Main Line: 305-644-2100
Fax: 305-644-2910
Email: info@mdthomehealth.com

Unveiling the Power of Cognitive Reserve: A Key Ally in Late Retirement

In an era where longer life expectancies have become the norm, the concept of cognitive reserve emerges as a crucial factor in navigating the complexities of an extended life.

Understanding Cognitive Reserve

Cognitive reserve refers to the brain’s ability to adapt and maintain normal cognitive function despite experiencing damage or changes. It acts as a sort of “reserve” or resilience, allowing individuals to withstand age-related brain changes, injury, or diseases without showing noticeable cognitive decline. This concept suggests that certain life experiences, education, profession, and engaging activities contribute to building a cognitive reserve, essentially acting as a buffer against cognitive decline.

The Components of Cognitive Reserve

Cognitive reserve isn’t a singular entity; rather, it’s a combination of various elements:

Education and Lifelong Learning

A higher level of education has been linked to greater cognitive reserve. Constantly engaging in learning, whether through formal education or self-driven exploration, keeps the brain active and resilient.

Occupational Complexity

Jobs that require mental agility, problem-solving, and continuous learning are believed to contribute to cognitive reserve. These professions stimulate the brain, potentially bolstering its ability to withstand cognitive decline.

Social Engagement

Active social lives, frequent interactions, and participation in social groups or activities have been associated with a higher cognitive reserve. Meaningful social connections and engagements serve as mental stimulation, which is beneficial for brain health.

Mental and Physical Activities

Regular physical exercise and mentally stimulating activities like puzzles, reading, or learning new skills play a significant role in building and maintaining cognitive reserve.

How Cognitive Reserve Supports Late Retirement

Cognitive reserve plays a pivotal role in supporting individuals in various ways:

Sustained Cognitive Function

Individuals with higher cognitive reserve tend to maintain better cognitive function even as they age. This means they can continue to perform work-related or daily-living tasks effectively and efficiently, despite the challenges of aging.

Adaptability and Learning

Having a robust cognitive reserve fosters adaptability and the ability to learn new skills. In late retirement, this becomes crucial as individuals may need to adapt to changing physical, emotional, and mental ability.

With a focus on ongoing learning, social connections, and stimulating activities, individuals can confidently embrace an extended life, leveraging their cognitive reserve to not only maintain their capabilities but also to enjoy a fulfilling and enriching life. Building and nurturing cognitive reserve is a strategy for a successful lifelong investment in cognitive well-being and mental resilience.

Know Your 3 Big Heart Numbers

Your heart is one of the most vital organs in your body and keeping it healthy is crucial for a long and fulfilling life. To assess and monitor your heart health, you need to be aware of three key numbers that provide valuable insights into the state of your cardiovascular system. These numbers can help you make informed decisions about your lifestyle and healthcare. This article explores these three big heart numbers and explains their significance.

Blood Pressure

Blood pressure is a measure of the force of blood against the walls of your arteries as your heart pumps it around your body. It’s expressed as two numbers: systolic and diastolic. The systolic pressure (the higher number) represents the force when your heart beats, while the diastolic pressure (the lower number) is the force when your heart is at rest between beats. For instance, a healthy blood pressure reading is typically around 120/80 mm Hg.

Understanding Your Blood Pressure:

High blood pressure, also known as hypertension, is a significant risk factor for heart disease and stroke. If your numbers consistently exceed the recommended range, it’s essential to take action through lifestyle changes or medication prescribed by a healthcare professional.

Cholesterol Levels

Cholesterol is a waxy, fat-like substance found in your blood. It’s essential for building healthy cells, but when there’s an excess of “bad” cholesterol (LDL) in your bloodstream, it can lead to plaque buildup in your arteries, increasing the risk of heart disease.

Understanding Your Cholesterol Levels:

Total Cholesterol: This number represents the overall cholesterol level in your blood. For most adults, a healthy total cholesterol level is below 200 mg/dL.

LDL Cholesterol: Often referred to as “bad” cholesterol, it should be kept low. An optimal level is typically below 100 mg/dL.

HDL Cholesterol: High-density lipoprotein (HDL) is considered “good” cholesterol because it helps remove LDL from your arteries. A higher HDL level, above 60 mg/dL, is beneficial for heart health.

Monitoring your cholesterol levels through regular blood tests is essential, and if your levels are not within the recommended range, your healthcare provider may recommend lifestyle changes, dietary adjustments, or medication.

Resting Heart Rate

Your resting heart rate is the number of heart beats per minute when you’re at rest. It’s a reliable indicator of your overall cardiovascular fitness. A lower resting heart rate is often associated with better heart health because it signifies that your heart doesn’t have to work as hard to pump blood.

Understanding Your Resting Heart Rate:

For most adults, a normal resting heart rate falls between 60 and 100 beats per minute.

Athletes and individuals who engage in regular aerobic exercise often have resting heart rates at the lower end of this range, which is a sign of good cardiovascular fitness.

Monitoring your resting heart rate over time can help you gauge the effects of your fitness routine and make necessary adjustments to improve your heart health.

Knowing your three big heart numbers—blood pressure, cholesterol levels, and resting heart rate—is essential for maintaining good cardiovascular health. Regular check-ups with your healthcare provider and a healthy lifestyle that includes a balanced diet and regular physical activity can help you manage these numbers and reduce your risk of heart disease. By staying informed and proactive, you can take control of your heart health and enjoy a longer, healthier life.

Connection Found Between Sleep issues and Elevated Stroke Risk

A recent investigation published in the online edition of Neurology®, the medical journal of the American Academy of Neurology, suggests a potential link between sleep disturbances and an increased susceptibility to strokes. The study, which delved into sleep patterns, snoring, and sleep apnea, reveals intriguing associations but doesn’t establish a causal relationship.

According to the research, conducted on a global scale and encompassing 4,496 participants, the risk of stroke was observed to potentially heighten among individuals grappling with diverse sleep-related issues such as inadequate or excessive sleep, extended napping, poor sleep quality, and disruptive conditions like snoring and sleep apnea. Remarkably, those encountering five or more of these challenges demonstrated a substantially amplified risk of stroke. The study, however, falls short of demonstrating that sleep difficulties directly trigger strokes, but rather highlights a noteworthy correlation.

Study author Christine Mc Carthy, MB, BCh, BAO, from the University of Galway in Ireland, underscores the significance of the findings: “Our research not only implies a heightened risk of stroke associated with individual sleep problems but also indicates that encountering five or more of these issues might translate to a fivefold increase in stroke risk compared to those unaffected. This calls attention to the importance of addressing sleep problems as a viable avenue for stroke prevention.”

The comprehensive international study enrolled 4,496 participants, among whom 2,243 had suffered a stroke, paired with 2,253 stroke-free individuals, with the average age of participants resting at 62. A wide array of sleep-related behaviors, spanning sleep duration, sleep quality, daytime napping, snoring, respiratory disruptions during sleep, and more, was examined.

Intriguingly, the research shows that both excessive and insufficient sleep are associated with a heightened likelihood of experiencing a stroke, in comparison to those maintaining moderate sleep durations. Notably, 162 of the stroke-affected participants had received fewer than five hours of sleep, while 43 stroke-free individuals reported the same. Additionally, 151 stroke-affected individuals logged more than nine hours of sleep each night, in contrast to 84 of their unaffected counterparts.

Upon thorough analysis, researchers ascertained that those obtaining less than five hours of sleep were three times more susceptible to strokes than those maintaining an average of seven hours of sleep. Similarly, individuals acquiring more than nine hours of sleep exhibited over twice the risk of stroke in comparison to those with a seven-hour nightly sleep routine.

Prolonged naps surpassing one hour were linked to an 88% increase in stroke risk when contrasted with individuals abstaining from extended daytime naps.

A noteworthy facet of the study lies in the investigation of respiratory disturbances during sleep, encompassing snoring, snorting, and sleep apnea. Participants identified as snorers demonstrated a 91% elevated stroke risk compared to their non-snoring counterparts, while those experiencing snorting episodes were almost three times more vulnerable to strokes. Equally, individuals grappling with sleep apnea faced nearly threefold heightened stroke risk.

Even after meticulous adjustments for confounding variables such as smoking, physical activity, depression, and alcohol consumption, the findings remained robust and consistent.

Christine Mc Carthy emphasized the practical implications of the research: “Armed with these insights, healthcare professionals can engage in earlier dialogues with individuals experiencing sleep problems. Furthermore, interventions designed to enhance sleep quality could potentially serve as a means to mitigate stroke risk, warranting dedicated research in this realm.”

Nonetheless, it is important to note that the study’s reliance on self-reported symptoms of sleep problems introduces a potential limitation, possibly affecting the precision of the information gathered.

For more insights into stroke-related matters, explore BrainandLife.org, the digital home of the American Academy of Neurology’s complimentary publication catering to patients and caregivers, focused on the interface of neurologic conditions and brain health. Stay updated by following Brain & Life® on Facebook, Twitter, and Instagram.


Source:
Mc Carthy CE, Yusuf S, Judge C, Alvarez-Iglesias A, Hankey GJ, Oveisgharan S, Damasceno A, Iversen HK, Rosengren A, Avezum A, Lopez-Jaramillo P. Sleep Patterns and the Risk of Acute Stroke: Results From the INTERSTROKE International Case-Control Study. Neurology. 2023 May 23;100(21) e2191-203.

It’s Better to Eat More Nuts – Squirrely or Smart?

Squirrels may be on to something. A study in the New England Journal of Medicine has found that the more nuts you eat, the longer you live.1

Researchers studied the association between nut intake and mortality among 76,464 women in the Nurses’ Health Study and 42,498 men in the Health Professionals Follow-up Study. They found that people who ate nuts 7 or more times per week had a 20% lower death rate over 30 years compared to people who didn’t. People who ate nuts more often were less likely to die from cancer, heart disease, or other causes. Even just occasionally eating nuts lowered the death rate by 7 percent. Results were similar whether the participants ate tree nuts, such as hazelnuts and chestnuts, or peanuts (peanuts are actually a legume.)

This is just the latest (and largest) study of the health benefits of nuts. In previous studies, nuts have been shown to help prevent heart disease and cancer, lower blood pressure and cholesterol, and improve blood sugar levels.

Before you start stuffing your cheeks like a chipmunk, it’s probably a good bet to choose dry roasted or raw nuts, avoiding added salt and oils, and stick to a handful a day. Nuts coated in layers of chocolate and sugar don’t count. Though nuts have the reputation of being fattening, the team found that “increased nut intake was associated with less weight gain.” Study participants who frequently ate nuts tended to lead a healthier lifestyle; they were leaner, less likely to smoke and more likely to exercise and eat fruit and vegetables than people who didn’t. So go nuts.

Source:

  1. Ying Bao, M.D., Sc.D., Jiali Han, Ph.D., Frank B. Hu, M.D., Ph.D., Edward L. Giovannucci, M.D., Sc.D., Meir J. Stampfer, M.D., Dr.P.H., Walter C. Willett, M.D., Dr.P.H., and Charles S. Fuchs, M.D., M.P.H. Association of Nut Consumption with Total and Cause-Specific Mortality.  N Engl J Med 2013; 369:2001-2011.

Stand Up to Disability

Did you know standing for just one extra hour a day greatly reduces the risk of disability, especially for retirees?1 Sedentary behavior, or sitting, is a very strong risk factor for disability and limitations in activities of daily living (ADL). ADL limitations are those that affect a person’s ability to complete self-care tasks without assistance or special equipment, such as getting dressed or bathing.

The US national data shows a strong relationship between greater time spent in sedentary behavior and the presence of ADL disability, independent of time spent in moderate or vigorous activity. These findings support programs encouraging older adults to decrease sedentary behavior.

The research team analyzed data from over 2,000 adults age 60+. The participants were asked to wear accelerometers and to keep a log as means of recording data regarding their time spent sitting versus time involved in standing activities. The records show that the participants averaged almost nine hours of sitting time, during non-sleeping hours, each day. The study also explains that for every additional hour a person spent sedentary each day, the likelihood of an ADL disability increased by 46 percent. This is true even for those who perform moderate exercise.

To reduce sedentary behavior, try standing when you talk on the phone or completing chores such as ironing or folding clothes while watching TV. It’s not too late to stand up against disability!

Reference:

  1. Dunlop DD, Song J, Arntson EK, Semanik PA, Lee J, Chang RW, Hootman JM. Sedentary time in US older adults associated with disability in activities of daily living independent of physical activity. Journal of Physical Activity and Health. 2015 Jan 1;12(1):93-101.

The Perils of Smoking in the Presence of Oxygen Therapy

When combined with the use of supplemental oxygen, the dangers of smoking are amplified, creating a potentially deadly combination. Oxygen therapy is a medical intervention aimed at improving the oxygen supply to various organs and tissues, particularly in patients with respiratory disorders.

However, the presence of oxygen-enriched environments significantly increases the risk of fire and other life-threatening complications. This article sheds light on the dangers of smoking when oxygen is in use and underscores the importance of maintaining a safe environment for individuals undergoing oxygen therapy.

One of the most critical dangers of smoking in the presence of oxygen therapy is the heightened risk of fire. Oxygen supports combustion, making any flammable material, including cigarettes, more susceptible to ignition. Even a small spark from a cigarette can lead to a catastrophic fire, causing severe injuries or fatalities. Oxygen-enriched environments create an atmosphere where fires ignite more easily and burn more intensely, leaving patients vulnerable to burns, smoke inhalation, and property damage.

Smoking is already associated with a myriad of health risks, including lung cancer, heart disease, and respiratory disorders.1 When combined with oxygen therapy, the adverse health effects can be exacerbated. Smoking hampers the respiratory system’s ability to transport oxygen effectively, undermining the very purpose of oxygen therapy. This can result in decreased treatment efficacy and worsened symptoms, ultimately hindering the patient’s overall well-being and recovery.

Oxygen therapy is often prescribed to individuals with compromised respiratory function, such as those with chronic obstructive pulmonary disease (COPD) or emphysema. Smoking further exacerbates respiratory issues, leading to increased breathlessness, reduced lung function, and diminished quality of life. Patients who smoke while on oxygen therapy may find it even more challenging to perform daily activities and maintain adequate oxygen levels in their bloodstream.

Individuals undergoing oxygen therapy are often in vulnerable health states, making them particularly susceptible to the harmful effects of secondhand smoke. Exposure to secondhand smoke can worsen their respiratory conditions, increase the risk of infection, and contribute to a decline in overall health. Loved ones and caregivers must also be cautious not to smoke near patients using oxygen therapy, as they could inadvertently harm the patient’s well-being.

It is crucial for patients, caregivers, and healthcare providers to understand the grave dangers associated with smoking while using oxygen and to take necessary precautions to create a safe and supportive environment for healing. Quitting smoking remains the best course of action to improve overall health and enhance the benefits of oxygen therapy for those in need.

Reference:

  1. Kamimura D, Cain LR, Mentz RJ, White WB, Blaha MJ, DeFilippis AP, Fox ER, Rodriguez CJ, Keith RJ, Benjamin EJ, Butler J. Cigarette smoking and incident heart failure: insights from the Jackson Heart Study. Circulation. 2018 Jun 12;137(24):2572-82.

What to Know about the Medicare Open Enrollment Period and Medicare Coverage Options

Each year, Medicare beneficiaries have an opportunity to make changes to how they receive their Medicare coverage during the nearly 8-week annual open enrollment period. The annual Medicare open enrollment period runs from October 15th to December 7th. During this time, people with Medicare can review features of Medicare plans offered in their area and make changes to their Medicare coverage, which go into effect on January 1st of the following year. These changes include switching from traditional Medicare to a Medicare Advantage plan (or vice versa), switching between Medicare Advantage plans, and electing or switching between Medicare Part D prescription drug plans.

Medicare is the federal health insurance program for people ages 65 and over and people under age 65 with long-term disabilities. The program helps to pay for many medical care services, including hospitalizations, physician visits, and prescription drugs, along with post-acute care, skilled nursing facility care, home health care, hospice care, and preventive services.

People with Medicare may choose to receive their Medicare benefits through traditional Medicare or through a Medicare Advantage plan, such as an HMO or PPO, administered by a private health insurer. People who choose traditional Medicare may sign up for a separate Medicare Part D prescription drug plan for coverage of outpatient prescription drugs and may also consider purchasing a supplemental insurance policy to help with out-of-pockets costs if they do not have additional coverage from a former employer, union, or Medicaid. People who opt for Medicare Advantage can choose from dozens of Medicare Advantage plans, which include all services covered under Medicare Parts A and B, and often include Part D prescription drug coverage as well.

Each year, Medicare beneficiaries have an opportunity to make changes to how they receive their Medicare coverage during the nearly 8-week annual open enrollment period. The annual Medicare open enrollment period runs from October 15th to December 7th. During this time, people with Medicare can review features of Medicare plans offered in their area and make changes to their Medicare coverage, which go into effect on January 1st of the following year. These changes include switching from traditional Medicare to a Medicare Advantage plan (or vice versa), switching between Medicare Advantage plans, and electing or switching between Medicare Part D prescription drug plans.

Medicare beneficiaries are encouraged to review their current source of Medicare coverage during the annual open enrollment period and compare other options that are available where they live. Because an individual’s medical needs can change over the course of the year, and from one year to the next, this may influence their priorities when choosing how they want to get their Medicare benefits. Medicare Advantage and Medicare prescription drug plans typically change from one year to the next and may vary in many ways that could have implications for a person’s access to providers and costs. Despite this, a KFF analysis of a nationally representative survey of people with Medicare found that only one-third (32%) compared their Medicare coverage options during a recent open enrollment period.

Traditional Medicare and Medicare Advantage both provide coverage of all services included in Medicare Part A and Part B, but certain features, such as out-of-pocket costs, provider networks, and access to extra benefits vary between these two types of Medicare coverage. When deciding between traditional Medicare and Medicare Advantage, people may want to consider a variety of factors, such as their own health and prescription drug needs, financial circumstances, preferences for how they get their medical care, and which providers they see.

People may prefer traditional Medicare if they want the broadest possible access to doctors, hospitals and other health care providers. Traditional Medicare beneficiaries may see any provider that accepts Medicare and is accepting new patients. People with traditional Medicare are not required to obtain a referral for specialists or mental health providers. Traditional Medicare covers seniors fully, wherever they travel nationwide.

People may prefer Medicare Advantage if they want extra benefits, such as coverage of some dental and vision services, and reduced cost sharing offered by these plans, often for no additional premium (other than the Part B premium).

People with Medicare can learn more about Medicare coverage options and the features of different plan options by reviewing the Medicare & You handbook. In addition, people can review and compare the Medicare options available in their area by using the Medicare Plan Compare website, a searchable tool on the Medicare.gov website, by calling 1-800-MEDICARE (1-800-633-4227), or by contacting their local State Health Insurance Assistance Program (SHIP). SHIPs offer local, personalized counseling and assistance to people with Medicare and their families. Contact information for state SHIPs can be found by calling 877-839-2675 or by checking the listing provided on the Medicare.gov website.

Additionally, many people use insurance agents and brokers to navigate their coverage options. While helpful, agents and brokers are financially compensated by private insurers for enrolling people in their plans, and often receive higher commissions if people choose a Medicare Advantage plan rather than remaining in traditional Medicare and purchasing a supplemental Medigap policy and stand-alone Part D plan.

Source:

KFF The independent source for health policy research, polling, and news. Available from: https://www.kff.org/medicare/issue-brief/what-to-know-about-the-medicare-open-enrollment-period-and-medicare-coverage-options/  

“An Apple a Day Keeps the Doctor Away: Exploring the Health Benefits of This Timeless Adage”

The proverbial phrase, “An apple a day keeps the doctor away,” has been ingrained in popular culture for generations, emphasizing the health benefits of consuming apples regularly. But it’s more than a saying. Let’s delve into the profile of this interesting fruit.

Apples are a rich source of essential nutrients, including dietary fiber, vitamin C, potassium, and various antioxidants. The dietary fiber in apples aids in digestion, promotes gut health, and can help manage cholesterol levels. Meanwhile, vitamin C boosts the immune system, aiding in the body’s defense against infections and illnesses. Potassium plays a crucial role in maintaining heart health and regulating blood pressure. Antioxidants like quercetin and catechins found in apples combat oxidative stress, which is linked to chronic diseases and aging.

Heart disease is a prevalent global health concern. Studies have shown that consuming apples regularly can have a positive impact on cardiovascular health.1 The soluble fiber in apples helps reduce cholesterol levels, particularly low-density lipoprotein (LDL) or “bad” cholesterol.2 Additionally, the antioxidants in apples help prevent the oxidation of LDL cholesterol, reducing the risk of atherosclerosis and heart attacks.

Incorporating apples into a balanced diet can support weight management efforts. The high fiber content of apples promotes feelings of fullness, which can help control appetite and prevent overeating. Furthermore, apples are naturally low in calories, making them a satisfying and healthy snack choice.

Type 2 diabetes is a growing health concern worldwide. Apples have a relatively low glycemic index, meaning they cause a slower rise in blood sugar levels compared to high-glycemic foods. The soluble fiber in apples also aids in slowing the absorption of sugar, which can contribute to better blood sugar regulation and reduce the risk of diabetes.

The fiber content in apples supports healthy digestion by promoting regular bowel movements and preventing constipation. Moreover, apples contain pectin, a type of soluble fiber that acts as a prebiotic, nourishing beneficial gut bacteria. A healthy gut microbiome is associated with various health benefits, including improved immune function and reduced inflammation.

Chewing apples stimulates saliva production, which helps neutralize acids and wash away harmful bacteria in the mouth. Additionally, the natural sweetness of apples is less damaging to tooth enamel compared to sugary snacks and desserts, making them a tooth-friendly option.

As the saying goes, “An apple a day keeps the doctor away,” and it’s evident that this simple adage holds a significant grain of truth. Apples, with their wealth of nutrients, antioxidants, and dietary fiber, can contribute to various aspects of our health, ranging from improved cardiovascular health and weight management to better digestion and blood sugar regulation. While apples are not a substitute for professional medical advice or treatment, incorporating them into a balanced diet can undoubtedly be a delicious and healthful step towards promoting overall well-being. So, let’s embrace the timeless wisdom and make apples a delightful part of our daily dietary habits!

Reference:

  1. Hyson DA. A Comprehensive Review of Apples and Apple Components and Their Relationship to Human Health. Advances in Nutrition. 2011 Sep 1;2(5):408-20.
  2. Bede Dery, Lou Zaixiang. (2023) Scanning Electron Microscopy (SEM) as an Effective Tool for Determining the Morphology and Mechanism of Action of Functional IngredientsFood Reviews International 39:4, pages 2007-2026.