the dining room, conversed with none of the other residents, and always wore the same faded-grey trousers and blue cardigan sweater. One day I walked over to his table after lunch and extended my hand. He starred at me for what seemed like an eternity. Then, slowly and cautiously he raised his hand to meet mine. When our hands touched, I was moved beyond words, and I watched as a smile spread across his face. After that day, at the end of every meal, I would make my way across the dining room to shake his hand. Neither spoke; but volumes could have been written about the change in each of our lives.

The grey trousers and cardigan sweater? He threw them away and began to wear colorful outfits – and one day walked into breakfast with a muted pink shirt and dark pink sweater. Something inside me said it was his last day on earth, and after his meal was finished, he broke tradition and walked over to my table, taking my hand in his. Tears were already streaming down my cheeks. “Don’t worry,” he said, a smile playing at the corners of his mouth. “Everything will be all right.” That night, Charles died, taking a part of me with him.

Will I have the grace and courage to look death in the eye and smile when it’s my time to pass?

Hard to say. But in the interim, there are hands to shake and lives to touch.