Dr. Rigali received her bachelor’s degree from the University of Massachusetts in Amherst, Mass., and her degree in osteopathic medicine from the University of New England College of Osteopathic Medicine in Biddeford, Maine. She completed her internship and residency in internal medicine at Carney Hospital in Boston, Mass. Board certified in internal medicine, Rigali joined Brooksby in October 2006.

Q. I’ve always had strong, healthy teeth, but now I seem to have cavities every time I see the dentist. Why is this happening?

A. Many factors can affect your teeth as you age. Your enamel wears down over time. You may not produce as much saliva as you used to, and many medications can also contribute to a dry mouth. You may develop gum disease. Changes in your vision, muscle weakness, or arthritis may affect your ability to brush and floss as well as you used to.

Talk to your regular doctor to see if you may have a health condition or a medication that is affecting your teeth. Pay close attention when you brush and floss and make sure you are using fluoride toothpaste. Your dentist may recommend an in-office fluoride treatment to strengthen your enamel.

Q. Is it better for older adults to drink filtered water instead of tap water?

A. Tap water from municipal water systems in the U.S. is generally safe for everyone to drink. An exception is if your water supply has been interrupted for a period of time due to a water main break or weather problems. In that case, you should wait to use water from the tap for drinking or cooking until your local government says it is safe. Well water, whether it’s from a private source or a small community well, should be tested regularly. If you have cancer, an immune system disorder, or have had an organ transplant, you should boil well water before using it to drink, cook, or brush your teeth.

Please send any questions or concerns you may have by email to expert@erickson.com

Pollution and brain function

Researchers at Rush University Medical Center in Chicago found that chronic exposure to certain types of air pollution may worsen cognitive decline in older adults. In this study, participants who were exposed to higher levels of particulate matter (PM) air pollution had worsening cognitive functioning over a period of four years. PM pollution is a mixture of small particles and liquid droplets, and can be made up of acids, chemicals, metals, soil, or dust. Researchers say that PM pollution may also be associated with an increased risk of heart disease, which may contribute to changes in the brain.

Other factors that affect air quality are levels of ozone, carbon monoxide, and sulfur dioxide. You can check the daily air quality index (AQI) in your area by a number of methods—the Environmental Protection Agency’s website (AirNow.gov), your local media’s weather reports, and also on some state and local telephone hotlines.

The preferred title for these professionals is speech-language pathologist (SLP), which better describes their scope of practice. There are over 120,000 SLPs working in the U.S., according to the American Speech-Language-Hearing Association (ASHA). “SLPs have a minimum of a master’s degree and take a national exam to obtain a certificate of clinical competence,” says Mary Wagner, corporate director of rehabilitation services for Erickson Living. “Each is licensed by their respective state.

“SLPs have a thorough knowledge of oral motor anatomy and physiology, neurology, and hearing science,” Wagner continues. “They also have the most effective evaluation and treatment tools available and know how to use the most current approaches to therapy.”

“There are problems that people may need help with, but because they aren’t aware of what we do, they may not discuss certain areas of concern with their doctor,” Vitelli says. “Someone might think that minor swallowing difficulties or cognitive issues may be due to aging and can’t be helped.”

Helping you communicate better

According to ASHA, about one million people in the U.S. have aphasia (a partial or total inability to understand or express language). “The most common cause of aphasia is stroke,” says Leslie Rigali, D.O., medical director for Brooksby, an Erickson Living community in Peabody, Mass.

“SLP’s can teach people with aphasia how to improve expressive language skills by working on tasks such as naming objects or teaching them how to put sentences together,” Vitelli explains. “We also may work on receptive language skills—understanding information that you hear.”

SLPs can help anyone who has speech problems, not just stroke patients. “Neurological problems such as Parkinson’s disease can affect speech,” Rigali says. “People with cognitive problems, hearing difficulties, or who have had surgery on their mouth or throat may also need an SLP’s services.”

What an SLP can do for you depends upon the severity of the problem, and how much you are able to participate in therapy. SLPs are skilled in working with people with all levels of disability and can also help your family and friends communicate with you better.

Along with teaching better speaking skills, SLPs assist people in improving reading and writing skills and teach the proper use of assistive devices or systems that can help you interact with others.

The sound of your voice

SLPs can work with you if your speaking voice has been affected by surgery or another medical problem.

“The biggest voice problem with older adults is the inability to speak loudly enough,” Vitelli says. “This is a particular problem in loud environments or when talking on the phone.”

To help your vocal volume, SLPs work with your breathing and vocal system. “Some therapists are certified in the Lee Silverman Voice Treatment program,” Vitelli explains. “This involves a series of voice exercises to help enhance the sound of your voice. It’s especially helpful for people with Parkinson’s disease.”

The swallowing experts

“Being unable to swallow correctly not only interferes with your nutrition but also puts you at risk for developing pneumonia because food and liquids can get into your airway,” Rigali says.

“Strokes and practically any neurological condition can interfere with your swallowing ability,” Vitelli says. “Cognitive problems can also contribute, as can rare conditions such as severe osteoarthritis of the neck,” Rigali adds.

“SLPs teach swallowing techniques, such as head and body positioning,” Vitelli says. “We also recommend food textures and eating strategies that may facilitate better swallowing.”

If it’s necessary for you to have a swallowing test, an SLP will be there to observe and make recommendations.

Working with cognitive problems

“Your cognitive functioning is your thinking ability,” Vitelli explains. “People with cognitive problems may have trouble with memory, attention, reasoning, or safety awareness.”

A little-known fact is that SLPs are experts at helping people with cognitive problems. “We perform memory screenings to help detect deficits before they affect someone’s functioning,” Vitelli says. “We look at short- and long-term memory, and problem-solving ability.

“We evaluate your ability to do day-to-day tasks and see what skills you can work on, such as balancing your checkbook or keeping track of your medications,” Vitelli adds. “Helping you improve your thinking skills may mean you can stay independent longer.”

Working with your therapist

Some people have trouble dealing with the changes in their lives that come with speech, voice, swallowing, or cognitive problems. “This can be a hindrance in therapy. “You have to acknowledge that a problem exists in order to be open to solutions,” Vitelli says.

“Give your therapy a chance,” Vitelli continues. “Different techniques work for different people, and it’s not easy to learn a new way of doing things. Keep in mind that even small changes can help you become more independent.”

According to the Centers for Disease Control and Prevention (CDC), about 45,000 adults die each year from diseases that can be prevented by vaccines. Most of these are from influenza, but about 10% of these deaths are due to pneumococcal pneumonia.

This type of lung infection can start in the upper respiratory tract and spread to the blood, lungs, middle ear, or nervous system. There are different types of pneumonia, but pneumococcal pneumonia is especially harmful, and adults over age 65 are particularly susceptible to the disease. Those with chronic health conditions affecting the heart, lungs, or liver are at an even greater risk. People who have had organ transplants or who are taking medications that affect their immune systems are also more likely to contract it.

Vaccine benefits

Like most vaccines, the pneumonia vaccine benefits far outweigh the risks. But many people still are hesitant to be vaccinated. Some simply think it’s not necessary, and others fear vaccines because of misinformation, such as the myth that the flu vaccine can give you a flu infection. According to the CDC, there might be side effects from the pneumonia vaccine such as pain or redness at the injection site, slight fever, muscle aches, or mild upper respiratory symptoms, but the risk of serious harm or death from this vaccine is extremely small.

Only about 65% of adults over age 65 get the flu vaccine, and even fewer (about 60%) receive the pneumonia vaccine. The U.S. Department of Health and Human Services’ Healthy People initiative aims to increase these percentages to 90% by educating patients and doctors.

Unlike the flu vaccine, which you need every year, a pneumonia shot is only needed once for most individuals over age 65, and every five years for people at higher risk. If you haven’t had a pneumonia vaccine, talk to your doctor about getting one. Taking this simple step may save your life.

In good health,

Dr. Narrett

Mistakes happen

If you can’t take your medicines correctly, it’s not because you are old and forgetful. “Older people may in fact have mild dementia, which can interfere with the ability to keep up with their medication schedule,” says Leslie Rigali, D.O., medical director at Brooksby, an Erickson Living community in Peabody, Mass. “But I’ve also known older patients who are mentally sharp who still make mistakes.”

An ever-changing medication schedule is often the culprit. “Some medications, such as anticoagulants, are stopped, restarted, or the dose is changed based on lab work,” Rigali says. “You may have different bottles with different dosages around the house.

“Or if a medicine for a particular condition is changed, such as one blood pressure pill for another, people might keep their old prescriptions around and mix them up accidentally,” she adds.

Simplify the problem

Keeping track of multiple sets of instructions on several medications is enough to confuse anyone. “Weekly planners, calendars, and pill boxes are essential tools,” Rigali says. “Otherwise, at lunchtime you may forget if you took your medicine that morning.”

“If you are taking something crucial such as a heart pill, missing a dose or taking it improperly can kill you,” Rigali explains. “Have someone else set up your pillbox if you can’t keep track.”

You may qualify for regular checks at home by a home health nurse or medicine aide, or you can ask a family member or friend to call to remind you. If you still can’t keep up with it, perhaps your doctor can simplify your schedule. For instance, something you take twice a day may be changed to once a day.

Out with the old

To minimize the clutter, discard expired medicines. “Adhere strictly to expiration schedules on prescription medication,” Rigali says. “Drugs may not necessarily become harmful after a certain date, but they may be less effective.”

“In the case of chronic conditions such as diabetes or high blood pressure, a less effective drug can be dangerous,” says Timothy West, Pharm. D., clinical pharmacy coordinator at Mercy Medical Center in Baltimore, Md. “If you reach for an expired nitroglycerin pill when you are having chest pain, it may not work.”

“With over-the-counter drugs, it’s usually safe to go beyond the expiration date within reason,” Rigali says. “If a drug such as Tylenol (acetaminophen) becomes less potent, it’s not going to significantly affect your health.”

According to the American Society of Health System Pharmacists, if you’re unsure about an expiration date, consider medications expired after six months. Ask your pharmacist about how to dispose of old medicines. “It’s no longer accepted practice to flush everything down the toilet,” West says. “Check around your community for prescription disposal centers or services.”

What the directions really mean

Suppose your bottle reads, “take three times a day.” Does that mean every eight hours or at breakfast, lunch, and dinner? You may not know unless you ask. “Always clarify with your doctor the exact directions for drugs that you take more than once a day,” Rigali advises.

“Certain drugs, such as antibiotics, work best when taken at regular intervals,” West explains.

What if you have five medications that you take only once a day? “It’s not necessarily safe to take them all at once,” West says. “Some medications may interact with others. Always ask your doctor or pharmacist which ones you can take at the same time.”

Avoid harmful interactions

“Bring all medications and supplements with you when you go to the doctor’s office, any specialist’s office, or hospital. Always use the same pharmacy, but if you have to use a different one, take a medication list with you,” Rigali advises.

Look carefully at the medicine itself, not only the label. If it looks different from what the printout indicates or if something doesn’t seem right, ask your pharmacist about it. According to the Agency for Healthcare Research and Quality, most errors of this type are first discovered by patients.

“Even if you’ve been taking the same drug for years, always read the printed material that comes with it,” West says. “Pharmaceutical companies update important information periodically.”

Vrinda Suneja, M.D., Medical Director Fox Run, Novi, Mich.

Dr. Suneja received her medical degree at Maulana Azad Medical College in New Delhi, India. She then completed her residency in internal medicine at Sinai Grace Hospital, affiliated with Wayne State University in Detroit, Mich. Board certified in internal medicine, Suneja joined Fox Run in November 2003.

Q. I have hypothyroidism. I like to take natural thyroid medicines rather than synthetic ones like Synthroid. What’s the difference between them?

A. Natural thyroid formulations are made from the dried thyroid glands of pigs or cows. Although they are available by prescription, as of the date of this writing they are not FDA approved—only levothyroxine (Synthroid) is approved for hypothyroidism. Although natural thyroid formulations may meet certain standards with regard to potency, the balance of thyroid hormones in animal glands is different from human levels, and different batches of animal-based thyroid may contain varying amounts of the hormones.

You should be carefully monitored for the therapeutic effectiveness of natural thyroid medicine. Check with your doctor or see an endocrinologist for a full evaluation.

Q. My doctor said my cataracts are so bad that I need surgery. At 87 years of age, I am rather hesitant about going under the knife. Is cataract surgery dangerous?

A. Some cataracts stay small, but others can get quite large and affect your vision—something that can be especially dangerous as you age. Cataract surgery is very safe. It is one of the most common surgical procedures in the U.S. and carries a 90% success rate. The procedure usually lasts under an hour and is practically painless. You will have your eye numbed, but you may also choose to have some sedation.

Any surgery carries risks such as bleeding or infection. In addition, cataract surgery raises your risk (although very slightly) of retinal detachment. Talk to your regular doctor and your eye doctor about your specific risks and any medication adjustments that might be necessary prior to the procedure. Ultimately, of course, the decision to have surgery is up to you.

Please send any questions or concerns you may have by email to expert@erickson.com

The most common type is an ischemic stroke, which is caused by a blockage in an artery that carries oxygen-rich blood to the brain. Blood clots are often the cause. Diseases such as atherosclerosis (especially in the carotid arteries) and atrial fibrillation are common culprits in clot formation.

Hemorrhagic strokes are the other main type. This type of stroke happens when bleeding occurs in the brain from a leaking or bursting artery. These can be caused by high blood pressure or the presence of an aneurysm (a weakened, bulging portion of an artery).

Transient ischemic attacks (TIA) or mini-strokes occur when blood flow is temporarily interrupted to a portion of the brain. Symptoms are the same as with a stroke, but effects tend to last only a few hours. TIAs are typically caused by blood clots. Having one or several TIAs means that you are at great risk for a stroke.

Call 911

Stroke symptoms vary depending upon which part of the brain is affected. “Common symptoms are difficulty speaking; vision problems; or weakness, numbness, or paralysis in the arms, legs, or face,” Bell says. “Less common symptoms may be confusion or a feeling that the room is spinning.”

A stroke, even a TIA, is a medical emergency. “Early stroke symptoms and TIA symptoms can be identical,” says Vrinda Suneja, M.D., medical director at Fox Run, an Erickson Living community in Novi, Mich. “Do not drive yourself or someone else to the hospital. Call 911 immediately. Emergency ambulance personnel may be able to start crucial treatment measures right away.”

“Some people deny that they’re having a stroke,” Bell explains. “If the first symptom you have is a minor speech problem, such as not being able to find the right word, you might not think it’s an urgent matter. After all, that happens to all of us.”

Life-saving early treatment

“Clot buster” medications, such as tissue plasminogen activator (tPA), are an essential part of treatment. “If tPA is started within four hours of the onset of an ischemic stroke, it can make a huge difference in how much damage is done and how well you recover,” Bell says. “About 30% of people who wouldn’t otherwise be functional can be functional after a stroke if they get tPA.”

Aspirin or other medications may also be given if tPA is unavailable. Other people may need surgery to unclog the carotid arteries.

To stop the bleeding in hemorrhagic strokes, the goal is to lower blood pressure by adjusting medication, or in some cases, brain surgery to clip the bleeding portion of the artery.

Your life after a stroke

“Once you’ve had a stroke, it’s a lifelong journey to stay well and function at your best,” says Anita Pinkney, M.S., OTR/L, rehabilitation manager for LifeBridge Health in Baltimore, Md. “You need to practice what you’ve learned in rehabilitation for the rest of your life.”

“Rehabilitation teaches you how to compensate for what you’ve lost and get back as much functioning as possible,” Pinkney explains. “It can be difficult to learn new habits and accept a new way of living. Advances in rehab techniques, technology, assistive devices, and home modifications make life easier after a stroke.”

You might have problems with paralysis, muscle weakness, or speech. Other post-stroke effects may include swallowing problems, a loss of bowel or bladder control, or mood and behavior changes.

A common complication

“Depression is common after a stroke,” Suneja says. “Debilitation and a difficult recovery can make you feel low. Some people may attribute depression symptoms such as fatigue, loss of appetite, or aches and pains to other things. Treating depression can make a big difference in how well you recover.”

“It is vital to have family or friends who will be available to support you for both the short term and the long term,” Pinkney says. “Support groups can also help.”

Prevent strokes

“Control your blood pressure and cholesterol,” Bell says. “A good way to do this is to follow the DASH [Dietary Approaches to Stop Hypertension] diet. DASH has been shown in many studies to dramatically lower blood pressure in a matter of weeks.”

DASH involves lowering dietary sodium, increasing vegetables, fruits, whole grains, and fiber, and only eating a set amount of lean meats and low-fat or fat-free dairy products. Details can be found at the American Heart Association’s website (heart.org).

“Stop smoking and get active,” Suneja advises. “Even walking is good exercise.”

“Stroke prevention measures are vital,” Pinkney says. “And if you’ve already had a stroke, you need to work the rest of your life to make sure you don’t have another one.”

Stroke risk factors

Family history of stroke

Unhealthy

cholesterol levels

Lack of

physical activity

Poor diet

Obesity

Smoking

High blood pressure

Diabetes

Depression

Warning signs call 911

Sudden weakness

Paralysis, especially on one side of the body

Confusion

Difficulty speaking or understanding speech

Vision problems

Breathing difficulties

Dizziness, trouble walking, loss of balance or coordination, and unexplained falls

Loss of consciousness

Sudden, severe headache

“The skin becomes thinner due to the loss of underlying collagen and elastin,” says Susan Stuart, M.D., board-certified dermatologist and faculty instructor at University of California San Diego Medical Center in San Diego, Calif. “The fatty layer also thins, which makes blood vessels and bones more prominent. The oil glands shrink, leading to scaling and flaking.”

These changes cause skin to lose its ability to do what it does best—protect you from infection, help you sense hot and cold, and regulate your body temperature. Some medical conditions (diabetes in particular) can make your skin fragile, as can medications such as steroids.

How dry I am

Skin dryness is by far the biggest problem for seniors. “Dry skin is more than a cosmetic problem,” says Vrinda Suneja, M.D., medical director at Fox Run, an Erickson Living community in Novi, Mich. “It can itch, and scratching can lead to tiny breaks in the skin which make you more prone to infection.” Many medications may also contribute to dryness, especially diuretics.

“Drying of the skin may worsen already existing skin disorders such as eczema,” Stuart adds.

Take care of dry skin every day and you will notice changes quickly. “Shower and bathe less—maybe every other day instead of daily. Use warm water instead of hot,” Suneja advises. “Use a mild soap with a moisturizer base.

“Right after bathing or showering, apply a moisturizer,” Suneja adds.

“I recommend using a hypoallergenic cream or ointment,” says Rebecca Baxt, M.D., board-certified dermatologist and assistant professor of clinical dermatology at New York University. “Lotions are not usually effective enough for older people. Petroleum jelly, in fact, works amazingly well and it’s very inexpensive.”

When choosing moisturizers, avoid lanolin. “Many older people are sensitive to lanolin,” Baxt explains.

Aside from moisturizing, there are other things you can do to take care of your skin. “Drink sufficient amounts of liquids,” Suneja says. “But avoid caffeine and alcohol, as both can contribute to dry skin.” Using humidifiers may also help.

“Don’t use medicated creams unless you check with your doctor first. Some can make skin conditions worse,” Suneja explains. “And if you have to scratch, use the pulp of your finger and not the nail. Or scratch through clothing rather than directly on your skin.”

Many people may notice dryness, especially on their lower legs. “This is due to swelling,” Suneja explains. “Vascular disease or other health conditions may cause you to retain fluid in your legs. Elevating your legs can help. Your doctor may recommend medication changes or compressive legwear.”

Skin cancers

The most common skin cancers are basal cell carcinoma and squamous cell carcinoma. “Basal cell carcinoma is the most common cancer in humans, and it is most prevalent in the elderly population,” Baxt says. “Skin that has been exposed to the sun is the most common site of these cancers. They grow slowly and don’t usually spread to other areas. Melanoma, while less common, spreads and can be fatal.”

Skin cancers are not usually painful, so do a monthly all-over check for skin changes such as a new growth, sores that won’t heal, bleeding moles, or other changes in moles or pigmented spots. Get help from someone to check hard-to-see areas such as your scalp and back. It may be hard to tell the difference between cancer and harmless changes (such as age spots and skin tags), so see your doctor if you notice anything new.

“I’ve had patients in their 90s diagnosed with new skin cancers,” Suneja says. “So no matter how old you are, always wear sunscreen.”

Maybe you’ve done everything right for your skin’s health and you want it to look better. “Topical agents such as retinoids and alpha hydroxyl acids, or the use of glycolic peels or other minimal invasive treatments can treat sun damage, pigment changes, or fine lines and wrinkles,” says Robert T. Grant, M.D., plastic surgeon-in-chief for the combined divisions of plastic surgery at New York-Presbyterian Hospital/Columbia University Medical Center. “All of these can really make a difference for seniors.”

We were recently reminded of the benefits of these suggestions in a study published in the Journal of the American Medical Association. Researchers found that hospital admissions related to heart failure dropped by almost 30% over a ten-year period.

While there have been advances in the medical treatment of heart failure during this time period, it is unlikely that this dramatic drop is solely based upon health care interventions. Rather, researchers speculate that the reason people are being hospitalized less is a result of advances in prevention and lifestyle.

According to the American Heart Association, approximately 5.8 million Americans are diagnosed with heart failure, and this disease is currently the most common reason that Medicare beneficiaries are hospitalized. Health care costs related to these inpatient stays are staggering. To give you some idea of the price tag, the recent drop in hospitalizations saved Medicare about $4 billion dollars in 2008 alone.

Preventive measures

Strategies such as exercising, eating a healthful diet, quitting smoking, maintaining a healthy weight, and controlling high blood pressure can help prevent heart disease. Heart attacks and other vascular problems such as atherosclerosis (plaque buildup in the arteries) often lead to heart failure because the heart muscle becomes damaged. The good news is that even if you already have heart failure, these same preventive health measures can still help you stay well and avoid hospitalization. If the trend of healthful living continues, we may soon see a dramatic improvement in the prevention of other common health problems such as high blood pressure and diabetes. Living well and eating well do make sense and it’s great to see lifestyle changes making a difference.

In good health,

Dr. Narrett

But if you’ve forgotten where you put your keys three times this week, how do you know you don’t have a memory-robbing disease such as Alzheimer’s? “You won’t know at first,” Gable says. “The first symptoms of Alzheimer’s or other dementia-related conditions and the signs of age-related memory changes are identical,” Gable says. “You have to be formally tested over time to determine if there’s a problem.

“Age-related memory changes tend to take the form of a delay in remembering something as opposed to a complete loss of the ability to recall information,” she explains.

Slightly more serious is mild cognitive impairment (MCI). People with MCI have more memory problems than normal for their age, but they are able to function fairly well, and their memory deficits are not as severe as those found in Alzheimer’s disease.

Signs of MCI include misplacing things frequently, forgetting important appointments, and having trouble coming up with a particular word in conversation. Not everyone with MCI will progress to Alzheimer’s disease.

Dementia-related disease such as Alzheimer’s is characterized by the loss of thinking, memory, and reasoning skills. People with dementia become unable to function in their daily activities. “With dementia-related disease, you tend to forget entire events or you may not recognize family members,” Gable says.

Causes of memory loss

Just because you have some memory problems doesn’t mean you have Alzheimer’s disease. “Memory problems can be related to treatable medical conditions such as thyroid problems, a vitamin B12 deficiency, or depression,” Gable explains. “Some medications may have side effects that interfere with your memory. Stress or a lack of sleep may also be contributing factors.”

Talk to your doctor about the difficulties you are having. “A brief screening test can be done right in the office, and if problems are found, a more intensive memory assessment can be performed,” Gable says. “After a full medical workup, if memory problems continue, you can be tested again in six months or a year to see if it’s progressing.”

Fortunately, both routine memory testing and a cognitive assessment are components of an annual wellness visit that is now covered by Medicare. “Having this wellness visit is an important way to catch problems early and possibly prevent a hospitalization,” Gable says.

Keep your memory fit

“There is a lot of misinformation, particularly on the Internet, about how to maintain memory health,” says Margaret Stewart, D.H.A., senior director of health services clinical programming for Erickson Living. “People should focus on strategies that are supported by solid scientific evidence to ensure they get the best results for their efforts.”

Research has given us examples of things that have not been proven to help your memory such as estrogen replacement therapy, antioxidants, or ginkgo biloba.

“Strategies to keep your memory sharp may depend on your diagnosis,” Gable explains. “But we know that people who exercise regularly hang onto their memories better. There is strong research evidence that physical activity is a prevention measure against Alzheimer’s disease.”

“Both vitamin D supplements and a Mediterranean diet are being studied as possibly beneficial to memory health,” Stewart adds.

With more research emerging on the topic of memory-related problems, people have increasing opportunities to take care of their memory health.

An example is the Memory Support program, which is currently in development across all Erickson Living campuses. “This program can help anyone—from those who want to prevent memory problems to people who need more support because of dementia-related illnesses,” Stewart says.

The Memory Support program has three components: memory fitness, memory health, and memory care.

“The memory fitness piece of the program is for individuals who have no memory problems and want to stay sharp,” Stewart says. “Part of this program is a class that teaches people to take care of themselves by eating a nutritious diet, reducing stress, exercising, and getting enough sleep. Classes also include memory exercises—such as learning a new game, skill, or anything that helps the brain make new connections.”

“We also have a memory health program for people who are starting to have MCI or early stages of a dementia-related disease,” Stewart continues. “Individuals in this program have more support services available to them, including medical management and ongoing monitoring by their doctors.”

The final component of the Memory Support program is memory care. “This comprehensive care model is developed for people who have dementia and need the most support in an extended-care environment,” Stewart says. “All elements are designed to help individuals stay as independent and productive as possible.”

Along with exercise, the National Institute of Aging offers these tips to keep your memory sharp:

• Make “to do” lists; use calendars and other notes.
• Develop new interests and hobbies.
• Limit alcohol use.
• Find ways to relieve feelings of stress and anxiety.