Archives for August 2016

Test of Experimental Alzheimer’s Drug Finds Progress Against Brain Plaques

( An experimental drug dramatically reduced the toxic plaques found in the brains of patients with Alzheimer’s disease, a team reports in the journal Nature.

Results from a small number of patients who received a high dose of the drug, called aducanumab, hint that it may also be able to slow the loss of memory and thinking.

“If that hint of a clinical benefit is confirmed, it would be a game changer in the fight against Alzheimer’s disease,” says Dr. Eric Reiman, executive director of the Banner Alzheimer’s Institute in Phoenix. Reiman wrote a commentary that accompanies the study in Nature.

But it will take much larger studies to show for sure whether aducanumab really does slow down Alzheimer’s disease, Reiman says.

Officials of Biogen, which is developing the drug, were also cautious about interpreting the results of the study, which included 165 patients in the early stages of Alzheimer’s disease.

“We think we have something important here,” says Dr. Alfred Sandrock, chief medical officer for Biogen.

“We hope we’re right because if it’s true it would benefit millions of patients. But we don’t know we’re right yet.”

The results are encouraging for pharmaceutical companies that have spent billions of dollars on efforts to come up with the first drug to treat the underlying cause of Alzheimer’s. Those efforts have failed to produce a single approved drug so far.

But last summer, Biogen began presenting its results with aducanumab at scientific meetings, including the Alzheimer’s Association International Conference in July. These early reports suggested the drug had a remarkable ability to remove plaques in the brain.

“It was surprising, encouraging and thought-provoking to see such a striking reduction of existing plaques,” Reiman says.

The publication in Nature Wednesday provides details about those early reports.

Biogen has already begun two much larger studies of aducanumab. They will include a total of 2,700 patients, and results are still several years off.

But there are reasons to think aducanumab may succeed where other drugs have failed.

One is that the drug appears to ignore benign forms of amyloid protein while attacking the toxic forms thought to damage brain cells. Another is that aducanumab seems to enhance the ability of existing immune cells in the brain to devour toxins, including amyloid.

But there’s a downside. The process of removing plaque sometimes causes fluid to build up in the brain. In rare cases, it can also cause bleeding. These side effects are known as amyloid-related imaging abnormalities, or ARIA.

“We were actually anticipating that we would see it,” Sandrock says. And the researchers did. Twenty patients dropped out of the trial because of adverse effects.

If aducanumab works in larger studies, it could help settle a long-running debate about whether amyloid is really the root cause of Alzheimer’s. This idea is known as the amyloid hypothesis.

And large studies showing that removing amyloid can preserve memory and thinking “would go a long way toward validating the amyloid hypothesis,” Sandrock says.

Results like those could also lead to the first approved drug to treat the underlying cause of Alzheimer’s rather than just the symptoms.


By Jon Hamilton

© 2016 npr


Comedy Legend Gene Wilder Dies from Alzheimer’s Disease

(UPI) Gene Wilder, the zany, wild-haired and soft-spoken comedian who appeared in nearly 30 films and several stand-up routines, died at his Connecticut home Monday at the age of 83.

Wilder, born as Jerome Silberman in 1933, died as the result of Alzheimer’s Diseaseat his home in Stamford, his family said.

“We understand for all the emotional and physical challenges this situation presented we have been among the lucky ones,” nephew Jordan Walker-Pearlman said in a statement.

“This illness-pirate, unlike in so many cases, never stole his ability to recognize those that were closest to him, nor took command of his central-gentle-life affirming core personality.”

According to family members, Wilder had been ill for an undisclosed period of time but opted to keep his condition private.

“The decision to wait until this time to disclose his condition wasn’t vanity, but more so that the countless young children that would smile or call out to him ‘there’s Willy Wonka,’ would not have to be then exposed to an adult referencing illness or trouble and causing delight to travel to worry, disappointment or confusion,” Walker-Pearlman added.

“He simply couldn’t bear the idea of one less smile in the world.”

Wilder became known for his mild-mannered and unassuming performances in several cult films, including Blazing Saddles (1974), Young Frankenstein (1974), Stir Crazy (1980) and Silver Streak (1976) — and paired up four times onscreen with fellow comedian Richard Pryor, successfully, as a counter balance to his brash and flamboyant characters.

Fellow funnyman and film director Mel Brooks, who collaborated multiple times with Wilder, expressed his sadness upon hearing the news Monday.

“One of the truly great talents of our time. He blessed every film we did with his magic and he blessed me with his friendship,” Brooks said.

He is best known by most, however, for his energetic and vibrant portrayal of the title character in 1971’s Willy Wonka and the Chocolate Factory — a quirky and irreverent British adaptation of the famous children’s book by Roald Dahl.

“Sad day,” Rain Pryor, Richard’s comedienne daughter, said on Twitter on Monday.

“He was always able to make us smile, and that is no small feat. Rest with the stars,” Star Trek actor George Takei tweeted.

“2016 has been painful so far,” actor Zach Braff added, referring to other unexpected deaths this year, including superstar musician Prince.

“He breathed life and joy into everything he touched. Rest in peace,” the 20th Century Fox Film Corporation said in a tweet.

Wilder, who married four times, is survived by his wife of 25 years, Karen Boyer.

“He continued to enjoy art, music, and kissing with his leading lady of the last twenty-five years, Karen,” Walker-Pearlman wrote.

“He danced down a church aisle at a wedding as parent of the groom and ring bearer, held countless afternoon movie western marathons and delighted in the company of beloved ones.”


Copyright © 2016 United Press International, Inc. All Rights Reserved.


Study Strengthens Evidence That Cognitive Activity Can Reduce Dementia Risk

(Massachusetts General Hospital) Are there any ways of preventing or delaying the development of Alzheimer’s disease or other forms of age-associated dementia?

While several previously published studies have suggested a protective effect for cognitive activities such as reading, playing games or attending cultural events, questions have been raised about whether these studies reveal a real cause-and-effect relationship or if the associations could result from unmeasured factors.

To address this question, a Boston-based research team conducted a formal bias analysis and concluded that, while potentially confounding factors might have affected previous studies’ results, it is doubtful that such factors totally account for observed associations between cognitive activities and a reduced risk of dementia.

“Our paper lends support to a potential role for late-in-life cognitive activity in prevention of Alzheimer’s disease,” says Deborah Blacker MD, ScD, director of the Gerontology Research Unit in the Massachusetts General Hospital Department of Psychiatry and senior author of the report in the September issue of the journal Epidemiology.

“While it is possible that socioeconomic factors such as educational level might contribute to the association between cognitive activity and reduced risk, any bias introduced by such factors is probably not strong enough to fully account for the observed association.”

Blacker and her colleagues from Harvard T.H. Chan School of Public Health maintain a database ( on the Alzheimer’s Research Forum website cataloging evidence from observational studies and some clinical trials about known and proposed risk and protective factors for the devastating neurologic disorder. The current paper was developed from the database’s systematic review of studies examining the impact of cognitive activity, conducted by lead author Guatam Sajeev, ScD, as part of his Harvard Chan school dissertation.

The research team analyzed 12 peer-reviewed epidemiologic studies that examined the relationship between late-in-life cognitive activities and the incidence of Alzheimer’s disease or other forms of dementia. The studies were selected on the basis of prespecified criteria for the AlzRisk database, included almost 14,000 individual participants and consistently showed a benefit, sometimes substantial, for cognitive activity.

Since any observational studies are likely to be confounded by unmeasured factors – such as participants’ socioeconomic level or the presence of conditions like depression – the researchers also conducted a bias analysis designed to evaluate how much such factors might influence reported associations between the amount of cognitive activity and dementia risk. This analysis indicated that bias due to unmeasured factors was unlikely to account for all of the association because the impact of such factors is likely to be considerably smaller than the observed effect.

The group also investigated the possible role of reverse causation – whether a reduction in cognitive activity among those already in the long phase of cognitive decline that precedes Alzheimer’s dementia might have led to an apparent rather than a real causal relationship. The findings of that analysis could not rule out the possibility that reverse causation contributed substantially to the observed associations, but analyses restricted to studies with longer term follow-up might be better able to address this question, the authors note.

“Ultimately, clinical trials with long-term follow-up are the surest way to definitively address reverse causation,” says co-author and AlzRisk co-director Jennifer Weuve, MPH, ScD, of Boston University School of Public Health.

“Trials could also confront the vexing question of whether training to improve specific cognitive skills has benefits that extend into everyday functions. But not every question about cognitive activity is well-suited for a trial. To fill those gaps, innovations in epidemiology, such as the analytic techniques used in this study, should help us get even greater insights from available observational data.”

Blacker adds,

“Cognitive activity looks like it may offer some modest protection, and based on our bias analysis, I am somewhat less skeptical than I was previously. But remember that any impact will be relative, not absolute. I typically advise people to engage in cognitive activities that they find interesting and enjoyable for their own sake. There is no evidence that one kind of activity is better than another, so I would advise against spending money on programs claiming to protect against dementia.”


Journal Reference:

Gautam Sajeev, Jennifer Weuve, John W. Jackson, Tyler J. VanderWeele, David A. Bennett, Francine Grodstein, Deborah Blacker. Late-life Cognitive Activity and Dementia. Epidemiology, 2016; 27 (5): 732 DOI: 10.1097/EDE.0000000000000513

Copyright © 2007-2016. The General Hospital Corporation. All Rights Reserved.


Stiff Arteries Linked with Memory Problems

(American Physiological Society) As we age, our arteries gradually become less flexible, making it harder for the heart to pump blood throughout the body. This hardening of the arteries occurs faster in people with high blood pressure and increases the risk for heart problems. Using a new mouse model, researchers have found that stiffer arteries can also negatively affect memory and other critical brain processes.

The new research may eventually reveal how arterial stiffness leads to Alzheimer’s and other diseases involving dementia. The work will be presented at the American Physiological Society’s Inflammation, Immunity and Cardiovascular Disease conference.

“Although the relationship between arterial stiffness and dementia has been hinted in human studies, the mechanisms by which arterial stiffness affects brain functions remain poorly understood,” said study co-author M. Florencia Iulita, PhD, Herbert H. Jasper Postdoctoral Fellow in Neurosciences at the University of Montreal, Canada.

“This is partly due to the lack of good animal models that are specific for this condition.”

To better study arterial stiffness, the researchers modeled the condition in mice by applying calcium chloride to one of the mouse’s carotid arteries. This treatment makes the artery stiff without increasing the animal’s blood pressure or decreasing the blood volume through the carotids, which can themselves damage the brain. With the new animal model, the researchers could study the direct effects of arterial stiffness on the brain’s function and health.

When the mice with stiffened carotids were presented with a task requiring memory, they showed slower learning and remembered less than the healthy mice. The brain vessels of the mice with arterial stiffness were also less responsive to stimuli that normally increase cerebral blood flow when required, suggesting that the brains of these mice might not be getting adequate blood supply to function properly.

The researchers also observed higher levels of amyloid-beta peptides in the brains of mice with arterial stiffness. Amyloid-beta peptides tend to clump together and are found in high amounts in the brains of people with Alzheimer’s disease.

“Our study provides evidence that arterial stiffness negatively affects vital brain processes,” said study coauthor Hélène Girouard, PhD, associate professor at University of Montreal.

“A better understanding of the mechanisms by which arterial stiffness affects brain functions and leads to dementia could allow us to identify new targets for therapeutics that might prevent or delay Alzheimer’s disease in the elderly and hypertensive individuals. Our new animal model will also allow us to test whether drugs that correct arterial stiffness can protect the brain.”


© 2016 The American Physiological Society


Using Multicountry Ecological and Observational Studies to Determine Dietary Risk Factors for Alzheimer’s Disease

J Am Coll Nutr. 2016 Jul;35(5):476-89. doi: 10.1080/07315724.2016.1161566.

Using Multicountry Ecological and Observational Studies to Determine Dietary Risk Factors for Alzheimer’s Disease.

Grant WB1.


Rates of Alzheimer’s disease (AD) are rising worldwide. The most important risk factors seem to be linked to diet. For example, when Japan made the nutrition transition from the traditional Japanese diet to the Western diet, AD rates rose from 1% in 1985 to 7% in 2008. Foods protective against AD include fruits, vegetables, grains, low-fat dairy products, legumes, and fish, whereas risk factors include meat, sweets, and high-fat dairy products.

The evidence comes from ecological and observational studies as well as investigations of the mechanisms whereby dietary factors affect risk. The mechanisms linking dietary risk factors to AD are fairly well known and include increased oxidative stress from metal ions such as copper as well as from advanced glycation end products associated with high-temperature cooking, increased homocysteine concentrations, and cholesterol and its effects on amyloid beta, insulin resistance, and obesity. Lower 25-hydroxyvitamin D concentrations also are associated with increased risk of AD.

In addition to reviewing the journal literature, a new ecological study was conducted using AD prevalence from 10 countries (Brazil, Chile, Cuba, Egypt, India, Mongolia, Nigeria, Republic of Korea, Sri Lanka, and the United States) along with dietary supply data 5, 10, and 15 years before the prevalence data. Dietary supply of meat or animal products less milk 5 years before AD prevalence had the highest correlations with AD prevalence in this study.

Thus, reducing meat consumption could significantly reduce the risk of AD as well as of several cancers, diabetes mellitus type 2, stroke, and, likely, chronic kidney disease.


  • Single-country ecological data can be used to find links between diet and AD because the national diet changes, such as during the nutrition transition to a Western diet.
  • Multicountry ecological studies can be used to find links between dietary factors and risk of AD.
  • Prospective observational studies are useful in linking dietary components and patterns to risk of AD.
  • The most important dietary link to AD appears to be meat consumption, with eggs and high-fat dairy also contributing.
  • Diets high in grains, fruits, vegetables, and fish are associated with reduced risk of AD, but these factors cannot counter the effects of meat, eggs, and high-fat dairy.
  • Higher vitamin D status is associated with reduced risk of AD.


Mediterranean Diet Meal Plan: Week 2

(Good Housekeeping) Welcome to Week 2 of the GH Mediterranean Meal Plan.

If you want to repeat a favorite meal from Week 1 instead of having one of these meals, go ahead.

Monday’s Menu:


• Pancakes and Creamy Ricotta

Have 1 serving of the fluffy pancakes from last Monday’s breakfast. Layer pancakes and spread 1/3 cup fat-free ricotta cheese mixed with 1 tablespoon light maple syrup between pancakes. Pour 2 tablespoons light maple syrup over the pancakes once layering is complete. Serve with 1 small orange and 1 cup fat-free milk.


• Black Bean, Corn, and Tomato Salsa Salad

Combine 3/4 cup canned black beans (rinse in colander to remove sodium) with 1 diced red tomato and 1 cooked ear of corn — scrape the corn from the cob into the mixture. Season with 1/2 teaspoon dried basil, a shake of ground black pepper, 2 tablespoons balsamic vinegar, and 1 teaspoon of olive oil. Mix thoroughly and serve over 2 cups romaine lettuce. Top mixture with 1/3 cup shredded 33% reduced-fat mozzarella cheese. Serve with 1 1/2 cups raspberries.


• Nutty Yogurt

Serve 6 ounces light yogurt, any flavor, topped with 3 tablespoons chopped walnuts and 1/2 cup blueberries.


• Grilled Chicken with Greek Salad

Marinate a 3-ounce chicken breast in 3 tablespoons fat-free Italian dressing at least 30 minutes (can also marinate the chicken overnight). Spray 9 small new potatoes with olive oil or butter-flavored cooking spray and sprinkle with a dash of ground black pepper. Grill the chicken and potatoes. Serve 5 potatoes now and save 4 for Tuesday’s lunch. Serve with 1 1/2 cups romaine lettuce topped with 1 tablespoon sliced black olives, 1/2 ounce crumbled reduced-fat feta cheese, and dressing: Whisk together 2 teaspoons olive oil, 1/2 teaspoon dried basil, 1 tablespoon lemon juice, 1 minced garlic clove, and a few shakes of ground black pepper.

Daily calorie total: 1,485
Fat: 39 g
Percent of daily calories from fat: 23%
Saturated fat: 8.5 g
Percent of daily calories from saturated fat: 5%
Carbohydrate: 200 g
Percent of daily calories from carbohydrates: 53%
Fiber: 43 g
Protein: 93 g
Percent of daily calories from protein: 24%
Cholesterol: 80 mg
Calcium: 1,581 mg
Sodium: 2,539 mg

Still hungry? Check out these low-cal snacks!

Tuesday’s Menu:


• Western-Style Scrambled Eggs and Wheat Toast

Scramble 1 egg plus 2 egg whites (or 1/4 cup egg substitute) with 1/2 chopped bell pepper, any color, and 1/4 cup chopped onion. Season with ground black pepper. Serve with 1 slice whole-wheat toast topped with 2 teaspoons trans-fat-free margarine and 1 cup fat-free milk.


• Veggie Burger with New Potatoes

Heat 1 veggie burger and 4 small potatoes from Monday’s dinner. Top the veggie burger with 1/4 cup shredded cheese and melt in the toaster oven for 2 minutes at 250 degrees. Add 2 tablespoons ketchup and 2 teaspoons spicy mustard if desired. Serve with 2 cups baby spinach leaves topped with 1/4 cup chopped onion and 1/2 chopped bell pepper.


• Raisin Bran, Yogurt, and Pecans

Serve one 6-ounce light yogurt with 1/4 cup raisin bran cereal and 8 pecan halves.


• Tomato Couscous with Asparagus and Crumbled Ground Beef

Cook 2 ounces dry couscous according to package directions. (Try Near East Mediterranean curry couscous.) Grill 4 ounces 90%-92% lean ground beef and 10 spears asparagus sprayed with olive oil nonstick cooking spray. Crumble hamburger into cooked couscous, chop asparagus and add to mixture, and top with 3/4 cup spaghetti sauce from jar. Serve with 4 ounces wine.

Daily calorie total: 1,530
Fat: 42 g
Percent of daily calories from fat: 23%
Saturated fat: 11 g
Percent of daily calories from saturated fat: 6.5%
Carbohydrate: 187 g
Percent of daily calories from carbohydrates: 47%
Fiber: 33 g
Protein: 98 g
Percent of daily calories from protein: 25%
Cholesterol: 292 mg
Calcium: 1,173 mg
Sodium: 3,498 mg

Still hungry? Check out these low-cal snacks!

Wednesday’s Menu:


• Energy Bar in the Car

Have 1 Luna bar (any variety) plus 8 pecan halves and 1 fresh plum. Drink 1 cup fat-free milk before you leave the house.


• Heat-and-Serve Italian with Tomatoes

Heat 1 Healthy Choice Grilled Basil Chicken (or Fettuccini Alfredo or Spaghetti with Meat Sauce). Serve with 15 grape tomatoes. For dessert, have 1 fresh peach dipped in 6 ounces light yogurt, any flavor.


• Flavored Hummus and Veggies

Bring along 15 baby carrots and 1 cup of string beans to dip in 1/4 cup flavored or plain hummus. Serve with 1/4 cup soy nuts.


• Halibut or Snapper on the Grill

Recipe serves 2. Slice 1/2 onion into 1/2-inch circular slices and grill. Fold over aluminum foil several times and fashion into a sturdy 10-inch-diameter bowl with the edges folded up a little to hold the fish and tomatoes. Empty an 8-ounce can diced tomatoes (no salt added) onto the foil bowl. Top the tomatoes with 12 ounces halibut or red snapper. Grill until fish flakes easily with a fork. Serve over 1 cup cooked brown rice (1/2 cup per person). Divide fish and tomatoes and top with grilled onion. For dessert, have a frozen fruit juice bar (limit 90 calories).

Daily calorie total: 1,530
Fat: 39 g
Percent of daily calories from fat: 23%
Saturated fat: 9.3 g
Percent of daily calories from saturated fat: 5.5%
Carbohydrate: 191 g
Percent of daily calories from carbohydrates: 50%
Fiber: 29 g
Protein: 102 g
Percent of daily calories from protein: 27%
Cholesterol: 84 mg
Calcium: 1,328 mg
Sodium: 1,494 mg

Still hungry? Check out these low-cal snacks!

Thursday’s Menu:


• Cereal and Cherries

Have 100 calories of your favorite cereal (1 cup plain flake cereal or 1/2 cup of nuts and/or raisins cereal) topped with 1 cup fat-free milk (drink up what’s left in the bowl) and 1/2 cup pitted fresh cherries (about 12). Have 1 stick of string cheese.


• Tuna Pasta

Combine 1 cup cooked whole-wheat pasta (any shape) with 3 ounces canned, drained white tuna, 1 1/2 tablespoons light mayonnaise, a sprinkle of ground black pepper, 1/4 cup chopped bell pepper, and 1/4 cup chopped onion. Serve with 1 fresh plum.


• Peanut Butter Crackers and Milk

Spread 2 Ak-Mak crackers or 1 Wasa crispbread cracker or 4 reduced-fat triscuits with 1 tablespoon peanut butter. Serve with 1 cup fat-free milk.


• Italian Restaurant

Order chicken marsala or chicken piccata (have a bar-of-soap-size piece of chicken) with a house salad topped with 2 teaspoons olive oil and vinegar or 2 tablespoons full-fat dressing. Have with either a side order of pasta (have 1/2 cup pasta with sauce) or 1 slice of Italian bread (palm-size) topped with 1 teaspoon of butter. Share your leftovers with a friend. Enjoy 4 ounces of wine.

Daily calorie total: 1,589
Fat: 53 g
Percent of daily calories from fat: 30%
Saturated fat: 15g
Percent of daily calories from saturated fat: 8.4%
Carbohydrate: 171 g
Percent of daily calories from carbohydrates: 43%
Fiber: 20 g
Protein: 92 g
Percent of daily calories from protein: 23%
Cholesterol: 152 mg
Calcium: 1,022 mg
Sodium: 2,275 mg

Still hungry? Check out these low-cal snacks!.

Friday’s Menu:


• Smoothie

At Jamba Juice, order a 16-ounce Enlightened Smoothie. Can’t find a Jamba Juice near you? Whip together 1 cup fat-free milk, 1/2 teaspoon vanilla, and 1 cup raspberries or strawberries. Serve with 1 stick of string cheese.


• Breakfast for Lunch

At your favorite diner or family-style restaurant, order French toast. Ask for your order to be made with 2 slices of whole-wheat bread and ask for it to be topped with confectioner’s sugar (use 2 tablespoons if shaking it on yourself). Get a side order of fruit salad (1 cup or the size of a baseball).


• Sour Cream and Chives Spread with Vegetables

Combine 1/2 cup fat-free sour cream with 1 tablespoon dried chives and 1 minced garlic clove. Dip 1 sliced bell pepper, any color, and half a sliced zucchini in the creamy spread.


• Spinach Feta Flatbread

Open one 6 1/2-inch whole-wheat pita bread, layer with 2 tablespoons reduced-fat feta cheese, 3/4 cup baby spinach leaves, 1 chopped scallion, 1/2 teaspoon lemon juice, and a sprinkle of ground black pepper. Spray a nonstick skillet with cooking spray and grill each side of the pita for 2 minutes. Serve with 2 cups spinach leaves topped with 1/8 cup chopped red onion, 1/4 cup diced zucchini, 2 tablespoons full-fat dressing, and 2 tablespoons toasted pine nuts. For dessert, have 1 frozen milk Popsicle (8 ounces fat-free milk mixed with 2 teaspoons chocolate syrup or 1 tablespoon strawberry drink mix, then frozen).

Daily calorie total: 1,434
Fat: 42 g
Percent of daily calories from fat: 25%
Saturated fat: 11 g
Percent of daily calories from saturated fat: 7%
Carbohydrate: 209 g
Percent of daily calories from carbohydrates: 56%
Fiber: 34 g
Protein: 69 g
Percent of daily calories from protein: 19%
Cholesterol: 242 mg
Calcium: 1,516 mg
Sodium: 1,892 mg

Still hungry? Check out these low-cal snacks!

Saturday’s Menu:


• Fluffy Pancakes

Reheat a serving of fluffy pancakes from Monday of Week 1. Top with 1/3 cup fat-free sour cream mixed with 1 tablespoon light maple syrup and 1 cup fresh raspberries. Serve with 1 cup fat-free milk.


• Scrambled Eggs with Feta Cheese

Scramble 1 whole egg with 2 egg whites or 1/4 cup egg substitute, mixed with a sprinkle of ground black pepper and 2 tablespoons fat-free milk. Spray a skillet with nonstick spray, pour in scrambled eggs, and top with 2 tablespoons reduced-fat feta cheese. Serve with a 2-ounce whole-wheat bagel, topped with 1 tablespoon light trans-fat-free margarine, and 1 cup spinach greens with a splash of balsamic vinegar.


• Apple and Peanut Butter

Spread 1 tablespoon peanut butter on 1 sliced apple. Serve with 1 cup fat-free milk mixed with 2 teaspoons chocolate syrup or 1 tablespoon strawberry drink mix.


• Scallops and Orzo

Make 2/3 cup cooked orzo. Slice 1/2 red onion and 1/2 eggplant. (Save the remainder for Sunday dinner.) Prepare a marinade of 1/4 cup Tuscan-style or Italian salad dressing whisked together with 1/2 cup apple juice. Marinate 16 scallops in half the marinade for 30 minutes (put the other half of the marinade aside), then discard that marinade. Cook vegetables on the grill, basting with some of the remaining marinade. Cook scallops on the grill for 2 minutes on each side, then brush with remaining marinade to finish cooking. Top orzo with scallops and grilled vegetables. Serve with 4 ounces wine.

Daily calorie total: 1,462
Fat: 33 g
Percent of daily calories from fat: 21%
Saturated fat: 5 g
Percent of daily calories from saturated fat: 3%
Carbohydrate: 180 g
Percent of daily calories from carbohydrates: 50%
Fiber: 24 g
Protein: 87 g
Percent of daily calories from protein: 21%
Cholesterol: 327 mg
Calcium: 926 mg
Sodium: 2,374 mg

Still hungry? Check out these low-cal snacks!

Sunday’s Menu:


• Ricotta Cheese and Blueberry Mixture

Toast half a 6 1/2-inch whole-wheat pita. (Save other half for dinner.) Break into small pieces or cut into triangles for dipping. Mix 1/2 cup fat-free ricotta cheese with 1 tablespoon honey and 3/4 cup fresh blueberries. Scoop mixture with toasted pita. Serve with 1 cup fat-free milk.


• Sub Shop Lunch

Get the meal deal at Subway, choosing a 6-inch sub on honey wheat or wheat bread. Select from ham, turkey, chicken breast, or roast beef (leave off the cheese!) and top with spicy mustard and/or 1 tablespoon light mayonnaise. Load up on the vegetables, such as green pepper, tomato, cucumber, lettuce, and onion. Add any variety of baked chips (baked Lay’s potato chips or baked Lay’s barbecue potato chips) and a diet soda.


• Fruits and Vegetables with Sweet Sour Cream Spread

Mix 1/2 cup fat-free sour cream with 1 to 2 packets of Equal or Sweet ‘N Low and 1/4 teaspoon vanilla extract. Have with 1 1/2 cups sliced fresh strawberries and 15 grape tomatoes.


• Roasted Mediterranean-Style Vegetables

Serves 2. Slice 1 zucchini, 2 peppers (any color), and the remaining vegetables from Saturday’s dinner (1/2 eggplant and 1/2 red onion). Drizzle the vegetables with 1 tablespoon olive oil, 1 to 2 teaspoons dried oregano, 1/2 teaspoon salt, and a shake of ground black pepper. Wrap completely in foil to form a parcel and roast on the grill for 10 minutes on each side. Serve with remaining half of whole-wheat pita bread from breakfast, toasted for 1 to 2 minutes on the grill. Spread pita with 2 tablespoons hummus.

Daily calorie total: 1,572
Fat: 34 g
Percent of daily calories from fat: 19%
Saturated fat: 6 g
Percent of daily calories from saturated fat: 3.4%
Carbohydrate: 258 g
Percent of daily calories from carbohydrates: 63%
Fiber: 42 g
Protein: 73 g
Percent of daily calories from protein: 18%
Cholesterol: 36 mg
Calcium: 1,301 mg
Sodium: 2,829 mg

Still hungry? Check out these low-cal snacks!


©2016 Hearst Communications, Inc. All Rights Reserved.

Alzheimer’s Disease: Tips for Staying Involved and Active

(Alzheimer’s Society, UK) As a person’s dementia develops, it is likely to have an impact on their ability to carry out certain activities. This fact sheet looks at why it is important to remain active, including maintaining everyday skills. It gives tips to carers on how the person with dementia can continue to take part in everyday tasks, and suggests pastimes that might be suitable at different stages of dementia.

Meaningful activities should be enjoyable, and may be linked to hobbies or interests that the person enjoyed before the diagnosis of dementia. Activities such as taking a walk, cooking or painting can help preserve dignity and self-esteem. Some of the most beneficial activities can be simple, everyday tasks such as setting the table for a meal or folding clothes. They can help a person with dementia feel connected to normal life and can maximize choice and control. Some activities offer an emotional connection with others.

Benefits of Keeping Active and Maintaining Everyday Skills

Keeping occupied and stimulated can improve quality of life for the person with dementia, as well as for those around them. Activities can act as an opportunity for fun and playfulness. They can also encourage independence, social inclusion, communication or expression of feelings.

Benefits to the person with dementia

  • Activities can bring enjoyment and pleasure.
  • By remaining involved and active, a person with dementia can maintain their skills and independence for longer.
  • Activities can help people to express how they are feeling and relieve the symptoms of anxiety and depression.
  • Activities can increase social interaction and reduce isolation.
  • Sharing an activity with others may promote shared interests, increased interactions and understanding.
  • An activity may help a person feel important and valued because it relates to past roles and experiences, such as raising children or helping around the home.
  • Shared activity can promote a sense of belonging.
  • Leading a physically active lifestyle can have a significant impact on well being. Exercise is beneficial for physical and mental health and can improve the quality of life for people at all stages of dementia.

Benefits to carers, family and friends

  • Taking part in activities with a person with dementia can help maintain a good relationship.
  • Activities can offer a break from the everyday caring routine.
  • Shared activities can provide mutual enjoyment and companionship, which can support the relationship between the person with dementia and their carer.
  • Activities can encourage closeness between a person with dementia and people around them and improve feelings of comfort and security.
  • Engaging a person with dementia in meaningful activities may improve behavior that challenges.

Tips: Finding Suitable Activities

It is helpful to talk to the person with dementia about what they enjoy. Take clues from them and try to find creative ways to adapt activities, focusing on what can be done. Try not to worry about getting things wrong first time; this can lead to finding the right activity. The focus of the activity should be on whether someone is enjoying it and that it has meaning for them, not the ‘result’ of the activity itself. The following suggestions may be helpful.


Conversation is a good example of a simple activity that is meaningful and beneficial for a person with dementia. It can take place in any setting, and with most people. It can be a good way for younger family members to engage with the person with dementia. This type of activity can have a positive impact on the wellbeing of the person with dementia.

Even if the person with is having difficulties with verbal communication, non-verbal communication (eye contact, gestures and touching) can be just as meaningful. The important thing is to have a connection through the social interaction.

It is important to involve the person with dementia in the conversation, not cutting them off or talking to others as if the person is not there. Do not assume that someone cannot contribute to a conversation just because they have dementia. Time and support can help the person with dementia make themselves understood and remain involved in the conversation.

Some ideas for aiding conversation can include using different prompts for conversation such as a past job or a favorite sports team, reading a newspaper or magazine together, or using technology such as online videos of old TV shows or events.


Exercise could include gardening, walking or swimming. Exercising together will be beneficial to the person with dementia and anyone accompanying them. Some exercises are appropriate for people with limited mobility, for example chair aerobics or a seated game of bowls.

Exercise can still be beneficial in the later stages of dementia. Exercises at this stage could include changing position from sitting to standing, walking a short distance or moving to a different chair.

Creative pastimes

Creative pastimes can be enjoyable and relaxing for the person with dementia and those supporting them. These could include knitting, woodwork, and painting or drawing. If these pastimes start to become difficult for the person with dementia, it may be possible to adapt them, for example using an easier knitting pattern. If the person with dementia previously did an activity to a high standard, they may be frustrated at not being able to maintain this standard. It may be better to introduce a similar, but completely new, activity. For example, if someone used to enjoy cooking, they may now enjoy growing herbs.

Puzzles and games

People with dementia may enjoy activities that keep their mind active such as crosswords, jigsaw puzzles, cards, board games and electronic games. If the person with dementia struggles with these, it may be possible to simplify them, for example choosing easier card games. Some people also find electronic versions of some puzzles easier to manage.

Activities at home

Activities around the home and garden are very important to people with dementia. They help people feel involved, provide a sense of normality and can help a person’s self-esteem because it shows they can still manage useful tasks. These activities can be enjoyable and can be adapted to a person’s abilities.

It may be that they can be continued with the help of a family member, or with reminders about what needs to be done. There are lots of tasks both indoors and outdoors that can provide opportunity for meaningful activity, such as washing up, dusting, or potting and watering plants. Reading aloud to a person with dementia who enjoys books and newspapers can also be a good joint activity.

People may enjoy activities that reflect past interests and hobbies, and they can be a good way of retaining skills. Examples include cooking a favorite meal or helping in the garden. The end result may not be perfect, but this is less important than the sense of achievement and involvement.


Even when other abilities are severely affected, many people still enjoy activities relating to music. Musical memory is often retained when other memories are lost. There are many ways to enjoy music, including listening, singing, following the rhythm and moving to the music.

Evidence suggests that music can improve someone’s mood, behavior and well-being. Physically responding to the music (through dance or movement to rhythm) can offer a chance for exercise and non-verbal communication. Favorite songs or pieces of music can also be powerful prompts for reminiscence.

Reminiscence (including life story work and memory boxes)

People with dementia can often remember the distant past more easily than recent events. Activities focusing on reminiscence can help improve mood and well being, and promotes social inclusion and seeing the person as an individual with a unique life experience.

It is a good way of helping relatives and friends stay connected as well. here are many ways to initiate conversation and participation in reminiscence, including using photos, creating a life story book or using technology, for example watching memorable events (such as the Olympics, a royal wedding or the moon landings) on a computer or handheld device.

Reminiscence should focus on the individual and their experiences; a person’s memories will have helped shape their present identity. However, it should be noted that not everyone will enjoy reminiscing about the past. The following suggestions for reminiscence activities may be helpful:

  • Involve the person with dementia. It is their life history and talking about it together will be beneficial.
  • Tangible items are an effective way of triggering memories. These could be photos or objects with significance to the person such as a football or quilt.
  • Make up a ‘memory box’, life story book or an attractive display board that captures important elements of the person’s life. Physically handling things may trigger memories more effectively than looking at pictures.
  • A visit to a favorite place might also prompt happy memories and provide another opportunity to get out and about.
  • Dementia damages the memory, and the thinking and reasoning parts of the brain, but emotions remain intact. It is not necessarily a bad thing if the person becomes emotional, although you may uncover painful memories as well as happy ones. Make sure you acknowledge someone’s feelings and allow them to express themselves.
  • Avoid asking very specific questions that require factual responses and could put the person under pressure, for example, asking where and when a photo was taken. The main aim is to enjoy the memories rather than to make the person feel tested in any way.
  • It is important to show a genuine interest in what the person is saying and value their story.
  • Stimulating all a person’s senses is important, as is using verbal and non-verbal communication.
  • Reminiscence may uncover other unknown activities or interests that the person has previously enjoyed.

Activities in the Community

There can be many opportunities for activity and engagement in the local community for people with dementia, their families, friends and carers. These can include art galleries, places of worship, museums and pubs. If the person has links to a community group it can be helpful to maintain these, as it will increase social interaction and provide an opportunity for activity. It may help to discuss the dementia diagnosis so that people in the community are aware of how they can offer support. However, this should only be done with the permission of the person with dementia and if it is what they want.


There are many pastimes that can be undertaken in groups which may help to prevent social isolation or loneliness. They can also create a sense of togetherness and belonging, for example singing or reminiscence groups.


Birthdays and seasonal events can be a good focus for activity and inclusion. They can help to bring people together and reduce social isolation, while helping to focus on the individual.

Involving others

Interactions with others, especially family members and friends who can offer emotional and practical support, are very important for people with dementia. It can be helpful for people other than the main carer to spend time with the person to do something they both enjoy. There are benefits to engaging other people, such as giving the main carer a break and allowing them to recharge their batteries. It gives the person with dementia more varied interaction and more social opportunities, which can lead to improved well being.

Touchscreen technology (such as tablet computers) has real potential to enhance interactions with others. For example, a person with dementia and their carer could use YouTube to watch an old film or play music together.

Applications for video calling (eg. Skype) can help people stay in touch with family and friends who don’t live nearby. The technology can also act as a link between younger and older generations.

Meetings with other people with dementia, and their families, can be rewarding for people with dementia and their carers. They give people the chance to share how they are feeling, offer support and a chance to meet with people in a similar situation.

Activities During the Later Stages of Dementia

As a person’s dementia progresses, they will still be able to carry out some tasks that are very familiar to them, but will probably be more interested in the process of doing the activity than in the end result. Activities can be simplified so they are still manageable.

Tips for finding an activity

  • Look for activities that are stimulating but that don’t involve too many challenges or choices.
  • Dementia often affects people’s concentration so they may not be able to focus on what they are doing for very long. It may be a good idea to do activities in short bursts.
  • Dementia can affect a person’s motivation. You may have to help them get started, but try not to be disheartened if they seem uninterested in the activity. It may be worth coming back to the activity later or trying a different activity.
  • Break instructions down and try to make sure each step of the task
    is simple.
  • Try to think of activities that involve an easy, repetitive action and simple steps, such as sweeping, dusting or watering plants.
  • People with dementia can sometimes crave a sense of structure, so folding or sorting things can be simple but rewarding tasks.

Sensory stimulation

Sensory stimulation is important for people with dementia, and can improve well being and quality of life. During the later stages of dementia, people often develop increased difficulties with reasoning and language, meaning that they may be unable to process information or communicate through words. They will still have some or all of their senses. There are various things you can do to stimulate these senses:

  • Encourage the person to touch or stroke pieces of fabric, dolls or cuddly toys.
  • Try giving the person a hand massage. This can be very soothing for those who enjoy touch. Some people may enjoy using a scented oil such as lavender, although not everyone will like the feel of the oil.
  • Continue to take the time to sit and talk to the person or to read out. Being with somebody sends out a powerful message that they are valued.
  • Help the person to position themselves so that they can see a fish tank, or a window with a nice view. This may have a calming effect.
  • Make sure the person has a regular change of scenery and the stimulation of fresh air and the outdoor environment.
  • If you are visiting a person living in a care home, you can help the person to feel included and active. You might like to take a short walk with them, even if it is just down the corridor, or to bring in something of interest from outside the care home such as flowers or a seashell.

Tips for Helping with a Task or Activity

If you spend time with someone with dementia, you can support and encourage them to do whatever they can for themselves, by only offering as much help as they need. This is not always easy – it can be frustrating watching something being done slowly when you could do it quicker and easier yourself. But even if the person is struggling with a task, try to avoid the temptation to take over. If you do, they may lose confidence and withdraw from engaging in activities.

  • If you do need to offer help, try to do things with, rather than for, the person. This will help them feel more involved and show that you are not taking over or questioning their abilities.
  • Focus on what the person can do rather than what they can’t.
  • Adjust activities as necessary based on a person’s interests and abilities.
  • Their concentration may be affected and they may find it difficult to follow instructions. Try to be patient and allow plenty of time for tasks. Take breaks if necessary.
  • Offer praise, reassurance and encouragement.
  • It is the sense of belonging and involvement that is important, not necessarily the activity itself.
  • Try breaking tasks down into sections. For example, the person may find it easier to continue dressing themselves if you put the clothes out for them in the order that they need to put them on. Or you could pass the next garment to the person, holding it out ready for them to grasp at the right place. You could also encourage them to put their vest on over their head before you straighten it down for them.
  • Even if the person can’t complete a full task, carrying out one or two steps of it – particularly the final step – can give them a sense of achievement.
  • Make sure that any reminders or instructions are simple. Use short sentences, with gestures and body language to add meaning.
  • Be tactful. Try to imagine that you are the person receiving help and speak in a way that you would find helpful if you were in their position.
  • Try doing things together, such as going for a walk, folding clothes or drying dishes.
  • Try to make doing things together a part of your daily routine.
  • Non-verbal communication is very important. Try gesturing, demonstrating, or guiding an action. For example, the person may be able to brush their own hair if you hand them the brush and start by gently guiding their hand.

Tips for Helping with a Sensory Impairment

Sight loss

  • Make the most of the person’s sight – make things such as a calendar or clock bigger, bolder (use contrasting backgrounds) and brighter (use good lighting).
  • If the person with dementia needs glasses, make sure they are the correct ones and that they are clean. It may help to label them.
  • Reduce physical and visual clutter and obstacles.
  • Good communication is important – describe what is happening, for example that you have just come into the room, or what they are eating.
  • Use other senses such as scent, sound, touch and movement. This could include massage, cookery and music.

Think about using versions of daily living items that have been adapted to make them more accessible such as:

  • audio versions of some newspapers, magazines and books
  • tactile and large-print games
  • audio guides (you can create your own) if going out and about
  • kitchen utensils and equipment.

Hearing loss

  • If the person with dementia needs a hearing aid, check that it works and encourage them to use it.
  • Communication is important. Make sure that the person can see your face clearly, get the person’s attention before you start to speak and speak slightly more slowly than usual but try to keep the natural rhythms of your speech.
  • Non-verbal communication is important. Use eye contact and use objects or pictures rather than just describing items.
  • In the physical environment, try to reduce any background noise and ensure that the area is well lit.

The following suggestions might help:

  • Think about where people are sitting.
  • Keep noise levels down.
  • Provide visual information – think about using both words and pictures.
  • As with sight loss use the other senses that the person still has.

Help the person to relax

There are plenty of things you can do to help the person feel calm and secure.

  • Ensure that the person is as close as possible to the people and things that give them pleasure.
  • A relaxing atmosphere could help the person feel calm and secure. This could be through music, people or familiar belongings.
  • Try to ensure familiar surroundings and a regular routine, as this may be reassuring.
  • Physical stimulation such as a cuddle or hand-holding can help the person with dementia feel valued and reassured.
  • Try to avoid too many conflicting sounds or large numbers of people, as this can add to a person’s confusion. If the person needs to concentrate on something in particular, take them to a quiet place.
  • If the person becomes upset or embarrassed by their declining abilities, give them plenty of reassurance. If things do go wrong, be tactful and encouraging. Keeping a sense of humor and having a laugh together can often help.

Memory aids

Memory aids and other reminders can help the person to remain active and use their skills. These may be of most help in the early to moderate stages of dementia when the person is better able to understand the aid and to act upon it.

Ideas include:

  • labeling cupboards and drawers, using pictures and words – for example, a photo of a cup and jar of coffee
  • a large calendar showing the day, month and year
  • a noticeboard for messages
  • notes stuck by the front door
  • a book containing named pictures of significant people such as home carers, or listing important contacts such as the day center.

There are assistive technology aids designed to help people with memory problems. For more information, see Alzheimer’s Society factsheet 437, Assistive technology – devices to help with everyday living.

Consider seeking professional advice

Help may be available if the person with dementia finds it particularly hard to cope with certain activities, either because of the dementia or because of other conditions or disabilities. An occupational therapist (OT) can assess the difficulties and can make recommendations that will aid the person’s independence, safety and confidence when doing certain activities. This may be by adapting the task, by doing things using a different approach or by using assistive technology. You can contact an occupational therapist through:

  • social services (look in the phone book under your local council)
  • your family physician
  • your local memory service (ask your local hospital for details)
  • the College of Occupational Therapists

If the occupational therapist recommends any changes, try to make them as soon as possible, to give the person the best chance of taking in the new information. The earlier you contact an occupational therapist, the more effective their solutions will be.

See also Alzheimer’s Society factsheet 429, Equipment, adaptations and improvements to the home.


Reviewed by: Annette Purves, Specialist Occupational Therapist, Memory Services, Huddersfield and Mr Danny Walsh, Senior Lecturer, School of Health and Social Care, University of Lincoln

This factsheet has also been reviewed by people affected by dementia. A list of sources is available on request.

All content © 2016 Alzheimer’s Society.


Japanese City Takes Community Approach to Dealing with Dementia

( Early mornings are routine for 69-year-old Hiroyuko Yamamoto. He’s typically at a busy intersection in the city of Matsudo, near Tokyo, where he volunteers as a school crossing guard. But one rainy morning a little over a year ago, an old woman caught his attention.


Hiroyuko Yamamoto, a crossing guard in Matsudo, Japan, has been trained in how to recognize and gently approach people who are wandering, or have other signs of dementia, in ways that won’t frighten them. Ina Jaffe/NPR

She was pushing a bicycle. She was kind of disheveled. Despite the rain, she didn’t have an umbrella. When Yamamoto spoke to the woman, she said she was trying to get to the city of Kamisuwa. That’s about four hours away by train.

Yamamoto recognized that the woman had several signs of dementia he’d learned about when he took his city’s dementia awareness training.

Yamamoto volunteers with Matsudo’s Orange Patrol. The organization’s formal name in Japanese — Olenji koe kake tai — translates awkwardly into English as “Troop that calls out to the elderly.” But the name accurately describes what the members do. Yamamoto says that just a simple, “Hello, what a nice day,” can tell you if someone is OK or needs help.

Because of his training, Yamamoto says, he knew how to talk with the old woman pushing the bicycle.

“I talked to her about things that, according to the training manual, would not upset her,” he says.

“And I spoke in a gentle manner.” These things helped him persuade the woman to stay with him until the police arrived about 20 minutes later.

If it hadn’t been for her chance encounter with Yamamoto, the woman might have gone missing, or worse. Last year, 12,208 people with dementia were reported missing to the National Police Agency in Japan. Most were found alive within a week. But 479 were found dead, and 150 were never found.

These numbers have been increasing every year as the number of older people in Japan continues to rise. Nearly 27 percent of the Japanese population is now 65 or older. And, as the number of older people grows, so does the number of people with Alzheimer’s disease or other dementia. The Japanese government expects that by 2025 more than 7 million of the nation’s residents will have dementia.

A comprehensive plan for dealing with that expected rise in dementia cases was passed by the national government last year. But Matsudo has been providing dementia awareness training for city residents since 2010. Thousands of people have taken it.

Atsuko Yoshioka conducts dementia awareness classes for the city of Matsudo. She says the sessions are brief — just 60 to 90 minutes — so she tries to customize the content for students.

For example, pharmacist Takayuki Yoshida says he sometimes had clients who “even after I gave the medication to them, they’d come back and say they didn’t get the drugs.” Now he knows that may be a sign of dementia, and he contacts the patient’s doctor.

Many post office workers have also taken the training. In Japan, post offices also conduct some banking transactions. Hiroki Yaita says sometimes an older client will come in several times to say that someone has stolen their bankbook. Now, because of the training, “we would think that maybe that person has dementia and we would talk to the family about that possibility.”

The purpose of the training isn’t to make Matsudo residents experts in dementia, says Tadashi Watanabe, chief of the city’s Welfare and Longevity Department. The goal, he says, is just “to support those with dementia, as well as their families, and make this a town where it’s more comfortable for them to live.”

Some communities in the United States have begun similar programs. And in Japan what’s been going on in Matsudo is now national policy. The comprehensive plan adopted by the government last year includes research and prevention and nursing services. It also includes a campaign for increasing dementia awareness among the general public. The country is on track to train 8 million people by the end of the next fiscal year.

Hidenori Kawashima, deputy director for dementia policy in Japan’s Ministry of Labor, Health, and Welfare, says the expected rise in dementia cases should not be seen as a threat. Interacting with people with dementia will become normal.

“It would be a familiar thing,” says Kawashima.

“So we wanted the plan: First, to create a structure in the local communities to support those with dementia and, second, to create a society where it will be natural for them to live.”

No government plan can keep people with dementia from wandering. But health officials in Japan hope there eventually will be entire communities prepared to help keep them safe, if and when they do.