-What’s one small change people can make now that will improve their brain health for the future?

-If I had to pick just one, I would say start exercising.

-You don't want to miss this conversation.

♪♪ I'm Cathleen Toomey, host of Seniority Authority, where we get smarter about growing older.

♪♪ Today, we're diving into one of the biggest concerns on people's minds: brain health.

And we've got the perfect expert to break it all down.

Doctor Maureen O'Connor has spent her career helping us understand memory, dementia and how it can protect our brains as we age.

From her work on the executive committee of Boston University's Alzheimer's Disease and Research Center and director of neuropsychology at the VA Bedford Health Care System, to her roles as a research scientist, educator and leader in Alzheimer's research.

Doctor O'Connor is at the forefront of this incredibly important field.

♪♪ Welcome, Doctor O'Connor.

We're so glad to have you with us today.

We have so much to talk about, but before we dive in, we want to share a real life example that shows that caring for someone with dementia often comes with difficult decisions, especially when that person doesn't recognize they need help.

Let's take a look at Carol's story.

[melancholy guitar] -My mom was perfect.

[Carol chuckles] She was the room mom.

She was the brownie leader.

She was my best friend.

Couldn't have asked for a better mom.

[melancholy music] She started to decline shortly after my father's death.

♪♪ And initially with mom's dementia, we all kind of laughed off the small things that she forgot.

Because we've all done that on occasion, but, over time, some of the small things became a little bigger.

[melancholy music] Mom’s decline, really started to take shape when she married her second husband.

♪♪ My mom was being left home by her husband for hours on end, when it was clear she should not be left alone.

And, I had one visit I got down there and it was abundantly clear that the situation had devolved.

She was turning the burners on on the stove and leaving them on.

Her hygiene was getting worse and worse, and it became clear that it was time for me to step in and get my mom the help she needed.

♪♪ And ultimately, we decided to put mom in a facility in Albany.

♪♪ My mom definitely flourished once she, ♪♪ moved into the memory care facility.

♪♪ She engaged with the other residents.

She made friends.

You know, she was getting three square meals a day.

♪♪ I think a lot of people struggle with putting their parents into a memory care or assisted living facility.

I struggled with that as well.

♪♪ I'm retired, and I thought I should take care of my mom, but it would not be what my mother would want.

♪♪ She would have, been horrified to know that I was giving up that much of my life, for her.

I can be her daughter when she's in the facility in the memory care facility.

I go, I visit, I spend, I would spend 3 or 4 hours with her.

And we would, you know, look at magazines, we would play games, we would work on puzzles.

And it was mom and Carol, not mom and caregiver.

And that's a whole nother dynamic.

So I don't think you should feel guilty you should feel grateful that there are facilities that can handle all of those things for you, so that you can just be your mom's daughter or your mom's son.

-Carol talks about her mom's dementia.

You've written two books on the topic.

Before we begin, can you clarify for us the difference between Alzheimer's and dementia?

-When we say that somebody has dementia, we're really talking about the, presence of, like, three criteria.

One is that the person themselves or somebody in their life is noticing changes in, memory and thinking.

So in Carol's story, she was noticing changes in memory and thinking in, in her mom.

Two is that on objective tests in a provider's office, there are changes in memory and thinking that we can see are not normal for age.

And then three is that those changes in memory and thinking are preventing the person from functioning in everyday life as well as they always have.

And when those three conditions are met, we say that somebody has dementia.

What that doesn't tell us is what the cause of the dementia is and Alzheimer's disease is the most common cause of dementia over the age of 65.

So I, typically will tell people that if they're told that, they or a family member has dementia, the next question that they should ask is caused by what?

-Can you describe, Maureen, what happens in the brain to create this issue?

Because not everyone gets it.

-That's right, it's important to to remember that not everybody gets Alzheimer's disease.

So, all of our brains have proteins.

Substances in our brain that help our brain to function normally, and for simplicity, in Alzheimer's disease, for reasons that are, still poorly understood, the proteins become misshapen, and form clumps that impact our brain's ability to function as it should.

-Okay, okay.

Now, I know many people confuse typical age related memory loss with something more significant.

How can we tell the difference between these two?

-Sure, so the, the first thing that I would tell people is that if you are worried about changes in memory and thinking, you should talk to your doctor, your treating providers about those concerns.

We, we know from research that most older adults that they're worried about changes in memory and thinking never bring it up to to their treating providers.

So, so that would be the first step.

When I think about normal aging, when I see patients in, in my office, in my clinic, and they come in and complain of things like forgetting where they put their keys or, forgetting where they parked their car in a parking lot.

Or things like, I walked into a room and for-- forgot what I went in for.

All of those things sort of sound like normal aging to, to me, when someone is in my office complaining of, different sorts of things.

I may become concerned.

So, for example, you know, you may have difficulty remembering where you parked your car in the parking lot at the grocery store.

But if you're telling me that you have difficulty remembering how to drive to the grocery store that you've been going to for the last 30 or 40 years, then I become a little bit worried.

-Mhm.

-When I hear a family member tell me that, the individual is asking them the same question over and over again, even though they've just answered a couple of minutes ago, then I become worried.

-That's so valuable because I think all of us, as you mentioned, forget a name or forget where you put your keys.

I mean, that happens to me on a regular basis.

What has research uncovered about the impact of the lifestyle on your brain health?

This is, the area that I get really excited to, to talk about -Me too!

[both chuckle] -Right.

So, so I have been talking about the impact of lifestyle factors on brain health for the last 20 years.

And the thing that is so exciting to me is that over that period of time, we have just had more and more research confirming how important lifestyle factors are to keeping our brains healthy.

And in 2024, the Lancet Commission, this is a, multidisciplinary group of experts, recognized this area of work, sort of updated some of their thinking in this area and identified some risk factors that can lead to dementia.

And many of those risk factors are modifiable through lifestyle change.

So I think this really puts us in the driver's seat in terms of what happens to the health of our brain as we get old.

-That's huge, because I think the outdated notion is that it's all determined by genes and if your grandparents have it, then your parents will have it and you will have it, and that, as we learn more, as we put more science behind this research, that's not true.

So, Doctor O'Connor, you've been working on this for 20 years.

You've written two books on the topic, and I am so excited that we have the ability to change our lifestyle to reduce our chance of getting dementia.

What are the 3 or 4 factors that we can change now that will help us in the future?

-So if I could pick four things to have people focus on, I would start with exercise.

Exercise has the largest amount of research behind it when it comes to maintaining the health of our brains.

Diet would be my next pick, and we often talk about things like following a Mediterranean-style diet, which emphasizes things like consumption of fruits and green leafy vegetables.

The third thing would be maintaining our social and, cognitive activity so making sure that we're seeing friends and family, that we're engaged in our communities, that we're learning new things and that we're not isolated.

-Those are great factors, Maureen, but can we get more specific?

So when you say exercise, exactly how much exercise?

When you say Mediterranean diet, what's most important about that particular diet?

Let's get into the nitty gritty.

-Sure, I'd love to.

So when we talk about exercise, a couple of things to mention here.

So what I mean by exercise in terms of the health of our brains is, aerobic or cardiovascular activity, something that gets our heart rate, a little elevated, you know, maybe we're, you know, a little bit out of breath, and the current recommendation is to aim for about 150 minutes of exercise, cardiovascular exercise per week.

So you can think of that as five days, of 30 minutes, each day of exercise as, as a place to start a starting goal.

Strength training and flexibility training also play a role, as recommended, about two days a week but they play a bit of a different role in terms of keeping our brains healthy so again, focused on that sort of cardiovascular activity that 150 minutes a week.

When it comes to the Mediterranean diet, the Mediterranean-style diet emphasizes as I mentioned things like my consumption of fruits and vegetables, particularly in green leafy vegetables, eating good fats, things like olive oil, nuts, avocados, eating fish twice a week, staying, away from, things like processed foods, sugars, reducing our, our meat consumption.

And the thing that is helpful to understand when we think about eating a mediterranean style diet is that we don't need to be perfect.

But just making small changes that get us closer to that Mediterranean-style diet, maybe like having a meatless Monday, or you know, incorporating, spinach or kale into, a couple of meals or trading one of our, you know, chip snacks or cookie snacks for, for fruit.

-Doctor O'Connor, thank you those are great recommendations for us.

But we know that not all dementia can be prevented, and it looks different for everyone.

Let's take a look of an example of a caregiver who expressed her love for her mom through her dementia journey in her photography.

-So my grandmother died at home.

My, my aunt died at home.

My great grandmother died at home.

And my mother was fully intending to die at home like that was something that was discussed, like, please don't put me in a nursing home.

And I think when you grow up hearing that, I mean, there's you really don't have any choice.

♪♪ Being an only child, I had a really close relationship with my mom and so she lived on this property for about 20 years as a totally functioning person she had a career.

She did a lot of gardening.

You know, was very close to her grandchildren.

It was about as wonderful a co-mingling of ages as you can imagine.

My mother was really the one that was kind of saying, like, I'm having trouble remembering how to get home, or there's a woman who calls me and I think she's my sister and her doctor, he's-- he just said dementia is one of those things we're not really sure how it's going to unfold.

So there was no roadmap, there was no promise.

But there also wasn't that sense that there should be.

It was like it was like he was explaining dementia as something that was making me not responsible for the national debt.

We're here together and we love each other, and we'll figure it out as we go.

And there was a lot of tears and a lot of sadness.

Really relied on a lot of my friends, which happened to be artists.

I had a couple friends who I think were teasing me and said, okay, so we want to see some pictures of your mother we've been telling you for a couple of months now you should be making pictures of your mother, and you don't want any part of that, because I felt like it would be be like making pictures of a a wounded bird.

But, you know, I sort of rose to the dare.

And so I told my mother, we're going to make a couple pictures for Joanie and Mary Ellen, but she did this thing that I'll never forget she just kind of went like, oh, okay.

[soft, solemn music] ♪♪ And I were thinking, ♪♪ Huh?

I don't know what just happened.

Like, you're this-- you, you're-- this isn't you somehow hearing the word picture and putting it all together, she sort of intrinsically kind of understood the 1950s of like, oh, let's put our best face forward and, and she kind of got into it and I, we looked at it together and she was like, who's that lady?

♪♪ I shared a couple of them on Instagram, or I posted them on Facebook or I sent them to friends and suddenly they were like, oh, wait, this is, this is crazy like you should be making more of this.

[inspirational music] ♪♪ ♪♪ And all of a sudden it was like these floodgates just opened up.

The more I share, the less pain I'll feel.

♪♪ And then we also had something to do.

For me it got me outside and it got me doing something with her.

I feel like I'm somebody who really likes to make things, build things.

I think for her it was helpful because she, she was outside in the sun, you know, which is something that she innately loved.

She was outside still listening to birds and saying, like, did you hear that?

You know, that's, that's a jay, that's a chickadee, or we could pick blueberries.

And that's what we needed, we needed some things to do, to go outside and get some activity, get some fresh air, get away from sitting at the table and just thinking about how sad it all is.

Hospice was really good about saying to me, like, you had this great relationship, and then all of a sudden she lost her ability to talk to you and you have nothing in common anymore you didn't have any way to communicate.

And all of a sudden the pictures and the art became the new way that you could communicate, and suddenly you're back to having a way to talk.

But, ♪♪ probably most days I just tried to not think about what it was going to be like when she wasn't here anymore.

And it's ironic, because I don't think I saw the pictures as, as something to hold on to.

I've certainly had people say to me like, it's so great that you have these pictures of your mother, because now that she's gone, and I think to myself, well, these aren't pictures of my mother.

My mother was this fully functioning human, and these are pictures about a relationship between two people as one of them was dying.

That's what those pictures are about for me.

-Now that we've seen Carol and Cheryle's story, what's one piece of advice you’d offer to family members caring for someone diagnosed with dementia?

-So I often tell caregivers you can't pour from an empty cup in order to take good care of the person that you're providing care to, you need to take good care of yourself.

Caregivers are often so involved in providing good care to the person that they're caring for, that they neglect their own care.

They don't go to their own medical appointments, even though they take the person with dementia to all of their medical appointments.

They don't socialize as much or sleep as much.

And, you need to be able to care for yourself in order to provide that good care to the other person.

And I will just add that, I had a caregiver that I was talking to about this and he said, oh, right, somebody once told me that I need to put my oxygen mask on first on the plane so that I can help the person next to me.

And I was like, that's exactly it, you need to be able to take care of yourself so that you can take care of the other person.

-Perfect advice.

That's fantastic.

Keep your oxygen mask on if you are caring for someone with dementia.

Now what if you worry that after hearing all this, you might have the start of cognitive loss?

What would you suggest someone do?

-So I think that that brings us back to the beginning of our conversation.

Really have that discussion with your treating provider, with your doctor.

Make sure that your concerns are heard.

So that you can start to understand whether the things that you're worried about are normal for your age or are not normal for your age, so that you can then figure out exactly what you need to to do moving forward.

-Great.

Can you tell us a little bit more about your research with veterans and what you're discovering?

-So, I am currently doing a five year study with veterans, and this is a study looking at the impact of a 12 week class, along with, eight weeks of individual work on lifestyle factors to support brain health.

So, this is a class that I developed along with my colleague, Doctor Malissa Kraft.

It's called AgeWISE, Aging Well Through Interaction and Scientific Education.

And it devotes all 12 weeks to talking much more in-depth about exactly the things that we've been talking about here today.

What normal aging look like, how is that different from diseases of aging like Alzheimer's disease?

What is the latest lifestyle science around how we can keep our brains healthy?

And, and then we teach some tips and tricks for people to function better and have better memory in their everyday life.

And then those folks that go through that class as a group, work with an individual brain health interventionist.

And, that individual work is really getting specific about, for that person what sorts of changes do they want to make in their lifestyle?

What are their, you know, areas of, of weakness?

Do they need to exercise more?

Do they need to improve their diet?

Do they need to find ways to socialize?

And really sort of working on those individual goals to support brain health.

I will have more to share with you in the future.

-I can't wait, it sounds like a great program.

I can't thank you enough, Doctor O'Connor for sharing such important information with us today.

-Thank you so much for having me it was a great conversation.

-To learn more about Doctor Maureen O'Connor's work and to keep the conversation going, visit nhpbs dot org slash seniority authority.

♪♪ Until next time, stay curious and keep thriving.

♪♪ -Major funding for the production of Seniority Authority is provided by Road Scholar ♪♪ and by viewers like you Thank you!

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