Here’s What You Don’t FULLY Understand About Caregiving

Sometimes, what you think you know is wrong.

5 Things You ‘Know,’ But You Don’t Know

When I was a kid, and I heard “adults” saying: “Oh, they grow up so fast,” I probably rolled my eyes. I mean, how obvious can you get, right?!

Now I have two sons – both in their early 20s. Now I know what “they grow up so fast” means.

Similarly, I didn’t need my dad and grandma to get Alzheimer’s Disease to know that “dementia is bad.”

But it’s a bit like “they grow up so fast.” Sometimes, the things you’ll nod your head (in agreement) to, don’t really sink in until you’ve had a certain amount or type of experience.

So, here’s what I’ll do in this video. I’d like to list five (5) things that probably seem so obvious that I don’t think I ever would have denied them.

At the same time, from where I sit now, I realize that I didn’t actually appreciate the full significance of any of the five until I became the daily caregiver for my dad around 2008.

(The video version of this presentation is available on our YouTube channel.)

My dad died in 2016 from complications related to his Alzheimer’s. I have had several years to decompress and reflect on my family’s experiences with that dreaded disease.

So, I don’t say that just being my dad’s caretaker illuminated my mind. And I won’t pretend that merely listing these things for you will illuminate yours.

At the same time, I feel like encouraging you to slow down and maybe meditate on these things might be worthwhile. So, okay…

  1. Dementia can change your loved one’s entire personality. 

If, pre-2008, you’d have asked me: “Can Alzheimer’s alter personality?” I’m sure I’d have said, “You bet.” Nevertheless… Here’s what I thought when I started caretaking. 

I thought my dad would continue to be the same extroverted, happy-go-lucky, laid-back person I had always believed him to be. – just with increasing memory problems. It took months – and countless frustrating, tearful, and sometimes (frankly) scary interactions – to learn that Alzheimer’s had flipped his personality. Almost all my dad’s traits that I just listed literally turned into their opposites. He was withdrawn and isolated, combative, agitated, etc.

Now… a case can be made that all these “negatives” had always been there, deep down. Everyone has a “dark side,” kind of thing.

So, maybe, for most of his life he was just really good at hiding or restraining those parts. And, maybe, when he got Alzheimer’s, he just couldn’t or wouldn’t hold back any more. Regardless…

What you “get” – when caring for a dementia-afflicted loved one – is often quite different from what you’re used to, what you expect, and especially what you hope for. So, be prepared for anything! Or, to put it another way, realize that the person you’re dealing with – while they may resemble the one you’ve known and loved your entire life – might act like a complete stranger.

  1. Being a caretaker can make you feel really depressed.

Again, is this a surprise? Even people with no experience with Alzheimer’s probably know that it’s a horrible – and terminal – disease. Watching a loved one deteriorate is depressing. 

But I thought that I’d at least feel as if I were doing something worthwhile by helping my dad. 

And, don’t get me wrong, it was worthwhile, objectively speaking. In hindsight, I do cherish the fact that I was present for and with my dad.

Subjectively, though, when everything was going on, I felt miserable. Caretaking frequently felt futile and useless. And I felt physically sick much of the time. Maybe it’s just me.

It wasn’t just the understandable fact that my dad didn’t appreciate what I was doing. It was that he resented and actively resisted me. The whole thing was a fight practically from day one.

I locked the doors from the inside. I hid his tools. I disabled the car and – ultimately – pushed his long-time doctor to petition the state to get his driver’s license revoked. I was the enemy. 

I knew that the steps I took had to be taken. But it was also painfully obvious my dad was being systematically cut off from all the things that gave him freedom and that he always loved to do.

I tried to remind myself that his disease was really to blame – not me. But that didn’t stop me from being overcome with guilt and regret. I’ve gotten more into all this in a dedicated video

So: If being a caregiver makes you feel awful, you’re not alone. I felt horrible. 

And, on the wavelength of things I didn’t fully know: Know that your life – and the life of your loved one – may be permanently changed. Relatedly…

  1. You will need to take breaks.

Not taking a break can lead to serious consequences – not least is your own emotional or physical breakdown and burnout. Who would deny it?

By the same token, you can’t exactly leave an Alzheimer’s sufferer by themselves for any length of time. It may be difficult for you to prepare and eat meals in peace or to get an uninterrupted night’s sleep, let alone to take a mini-vacation. And this can go on for years. 

In our case, my dad would live nearly eight (8) years after his diagnosis. That’s a long time to be someone’s 24/7 caretaker all by yourself.

So… how are you going to take those needed breaks?

As I’ve mentioned in other presentations, if you have no able or willing family members to relieve you from time to time, or in an emergency, then you may have to turn to professionals. Adult daycare, home-care providers, and (what are called) respite-care specialists can all play rôles, here. But, however you get help, you need to make sure that you take care of yourself.

Ultimately, a nursing home or other long-term care facility may be the only game in town. And on that note, try to more fully appreciate that…

  1. Your loved one may end up in a nursing home.

And when I say “end up,” I don’t mean to suggest that it’s inevitable. I don’t believe that.

And, in my case, I don’t mean to refuse responsibility for the decision to get him admitted. It was my choice.

But, honestly, early on, I did a lot of “ostriching.” If I had seriously faced the fact that a nursing home was a possible – or eventual – outcome, I’d like to think that I would’ve planned for it.

I’d say: “I would have planned better.” Except, to be frank, I didn’t do any real planning at all.

No one in my family wanted to think about dad being in a nursing home. – including me.

And I put off any serious thought about that option until I was totally exhausted with caretaking. By that time, our options were severely limited. Even among homes we could “afford” (quote, unquote), our top two (2) choices were unavailable. They both had year-long waiting lists.

And because I was emotionally broken when I started to look into various homes, it’s likely that I didn’t investigate as thoroughly as I might have. – or, quite possibly, as I should have.

Since you can’t reason well when you’re under duress, my evaluation of the options – and my decision – were probably compromised also. It would have been healthier for me to admit, from the get go, that I couldn’t really rule out nursing homes. 

If I’d have done only that, our decision-making process would have gone much better – and, possibly, yielded a better outcome. To top it off, I didn’t fully appreciate that…

  1. A nursing home isn’t a perfect solution.

Again, who would say otherwise? For one thing, it’s obvious – at a general level – that when we’re deciding between two or more options, each choice will have positives and negatives.

Duh. Right? In hindsight, it seems pitifully naïve of me to have ever hoped that a nursing home would be “the answer to all my prayers.” Of course, nursing homes have their own drawbacks. 

Some of these disadvantages are both major and pretty obvious – like the fact that they have a staggering, current average cost in the vicinity of $8,000 per month.

Another serious downside – one that I intend to make the focus of its own video – is the arguable tendency of nursing homes to over-medicate their patient-residents. I don’t want to go too far down this rabbit trail right now. Let’s just say that – in my opinion – my dad’s nursing home medicated him just to make him docile.

But it was hard for me to understand all this when I was at the end of my rope with homecare. The situation became seriously unmanageable. And I became desperate for an escape route.

So, at the risk of concluding with another one of those aphorisms that’s easy to say, but hard to appreciate or do… Try to stay as clear-headed as possible. 

From a practical standpoint, try to have open and honest conversations with every interested person in your circle: from family and friends to doctors, lawyers, and so on.

Solicit advice from as many reputable sources as possible. And run your options past your family “think tank.” Try not to exclude any possibilities. 

In two (2), planned, follow-up videos, I’ll expand on some of these ideas and explore related topics like “things I wish I’d known when I started off caretaking.” In the very next installment, already written, I’ll suggest three (3) things that I would do immediately, if I had to be a caregiver all over again.

But if you found something of interest or of use in this video, I invite you to click “Like.” It helps YouTube know that you appreciated the presentation. 

If you’d be interested in hearing some of my tips, then please Subscribe to the channel (if you haven’t already) and don’t forget to make sure your notifications are turned on – the “bell” icon. 

And if you think someone else might get something out of the video, kindly share the original link on your social media pages. 

Either way, though, I thank you for watching. 

And I wish you all the best for your caretaking efforts.

Does Alzheimer’s Disease Disprove the Existence of a ‘Soul’?

Alzheimer's Disproves the Soul?

Introduction

So far, most of my content has dealt with Alzheimer’s proofing in home-modification scenarios and other long-term-care conversations.

But, today, I thought I would venture off the beaten path just a little bit.

Alzheimer’s also has a number of interesting theoretical implications as well. My academic background is partly in philosophy and so these theoretical questions are also of interest to me personally.

There are a great number of these cognitive impairments and dementia might surface in a number of different contexts. Ethics is going to be one. Metaphysics is another. Philosophy of mind has obvious relevance. So, I thought I would just pick one of those issues and I decided upon the question of the existence of the soul; that this is an issue that has been debated for thousands of years, so I am under no illusions about trying to resolve the issue in the space of a short web article.

In fact, I am not even going to take sides on the issue, what I want to do instead is just trying to present an accessible introduction to the range of issues, or if you are already familiar with these then call it a refresher course.

The question that is going to be somewhat in focus here is:

Does Alzheimer’s disease disprove the existence of the soul?

What I am going to do is assume the role of the person who says that Alzheimer’s does disprove the soul and then, on the other side of the fence, I’ll play the person who says it does not. I’ll go back and forth like this through five (5) considerations.

But, without further ado, let me present both sides!

Pro and Con Arguments

Against Soul #1: Alzheimer’s is a brain disease that can destroy someone’s personality. That’s the key point.

Alzheimer’s destroys personality by destroying the brain. So, take away the brain, and you take away the personality. A soul simply does not fit into that picture anywhere.

The brain is necessary for personality.

For Soul #1: The brain is necessary for personality. There is no real question about that. So yeah, if you take away the brain, you take away the personality.

But think of a Philly-Cheese-Steak sandwich. If you take away the cheese, you take away the Philly cheese steak sandwich. That does not show that there is nothing to a Philly cheese steak sandwich other than cheese.

The cheese is necessary, just like the brain is necessary. But arguing that the necessity of the brain shows the nonexistence of the soul is like arguing that the necessity of the cheese shows the nonexistence of …bread rolls.

Against Soul #2: Not really, because we already know that bread rolls exist, and we know the full recipe for a Philly cheese steak. It is part of our background information.

But, here, we’re trying to figure out what the full recipe for personality is, based on empirical evidence.

Personality is made up of brain states. Think of it as like how a team is made up of players and coaches. There is nothing more to a team than the people who make it up, and there is nothing more to a personality than the brain states that make it up.

For Soul #2: Well, wait a minute!

The evidence shows dependence. Personality depends on the brain. But dependence is not the same thing as identity.

A team may be identical to the people that make it up. But, then, a team is not a good analogy.

A better analogy would be to think of a musician. A musician depends on a working, well-tuned instrument in order to make music. If the instrument is broken, or out of tune, then the quality of the music is either dramatically lowered, or the musician may not be able to make any music at all. But this dependence of the musician on a working instrument certainly does not imply that music is identical to a good instrument.

Similarly, the fact that personality is dependent on the brain does not mean the two are identical. The brain is an instrument of the soul.

Against Soul #3: But we can experience both musicians and musical instruments. We know they are two separate things because we can have dealings with both of them.

Again, in this case, were trying to figure out how many things there are.

Just because there could be something more than the physical brain does not mean that there is.

Number one, it’s not clear how a nonphysical thing like a soul could use a physical brain as a tool.

And, number two, the principal known as “Occam’s Razor” tells us not to multiply causes, and to prefer simpler explanations.

So, in this case, saying that personality is due to one thing – a physical brain – is simpler than saying that it is due to two things – a physical brain plus some mysterious “soul.”

For Soul #3: There’s a saying, sometimes attributed to the famed physicist Albert Einstein: “Make everything as simple as possible, but not simpler.”

Simplicity is great, but it is not always a matter of just counting proposed causes.

Suppose someone is investigating a house fire, and they notice that the wiring is faulty, and that there were oily rags strewn about the entire place.

Now, it would, of course, be simpler to explain the house fire only by talking about the faulty wiring, and not mentioning the oily rags at all. But, if the house fire was in fact caused by faulty wiring and the rags together, then any explanation that leaves one of those factors out is not a good explanation.

Occam’s Razor says we should not multiply causes beyond necessity. Sometimes multiplying causes is necessary.

Against Soul #4: In the case of your fire example, the multiplication of causes is necessary because the scientist, or in that case, the fire investigator, concludes from the evidence that having more than one cause is necessary to give a full explanation.

In the case of personality, the investigators, for example, neuroscientists, have not concluded that we need to appeal to more than the physical brain in order to have an adequate explanation.

So, appealing to anything else simply goes beyond what is needed.

For Soul #4: Fire investigators and neuroscientists are both scientists of nature.

Natural science deals with what is physically measurable and physically detectable.

So, natural scientists can tell you all about the physical causes of physical things, but they cannot tell you about nonphysical things. For example, the fire investigator can tell you about faulty wiring and oily rags but cannot tell you that the fire was a tragedy.

Things like tragedies, or indeed souls, are nonphysical things. But, being nonphysical does not mean that they are not real parts of human experience. They are; they just go beyond what natural science can talk about.

Against Soul #4: We do not need the fire investigator to tell us that the fire was a tragedy. That’s obvious. But having a soul is not obvious.

For Soul #4: Here is what’s obvious: I have a rich inner experience – a private mental life – that goes beyond what neuroscientists can image, or test, or quantify in physical experiments.

Against Soul #5: We are getting off track. Here is the bottom line.

My dad got Alzheimer’s disease and progressively forgot more and more, and got worse and worse until, eventually, somebody could have looked at him and said he was a completely different person.

And that horrible decline was due to a brain disease.

So, at the end of the day, who my dad was, and who we all are, is dependent on, caused by, or explained in terms of the brain.

If something like Alzheimer’s disease comes along and damages our brains enough, it can literally change who we are.

And this is not at all what we would expect if we had, or if we were, something other than, a physical brain.

Therefore, Alzheimer’s disease shows: Probably, there is no such thing as a nonphysical soul.

For Soul #5: Well, my dad went through Alzheimer’s disease, too.

Notice how we both said that.

My dad developed Alzheimer’s disease.” “My dad got progressively worse.” “My dad forgot who he was.”

But all that happened to the same person: My dad.

Yes, his personality was dramatically and tragically changed, because we know – from science – that you have to have a working brain in order to be a healthy and recognizable version of yourself.

But my dad never literally became someone else. If he had, why would the family have continued to care about him at all?

See, that is really the point. If, as I think, he was still numerically one and the same person, even after his brain and his personality were destroyed, then the question is: What was it about them that stayed the same the whole time? What continuous, existing thing explains that identity over time?

It wasn’t his brain, or his memories, or his personality. All those things were destroyed by the Alzheimer’s!

Therefore, I say that the thing that stayed the same was something the Alzheimer’s could not destroy: It was his soul.

Conclusion

These are heavy, theoretical topics! Bear in mind that I have left out quite a lot!

Philosophical reflections on questions regarding the soul may spill over into discussions of personal identity, memory, and so on – each of which on their own fill countless pages and extend back hundreds and even thousands of years.

Conversations of this kind often invoke obscure words and forbidding terminology. You may hear talk of “aboutness” and “intentionality.” You may be exposed to ponderous phrases like “mind-body dualism” and “reductive versus non-reductive physicalism.” You might hear great-big words like “supervenience.”

In the above presentation (and accompanying video!), what I have tried to do is to give a presentation of the issues without any of that jargon.

I have, however, bumped up against some of the deeper concepts. For example, there is an underlying discussion of necessary and sufficient conditions. I touched on this a little bit, without naming it specifically.

But, there are other important issues that I simply haven’t gotten into at all. For instance, there are questions about identity and what is sometimes called “Leibniz’s Law.” I did not really get into those at all.

And the conversation can easily turn into a subset of philosophy called “modality,” where the discussion is about concepts like contingency, possibility, and necessity.

Suffice it to say that there is plenty of room to expand a conversation like this!

So… if you feel like I have left out your favorite argument or your favorite consideration, please understand that I have not done it to purposely weaken one side of the argument or another, or to play favorites. I have simply done it because I felt that introducing another concept might have made the article a little bit less accessible.

And bear in mind that all of that is simply keeping the conversation in the realm of what you might call “philosophy.” The conversation could easily be further expanded to include religious doctrines, theological opinions, etc., and that could be an entire presentation all on its own.

What I did present was simply designed to be an introduction to the issues.

Although I may certainly get into further theoretical issues in the future, understand that this website is mostly about some very practical concerns about how to Alzheimer’s Proof your care environment. Or, indeed, I get into how to Alzheimer’s Proof your own diet and lifestyle to reduce your own risk of developing diseases like Alzheimer’s and other forms of dementia.

Of course, I have further content along those lines planned. So, I invite you to bookmark the page and check back!

Thank you for reading or watching!

Feel free to leave your thoughts in the comments, below.

16 Antioxidant Herbs for Alzheimer’s on Your Spice Rack

Antioxidant Herbs for Alzheimer's

Researchers have not yet been able to say definitively what the cause of Alzheimer’s disease is. But, among the candidate causes discussed is oxidation in the body – also called “oxidative stress.”

I want to survey the antioxidant potential of sixteen (16) herbs that you might have on your spice rack at home.

The Relevance of Oxidation

Oxidative stress dovetails with Alzheimer’s disease in several respects.

Firstly, patients who already have Alzheimer’s disease have problems with accelerated oxidation. They have more oxidative stress in their brains.

Secondly, many readers may also be aware that one of the primary characteristics of Alzheimer’s disease is that there is an abnormal accumulation of beta-amyloid and tau protein deposits, which aggregate between – and inside of – nerve cells, gumming up the neural “works.” Well, this abnormal deposition of protein has been speculated either to be the result of an increase in “free radicals” or a decrease in antioxidant defenses inside of some people’s bodies. In other words, it’s the result of oxidation.

But that raises the question: Are antioxidant therapies for Alzheimer’s disease viable?

In attempting to answer this question, we should be mindful of the fact that herbs can be excellent sources for antioxidant. And, as I mentioned at the outset, many of these versatile plants can be found in your kitchen.

In this article, I’ll list sixteen of the most common. (In a follow-up post, I’ll provide a further sixteen that, while less common, are still available.)

Caveats

Obviously, I’m not guaranteeing that you will have all – or even any of – these on your spice rack. Various starter sets will likely include some elements that I don’t write about. Contrariwise, your set may fail to have some component that I do discuss.

Additionally, these profiles are not exhaustive. Moreover, not every example of these herbs will have exactly the same chemical constituents or in the same amounts. It often depends on how the plants are grown, what weather conditions were like, how they were harvested, how the extract was harvested, how was stored, etc. Numerous peer-reviewed scientific journals contain more detailed information on herbs, in general, and on their antioxidant constituents, specifically.

16 Common Antioxidant Herbs You Have on Your Kitchen Spice Rack

Spice #1: Basil[1] (Ocimum basilicum)

Like most of the herbs surveyed here, basil is a good source of vitamins – many of which actually are antioxidants, themselves. But what I’m going to be concerned with is some of the other antioxidant chemicals that are found in these plants.

Basil’s Antioxidant Profile

I have come up with these little graphics with a list of antioxidants. I’m calling these the “antioxidant profile.”

In some cases, an herb’s antioxidant activity can’t be explained solely by the presence of any single compound on the list. In other words, following this line of thinking, it’s not just eugenol, but it’s eugenol in conjunction with all of the other chemicals contained in basil.

(Note: eugenol is more abundantly present in oil of clove. See Part 2.)

This propensity of antioxidants to complement and mutually amplify one another is referred to as “synergism.”

In addition to basil’s significant antioxidants, the herb has also been shown to increase both “memory retention” and “memory retrieval” in experiments on mice.[2]

Spice #2: Bay Laurel Leaves (Laurus nobilis)

Bay Laurel’s Antioxidant Profile

You can see that my list for bay leaves is a little bit less expansive than it was for basil. sale being the primary one.

Nevertheless, bay laurel essential oil is a rich source of natural antioxidants. In fact, the anti-inflammatory and antioxidant potential of “laurel extracts is very significant,” particularly in relation to pathologies such as “Parkinson’s disease, Alzheimer’s disease, and atherosclerosis.”[3]

Spice #3: Black Pepper (Piper nigrum)

Black Pepper’s Antioxidant Profile

This one is really interesting to me. I’m fascinated that this is on the list because even people who don’t have a “collection” of herbs and spices probably have a salt and pepper shaker!

So, it’s amazing that pepper – regular pepper – may have many health-promoting qualities. And it may be highly relevant to Alzheimer’s prevention and treatment.[4]

For example, it’s full of antioxidants.

Piper nigrum’s signature component is something termed “piperine.” You don’t have to go further than the title of one Food-and-Chemical-Toxicology article to get a sense of why this is constituent is so exciting. “Piperine, the main alkaloid of …black pepper, protects against neurodegeneration and cognitive impairment in animal model[s] of cognitive deficit[s] like …Alzheimer’s disease.”[5]

It might be worthwhile to develop a taste for black pepper – if you don’t have one already! Sprinkle a little on your food next dinnertime.

Not only is a good antioxidant, in general, but it actually helps reduce high-fat-intake-induced oxidative stress, specifically.[6] Obesity, and consumption of high-fat diets are both known to be risk factors – that is, increase risk – for Alzheimer’s.

I get into this further in Part 1 of my YouTube-video series on sugar and dementia. (Watch Part 1, HERE.)

But, since black pepper is also purported to have acetylcholinesterase activity,[7] Piper nigrum is also an excellent and promising candidate for multi-target Alzheimer’s-disease therapies.

(And… if you want to get more into acetylcholinesterase inhibitors, I have separate YouTube videos on that subject. For a rudimentary explanation of how acetylcholinesterase inhibitors are supposed to work, see HERE. On the perhaps far-fetched and – as far as I know – merely theoretical possibility that a natural “acetylcholinesterase deficiency” might be beneficial in avoiding Alzheimer’s, see HERE. Finally, on the six, Food-and-Drug-Administration-approved Alzheimer’s drugs – five of which have acetylcholinesterase-inhibiting functions – see HERE.)

It’s worth observing that it’s not just black pepper that is reported to deliver positive health effects. The Piper genus has some 2,000 species of plants.[8] It is plausible to think that at least some of these will have effects similar to those of black pepper just rehearsed.

Spice #4: Cayenne / Paprika (Capsicum annuum)

Cayenne / Paprika’s Antioxidant Profile

Speaking of varieties of pepper, cayenne is another one commonly locatable on kitchen spice racks.

Rich in antioxidants, Cayenne’s main constituents include ascorbic acid, which is (of course) the more “sciency” name for Vitamin C. (By the way, for more on Vitamin C, glance see further down in this article.)

Vitamin C isn’t this pepper’s only arrow in its nutritional quiver. Cayenne also contains a healthy quantity of calciferol, that is, Vitamin D.[9]

Cayenne is known, in part, for is its antidiabetic effect.[10] Of course, diabetes may increase a person’s risk of Alzheimer’s.[11]

I’ll add that some people might have a cannister labeled paprika in their herbal starter packs. Now, I am not a chef, so this is not a culinary observation, but… cayenne and paprika are very similar. In fact, they’re similar enough that, from our standpoint, they can be considered readily interchangeable.[12]

So, for example, paprika is an antioxidant. It contains a variety of compounds, including Vitamin A – or “retinol” – and some other carotenoids, similarly to cayenne. It’s rich in antioxidants.[13]

You can see some validation of this in the article with the somewhat forbidding title, “Binding Antioxidant and Antiproliferative Properties of Sweet Paprika.”[14]

I’ll presently toss in a little caveat. Weather conditions as well as the various, possible ripening stages of individual peppers are going to impact the chemical constituents of these herbs. In the article cited in my footnote, you can see this point in reference to paprika.[15] However, as hinted at in my “disclaimers,” similar statements considerations apply to any of the herbs surveyed.

Spice #5: Cinnamon (Cinnamomum verum)[16]

Cinnamon’s Antioxidant Profile

Cinnamon is loaded with antioxidants, according to the commonly cited website Healthline.[17]

In some ways, cinnamon’s antioxidant effects are similar to those of black cardamom (Amomum subulatum),[18] which I’ll get into in Part 2. (Again, to see this presentation in a YouTube-video format, see HERE.)

Spice #6: Coriander Seeds [19] (Coriandrum sativum)

Coriander Seed’s Antioxidant Profile

Coriander seeds have potential as natural antioxidants.[20] In fact, in addition to coriander’s ability to counteract oxidative stress, the seeds also show antihyperglycemic activity.[21] This makes Coriandrum sativum yet another potential herbal prophylaxis against diabetes. (And this, in turn, may help to reduce a person’s risk of dementia.[22])

Beyond these properties, “Coriandrum sativum seed extract” appears directly relevant to Alzheimer’s and other forms of dementia (for example, Multi-Infarct Dementia, also called “Vascular Dementia”) in virtue of its observed “ameliorative effects on memory impairment in… mice.”[23]

To put it slightly differently, it can possibly “[repair] memory deficits”[24] – which is cause for excitement!

Spice #7: Cumin (Cuminum cyminum)

Cumin’s Antioxidant Profile

“…[C]umin is a potent antioxidant.”[25]

Its constituents include beta-carotene, cineole, and limonene.

According to an article in the peer-reviewed journal Pharmaceutical Biology, cumin also has antistress potential. But, interestingly, especially for the focus of this website, the authors enthuse that cumin also has “memory-enhancing activity.”[26]

They wrote: “This study provides scientific support for the antistress, antioxidant, and memory-enhancing activities of cumin extract and substantiates that its traditional use as a culinary spice in foods is beneficial and scientific in combating stress and related disorders.”[27]

It happens to be an excellent stand-in for coriander. So, if you don’t have coriander seeds, but you do have cumin, you’re in luck. Not only can you expect that cumin is substitutable from a culinary standpoint, but – as alluded to – it also can be used as a stand-in from the standpoint of antioxidant profiles.

Spice #8: Garlic (Allium sativum)

Garlic’s Antioxidant Profile

Speaking of those antioxidant profiles, garlic has a unique one.

Among its noteworthy chemical parts, garlic’s “signature” antioxidant is something called allicin.

Firstly, allicin is being investigated for its possible dual ability to “reduce neuronal death and ameliorate …spatial memory impairment in Alzheimer’s disease models.”[28]

Additionally, allicin also holds promise as an acetylcholinesterase inhibitor[29] – which is the main therapeutic action of the majority of Alzheimer’s drugs – including the preeminent donepezil (sold as Aricept) – currently prescribed.

We already touched on this a bit with black pepper (see above). And we’ll get into it again when we talk about sage (see below), which is also reported to have exceptional acetylcholinesterase-inhibiting activity.[30]

(For my YouTube video on how acetylcholinesterase-inhibiting pharmaceuticals work, click HERE. For my presentation on the six FDA-approved for Alzheimer’s, see HERE.)

In addition to its own antioxidant constituents, Aged Garlic Extract (AGE) has “the ability …to increase the levels of some antioxidant enzymes.”[31]

Among other things, garlic also has a storied history as an antibacterial agent. For more on the herb that, before Alexander Fleming arrived on the scene, was referred to “Russian Penicillin,” see, for example, the article “Extracts From the History and Medical Properties of Garlic.”[32]

Spice #9: Ginger (Zingiber officinale)

Ginger’s Antioxidant Profile

“Ginger is loaded with antioxidants…”.[33]

Recalling from our discussions of cayenne and cinnamon that diabetes is an Alzheimer’s risk factor, it’s also notable that “[g]inger has been shown to possess anti-diabetic activity in a variety of studies.”[34]

It also turns out that ginger has health-giving properties that are particularly relevant to females of the species. According to the peer-reviewed journal Evidence-Based Complementary and Alternative Medicine: “[G]inger is a potential cognitive enhancer for middle-aged women.”[35]

Finally, for Alzheimer’s, in particular, “Z. officinale may be a promising source of AChE [i.e., acetylcholinesterase – editor] inhibitors for Alzheimer’s disease.”[36] Indeed, some researchers think ginger may spark new insights into multi-targeted pharmaceutical approaches.[37]

Spice #10: Mustard (Brassica nigra)

Mustard’s Antioxidant Profile

It’s easy to dismiss mustard as a mere condiment. But, in fact, “Brassica nigra” is a remarkable “natural food source for antioxidants.”[38]

Healthline elaborates, stating: “Mustard contains antioxidants and other beneficial plant compounds thought to help protect your body against damage and disease. [i]t’s a great source of glucosinolates, a group of sulfur-containing compounds found in all cruciferous vegetables, including broccoli, cabbage, Brussels sprouts, and mustard.”[39]

Its antioxidant profile includes carotenes and kaempferol.

In the article titled “Kaempferol Attenuates Cognitive Deficit Via Regulating Oxidative Stress and Neuroinflammation…,”[40] appearing in the scientific journal Neural Regeneration Research, investigators report “that [kaempferol] may be a potential neuroprotective agent against cognitive deficit in [Alzheimer’s Disease].

As one of the most popular and widely used spices in the world, mustard is readily incorporated into a wide variety of dishes, recipes, and other culinary applications.

That said, however, bear in mind that various mustard-based preparations may include other ingredients besides the bare mustard seeds. Though, admittedly, some of these – for example, turmeric (see my YouTube videos HERE and HERE) and vinegar – may have salubrious properties of their own.

Spice #11: Nutmeg (Myristica fragrans)

Nutmeg’s Antioxidant Profile

Nutmeg is an interesting entrant to this list. First, let’s look at its “pluses.”

Predictably, the stuff “[c]ontains powerful antioxidants.”[41] As Healthline puts it: “Nutmeg contains an abundance of antioxidants, including plant pigments like cyanidins, essential oils, such as phenylpropanoids and terpenes, and phenolic compounds, including protocatechuic, ferulic, and caffeic acids.”[42]

Among its various “catechins,” and other assorted constituents – which together give it a free-radical-scavenging efficiency – is a unique chemical called “myristic acid.”

In one experiment, which involved feeding mice a “ketogenic diet …rich in myristic acid,” the studied diet “…significantly reduced total brain Aβ levels by approximately 25%.”[43]

Of course, the phrase “brain Aβ levels” refers to the pathological accumulation of junk, known as “beta-amyloid protein,” in the brains of Alzheimer’s suffers. These protein deposits are believed by some researchers to be the at-bottom cause of the dread disease. But, the jury is still out.

(For my own discussions of candidate Alzheimer’s-Disease causes, I invite you to see my WRITTEN ARTICLE elsewhere on this website or, if you’d prefer, view one of my early YOUTUBE-VIDEO efforts.)

Now… onto a few significant “minuses.”

In a New York Times article titled “A Warning on Nutmeg,” the author points us to the historical fact that, “[i]n the Middle Ages, it was used to end unwanted pregnancies.”[44]

This past employment as an herbal abortifacient would probably be little more than a footnote, were it not for the fact, reported by the Journal of Medical Toxicology, that there is such a thing as “nutmeg poisoning.”[45]

And this leads us to the somewhat darker side of nutmeg’s properties: myristicin’s potentially toxic effects.[46]

The concern shouldn’t be overstated, however. These poisoning cases are rare. They tend to involve teenagers horsing around. So, you don’t necessarily have to worry – for example, if you’re following quantity information in a tried-and-true recipe.

Still, interested persons should proceed with caution, since there’s little to go on in terms of precise information regarding how much nutmeg may be needed to cause some of the nastier effects (like hallucinations, nausea, and vomiting).

The New York Times says: “It takes a fair amount of nutmeg — two tablespoons or more — before people start exhibiting symptoms.”[47] That quantities of this sort (two tablespoons or more) are required is underscored by some of the poisoning reports available.[48]

Healthline suggests that doses can be less and still result in adverse events. In the article “High on Nutmeg,” writer Eleesha Lockett tell us: “According to the case studies from the Illinois Poison Center, even 10 grams (approximately 2 teaspoons) of nutmeg is enough to cause symptoms of toxicity. At doses of 50 grams or more, those symptoms become more severe. Like any other drugs, the dangers of nutmeg overdose can occur no matter the method of delivery.”[49]

(For more on this, see my YouTube video, HERE.)

Just handle nutmeg with care. For example, use only as directed by trusted recipes, and keep it out of reach of kids, teenagers, and the cognitively impaired.[50]

Spice #12: Oregano (Origanum vulgare)

Oregano’s Antioxidant Profile

“Oregano is rich in antioxidants…”.[51]

A glance at my “profile” for oregano reveals a plethora of powerful, constituent antioxidants, including rosmarinic acid – a compound also found in lemon balm (Melissa officinalis), peppermint (Mentha × piperita), rosemary (Rosmarinus officinalis), sage (Salvia officinalis), and thyme (Thymus vulgaris) – and which, in addition to its antioxidant capabilities, “…possesses many biological activities including …anti-inflammatory, anticancer, antiviral, antibacterial, and neuroprotective effects.”[52]

“Dietary intake of oregano oil has been reported to significantly delay lipid oxidation in animal models…”.[53]

One Science Daily post humorously puts things this way: “In what may be good news for pizza lovers and Italian-food connoisseurs everywhere, the herbs with the highest antioxidant activity belonged to the oregano family. In general, oregano had 3 to 20 times higher antioxidant activity than the other herbs studied,” according to at least one American-Chemical-Society investigation.[54]

Spice #13: Rosemary (Salvia rosmarinus / Rosmarinus officinalis)

Rosemary’s Antioxidant Profile

Rosemary has “potent antioxidant properties” which “have been mainly attributed to its major diterpenes, carnosol and carnosic acid, as well as to the essential oil components”[55] – names for some of which you can read on the “dossier” that I have prepared.

We looked at another, characteristic antioxidant component – namely, rosmarinic acid – when we covered oregano, above.

Rosemary is quite noteworthy. In fact, I have two video presentations dedicated to it (viewable HERE and HERE), including one (ßthe second link!) where I (unofficially!) name it my pick for the second-best “Alzheimer’s herb” – just behind Gingko biloba.

Suffice it to say that rosemary is one of those “powerhouse” herbs that appears to be capable of attacking Alzheimer’s from multiple angles, including: providing “…general antioxidant-mediated neuronal protection,” guarding against “brain inflammation,” and even possibly hindering “amyloid-beta (Aβ) formation.”[56]

(Recall that nutmeg was alleged to have a similar, Aβ-inhibiting action. For a review, see the relevant section, above. And, for similar remarks about sage, continue, below!)

Spice #14: Sage (Salvia officinalis)

Sage’s Antioxidant Profile

As Healthline puts it: Sage is “Loaded With Antioxidants”![57] In fact, the herb reportedly “…contains over 160 distinct polyphenols, which are plant-based …antioxidants…”.[58]

Like oregano and rosemary before it, sage also contains nonnegligible quantities of rosmarinic acid (see the writeup on oregano for details). But it also has salvianolic acid, a chemical that is somewhat unique to Salvia plants.

The widely studied Red-Sage species, Salvia miltiorrhiza, for example, has “Salvianolic acid B (Sal B),” a “major and …active anti-oxidant …[that] protects diverse kinds of cells from damage caused by a variety of toxic stimuli.”[59]

Though, I hasten to add that “…salvianolic acid” shows up as one of the “major components” in “…analyzed samples of S. officinalis…,” or garden-variety sage, as well.

The remarks made in one scientific article are worth quoting at length.

“Amongst many herbal extracts, Salvia species are known for the beneficial effects on memory disorders… S. officinalis (common sage), Salvia lavandulaefolia (Spanish sage), and Salvia miltiorrhiza (Chinese sage) have been used for centuries as restoratives of lost or declining mental functions such as in Alzheimer’s disease (AD).

“…In AD, the enzyme acetyl cholinesterase (AChE) is responsible for degrading and inactivating acetylcholine, which is a neurotransmitter substance involved in the signal transferring between the synapses. AChE inhibitor drugs act by counteracting the acetylcholine deficit and enhancing the acetylcholine in the brain. …Essential oil of S. officinalis has been shown to inhibit 46% of AChE activity at a concentration of 0.5 mg/ml.

“…A study shows that S. officinalis improves the memory and cognition… A randomized, double-blind clinical study has shown that an ethanolic extract from common sage (S. officinalis) as well as Spanish sage (S. lavandulaefolia) is effective in the management of mild to moderate AD…”

“…The cytoprotective effect of sage against Aβ (amyloid-beta plaques) toxicity in neuronal cells has also been proven by …a study which provides the pharmacological basis for the traditional use of sage in the treatment of AD.”[60]

Therefore, sage – along with other plants like gingko, rosemary, and saffron – belongs high on any list of possible herbal Alzheimer’s interventions.

Let me interject, at this point, that if you want more detailed information on or about any of these herbs, then I would invite you to do a little bit of research yourself on PubMed.

First of all, many articles specify more of the antioxidant constituents than I do.

Secondly, as just illustrated by the previous, long quotation, numerous scholarly articles excavate the therapeutic potential of these spices much more completely – and expertly – than I can do in this space.

(However, for a nontechnical introduction, I invite you to check out my own treatment of sage on YouTube, HERE.)

(For a refresher regarding the significance of this activity for Alzheimer’s Disease, see the entries for black pepper and garlic, above. See also: my YouTube presentations on the function of acetylcholinesterase inhibitors, HERE; hypothetical “acetylcholinesterase deficiency,” HERE; and FDA-approved Alzheimer’s drugs which have acetylcholinesterase-inhibiting functions, HERE.)

Spice #15: Thyme (Thymus vulgaris)

Thyme’s Antioxidant Profile

Regarding thyme, one website reports: “It turns out that this useful kitchen herb is also a high-antioxidant food.”[61]

In fact, thyme – or, at least, its essential oil – is arguably one of the most potent herbal antioxidants. One set of authors reports: “The best antioxidant[62] was T. vulgaris oil.”[63]

And among thyme’s most important constituents – a summary of which you can see in the “profile” that I prepared – is thymol, itself one candidate (on a short list) for the title most powerful antioxidant.

One journal states: “Thymol, carvacrol, and eugenol are the most powerful antioxidants…”.[64]

Thymol is so potent that even “waste thyme extract can… be used as an antioxidant either in food or pharmaceutical emulsions…”.[65]

In terms of Alzheimer’s-Disease relevance, I note that “…thymol decreased the effects of Aβ on memory and could be considered as neuroprotective.”[66]

On top of all this, thyme also displays antimicrobial properties.[67]

(For more on thyme, including a segment on borneol (a constituent that is able to improve the transportation of other therapeutic compounds into the brain) see the YouTube version of this presentation, HERE.)

Spice #16: Turmeric (Curcuma longa)

Turmeric’s Antioxidant Profile

This herb is more widely known – and regarded – for its potent anti-inflammatory properties.[68]

But, make no mistake, “[t]urmeric is a powerful antioxidant,” also.[69]

The key component is something called “curcumin.” Now, the relationship between curcumin and turmeric is a bit tricky, especially when it comes to supplements. Curcumin has been thoroughly studied for its health benefits – which are numerous.

But, by itself, curcumin does not have the same health benefits from a practical standpoint, because it doesn’t get absorbed well in the digestive tract.

An article in USA Today makes the point.

“Curcumin is a nutritional compound located within the rhizome, or rootstalk, of the turmeric plant. An average turmeric rhizome is about 2% to 5% curcumin. …[I]t’s the curcumin …that has the powerful health benefits. …You would have to take hundreds of [turmeric] capsules to get a clinically studied amount of curcumin. …[But p]lain curcumin extracts are poorly absorbed in the intestinal tract.”[70]

Synergy

One possible workaround arguably depends upon the concept of synergism – mentioned earlier. Recall that this has to do with the idea of “combining” or “pooling” potencies.

So, for example, curcumin can be taken with another of turmeric’s constituents, namely, aromatic turmerone, sometimes abbreviated as “ar-turmerone.”[71]

Another possibility is a combination of curcumin and black pepper, the common spice discussed earlier in this article. “[P]iperine is the major active component of black pepper and, when combined in a complex with curcumin, has been shown to increase bioavailability by 2000%.”[72]

A further illustration of the power of synergy is offered by the Journal of Agricultural Food Chemistry, where we read the following. When sage and thyme are combined, antioxidant constituents, including “[c]arnosol, rosmanol, epirosmanol, isorosmanol, galdosol, and carnosic acid” together “exhibited remarkably strong activity, which was comparable to that of alpha-tocopherol.”[73]

“Alpha-tocopherol is the most active form of vitamin E in humans.[74] It is also a powerful biological antioxidant. Vitamin E supplements are usually sold as alpha-tocopheryl acetate, a form that protects its ability to function as an antioxidant.”[75]

Blends

And… don’t forget about spice blends! Many blends provide you with these common herbs in combination.

For instance, curry powder frequently includes ingredients such as coriander, fenugreek, ginger, and – of course – turmeric.

Chili powder might have garlic in addition to cayenne or paprika.

Italian-seasoning blends are typically going to include basil, garlic powder, oregano, Rosemary, thyme, and so on. Sometimes there’s an assist from things like marjoram or parsley – both of which I get into in part 2. (See HERE.)

There are a number of other blends, of course. For example, there’s poultry seasoning, which can have oregano, sage, and rosemary, but also secondary constituents like black pepper and marjoram.

My point in mentioning blends in these cursory comments is simply this.

Even if you look at your spice rack see discover that you don’t have most – or any – of the sixteen herbs expressly named on my list, if you have a few blends, you might find that you have more than you think you do.

Vitamin C

As a coda, I’ll add that many – in fact, nearly all – of these herbs also include vitamins. In conversations about antioxidants, one of the most significant vitamins is Vitamin C, or ascorbic acid.

Take thyme, for example. Thyme is frequently touted as a significant source of vitamin C. In its article “20 Foods That Are High in Vitamin C,” Healthline reports that “[o]ne ounce (28 grams) of fresh thyme provides 45 mg of vitamin C, which is 50% of the D[aily]V[alue].”[76]

Of course, you’re probably unlikely to consume that much thyme at one sitting.

Moreover, note that the article in question specifically mentions fresh thyme – as opposed to the dried stuff. It’s arguable that fresh herbs are often higher than their dried counterparts in terms of vitamin content, but lower in terms of other antioxidants – or, at least, in terms of measured, overall antioxidant potency.[77]

(I plan on tackling the vexed topic of “ORAC values” in another place.)

Bottom line: just be aware that many of these herbs can deliver some vitamin content. In fact, every one of the herbs that I survey, here, is reported to have some Vitamin-C content.

For More Information

Where can you go for more?

  • PubMed is a publicly searchable database of scholarly articles, many of which (though, not all) are posted in full-text format. Just use search strings such as <“antioxidant” + [your favorite herb]>. PubMed is accessible, HERE.
  • Among the numerous, informative articles that you may find is an offering like this: “Antioxidant Activity of Spices and Their Impact on Human Health: A Review.”[78]
  • That article is actually published by the international, peer-reviewed, academic journal Antioxidants – located HERE – which, as its name suggests, focuses on the topic that has occupied us in this post.
  • Additionally, though, my website and YouTube channel are sources for basic introductions to many topics in the vicinity. Some of the titles that readers may find interesting include:
    1. Antioxidants on Your Kitchen Spice Rack, Part 1” (16 Common Herbs)
    2. Antioxidants on Your Kitchen Spice Rack, Part 2” (16 Less-Common Herbs)
    3. Alzheimer’s Herbs, Part 1: “Top 10 Ayurvedic Herbs” (except for turmeric!)
    4. Alzheimer’s Herbs, Part 2: “10 Miscellaneous Brain-Health Herbs” (including sage)
    5. Alzheimer’s Herbs, Part 3: “Top 5 Herbs for Alzheimer’s Disease” (turmeric is in this one!)
    6. All 25 of the herbs in the three installments just mentioned appear in a written article on my website, available HERE.
    7. Finally, I’ll mention my YouTube presentation on “Rosemary” (a dedicated, early video I made on this spice)

[By Matthew Bell]

Notes:

[1] Basil is sometimes referred to as “Sweet Basil.”

[2] Shadi Sarahroodi, Somayyeh Esmaeili, Peyman Mikaili, Zahra Hemmati, and Yousof Saberi, “The effects of green Ocimum basilicum hydroalcoholic extract on retention and retrieval of memory in mice,” Ancient Science of Life, vol. 31, no. 4, Apr.-Jun. 2012, pp. 185-189, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3644756/>.

[3] According to: Biljana Kaurinovic, Mira Popovic, and Sanja Vlaisavljevic, “In Vitro and in Vivo Effects of Laurus nobilis L. Leaf Extracts,” Molecules, vol. 15, no. 5, May 2010, pp. 3,378-3,390, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6263372/>.

[4] For just one hint of this, see: Lokraj Subedee, R. Suresh, M. Jayanthi, H. Kalabharathi, A. Satish, and V. Pushpa, “Preventive Role of Indian Black Pepper in Animal Models of Alzheimer’s Disease,” Journal of Clinical and Diagnostic Research, vol. 9, no. 4, Apr. 2015, pp. FF01-FF04, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4437082/>.

[5] Pennapa Chonpathompikunlert, Jintanaporn Wattanathorn, and Supaporn Muchimapura, “Piperine, the main alkaloid of Thai black pepper, protects against neurodegeneration and cognitive impairment in animal model of cognitive deficit like condition of Alzheimer’s disease [sic],” Food Chem. Toxicol., vol. 48, no. 3, Mar. 2010, pp. 798-802, < https://pubmed.ncbi.nlm.nih.gov/20034530/>.

[6] BrahmaNaidu Parim, Nemani Harishankar, Meriga Balaji, Sailaja Pothana, and Ramgopal Rao Sajjalaguddam, “Effects of Piper nigrum extracts: Restorative perspectives of high-fat diet-induced changes on lipid profile, body composition, and hormones in Sprague-Dawley rats,” Pharmaceutical Biology, vol. 53, no. 9, Apr. 9, 2015, pp. 1,318-1,328, <https://pubmed.ncbi.nlm.nih.gov/25856709/>.

[7] Kazuya Murata, Shinichi Matsumura, Yuri Yoshioka, Yoshihiro Ueno, and Hideaki Matsuda, “Screening of β-secretase and acetylcholinesterase inhibitors from plant resources,” Journal of Natural Medicines, vol. 69, no. 1, Aug. 15, 2014, pp. 123-129, <https://pubmed.ncbi.nlm.nih.gov/25119528/>.

[8] J.D.D. Tamokou, et al., “Antimicrobial Activities of African Medicinal Spices and Vegetables,” Victor Kuete, ed., Medicinal Spices and Vegetables from Africa: Therapeutic Potential against Metabolic, Inflammatory, Infectious and Systemic Diseases, London: Academic Press; Elsevier, 2017, p. 223, <https://books.google.com/books?id=SHjUDAAAQBAJ&pg=223>.

[9] Cholecalciferol, also known as Vitamin D3, is a particularly highly regarded variety.

[10] Setareh Sanati, et al., “A Review of the Effects of Capsicum annuum L. and Its Constituent, Capsaicin, in Metabolic Syndrome,” Iranian Journal of Basic Medical Sciences, vol. 21, no. 5, May 2018, pp. 439-448, <https://pubmed.ncbi.nlm.nih.gov/29922422/>.

[11] “Diabetes and Alzheimer’s linked,” Mayo Clinic, May 22, 2019, <https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/in-depth/diabetes-and-alzheimers/art-20046987>.

[12] Arguably, they’re literally identical. At least, in some preparations, they seem to be the same herb. But, since I am not experienced enough to know whether this is the usual state of affairs, I’ll stick to the more reserved word, and simply say that they’re similar.

[13] Lizzie Streit, “8 Science-Backed Benefits of Paprika,” Healthline, Aug. 20, 2019, <https://www.healthline.com/nutrition/paprika-benefits>.

[14] Hong-Gi Kim, et al., “Binding, Antioxidant and Anti-proliferative Properties of Bioactive Compounds of Sweet Paprika (Capsicum annuum L.),” Plant Foods for Human Nutrition, vol 71, no. 2, Jun. 2016, pp. 129-136, <https://pubmed.ncbi.nlm.nih.gov/27184000/>.

[15] F. Márkus, H. Daood, J. Kapitány, and P. Biacs, “Change in the carotenoid and antioxidant content of spice red pepper (paprika) as a function of ripening and some technological factors,” Journal of Agricultural Food Chemistry, vol. 47, no. 1, Jan. 1999, pp. 100-107, <https://pubmed.ncbi.nlm.nih.gov/10563856/>.

[16] Cinnamomum verum is sometimes designated “Ceylon Cinnamon.” It is a close cousin to the Chinese variety, Cinnamomum cassia, which is more commonly found on grocery-store shelves. According to an article in the Wall Street Journal, C. verum is considered safer than C. cassia – at least in high doses. Additionally, C. verum is assumed to share many of the same salubrious properties of C. cassia, which latter has (admittedly) been more thoroughly studied in scientific experiments. See Laura Johannes, “Little Bit of Spice for Health, but Which One? While Ceylon Cinnamon Is Milder Than Grocery-Store Variety, There Are Few Studies on Its Benefits,” Wall Street Journal, Oct. 14, 2013, <https://www.wsj.com/articles/little-bit-of-spice-for-health-but-which-one-1381786452>.

[17] Joe Leech, “10 Evidence-Based Health Benefits of Cinnamon,” Healthline, July 5, 2018, <https://www.healthline.com/nutrition/10-proven-benefits-of-cinnamon>.

[18] J. Dhuley, “Anti-Oxidant Effects of Cinnamon (Cinnamomum verum) Bark and Greater Cardamom (Amomum subulatum) Seeds in Rats Fed High-Fat Diet,” Indian Journal of Experimental Biology, vol. 37, no. 3, Mar. 1999, pp. 238-242, <https://pubmed.ncbi.nlm.nih.gov/10641152/>.

[19] Just a terminological note: Coriander and cilantro are the same plant, Coriandrum sativum. Some people, in some contexts, probably use the words “coriander” and “cilantro” as synonyms. But the way I’m using these words is this. “Coriander” refers to the seeds of the plant, whereas, “cilantro” refers to the aerial parts (leaves, etc.).

[20] Helle Wangensteen, Anne Samuelsen, and Karl Malterud, “Antioxidant activity in extracts from coriander,” Food Chemistry, vol.88, no. 2, Nov. 2004, pp. 293-297, <https://www.sciencedirect.com/science/article/abs/pii/S0308814604001219>.

[21] B. Deepa, C. Anuradha, “Antioxidant potential of Coriandrum sativum L. seed extract,” Indian Journal of Experimental Biology, vol. 49, no. 1, Jan. 2011, pp. 30-38, <https://pubmed.ncbi.nlm.nih.gov/21365993/>.

[22] For just one report on this, see: Ramit Ravona-Springer and Michal Schnaider-Beeri, “The association of diabetes and dementia and possible implications for nondiabetic populations,” Expert Review of Neurotherapeutics, vol. 11, no. 11, Nov. 2011, pp. 1,609-1,617, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3240939/>.

[23] Yurina Mima, Nobuo Izumo, Jiun-Rong Chen, Suh-Ching Yang, Megumi Furukawa, and Yasuo Watanabe, “Effects of Coriandrum sativum Seed Extract on Aging-Induced Memory Impairment in Samp8 Mice,” Nutrients, vol. 12, no. 2, Feb. 11, 2020, pp. 455ff, <https://pubmed.ncbi.nlm.nih.gov/20848667/>.

[24] Ibid.

[25] N. Thippeswamy and K. Naidu, “Antioxidant potency of cumin varieties—cumin, black cumin and bitter cumin—on antioxidant systems,” European Food Research and Technology, Jan. 12, 2005, vol. 220, pp. 472-476, <https://link.springer.com/article/10.1007/s00217-004-1087-y>.

[26] Sushruta Koppula and Dong Kug Choi, “Cuminum cyminum extract attenuates scopolamine-induced memory loss and stress-induced urinary biochemical changes in rats: a noninvasive biochemical approach,” Pharm. Biol., vol. 49, no. 7, Jul. 2011, pp. 702-708, <https://pubmed.ncbi.nlm.nih.gov/21639683/>.

[27] Ibid.

[28] Xian-Hui Li, Chun-Yan Li, Zhi-Gang Xiang, Fei Zhong, Zheng-Ying Chen, and Jiang-Ming Lu, “Allicin can reduce neuronal death and ameliorate the spatial memory impairment in Alzheimer’s disease models,” Neurosciences (Riyadh, Saudi Arabia), vol. 15, no. 4, Oct. 2010, pp. 237-243, <https://pubmed.ncbi.nlm.nih.gov/20956919/>.

[29] Suresh Kumar, “Dual inhibition of acetylcholinesterase and butyrylcholinesterase enzymes by allicin,” Indian Journal of Pharmacology, vol. 47, no. 4, Jul.-Aug. 2015, pp. 444-446, <https://pubmed.ncbi.nlm.nih.gov/26288480/>.

[30] See: Agatonovic-Kustrin, et al., <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334595/>, op. cit.

[31] Ana L. Colín-González, Ricardo Santana, Carlos Silva-Islas, Maria Chánez-Cárdenas, Abel Santamaría, and Perla Maldonado, “The Antioxidant Mechanisms Underlying the Aged Garlic Extract- and S-Allylcysteine-Induced Protection,” Oxidative Medicine and Cellular Longevity, vol. 2012, 2012, p. 907,162, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3363007/>.

[32] Biljana Petrovska and Svetlana Cekovska, “Extracts from the history and medical properties of garlic,” Pharmacognosy Review, vol. 4, no. 7, Jan.-Jun. 2010, pp. 106-110, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249897/>.

[33] “Health Benefits of Ginger,” WebMD, Melinda Ratini, reviewer, Nov. 6, 2020, <https://www.webmd.com/diet/ss/slideshow-health-benefits-ginger>.

[34] Nafiseh Khandouzi, Farzad Shidfar, Asadollah Rajab, Tayebeh Rahideh, Payam Hosseini, and Mohsen Mir Taherif, “The Effects of Ginger on Fasting Blood Sugar, Hemoglobin A1c, Apolipoprotein B, Apolipoprotein A-I and Malondialdehyde in Type 2 Diabetic Patients,” Iranian Journal of Pharmaceutical Research, vol. 14, no. 1, Winter 2015, pp. 131–140, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4277626/>.

[35] Naritsara Saenghong, et al., “Zingiber officinale Improves Cognitive Function of the Middle-Aged Healthy Women,” Evid. Based Complement Alternat. Med., vol. 2012, Dec. 22, 2011, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3253463/>.

[36] Bui Thanh Tung, Dang Kim Thu, Nguyen Thi Kim Thu, and Nguyen Thanh Hai, “Antioxidant and acetylcholinesterase inhibitory activities of ginger root (Zingiber officinale Roscoe) extract,” Journal Complementary and Integrative Medicine, vol. 14, no. 4, May 4, 2017, <https://pubmed.ncbi.nlm.nih.gov/29345437/>.

[37] See: Faizul Azam, Abdualrahman Amer, Abdullah Abulifa, and Mustafa Elzwawi, “Ginger components as new leads for the design and development of novel multi-targeted anti-Alzheimer’s drugs: a computational investigation,” Drug Design, Development and Therapy, vol. 8, 2014, pp. 2,045-2,059, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4211852/>.

[38] R. Rajamuruganab, N. Selvaganabathyc, S. Kumaraveld, C. Ramamurthyc, V. Sujathae, and C. Thirunavukkarasu, “Polyphenol contents and antioxidant activity of Brassica nigra (L.) Koch. leaf extract,” Natural Product Research, vol. 26, no. 23, Dec. 2012, pp. 2,208-2,210, <https://www.researchgate.net/profile/Dr_Chinnasamy_Thirunavukkarasu/publication/51818527_Polyphenol_contents_and_antioxidant_activity_of_Brassica_nigra_L_Koch_leaf_extract/links/55ca502608aeca747d69e63f/Polyphenol-contents-and-antioxidant-activity-of-Brassica-nigra-L-Koch-leaf-extract.pdf>.

[39] Alina Petre, “Is Mustard Good for You?” Healthline, Jan. 10, 2020, <https://www.healthline.com/nutrition/is-mustard-good-for-you>.

[40] Somayeh Kouhestani, Adele Jafari, and Parvin Babaei, “Kaempferol attenuates cognitive deficit via regulating oxidative stress and neuroinflammation in an ovariectomized rat model of sporadic dementia,” Neural. Regen. Res., vol. 13, no. 10, Oct. 2018, pp. 1,827-1,832, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128063/>.

[41] Jillian Kubala, “8 Science-Backed Benefits of Nutmeg,” Healthline, Jun. 12, 2019, <https://www.healthline.com/nutrition/nutmeg-benefits>.

[42] Ibid.

[43] Milad Iranshahy and Behjat Javadi, “Diet therapy for the treatment of Alzheimer’s disease in view of traditional Persian medicine: A review,” Iranian Journal of Basic Medical Sciences, vol. 22, no. 10, Oct. 2019, pp. 1,102-1,117, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885391/>.

[44] Deborah Blum, “A Warning on Nutmeg,” New York Times, Nov. 25, 2014, <https://well.blogs.nytimes.com/2014/11/25/a-warning-on-nutmeg/>.

[45] See: Jamie Ehrenpreis, Carol DesLauriers, Patrick Lank, P. Keelan Armstrong, and Jerrold Leikin, “Nutmeg Poisonings: A Retrospective Review of 10-Years Experience from the Illinois Poison Center, 2001–2011,” J. Med. Toxicol., vol. 10, no. 2, Jun. 2014, pp. 148-151, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057546/>.

[46] Note: Beside the fact that “[m]yristicin is present in nutmeg” – and the related “mace” – it’s also present in “…black pepper, parsley, celery, dill, and carrots.” This is according to the chapter titled “Toxins in Food: Naturally Occurring,” by D. Hwang and T. Chen, contributors to the academic volume Encyclopedia of Food and Health (Oxford and Waltham, Mass: Academic Press; Elsevier, 2016), edited by Benjamin Caballero, Paul Finglas, and Fidel Toldrá (text excerpted at <https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/myristicin>). However, I am reporting on myristicin in relation to nutmeg – and not in relation to other of the named plants – because the quantities are orders of magnitude higher in nutmeg, resulting in the fact that “…nutmeg and mace induce greater narcotic and psychotomimetic activity than” some other herbs, or even of “…an equivalent amount of myristicin or elemicin, also a component of nutmeg” separately. Ibid.

[47] Blum, loc. cit.

[48] Ehrenpreis, et al., op. cit. In fact, one report involved “…ten tablespoons of nutmeg.” Ibid.

[49] Eleesha Lockett, “Can You Get High on Nutmeg? Why This Isn’t a Good Idea,” Gerhard Whitworth, reviewer, Healthline, Aug. 31, 2018, <https://www.healthline.com/health/high-on-nutmeg>. Note that in a Google snippet, the article’s title displays as “High on Nutmeg: The Effects of Too Much and the Dangers”; whereas, on the actual Healthline website, the title reads “Can You Get High on Nutmeg? Why This Isn’t a Good Idea.” Presumably, the difference has to do with Search-Engine-Optimization (SEO) settings, which is an esoteric conversation that would implicate technical terms like “metadata” and “metatags,” and lies far afield from anything I’ll be delving into, presently.

[50] Of course, the focus of my work is on people with Alzheimer’s Disease and other forms of dementia. These conditions negatively affect memory and reasoning. Confused sufferers can sometimes expose themselves (or others) to dangers – whether advertently or inadvertently. For instance, one journal article reports on the case of one woman whose cognitively afflicted “…husband put nutmeg on his steak instead of pepper.” Els van Wijngaarden, et al., “Entangled in uncertainty: The experience of living with dementia from the perspective of family caregivers,” PLoS One (Public Library of Science), vol. 13, no. 6, Jun. 13, 2018, p. e0198034, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5999274/>.

[51] Rachael Link, “6 Science-Based Health Benefits of Oregano,” Healthline, Oct. 27, 2017, <https://www.healthline.com/nutrition/6-oregano-benefits>.

[52] Niloufar Ansari and Fariba Khodagholi, “Natural Products as Promising Drug Candidates for the Treatment of Alzheimer’s Disease: Molecular Mechanism Aspect,” Current Neuropharmacology, vol. 11, no. 4, Jul. 2013, pp. 414-429, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744904/>.

[53] Muhammad Ayaz, Abdul Sadiq, Muhammad Junaid, Farhat Ullah, Fazal Subhan, and Jawad Ahmed, “Neuroprotective and Anti-Aging Potentials of Essential Oils from Aromatic and Medicinal Plants,” Frontiers in Aging Neuroscience, vol. 9, May 30, 2017, p. 168, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447774/>.

[54] “Researchers Call Herbs Rich Source of Healthy Antioxidants; Oregano Ranks Highest,” Science Daily, Jan. 8, 2002, <https://www.sciencedaily.com/releases/2002/01/020108075158.htm>; citing: American Chemical Society. On oregano outperforming other herbals in terms of its antioxidant abilities, see also: Snezana Agatonovic-Kustrin, Ella Kustrin, and David Morton, “Essential oils and functional herbs for healthy aging,” Neural Regeneration Research, vol. 14, no. 3, Mar. 2019, pp. 441-445, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334595/>.

[55] Aleksandar Rašković, Isidora Milanović, Nebojša Pavlović, Tatjana Ćebović, Saša Vukmirović, and Momir Mikov, “Antioxidant activity of rosemary (Rosmarinus officinalis L.) essential oil and its hepatoprotective potential,” BMC Complementary and Alternative Medicines (alternatively titled BMC Complementary Medicine and Therapies), vol. 14, Jul. 7, 2014, p. 225, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4227022/>.

[56] As discussed in: Solomon Habtemariam, “The Therapeutic Potential of Rosemary (Rosmarinus officinalis) Diterpenes for Alzheimer’s Disease,” Evidence Based Complementary and Alternative Medicine, vol. 2016; Jan. 28, 2016, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4749867/>.

[57] Ryan Raman, “12 Health Benefits and Uses of Sage,” Healthline, Dec. 14, 2018, <https://www.healthline.com/nutrition/sage>.

[58] Ibid.

[59] Yan-Hua Lin, Ai-Hua Liu, Hong-Li Wu, Christel Westenbroek, Qian-Liu Song, He-Ming Yu, Gert Horst, and Xue-Jun Li, “Salvianolic acid B, an antioxidant from Salvia miltiorrhiza, prevents Abeta(25-35)-induced reduction in BPRP in PC12 cells,” Biochemical and Biophysical Research Communications, vol. 348, no. 2, Jul. 28, 2006 [online], Sept. 22, 2006 [print], pp. 593-609, <https://pubmed.ncbi.nlm.nih.gov/16890202/>.

[60] Mohsen Hamidpour, Rafie Hamidpour, Soheila Hamidpour, and Mina Shahlari, “Chemistry, Pharmacology, and Medicinal Property of Sage (Salvia) to Prevent and Cure Illnesses such as Obesity, Diabetes, Depression, Dementia, Lupus, Autism, Heart Disease, and Cancer,” Journal of Traditional and Complementary Medicine, vol. 4, no. 2, Apr.-Jun. 2014, pp. 82-88, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003706/>.

[61] Amanda Rose, “Antioxidants in Thyme,” Traditional Foods; The Antioxidant Project, Jun. 30, 2011, <http://www.traditional-foods.com/antioxidants/thyme/>.

[62] At least, it was the best among the five explicitly tested: bitter orange (Citrus aurantium), Fennel (Foeniculum vulgare), Mediterranean cypress (Cupressus sempervirens), Tasmanian blue gum (Eucalyptus globulus), and Thyme (Thymus vulgaris).

[63] Smail Aazza, Badiâ Lyoussi, and Maria Miguel, “Antioxidant and antiacetylcholinesterase activities of some commercial essential oils and their major compounds,” Molecules, vol. 16, no. 9, Sept. 7, 2011, pp. 7,672-7,690, <https://pubmed.ncbi.nlm.nih.gov/21900869/>.

[64] Yasiel Crespo, Luis Sánchez, Yudel Quintana, Andrea Cabrera, Abdel del Sol, and Dorys Mayanchaa, “Evaluation of the synergistic effects of antioxidant activity on mixtures of the essential oil from Apium graveolens L., Thymus vulgaris L. and Coriandrum sativum L. using simplex-lattice design,” Heliyon, Jun. 15, 2019, vol. 5, no. 6, p. e01942, <https://pubmed.ncbi.nlm.nih.gov/31245650/>.

[65] Soukaïna El-Guendouz, Smail Aazza, Susana Dandlen, Nessrine Majdoub, Badiaa Lyoussi, Sara Raposo, Maria Antunes, Vera Gomes, and Maria Miguel, “Antioxidant Activity of Thyme Waste Extract in O/W Emulsions,” Antioxidants (Basel, Switzerland), vol. 8, no. 8, Jul. 25, 2019[online], Aug. 2019 [print], pp. 243, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719112/>.

[66] Masoumeh Asadbegi, Parichehreh Yaghmaei, Iraj Salehi, Alireza Komaki, Azadeh Ebrahim-Habibi, “Investigation of thymol effect on learning and memory impairment induced by intrahippocampal injection of amyloid beta peptide in high fat diet- fed rats,” Metabolic Brain Disorder, vol. 32, no. 3, Mar. 2, 2017 [online], Jun. 2017, [print], pp. 827-839, <https://pubmed.ncbi.nlm.nih.gov/28255862/>.

[67] Monika Sienkiewicz, Monika Łysakowska, Paweł Denys, and Edward Kowalczyk, “The antimicrobial activity of thyme essential oil against multidrug resistant clinical bacterial strains,” Microbial Drug Resistance, vol. 18, no. 2, Nov. 21, 2011 [online], Apr. 2012 [print], pp. 137-148, <https://pubmed.ncbi.nlm.nih.gov/22103288/>.

[68] Julie Jurenka, “Anti-inflammatory properties of curcumin, a major constituent of Curcuma longa: a review of preclinical and clinical research,” Alternative Medicine Review, vol. 14, no. 2, Jun. 2009, pp. 141-153, <https://pubmed.ncbi.nlm.nih.gov/19594223/>.

[69] “The health benefits of turmeric,” Nuffield Health, Nov. 18, 2020, <https://www.nuffieldhealth.com/article/the-health-benefits-of-turmeric>.

[70] Terry Naturally, “The ways turmeric and curcumin differ might surprise you,” USA Today, May 1, 2019, <https://www.usatoday.com/story/sponsor-story/terry-naturally/2019/05/01/ways-turmeric-and-curcumin-differ-might-surprise-you/3541923002/>.

[71] Ibid.

[72] Susan Hewlings and Douglas Kalman, “Curcumin: A Review of Its’ Effects on Human Health,” Foods, vol. 6, no. 10, Oct. 22, 2017, p. 92, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664031/>. A similar extract is sometimes referred to as “bioperine.”

[73] Kayoko Miura, Hiroe Kikuzaki, and Nobuji Nakatani, “Antioxidant activity of chemical components from sage (Salvia officinalis L.) and thyme (Thymus vulgaris L.) measured by the oil stability index method,” J. Agric. Food Chem., vol. 50, no. 7, Mar. 27, 2002, pp. 1,845-1851, <https://pubmed.ncbi.nlm.nih.gov/11902922/>.

[74] Though, see my YouTube-video presentation Antioxidants, Part 2 to discover gamma-tocopherol, a form of Vitamin E more commonly found in seeds – such as sesame seeds, which are on my list.

[75] M. Saljoughian, “Natural Powerful Antioxidants,” U.S. Pharmacist, vol. 1, Jan. 23, 2007, p. HS38-HS42, <https://www.uspharmacist.com/article/natural-powerful-antioxidants>.

[76] Caroline Hill, Jun. 5, 2018, <https://www.healthline.com/nutrition/vitamin-c-foods>.

[77] Also, pasteurization or processing can cause the vitamin content (especially in the case of Vitamin C) to diminish.

[78] Alexander Yashin, Yakov Yashin, Xiaoyan Xia, and Boris Nemzer, Antioxidants (Basel, Switzerland), vol. 6, no. 3, Sept. 15, 2017, p. 70, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5618098/>. Innumerable other articles could be given at this point, including many cited elsewhere in this post, or in any of the companion videos, but also: T. Alan Jiang, “Health Benefits of Culinary Herbs and Spices,” Journal of AOAC International, vol. 102, no. 2, Jan. 16, 2019 [online], Mar. 1, 2019 [print], pp. 395-411, <https://pubmed.ncbi.nlm.nih.gov/30651162/>.

Intro to Family Councils in Long-Term-Care Facilities

People can end up in nursing-home and other long-term-care environments for any of several reasons. And residents may run the gamut in terms of their levels of awareness and disability.

When a resident retains his or her reason, then – in principle – he or she can “advocate” for themselves in the sense of communicating their desires and needs to facility administrators and staff. But what about cognitively impaired residents, such as those with Alzheimer’s Disease or some other form of dementia?

Such persons may require additional assistance. And this is where a Family Council can come in.

Long-Term-Care Resident Groups

Residents in long-term-care facilities, and families of people residing in such facilities, have the ability to form groups. These groups are often organized to facilitate discussions focused on resident needs and facility changes that may have to do with quality-of-care and quality-of-life issues.

As it happens, these groups, when formed, have tended to be referred to as “councils.” There are two main types of these councils that may be created: family councils and resident councils.

Resident Councils

The most basic variety of long-term-care group is going to be the resident council.

In general terms, a “resident council” is an association of individuals who live in a particular care facility and who wish to work together for the enhancement of their shared living experience.

When they exist, resident councils are independent of the care facility. To put it another way, the resident councils are not controlled or run by the facility administrators or staff.

I say that this sort of group is the “most basic” because it is natural for facility residents to provide feedback and input that pertains to their living conditions. They are interested in the facility, not simply in a psychological sense, but in an economic sense – that is, they have an interest in the policies and procedures of the relevant facility.

Family Councils

A related type of long-term-care group is the family council. As the name implies, “family councils” are groups organized and run by families (or close friends or representatives) of nursing home residents instead of the residents themselves. These family members then join with other families and speak for residents in advocating for policy and procedure changes that improve daily care and quality of life.

It should be said that nothing prevents residents from joining or participating in family councils.

Relatedly, I note that the point of the family council is not to compete with, replace, or supplant the resident council.

Rather, the point is to offer assistance to residents. And, the focus of this website being what it is – namely, Alzheimer’s Disease – it is important to observe that this assistance is especially necessary and valuable in cases where residents lack the ability to speak for themselves because of cognitive impairment, dementia, or similar conditions. (More on this, below.)

Brief Council-Related Questions and Answers (Q&A)

What Do Councils Do?

Both family and resident councils may bring to light issues surrounding care and living conditions. These may include, without limitation: the availability of food, medical equipment, silverware; the cleanliness of the facility; the functionality of things such as elevators; the reliability of internet access; and so on.

Essentially, any topic that impacts the quality of life of residents is fair game.

Once topics have been discussed, it is up to the individuals in the council as to how to proceed. Many facilities (see further on) are required to provide the council with a go-between or contact so that concerns can be delivered to the administration or staff without delay.

Councils may decide to bring their concerns to the facility orally or in writing – in a small group or via a designated council representative.

The first and preferable route would be to communicate with the facility.

However, if the facility is unreceptive for whatever reason, or if it somehow fails to satisfactorily address the expressed concerns, then councils may contemplate or undertake other actions.

Are Family Councils Only Allowed When Residents Have Dementia?

No. Family councils can be formed in order to support any person residing in a particular long-term-care facility, whether the resident is impaired or not.

However, it’s arguably even more important for a family council to be formed when resident loved ones do have cognitive impairments, since dementia sufferers may be unable to speak for themselves.

What Are Examples of Conditions That May Result in Cognitive Impairments?

Conditions may include: Alzheimer’s Disease, Creutzfeldt-Jakob Disease, Frontotemporal Dementia (Pick’s Disease), Huntington’s Chorea (Huntington’s Disease), Lewy-Body Dementia, Multi-Infarct (or Vascular) Dementia, Parkinson’s Disease, Wernicke-Korsakoff Syndrome, etc.

What If a Resident Has No Living (Or Interested) Family Members?

Residents may give permission to non-family members to participate in family councils on their behalf.[1] If a resident has a cognitive impairment, then things can get a little dicey. If you would like a non-family member to represent your interests in a family council, you may wish to record your wishes in writings prior to the manifestation of any condition that might call in question your mental fitness.

Are Long-Term-Care Facilities (Such as Nursing Homes) Required to Recognize Family Councils?

I will address this question at greater length in a forthcoming post.

But, for now, suffice it to say that Federal regulation (in Title 42 CFR 483.10) states that Medicare/Medicaid-participating nursing homes must recognize family and resident groups when they form.

Further, these facilities have to provide resident and family groups with private meeting spaces, and they need to take reasonable steps (with the approval of the groups) to make residents and family members aware of upcoming meetings in a timely manner.

Additionally, the facility must provide a designated staff person to act as a liaison to the group. This person will be responsible for providing assistance to the group and with delivering (though not necessarily writing) responses to formal requests that result from the group meetings.

Does the Long-Term-Care Facility Have to Respond to Council Requests?

The facility cannot ignore the group or suppress its ability to form. So, in this sense, yes, the facility must provide some sort of reply to a group when it is asked to do so.

This does not mean, however, that the facility is compelled to do precisely what the council requests.

Things are tricky. I will try to explore some of these issues at greater length in a future installment.

Six Characteristics of a Family Council

It may be helpful if I briefly sketch some of the qualities that a family council will have.

Autonomy

Autonomy refers to the fact that the group is self-led. Neither a family council nor a resident council is created or led by facility administrators or staff members. If the facility has started and controls a group, then it is not a family or resident council in the relevant sense – regardless of what the facility calls it.

Facilities are of course free to form their own groups; and residents or families are free to join these facility-created groups if they choose to do so. But the formation of a facility-led group is not a replacement for an autonomous family council, and joining a facility group does not bar a person from joining an autonomous group.

Facility Specificity

There may be groups that support anyone living at any nursing home. However, a family council is relative to a specific facility. The ties that bind the members of a family council have to do with the fact that members all have relatives who live in the same long-term-care facility.

Independence

Independence is an extension of autonomy. The administration does not have claims over the family council. The councils are not dependent upon the facility. Moreover, the council is not considered to be a government program. It is an independent association of families of people living at a particular facility.

Interest

A family council must be made up of a group of people who have an interest in the facility. In this context, “interest” does not simply mean a curiosity. It means there has to be an interest in more of an economic sense. Member families have to have some “stake” in the facility and, going further, in the standards according to which the facility operates.

Openness/Inclusivity

There must be no barrier to entry into the family council other than having a close friend or relative involved in the facility. The council be must inclusive or open in terms of its membership.

Privacy

The group is owed a private space that should be provided by the administration of the facility on the facility grounds. The facility cannot appoint a staff member to “sit in” on the meetings.

Administrators or staff may be invited by the group to attend meetings. But, apart from such an invitation, presumably furnished by a council officer or spokesperson, the group should be allowed to meet privately.

Once again, the facility may endorse or sponsor other, staff-led groups. And these groups may also listen to complaints or solicit feedback from families and residents. But, the existence of such facility-controlled groups does not undermine the ability of residents and families to form their own councils to advance their own interests.

Notes:

[1] Presumably, if there is a conflict, a resident could also revoke a family member’s permissions or otherwise “block” one of his or her family members from participating in a council.

Mandatory-Physician-Reporting States & Drivers’ Licensing

Does Your State Have Mandatory-Reporting Laws?

Within the United States and Canada there are laws that require a physician to report a patients with neurological or cognitive disorders to a licensing agency, as those patients may be a danger behind the wheel of a vehicle.

This type of reporting is not mandatory across the entire United States.  Currently, there are only six (6) states that mandate a physician to report on a patient’s ability to operate a motor vehicle. These six states include:

  • California
  • Delaware
  • Nevada
  • New Jersey
  • Oregon
  • Pennsylvania

Not all mandatory states direct their reporting law toward those who are afflicted with Alzheimer’s Disease or, indeed, any sort of dementia whatsoever. Below are some specifics around each mandatory state and what is defined in their law.

If you want to see and hear me present the material, feel free to watch the YouTube video that I prepared, here:

California

The state of California is the first that I will discuss. It’s a prime example of a state in which (a.) there is mandatory reporting, and (b.) that reporting is at least partially concerned with Alzheimer’s Disease expressly.

The California Legislative Information website (leginfo.legislatures.ca.gov) references chapter 3 – Disorders Characterized by Lapses of Consciousness [103900-103990].

103900 states: “Every physician and surgeon shall report immediately to the local health officer in writing, the name, date of birth, and address of every patient at least 14 years of age or older whom the physician and surgeon has diagnosed as having a case of a disorder characterized by lapses of consciousness.”

This law specifically includes Alzheimer’s Disease as a disorder that involves the requisite “lapses of consciousness.”

For additional information, see the entry on California – “What does California State Law say about Driving with Alzheimer’s?” – in my “50-State Guide to the Laws on Driving With MCI and Alzheimer’s.”

Delaware

In Delaware, the focus is on conditions that are characterized by “losses of consciousness.” In this respect, Delaware’s statutory language is similar to the “lapses of consciousness” verbiage present under California law.

Title 24 of the Delaware Code Online – Professions and Occupations Chapter 17, Medical Practice Act states: “Every physician attending or treating persons who are subject to losses of consciousness due to disease of the central nervous system shall report within 1 week to the Division of Motor Vehicles the names, ages and addresses of all such persons unless such person’s infirmity is under sufficient control to permit the person to operate a motor vehicle with safety to person and property.”

Again, for further reading, scroll down to “Delaware’s entry, HERE.

Nevada

Nevada is a good example of a state in which, while there is mandatory-physician reporting, it is not directed towards cognitive impairments such as dementia (of which, as we know, Alzheimer’s Disease is the most common variety). (On two ways of understanding the difference between Alzheimer’s Disease and dementia, see my YouTube video, HERE.)

According to the Bradley, Drendel & Jeanney law firm: “…Nevada laws can regulate the driving rights of individuals with epilepsy. In fact, doctors in our state are required to report epileptic seizures to the state’s Department of Motor Vehicles…”

You might be picking up on a recurring theme, here, but… for additional information, click down to “What does Nevada State Law say about Driving with Alzheimer’s?” in my 50-State Guide, HERE.

New Jersey

The New Jersey Academy of Ophthalmology, states, “NJ Law (N.J.S.A. 39:3-10.4) requires all physicians to report patients to the Motor Vehicle Commission within 24 hours after determining that a patient experiences any of the following:  Recurrent convulsive seizures, recurrent period of unconsciousness or impairment, or loss of motor coordination due to conditions such as, but not limited to epilepsy in any of its forms which persist or recur despite medical treatment.”

Even so, New Jersey appears to be one of those states in which physicians could potentially be held liable, legally, if they don’t report potentially dangerous drivers.

While New Jersey law has established an elective reporting system for drivers with vision deficiencies and mandatory process for reporting specific neurological dysfunctions, there is no statute that protects a physician from liability if they have failed to report a patient that may cause injuries to a third party due to a condition known by the physician.

Given this, you might think that a New Jersey doctor will err on the side of reporting. And, I may be inclined to agree.

For more info, where do you think I’ll send you? My state guide, of course! Find it, HERE.

Oregon

The Oregon Driver & Motor Vehicle Services states: “Most medical professionals are required to report drivers who can no longer drive due to impairment.”

It is required of medical professionals to report on a patient’s impairment, even if that patient has agreed to give up driving.

The Oregon Secretary of State website similarly states: “…mandatory reporting by physicians and health care providers of those persons with severe and uncontrollable cognitive or functional impairments affecting a person’s ability to safely operate a motor vehicle.”

Cognitive impairments as specified in Oregon include: attention, judgement and problem solving, reaction time, planning and sequencing, impulsivity, visuospatial, memory and/or loss of consciousness or control.

Intuitively, this list is expansive enough to range over various cognitive impairments like dementia and Alzheimer’s Disease, even if they are not singled out for special or explicit attention.

See: “What does Oregon State Law say about Driving with Alzheimer’s?” which is a subsection of my longer, and more comprehensive (but certainly not exhaustive) reference, elsewhere on this website.

Pennsylvania

According to Schemery Zicolello Law Firm, the Pennsylvania Medical-Reporting Law requires health care personnel to report to the Pennsylvania Department of Transportation the full name, date of birth and address of every person over 15 years of age that is diagnosed as having a disorder or disability that could impair his/her ability to drive.  In the list of reportable medical conditions, the attorneys specifically call out dementia.

That’s good enough for me.

If you want a bit more detail, scroll down to “Pennsylvania,” on my article, HERE.

Utah

Utah was mentioned in an article by National Center for Biotechnology Information (NCBI) as a reporting state. However, in the Fact Sheet for Patients and Families provided for Utah drivers, the indication for mandatory reporting by physicians is not present.

The document does state that the patient is expected to report and disclose their impairments to the department of motor vehicles.

So… I don’t find that Utah is actually a mandatory-reporting state.

For more, see: https://alzheimersproof.com/u-s-laws-on-driving-with-mci-and-alzheimers-disease/.

Concluding Remarks

Bear in mind that just because a state does not have mandatory-reporting laws, it should not be assumed that physicians won’t report anyway.

In the first place, a doctor might believe that it is his or her ethical duty to report a potentially dangerous driver – regardless of whether state law strictly requires that he or she do so.

Additionally, the physician’s other professional entanglements – for instance, his or her affiliation with a medical group or his or her professional-liability insurance – might have stricter requirements governing action steps in relevant cases.

Additional Information Or Resources

Over the course of several months, I compiled an article as a reference to U.S. Laws on Driving with MCI and Alzheimer’s Disease which provides a guide on all 50 states and their associated laws.

Another of my references is the post Canadian Laws on Driving with MCI and Alzheimer’s Disease which outlines comparable laws specified within the Canadian provinces.

You might also want to consult the National Highway and Traffic Safety Administration at their website: https://www.nhtsa.gov.

Moreover, in the Physician’s Guide to Assessing and Counseling Older Drivers, Chapter 7, Legal and Ethical Responsibilities of the Physician, some important key terms are defined.  Here are a few highlights.

Mandatory Medical Reporting Law States:  In some states, physicians are required to report patients who have specific medical conditions (e.g., epilepsy, dementia) to their state Department of Motor Vehicles (DMV).  These states generally provide specific guidelines and forms that can be obtained through the DMV.

Physician Reporting Law States: Other states require physicians to report ‘unsafe’ drivers to their state DMV, with varying guidelines for defining ‘unsafe.’  The physician may need to provide (a) the patient’s diagnosis and (b) any evidence of a functional impairment that can affect driving (e.g. Results of neurological testing) to prove that the patient is an unsafe driver.

Physician Liability States:  Case law illustrates situations in which the physician was held liable for civil damages caused by his/her patient’s car crash when there was a clear failure to report an at-risk driver to the DMV prior to the incident.

On the NHTSA’s website, a survey of medical review practices can be found that indicate while all 51 jurisdictions accept reports of potentially unsafe drivers from physicians, only 6 jurisdictions require physicians to report drivers to the motor vehicle agency.

Another helpful article on NHTSA’s website is ‘Current Screening and Assessment Practices’.  This article summarizes the legal requirements in each of the six mandatory reporting states.

Another helpful resource is the National Center for Biotechnology Information, the website for which can be found, here: https://www.ncbi.nlm.nih.gov.

National Library of Medicine, National Institutes of Health contains an article within the Journal of General Internal Medicine (abbreviated “J Gen Intern Med”).  Of interest is an article titled “Reporting by Physicians of Impaired Drivers and Potentially Impaired Drivers,” which mentions that virtually all states have established policies for the identification of drivers with physical or mental impairments, however, the reporting is voluntary with the exception of specific states.[1]

Additional references on AlzheimersProof.com include:

Is it Legal to Drive with Alzheimer’s Disease?

This is a resource regarding the legalities of driving with Alzheimer’s or another cognitive disorder.  This is not legal advice, simply research and research leads presented in a comprehensive article to assist in locating additional sources for further information. You can find additional information and important aspects specific to your state within my 50-State legal guide, HERE.

Are Drivers with Alzheimer’s more Dangerous than Others?

The above article, also on my website, goes into a discussion about a number of factors that may impact a person’s ability to drive, given their cognitive or mental state. This not only addresses that Alzheimer’s Disease occurs in stages (for more on which, see HERE), but also addresses some concerns around other cognitive impairments.

Is it Safe to Drive with Alzheimer’s?

I also have an article – and a companion video (see my YouTube channel, HERE) – talking specifically about considerations of driving safety, apart from an explicit discussion on any legal requirements.

Disabling Devices – Car

Now, if it gets to the point where you have to actually restrict your loved one’s access to the vehicle (and I sympathize with you if this happens), then you might find something of use in the above resource.

How do you Alzheimer’s Proof a Car?

The final piece that I’ll note, here, is a general article that I did on the question of how to “Alzheimer’s Proof” a car. Recall that Alzheimer’s Proofing is akin, in this context, to baby proofing or childproofing. For more on this, see HERE.

Disclaimer

Please note – this article should not be treated as providing legal or medical advice, but purely as a reference that provides general information in regards to the laws that require a physician contact a licensing bureau in regards to a patient’s ability to operate a vehicle. This post is given as-is; I do not warrant that the information is accurate or complete. But I provide the information in good faith and I believe, to the best of my knowledge, that it is reliable.

Notes:

[1] As noted in the main text, the article’s list of states includes Utah, while in other references, Utah is not mentioned as a mandatory state.

Warning Signs of an Unsafe Driver: Alzheimer’s Dementia

Alzheimer’s Disease is a progressive, neuro-degenerative illness that presents itself in stages. While there is some debate over the precise number of stages (for more on which, see my ARTICLE or companion VIDEO), for present purposes, we can say that there are three: early, middle and late. Because cognitive degradation is just what it is to have some form of dementia, the fact is, at some point, an Alzheimer’s sufferer will become unsafe behind the wheel of a car.

In the early stage of Alzheimer’s, memory impairments may be mild affording a person the ability to safely drive. A larger concern occurs during the transition from the early to middle stage of the illness.

During the middle stage of Alzheimer’s, memory impairments may become more severe. You or your loved one may be doing fine one day, but have a lapse in memory or judgement, causing challenges the next day. These lapses, or deterioration in memory, can make a person with Alzheimer’s more of a danger to themselves or others, especially when driving.

By the time a person reaches the late stage of Alzheimer’s, he or she will have lost so many abilities (including language, mobility, responsiveness, etc.) that driving will be virtually inconceivable. Generally, by that time, the level of physical disability alone makes operating a motor vehicle practically impossible.

But before that threshold is reached, it may be somewhat difficult to identify the precise time at which a person becomes an unsafe (or at least unreliable) driver. Here is a breakdown of some early signs or symptoms that may indicate it is no longer safe for a person with this illness to operate a vehicle.

(These signs may be noticed by the person themselves, a loved one, vehicle caretaker or an outside party such as a neighbor, physician, police officer, etc. Additionally, it is important to assess behaviors and signs relative to a person’s “baseline.” In this context, a baseline is the starting point for comparison. It’s basically the way a person acted or the degree of functionality they possessed for most of their adult life – at a point when they were obviously not impaired in the relevant sense.[1])

Emotional Changes

A person with a mild demeanor may become more aggressive, hostile, or otherwise difficult. These changes in behavior could potentially be due to a mood disorder or other neurological problem. However, these behavioral changes can also occur in a person with Alzheimer’s Disease or some other form of dementia.

If you notice that you or a loved one becomes unable to control anger or depression, becoming so overcome with emotional fits or episodes, it may be an indicator of Alzheimer’s or some other serious condition. Whatever the cause, these emotional changes will increase the dangers and risks of being behind the wheel of a car.

  • Anger – Your loved one may become agitated or irate with little or no apparent provocation, or beyond what a normally functioning person would think of as justified or reasonable.
  • Anticipation – In this case, the pathological component may be another outgrowth of memory loss. If you loved one seems or professes to expect or hope for an imagined or past event, it may be a sign of worsening dementia.
  • Disgust – An Alzheimer’s patient may have difficulty masking emotions and might display naked aversion, distaste, loathing, revulsion, etc. even in inappropriate contexts or directed toward things that they previously felt fondly toward.
  • Fear – On a low level, this might result in an increasing level of anxiety. It could be apparent through spoken language, but it may only become apparent to people who notice subtler signs or body language (e.g., in facial expression or posture) or habit (such as hand wringing or nail biting). Alternatively, fear may manifest in more extreme ways, for instance, through indications of a pathologically paranoid or suspicious turn of mind.
  • Joy – We all like to see our loved ones content and happy. But, in some cases, the level of jubilation or excitement may exceed what is appropriate to or warranted for the occasion. For instance, your loved one may not exercise due restraint. Alternatively, it may appear strike you as inappropriate in the sense that he or she seems to be taking pleasure in something that ought to elicit a different emotional reaction.
  • Sadness – A dementia-afflicted people might suffer from apathy or depression, or from some other related sort of unrelenting melancholy. They may tend to brood or become removed or withdrawn from family or other social circles.
  • Surprise – Look for evidence or amazement or bewilderment that seem out of place. Astonishment or shock could be a result of affected judgment or reasoning. But it also could be a function of increasing forgetfulness and impaired memory.
  • Trust – This may be related to fear and paranoia in the sense that your loved one may begin to suspect family members of plotting against them. Contrariwise, it might be expressed in an inappropriate or unwise willingness to follow or receive instructions from strangers.

Memory Changes

Some Alzheimer’s-afflicted individuals may have issues with short-term memory loss but are able to remember things that occurred further back in time. Vehicle operations can be broken up into “before,” “during” and “after” categories to determine if memory changes impact or undercut safe driving. Here’s what I mean.

Before Getting Into the Vehicle, Ask…

  • Do you or your loved one have an issue finding the keys?
  • Is it consistently a challenge to remember where the vehicle is parked? Or…
  • Is it hard to recall which vehicle belongs to you?

Everyone misplaces things from time to time. Obviously, when it is sporadic, this is not necessarily an indicator of Alzheimer’s Disease or some other form of cognitive impairment or dementia. However, the issue occurs when this becomes more of a pathological condition where memory loss is more frequent than normal, or when its occurrence undermines safety.

While Inside of the Vehicle, Ask…

  • Do you or your loved one have trouble remembering which pedal is the accelerator and which is the brake?
  • Is there confusion on what traffic signs or signals are indicating?
  • Do you or your loved one regularly forget where you are going, or how to get there?
  • Beyond the perceptual diminishment that often accompanies normal aging, cognitive impairments may erode sensory faculties. Does the driver have reduced sensory-processing capabilities? (See further below.)
  • Do the A/C or radio controls confuse you or distract you from the road?

A person with this illness may not understand signs to where they inadvertently drive through a construction zone. They may also forget where they are going or how to get where they are going, even if the route is familiar.

After Exiting the Vehicle, Ask…

  • Are there dents or scratches that cannot be accounted for?
  • Is parking haphazard or erratic?
  • Are items forgotten inside the car inadvertently?
  • Are keys routinely left in the vehicle?
  • Is the car left running unintentionally?
  • Have you or your loved one begun to receive mailed traffic citations? Or…
  • Is the driver being pulled over more frequently than before?

A person afflicted with this some form of dementia or other cognitive difficulty may not remember how a particular dent or scrape appeared on the vehicle.

All these items are warning signs or indicators that something else may be going on beyond normal forgetfulness.

Motor-Skill Changes

Cognitive disabilities are only half of the picture, though. Driving also places physical demands on a person. Therefore, various physical impairments can also undermine safe-driving abilities.

Similarly to the previous category, these changes can also be evaluated by looking at requirements that impose themselves before, during, and after using a vehicle.

Before Getting Into the Vehicle, for Example…

  • Changes in motor skills or reductions in physical strength may hinder a person from doing something as simple as opening or closing a vehicle door.
  • You or your love done may struggle with opening or closing the hatch or trunk.
  • It may become difficult or practically impossible properly open or close the hood of a vehicle.

It is true that memory may come into play here as well. And there’s little question but that forgetting how to do these minor tasks may be an indicator of Alzheimer’s.

But diminished motor skills can be serious problems on their own. And, when determining a person’s driving fitness, physical abilities need to be assessed alongside cognitive ones.

While Inside of the Vehicle, for Example…

  • A person with diminished motor abilities may have difficulty turning the wheel.
  • He or she may have trouble physically depressing the pedals or shifting gears.
  • Someone might find it physically taxing to keep the car in the correct lane.
  • Parking the vehicle may begin challenging, especially if the individual has limited abilities to turn their body or head.
  • Sensory impairments such as hearing or vision loss can also undercut the ability to safely operate a car or truck.

After Exiting the Vehicle, for Example…

  • Do you or your loved one have difficulties just physically getting in and out of the house, opening entry or garage doors, carrying groceries, and so on?

Of course, people often drive in order to assist them with the functional activities of life – such as shopping. While general impairments may not specifically speak to the question of safety behind the wheel, they do speak to the issue of whether driving is beneficial or necessary. If you or your loved one can no longer perform or engage in other life activities – like shopping – then it may be that driving is no longer helpful. This suggests that it may pose a risk that outweighs any potential benefit.

Additionally, the loss of non-driving-specific abilities indicates a general physical decline any may suggest either that driving-related abilities may soon erode or that further cognitive impairment is on the horizon.[2]

Clearly, being unable to physically control a vehicle, while not an Alzheimer’s-specific problem, may be an indicator that you or your loved one can no longer reliably or safely operate a vehicle.

Perceptual Difficulties

The normal aging process can cause perceptual difficulties. However, Alzheimer’s can exacerbate these issues.

Perceptual difficulties may impact visual-spatial abilities such as being able to judge distance or peripheral vision. Being spooked by shadows or not noticing cars or pedestrians next to you may be a result of diminished perception.

There may also be an inability to see traffic signs, signals, or other drivers (for example, people braking in front of them or merging into the same lane).

Perceptual difficulties may also include a decreasing ability to hear sirens or horns. This poses an obvious danger – especially, though not exclusively, if it is coupled with memory impairments. Forgetting what emergency-vehicle sounds indicate or require in terms of courses of action can lead to accident, injury, or death.

Reasoning Changes

A deviation from a normal route may cause confusion for a person with Alzheimer’s, as they may not be able to react or think through an alternate route. They may also have issues navigating around accidents or construction sites.

A person with this disease, or some other form of cognitive impairment or dementia, may have a reduced reaction time that, in turn, undermines their ability to react to unexpected changes within their route. These include such things as closed roads and bridges, etc., which could potentially lead to accident, and certainly engender confusion.

Deviations and detours can also result in you or your loved one becoming lost.

Concluding Remarks

As difficult as this can be for the afflicted individual, there will come a point where having them behind the wheel of a car or truck will become more of a danger than a benefit.

For more information, please see my companion YouTube video, HERE.

Postscript

In addition to these safety considerations, there may also be legal implications and potential liabilities in regards to a person driving with Alzheimer’s Disease.

While I am not a lawyer or legal expert, I do have several, relevant resources available on AlzheimersProof.com.

For instance, I have:

Additional Resources

Notes:

[1] Of course, some persons may have lifelong afflictions or disabilities. These will have to be factored in as well. Doing so is beyond the scope of this article. Consult a healthcare or medical professional for personal evaluations or recommendations.

[2] See, e.g., Salynn Boyles, “1st Signs of Dementia May Be Physical,” WebMD, May 22, 2006, <https://www.webmd.com/alzheimers/news/20060522/1st-signs-of-dementia-may-be-physical>.

Reduce Elopement/Wandering: ‘Defender’ Lock for Alzheimer’s

This one simple device may reduce 'elopement' risk

One of the major challenges in caring for someone who has Alzheimer’s Disease, or some other form of dementia, is that they are often prone to “elopement.” Of course, in the context of long-term care, elopement has nothing to do with illicit or surreptitious marriage. It has to do with a cognitively impaired person leaving the safety of the care environment without supervision.

This problem can be extremely vexing for the caregiver and perilous for the Alzheimer’s sufferer. I know this firsthand. On one memorable occasion, my dad was returned to his home by a police officer after he had been found wandering along a busy road in our city. During a snowstorm.

However, I was able to hinder my dad from wandering with an ingenious little gadget. In this article, I’m going to explain how to install that device – a door blocker called the “Defender.”[1] I have installed several of these blockers: one in an apartment, and a couple of them in a townhouse. I absolutely love these products. And I think that you might, too.

Introduction

What’s the Function of the ‘Defender’?

Knowing your loved one can open doors and leave the care environment without you or a caretaker in tow – or even realizing your charge is gone – is a terrifying proposition. Memory and reasoning deficits raise the possibility that he or she could become disoriented and lost, or even injured or worse.

From the perspective of long-term home care, then, the main benefit of these locks is to prevent your loved one from eloping. The devices are inexpensive, and the contemplated modification may be performed relatively easily.

This sort of change is part of what I mean by “Alzheimer’s proofing” your home environment. (This is a concept that I describe more fully HERE.) Under this way of using the phrase, it is a close cousin to childproofing a house as expectant parents would do in preparation for the arrival of a newborn.

Devices Double as Theft Deterrents

These door blockers can deter Alzheimer’s sufferers, or other cognitively disabled persons, from opening exit doors, leaving the care environment, and potentially putting themselves in harm’s way.

But it is worth noting that this particular use – keeping someone inside the house – is a bit of a departure from the product’s stated purpose.

This style of door lock has been designed and marketed as a security device and theft deterrent. When properly installed on an entrance door, the lock helps to prevent forcible entry into a house. It essentially fortifies the door so that even if a thief has jimmied it, or defeated its deadbolt and locking mechanisms, the door blocker will enable the door to remain in a closed position.

So, beyond the standpoint of Alzheimer’s proofing, it will add another layer of security to your home.

Can Your Alzheimer’s-Afflicted Loved One Defeat the Blocker?

As stated, the Defender is intended to be set into a locked position inside the home in order to reduce the probability of forcible entry should an intruder attempt to gain access to the interior of your house.

Given this, it has been designed to be locked and unlocked by normal-functioning adults. Therefore, it is possible for a cognitively impaired person to operate the latch. However, to do so he or she would have to have a number of cognitive and physical abilities. A rough-and-ready enumeration of these might look the following.

Cognitive Abilities Plausibly Needed to Defeat the Blocker:

  • The ability to notice the device
  • The capability to identify its function
  • The capacity to understand or the resourcefulness to determine the correct way to unlock it once
  • The motor skill and dexterity required to execute the unlocking action
  • The memory power to remember how to defeat it on subsequent encounters

I’m certainly no medical or psychological expert. But, the likelihood that a cognitively impaired individual would possess this collection of abilities seems to me to be somewhat low. More guardedly, I suppose that I would venture the opinion that the probability is low at least once your loved is sufficiently advanced in his or her dementia to be a serious elopement risk.

Often, if it is positioned high enough on the door – or if it is camouflaged – your loved one may not even recognize that the door blocker has been installed. Of course, this is because Alzheimer’s tends to diminish perception. In the case of my dad, for instance, I don’t believe he noticed that the thing was even there.

Additionally, a high-up position might hinder the door-opening ability of a senior adult in general – quite apart from any dementia – for example if he or she has joint or mobility issues.

Moreover, the door blocker requires an additional motion, outside of those used to open doors in the usual way, that may frustrate a person with a cognitive deficit and prevent them from eloping from the home.

WARNING!

I should, however, inject an important word of caution.

These door blockers may hinder your and your loved one’s abilities to exit the house in the event of a fire or other emergency. If you’re going to use these products as a deterrent to help prevent elopement of a loved one from the residence, you may want to ensure the blocker is activated only during the time periods where your loved one is at the highest risk of vacating the premises without you noticing.

Of course, from a theft-deterrence perspective, it is appealing to have the latch activated throughout the night or during whatever intervals occupants of the house wish to lower the likelihood of intrusion.[2]

Disclaimer:

I cannot advise you as to the appropriateness of any particular course of action for your application. Furthermore, I cannot be sure, and do not warrant, that the device will be effective for you – for any purpose whatsoever. This information is presented as-is, for general or entertainment purposes only. Whatever use you put this information to is entirely your own responsibility. No one at or affiliated or associated with AlzheimersProof.com assumes any liability for how you may implement or not implement any of the ideas described in on this website or in any companion videos.

Be aware of where and under what circumstances you are installing these blockers. The upshot is that I am certainly not guaranteeing that these devices or installation methods will be successful or safe for your individual or family situation.

I can only state that these blockers were a tremendous help for me and my family when caring for my Alzheimer’s-afflicted dad.

My Installation Procedure

‘Unboxing’ & Collecting Required Tools

'Defender' Install Sheet
‘Defender’ Installation Instructions

Upon opening the Defender’s packaging, you will find several items. These include:

  • The door blocker device itself;
  • Instructions;
  • 3 large wood screws;
  • 4 smaller metal screws;

Tools

The main tools needed include:

  • A drill (this could be theoretically be corded or cordless; mine was the latter)
  • 1/8-inch drill bit
  • Philip’s screwdriver

Optional (& Possibly Necessary) Tools

  • Wood chisel (if there is insufficient space in between the door and door jamb to accommodate the blocker)
  • Hammer (to use the chisel, if one is needed)
  • Center Punch (to tap a small “pilot” for the drill bit)
  • Tape Measure (to assist in positioning the blocker on the door with respect to the other locking hardware – such as doorknobs and deadbolts)

Safety Equipment

  • Safety goggles

Positioning the Blocker

You may want to begin by determining where you want to place the Defender door blocker. The instructions suggest that it be installed at least 6 inches above the door handle and deadbolt.

As suggested above, it may be beneficial to install this blocker a bit higher than this. In fact, there is an “L-shaped” area on the door within which the manufacturer recommends placing the Defender.

'L'-Shaped Area
Inverted ‘L’-Shaped Install Location

While determining where to install the blocker, place the blocker in the locked position. While in this fully closed position, slide the plate between the door frame and door with the black pad against the door.

This will allow you to get a good look at everything, and to reposition the blocker is desired or necessary.

**Be mindful of any electrical outlets nearby as there may be wiring within the walls near where you may be drilling. Additionally, look at surrounding door hardware, molding, key hooks, or other things that might interfere with your ability to operate the blocker and allow it to swing fully from locked to unlocked positions, and back again.

Actual Installation Steps

Step One

Once you have determined where you want to place the door blocker, use a pencil to mark the placement of the center screw within the door frame.

Step Two

Use your drill and 1/8-inch drill bit to make a hole where the center screw will be placed.

Step Three

Place the door blocker plate back against the door frame, allowing the recently drilled hole drilled to be visible in the center-hole of the plate.

Step Four

Drive the center screw into the door frame allowing the blocker plate to be provisionally positioned.  The center hole is oval shaped and allows for the back-and-forth movement of the device in order to ensure that it is tight enough against the door to perform its function, but not so tight that it prevents you from latching and unlatching it.

Step Five

Test for the appropriate and desired fit. Before fully securing the door blocker, close the door and test the blocker in the locked position to ensure the placement is optimal. If the lock is difficult to engage or disengage, the placement of the plate may need to be adjusted slightly for proper operation of the device. In this case, you would simply loosen (but not remove) the center screw, move the blocker, and re-tighten the screw.

Step Six

Once the positioning has been established, ensure that the center screw is fully tightened – but not over-torqued. (You don’t want to strip the head or threads.)

Screw assortment
Longer Wood Screws & Shorter Metal Screws

Then, drive in the remaining three (3) screws – large screws for a wooden door frame; small screws for metal – into the remaining holes present on the door blocker plate to firmly secure the blocker.

Congratulations!

Your Defender door blocker has now been successfully installed!

Open & Closed
‘Defender’ in Position

If you need an additional assist, or a bit more in the way of visual aids, never fear. For a demonstration of the operation of the lock, or for a video tutorial on the installation procedure, please view my companion YouTube video: Alzheimer’s Elopement & Access Control: Install the Defender Door Lock.

Thank you for reading! I wish you all the best trying to deal with elopement risk.

Notes:

[1] The “Defender” appears to me to be an off-brand version of a different door blocker known as the “Door Guardian.” I also have the Door Guardian and will walk through its – nearly identical – installation procedure in a subsequent post.

[2] Note that there is no “key” and that the device is not designed to be unlocked from the outside. It is supposed to be activated and deactivated from within the area being secured.

12 Mental Exercises for Staving Off Alzheimer’s (POSSIBLY)

Alzheimer’s is a degenerative brain disease that causes diminution of cognitive abilities, including memory, perception, and reasoning. As of this writing, Alzheimer’s Disease afflicts between 5.5 and 5.8 million people in the United States and between 44 and 47 million people in the world. It’s possible causes – discussed HERE – are not well understood. (There are widely mentioned RISK FACTORS.)

Various researchers, however, have suspected that at least some of the blame for Alzheimer’s can be placed on controllable things like diet/nutrition and exercise – both mental and physical. The general idea is that if you don’t “use it” (i.e., your brain), you might “lose it”![1] To that end, several sources have posited a slew of activities that are geared toward keeping you cerebrally fit. I’’ take a sort of “cocktail” or “grab-bag” approach.

Here is my list of the top twelve ways you might be able exercise your brain to prevent Alzheimer’s Disease. (See “Caveats,” below.)

Board and Card Games

An article in the British newspaper Independent related that “playing board games …could help” with mental decline – perhaps to an even greater extent than working crossword puzzles (about which, more in a moment).[2]

According to the results of one study that looked at brain scans: “Middle-aged people who [are] avid game players …[tend] to have bigger brains than people who [do] not play games…”.[3]

These more massive brains can confer a big advantage. Some people refer to this as “cognitive reserve.”[4]

Brain Teasers

“Brain teasers” are a type of game, usually consisting of problems, riddles, and the like of that that are solved usually for amusement. But what if they could serve a more useful purpose?

Numerous news outlets have reported on the possibility that various brain teasers, mathematics puzzles, and mysteries might help to enhance your cognitive health.

In the article “How to Outsmart Alzheimer’s,” Wall Street Journal columnist Amy Marcus reported that “quizzes and other cognitive challenges” might push back the onset of Alzheimer’s – “perhaps indefinitely.”[5]

So, reach for those puzzles and put your mind to work!

Chess

Chess is a two-player strategy game that has been around for hundreds of years. It’s played on a board composed of 64 squares of alternating colors. In total, there are 16 pieces per side (32 in all): eight pawns, 2 knights, 2 bishops, 2 rooks, 1 queen, and 1 king. Each type of piece has different rules governing its legal moves. The overall objective of the game is to “corner” (or “checkmate”) the opponent’s king in such a way as to leave it with no counterattack or means of escape.

Chess can be a very involved game with lots of subtlety and variety. It has competitive and social aspects (on the further benefit of which, see further on). But, on the other hand, it can be played over the internet without you (or your loved one) having to leave home.

Once again, some researchers suggest that “playing chess helps stave off the development of dementia.”[6] In fact, one study showed that playing chess “resulted in an almost 30% reduction in” dementia risk.[7]

Checkers

A two-player game, checkers is similar in some respects to the aforementioned chess. For instance, the board consists of 64 alternately colored – or “checkered” – squares.

Checkers is, however, played with 12 pieces per side instead of 16. Each piece is the same at the beginning of the game: simply a small, circular disk. The object of checkers is to “capture” or remove all (or at least most) of your opponent’s pieces or to leave him or her without any legal moves.

Although checkers has less variety in terms of pieces and moves, it is plenty rich in terms of move combinations and traps.

“Studies show games like checkers can boost your brain strength.”[8]

Crosswords

Admit it: Here’s the one you’ve probably been waiting for!

Simply put, a “crossword” is a kind of word puzzle. It is usually presented as a sort of grid with a combination of “empty” boxes and shaded boxes. The object of a crossword is to answer questions or use clues to fill in the empty boxes with words. Often, the words crisscross and interconnect in interesting ways – usually by sharing letters – which accounts for the name of this puzzle type.

Some investigations have suggested that working crosswords can boost mental ability and function.

Whether these activities affect age- or Alzheimer’s-related cognitive decline is an open question.

However, the National Center for Biotechnology Information, part of the National Institute of Health, published a study revealing that doing crossword puzzles delayed cognitive impairment – specifically, memory decline – by an average of two and a half years.[9]

Language

There’s a joke that goes something like this.

Question: What do you call a person who speaks three languages? Answer: Trilingual. Question: What do you call a person who speaks two languages? Answer: Bilingual. Question: What do you can a person who speaks only one language? Answer: American!

A quick Google search suggests that around 80-85% of Americans are monolingual.[10] Similar percentages apply in Canada. And the United States and Canada have some of the highest rates of Alzheimer’s Disease. For instance, it is the sixth leading cause of death in this country.

This is compared to approximately 45% of Europeans who are monolingual.[11]

Some research suggests that being bilingual can delay the onset of dementia.[12] For example, a 2013 article from CBS News is titled “Learning Another Language May Help Delay Dementia.”[13]

The article reported on a scientific study of various subpopulations in India. The suggestion was that speaking another language can push Alzheimer’s onset back an average of four to six years.

However, a key word is delay. Many people Belgium and Iceland are multilingual. However, both of those countries are in the top ten of nations with high percentages of Alzheimer’s dementia – according to WorldAtlas.com

In fact, Finland is the nation with the highest affliction rate. And a preponderance of the population appears to be bilingual to one degree or other.

Still, it seems reasonable to talk about a “protective effect of bilingualism.”[14]

Music

I have written a bit about how musical therapy can be a helpful intervention to explore when it comes to treating Alzheimer’s sufferers. (See my article “Can Music Calm an Alzheimer’s Patient?”)

A few studies have also led investigators to conclude that things like “playing musical instruments” can be better than working crossword puzzles or doing Sudoku. In fact, some suggest that this can “significantly reduce” a person’s risk.[15]

But for a more complete look at risk factors, see my video dedicated to that topic.

Puzzles

For those who weren’t introduced to these as children, jigsaw puzzles are basically jumbles of irregularly cut pieces (originally of wood, but now largely cardboard or plastic) that must be assembled in the correct order to reveal a pattern or picture. Pieces range in size from large (for small children or Alzheimer’s sufferers) to small (for people of normal to high cognitive function who may be looking for a challenge).

This deep into the article, you can probably predict what I’ll say next. “[J]igsaw puzzles …can help keep the mind active and a little sharper.”[16] (There are numerous kinds available. For my suggestions, see HERE.)

Reading

Some researchers believe that simply reading (books, magazines, etc.) frequently can have a protective and supportive effect on our brains. This could honestly be as mundane as picking up the daily newspaper. Or, for people who are more electronically inclined, visiting your favorite news website.[17]

If you walk to your local library, you could add a bit of exercise into the mix as well!

Social Interaction

According to a report from National Public Radio: “social interaction may be a better form of mental exercise than brain training,” where “brain training” refers to exercises designed to enhance processing speed and promote reasoning.[18]

Just “being around” other people can be of great benefit to Alzheimer’s sufferers.

Still, it is well to recall that causal direction is difficult to establish. Is it that social withdrawal leads to Alzheimer’s, or that Alzheimer’s leads to social withdrawal?

Sudoku

Here’s another – and more arithmetical – sort of puzzle: Sudoku. This Europe-originated puzzle with the Japanese name is essentially a reworked “magic square” in which numbers are inserted into a 9×9 grid. The object of the number game is to fill paper so that every column, row, and embedded 3×3 grid contains all numerals from 1 to 9.

One scientist stated: “…doing Sudoku isn’t probably going …to prevent you from developing Alzheimer’s disease” by itself.[19] Still, there’s little doubt from many investigators that “regular use of word and number puzzles” – like Sudoku – “helps keep our brains working better for longer.”[20] At least one scientific “study has identified a close relationship between frequency of number‐puzzle use and the quality of cognitive function in adults aged 50 to 93 years old.”[21]

If numbers are in your wheelhouse, give it a shot. If letters are more your thing, feel free to see our section on “crosswords,” above!

Working

You read that correctly. We’re talking about going to work.

Before you complain about your job, consider that, for many people, their job provides their “daily cognitive training.”[22]

This is to say that just going to work can have some neural-protective value.

Many jobs are going to present workers with daily brain challenges. These may include having data to enter, information to process, items to remember, things to multi-task, questions to answers, and so on.[23]

Now, if your nine-to-five has you on the verge of a panic-induced coronary, then you might want to seek stimulation elsewhere. But if your day job isn’t overly stressful or soul-sucking, then realize that it might be giving your brain an assist.

Caveats

When it comes to Alzheimer’s prevention, there are three divergent perspectives on the efficacy of mental exercise. These are as follows. (1) Mental exercise is possibly helpful. (2) Mental exercise is likely neither helpful not harmful. (3) Mental exercise is potentially harmful.

Objections

The third position – that mental can be potentially harmful – suggests a few objections to the strategies outlined above.

False Hope?

Firstly, some investigators worry that these considerations might give a person “false hope.” The idea, here, is – presumably – that someone might form beliefs such as that doing crossword puzzles has the power to confer some sort of magical protection against dementia, or that doing them could even reverse the disease. Sadly, these don’t seem to be the case.

But it seems to me that the solution is to have realistic expectations, rather than abandoning the idea of doing mental exercises.

Ineffective?

Secondly, and relatedly, some people object that these interventions are just plain ineffective. For example, in some studies – like regarding bilingualism – participants ended up getting Alzheimer’s anyway.

But this shouldn’t mean that the interventions are without value. It may be that we have to clarify what we mean by “effective.” If “effective” has to mean 100% protection against Alzheimer’s, then we might have to confess these interventions to be “ineffective.” But could mental exercises be “effective” at delaying Alzheimer’s?

Delaying onset of a disease seems valuable in and of itself. For example, if you can maintain a higher quality of life longer, wouldn’t you want to do it?

So, maybe playing checkers or working won’t guarantee that I never get Alzheimer’s. But if they (and other things) can help me to push onset back 2 years, 4 years, 6 years… it’s worth it to me.[24]

However, some people mention another facet of this objection. To put it directly, it’s possible that “incipient” or as-of-yet undetected dementia might prompt people to withdraw from social situations and to cease engaging in mentally stimulating activities.

On this picture, it’s not so much that you should exercise your brain to ward off Alzheimer’s. It’s more that once you reduce your level of mental engagement, it’s likely that you have Alzheimer’s – latently – already.

Of course, it is true that I don’t have any special insight into the mechanics or direction of the causation – if any – between mental exercise and dementia. It could be that dementia causes a lack of mental exercise; it could be that a lack of brain engagement causes dementia; it could be that they both have a third, presently unknown cause; or it could be that they are causally unrelated.

Still… only one of those possibilities suggests any direct way for me to influence my mental health positively. In the absence of some impelling reason for me to think that brain exercise isn’t at least possibly beneficial to me, I’ll continue to operate as though it might.

Counterproductive?

Thirdly, some commentators have spoken (or written) in such a way as to suggest that brain exercises could actually be harmful! A few titles make statements such as that mental training can “speed up dementia.” A few acknowledge that mental stimulation might buy time, but that it also accelerates decline once it begins.

There are a few things to be said.

Number one, insofar as these statements make it seem as if someone could be worse off for having exercised their brains, these summaries are a bit misleading. The “acceleration” of the decline can be explained as a simple matter of mathematics, provided only that the dementia is at least partially a matter of biology or physiology.

What I mean is this. Mental exercises almost certainly help boost or preserve cognitive function. But Alzheimer’s involves literal, physical damage to the brain. So, ultimately, mental exercises cannot undo physical damage.

However, through things such as by increasing “cognitive reserve,” they may be able to stave off the noticeable effects of the condition. But this means that once the effects of the condition do become noticeable, the disease may be “compressed,” and the decline may appear to be more rapid or steeper than it would have been otherwise.

Mathematically, this means that the decline is “quicker” either in that it happens over a shorter time, or that it occurs from a higher “starting point” – or both. This can be seen fairly readily from a simple curved-line graph.

In the graph, I show four different trajectories, all ending at age 80.

Red line: no exercise

The red line represents a person who doesn’t exercise at all, and whose decline begins at age 70. The decline concludes at age 80 – as it will for each of the four imagined scenarios.

Blue line: exercise preserves brain function

The blue line represents a person whose exercise preserves their cognitive function an extra five years. So, their decline begins at age 75. It still concludes at age 80.

Orange line: exercise increases, but doesn’t preserve

The orange line represents a person for whom exercise gives their brain function a boost. I didn’t also assume that this boost bought them any additional time. So, you see their decline begins at the same point as the person who doesn’t exercise at all: age 70. This is the person who has a “higher starting point.” The decline also ends at age 80.

Green line: exercise increased brain function

Finally, the green line represents the person for whom exercise both gives a boost to brain function and preserves it. Obviously, this is the best-case scenario. Since the brain function is boosted, the starting point is higher. Since it is preserved, I have their decline begin at age 75. Like everyone else, it stops at age 80.

Analysis

In this toy model, I have envisioned four scenarios, representing four possible combinations. (1) No boost to brain function and no preservation of brain function;[25] (2) preservation of brain function with no boost; (3) no preservation of function, but some boost; and (4) both preservation and boost.

In each of the four cases, we’re looking at people between the ages of 65 and 80. I have assigned arbitrary “brain-function points” between 100 and 400.[26] Furthermore, I have supposed that people start to decline beginning at age 70 or 75, depending on whether there is preservation or not.[27]

(You could either see these as representing four different, but relevantly similar, people. Or you could see it as representing four different possible trajectories for one and the same person. I prefer the latter.)

The four resulting combinations are as follows.

No boost, no preservation

The red line depicts a person who doesn’t engage in any mental exercise at all. The decline begins at level “300” (just an arbitrary number) and ends at level “100.” This is a difference of 200 points. It takes ten years, which means that they lose twenty points a year.

No boost, preservation

The blue line buys the person an extra five years of preservation. Since they hit the same level – level “100” – at the end, their decline occurs twice as fast as for the person who didn’t exercise. They drop 40 points per year, which is twice the rate of decline. This is because the same amount of decline (as occurred with red) is compressed into half the time.

Boost, no preservation

The orange line shows a person with a bit of a boost (getting them to 400), but no extra time before decline begins. They start higher, but end in the same place, dropping 300 points in ten years. This yields a rate of 30 points per year. The amount of decline (compared with red) is 1.5 times greater (150%) but is stretched over the same length of time (as red).

Boost, preservation

The green line shows a person with both boost and preservation. This person bought an extra five years before visible decline. But they also have the extra “100 points” of function. So, their decline starts at a later age (compared to red) – age 75 – and from a higher starting point (again, compared with red) – 400 points. Since they decline 300 points over five years, their rate of decline is 60 points per year.

Conclusion

That we see “higher rates” of decline in the exercisers is due to either (or both) of two factors.

Factor 1: The decline happens over a shorter span of time (as with blue and green); or…

Factor 2: The decline happens from a higher starting point (as with orange and green).

I said earlier that the explanation for the higher decline rates was mathematical. When a predetermined amount of decline happens over a shorter time frame, the rate of decline is increased. This is mathematical in this sense. Take some number, n. n divided by 5 is going to be bigger than n divided by 10.

Moreover, when a predetermined endpoint of decline is reached from a higher beginning point, the slope of the line representing that decline is steeper.[28] This is also mathematical, since the slope of a line is merely a value (m) in the equation representing that line. So, if the cognitive “drop off” is steeper, all we’re saying is that the value of slope (m) for that drop off is a bigger number than it is if the drop off were not as steep.

At the end of the day, for me, I would rather have my cognitive function preserved for as long as possible – and boosted as high as possible – even if I experience an eventual decline.[29]

Curiously, you could even argue that having a “quicker” or “higher” rate of decline is preferable to a slower rate in that it likely saves caretaker energy as well as money devoted to care!

Training Is Parochial

Fourthly, you may read that certain forms of “brain training” are very limited in terms of what they accomplish. Even where certain mental exercises may be worthwhile, their impact may be restricted. To put it another way, specific benefits may not generalize to other areas of your daily or mental life.

For example, reading books may help boost your processing speed, but maybe doesn’t help enhance your memory. (It’s just an illustration; I don’t know whether it does or doesn’t.)

Somewhere I read a researcher giving the following analogy. Some brain exercises can be likened to working out physically by doing only one or two exercises. These exercises – like bicep curls – may strengthen a single muscle (the biceps), but they are unlikely to impact the overall health of the body much.

A few things may be said in reply. Number one, you can make the case that doing a few exercises is better than doing none. A person who does biceps curls may not be as fit or healthy as a person who trains his or her whole body. But he or she may well be more fit or healthy than he or she would be if they did nothing at all.

Number two, whether a given exercise has broad or narrow impact may depend on the sort of exercise being done. In physical training, there are differences between compound and isolation exercises. It’s one thing to do bicep curls or grip strengtheners all day long. It’s another to do deadlifts or squats. The former may only affect one or two muscles; the latter might well affect the entire body. It is doubtful that we know enough about “brain training” to really understand the broader impact of a lot of the mental exercises discussed here. For example, is playing chess more than doing bicep curls, or more like doing squats? I’m not sure. And I’m not sure that anyone else is sure, either!

Blame the Victim?

Yet another objection, fifthly, is that talking about mental exercise may lead to sufferers being “blamed” for their Alzheimer’s. The idea here is that some people might conclude that if John Doe has dementia, then he must have been mentally inactive or lazy.

Sometimes you may read comparisons to smoking. People who smoke are at higher risk of lung cancer. So, if a smoker gets lung cancer, then he or she assumes some of the responsibility for that condition.

By way of response, I should first remind readers that Alzheimer’s risk almost certainly has a – probably a significant – genetic component. (See my video about risk factors HERE; or read the article on the same topic HERE.) To put it differently, some people are simply more at risk than others of developing it.

Having said that, I will simply repeat what I have mentioned many times in my written and video-graphic work: I am trying to stack the odds in my favor. I realize that if I smoke, I’ll be at increased risk for lung cancer. Although the data may not be as clear cut for the relationship between mental exercise and dementia, I’ll say that for me personally I’d rather exercise, and have it avail me nothing, than not exercise and have it turn out that it would have helped me.

If other people value other things over exercising, then I would suggest that it is their prerogative to do so. In the first place, the data in favor of mental exercise is not so compelling as to make it undeniable that it helps preserve or boost cognitive function or that it can ward off Alzheimer’s.

But even if the data were that compelling, it’s not clear that someone has to value preserving or boosting cognitive function or must value warding off Alzheimer’s, over not doing any of these. I confess that such a position would be foreign to my own thinking. But it’s not something that moves me to start throwing words like “blame” around.

I suppose you could put my answer this way. If a person doesn’t perform mental exercises, it’s either because they don’t think it will help or they don’t care if it helps or not. If they don’t think it will help, then their choice not to exercise is rational. They have discharged their rational duty and it’s not obvious to me that there’s anything to blame them for.

If they don’t care, then the choice itself may be irrational (i.e., not rational). But it’s not clear why a person choosing irrationally in this way wouldn’t care if exercising helps but would care if they’re “blamed” for not caring. It seems to me more likely (or at least more consistent) if they didn’t care about either one. So, even if the choice is blameworthy, it doesn’t appear to have the result the objector is worried about. It seems that the concern in the objection is centered on the perceived hurt feelings of the person being blamed. But, to reiterate: for all we know, the person who doesn’t care about not exercising wouldn’t care about being blamed for not exercising. If this is so, then it’s not obvious that there would be any hurt feelings for us to worry about.

Conclusions (Tentative)

One article ventured the opinion “that lifestyle choices may even counteract genetic predisposition for Alzheimer’s.” If true, that’s huge.[30] And it would put a lot of control in our hands.

Here are a few takeaways.

Train the Whole Brain

But staying mentally fit and sharp may really come down to neural recruitment: using multiple parts of your brain, not just a few.

Be Consistent

It’s also going to involve consistency. Many reports mention the need to engage in stimulating activities regularly – say two or more times weekly – not just every blue moon.

Try Something New

Another key element is novelty. Sometimes trying something new may be more valuable than doing the same things over and over. There may be two “levels” of novelty. Think about some of the things on this list. For example, chess or reading. Every game of chess you play has the possibility of being different from every other game. And if you read new articles or books every day, you are adding some variety. However, we might call this low-level variety. A higher level of variety can be attained if you learn a new language or musical instrument, for example. Interestingly, there may be a kind of middle level as well. For example, a person could switch from reading fiction to nonfiction, or from reading prose to reading poetry.

Act as Though It’s ‘Use It Or Lose It’

As the Independent put it: “use it or lose it” idea may just “give a person a ‘higher starting point’ from which to decline.” But this still seems advantageous.

Realize: ‘Better Late Than Never’

Some commentators express the message that its always “better late than never.” But you should probably take the position that it’s desirable to start now! This applies to you whether you are a sufferer or a person looking to avoid the condition altogether.

No Silver Bullets

Still, neither I nor most other researchers are suggesting that any of these measures amounts to a “cure.”

Aim to Have a Healthy Lifestyle

Additionally, these mental activities almost certainly need to be situated in a larger context – a “lifestyle package,” as it were. Genetic predisposition notwithstanding, if you really want to stack the odds in your favor, you’ll need to address your blood pressure, body mass, cholesterol, diet, level of physical exercise, and sleep patterns.

I can tell you that I’m implementing a number of these measures today. Most of the items on this list are cheap (or free) and easy to obtain. And after all that’s been said, I think it’s reasonable to maintain that they can’t hurt. And some of them just might help. So…go on: give your brain a good workout!


[1] See, e.g., Chiara Giordano, “Doing Sudoku and Crosswords Won’t Stop Dementia or Mental Decline, Study Suggests,” Dec. 11, 2018, <https://www.independent.co.uk/news/health/sudoku-crosswords-dementia-mental-decline-brain-study-aberdeen-university-research-a8677466.html>.

[2] Giordano, loc. cit.

[3] Felix Gussone, “5 Things You Didn’t Know About Alzheimer’s,” CNN, Jul. 17, 2014, <https://www.cnn.com/2014/07/14/health/alzheimers-disease-conference/index.html>.

[4] See, e.g., Margaret Gatz, Educating the Brain to Avoid Dementia: Can Mental Exercise Prevent Alzheimer Disease?” Public Library of Science, vol. 2, no. 1, Jan. 25, 2005, p. e7, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC545200/>.

[5] Amy Marcus, “How to Outsmart Alzheimer’s,” Wall Street Journal, Mar. 30, 2010, <https://www.wsj.com/articles/SB10001424052748703416204575145921517534304>.

[6] Allison Aubrey, “Mental Stimulation Postpones, Then Speeds Dementia,” National Public Radio, Weekend Ed. Saturday, Sept. 4, 2010, <https://www.npr.org/templates/story/story.php?storyId=129628082>.

[7] Ivan Vega, “‘Checkmate the Onset of Dementia’: Prescribing Chess to Elderly People as a Primary Prevention of Dementia,” Journal of Alzheimer’s Disease, Jan. 25, 2019, <https://www.j-alz.com/editors-blog/posts/checkmate-onset-dementia>.

[8] Gussone, loc. cit.

[9] According to Jagan Pillai, Charles Hall, Dennis Dickson, Herman Buschke, Richard Lipton, and Joe Verghese, “Association of Crossword Puzzle Participation with Memory Decline in Persons Who Develop Dementia,” Journal of the International Neuropsychological Society, vol. 17, no. 6, Nov., 2011, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3885259/>.

[10] At least, this is the assertion of the weblog Puerto Rico Report, in the post “Bilingual America,” Aug. 11, 2017, <https://www.puertoricoreport.com/bilingual-america>.

[11] Ingrid Piller, “Multilingual Europe,” Language on the Move, Jul. 18, 2012, <https://www.languageonthemove.com/multilingual-europe/>.

[12] The precise time of onset can be extremely difficult to identify.

[13] Ryan Jaslow, “Learning Another language May Help Delay Dementia,” CBS, Nov. 6, 2013, <https://www.cbsnews.com/news/learning-another-language-may-help-delay-dementia/>.

[14] Ibid.

[15] Giordano, loc. cit.

[16] Rob Nelson, “Hidden Heroes: Queens 12-Year-Old Helping People With Alzheimer’s,” ABC News, Apr. 26, 2019, <https://abc7ny.com/health/hidden-heroes-queens-12-year-old-helps-people-with-alzheimers/5272644/>.

[17] Though, for the counterpoint that online reading may be detrimental, see “‘The Shallows’: This Is Your Brain Online,” National Public Radio, All Things Considered, Jun. 2, 2010, <https://www.npr.org/templates/story/story.php?storyId=127370598>.

[18] “A Brain Scientist Who Studies Alzheimer’s Explains How She Stays Mentally Fit,” National Public Radio, Morning Ed., Oct. 8, 2018, <https://www.npr.org/sections/health-shots/2018/10/08/654903558/a-brain-scientist-who-studies-alzheimers-explains-how-she-stays-mentally-fit>.

[19] “A Brain Scientist Who Studies Alzheimer’s Explains How She Stays Mentally Fit,” loc. cit.

[20] “Sudoku or Crosswords May Help Keep Your Brain 10 Years Younger,” Healthline, n.d., <https://www.healthline.com/health-news/can-sudoku-actually-keep-your-mind-sharp>.

[21] Helen Brooker, Keith Wesnes, Clive Ballard, Adam Hampshire, Dag Aarsland, Zunera Khan, Rob Stenton, Maria Megalogeni, and Anne Corbett, “The Relationship Between the Frequency of Number‐Puzzle Use and Baseline Cognitive Function in a Large Online Sample of Adults Aged 50 and Over,” International Journal of Geriatric Psychiatry, vol. 34, no. 7, publ. in print Jul. 2019, pp. 932-940, publ. online Feb. 11, 2019, <https://onlinelibrary.wiley.com/doi/abs/10.1002/gps.5085>.

[22] “A Brain Scientist Who Studies Alzheimer’s Explains How She Stays Mentally Fit,” loc. cit.

[23] Ibid.

[24] Again, onset detection is not a little tricky.

[25] Both ideas – “boosting brain function” and “preserving brain function” – are a little vague and would need to be sharpened to be of greater use. However, my model is merely trying to show that the “higher rates of decline” spoken about in some articles might well be nothing to worry about. So, I have abstracted away from some of the details because I don’t think they’re necessary for the point.

[26] This raises the issue of how we would actually be able to measure cognitive ability. There are various assessment tests. But it is possible that these assessments fail, for one reason or other, to paint a true or complete picture of a person’s cognitive situation. This is simply a model.

[27] This choice was arbitrary.

[28] I realize that I opted to display the graph with curved lines. This was simply an esthetic choice since when I used straight lines, the lines overlapped in places and couldn’t be easily distinguished. The information is simply sample and hypothetical data for illustrative purposes only. It could be represented with straight lines. And if it were represented this way, then the resulting lines would have calculable slopes in the usual sense.

[29] As a side note, the red line also represents a case in which a person exercises, but it fails to boost their brain function or preserve it at all. So, you’ll notice that if the exercises are utterly ineffective, you’re no worse off than you would be had you not exercised at all. You might think that you would have wasted your time. I suppose this boils down to whether you find any of the exercises enjoyable – or potentially enjoyable – or not. But even still, personally, it strikes me as improbable that mental exercises would do nothing whatsoever. Readers may think differently.

[30] More scientific study and philosophical reflection is needed, however. Some studies abstract away from possibly relevant data, including economic, educational, genetic, intelligence, and sociological factors.

How Do You Alzheimer’s Proof a Car?

There are a number of reasons why automobiles pose particular risks for persons afflicted with Alzheimer’s disease and other forms of dementia. Most obviously, a motor vehicle is a 2,000-lb missile in the hands of an impaired driver. And, if it is anything, Alzheimer’s is a mental impairment.

But not all perils presuppose that the Alzheimer’s sufferer is in the driver’s seat. Dangers abound for passengers as well.

But there are several things that you can do with a car to minimize the risk to the patient and to others.

(Readers will observe that there are numerous points of contact between “Alzheimer’s proofing” and childproofing. For a few thoughts on that topic, see my overview, HERE.)

Let’s begin by distinguishing various categories of danger. On the one hand, there are dangers to persons inside of a car and, on the other hand, there are dangers to persons outside of a car.

Minimizing Dangers Inside of a Car

To add a further layer of complexity, this arguably has two versions to it. On one version, the Alzheimer’s sufferer is the driver (see the subsection “Supervise, Supervise, Supervise!” below) and on another (probably the more usual case for readers), he or she is a passenger.

1.     Utilize Your Child Safety Locks

As discussed in a previous article (HERE), many childproofing suggestions pull double duty for Alzheimer’s proofing. In this case, we note that many (even most) sedans come with special safety latches built into the rear doors. On the majority of passenger cars built in the United States since the 1980s, turning on this safety feature is as easy as flipping as switch.

The function of the child lock is easily summarized. Most doors can be opened (and many can be unlocked) from within the cabin by simply pulling on the interior door handle. However, once the child-lock system has been engaged, the door cannot be opened from the inside. Even if the door is unlocked, the occupant has to be released from the cabin by someone operating the exterior door handle.

The only “loophole” is that the exterior door handle can be operated by reaching outside the vehicle – for example, through an open window. So, in addition to using the child-safety locks…

2.     Utilize Your Window-Switch Locks

On most modern vehicles that are equipped with power-window switches, there is a master panel located on the driver’s door panel. On that door panel, usually, there is a “lock” or “window lock” button situated near the window switch assembly. The button gives the driver the ability to override auxiliary door switches so that the window positions on passenger doors cannot be changed without the driver’s authorization. Of course, it was designed primarily with children in mind.  The idea was to prevent youngsters from playing around with the windows – perhaps raising and lowering them haphazardly, or at inappropriate times – and possibly getting one of their little digits crushed in the process.

But, as in other cases, what works to prevent children from getting hurt sometimes also translates into a workable solution for keeping Alzheimer’s patients out of trouble.

3.     Clean up the Cabin Interior

This one may seem commonsensical, but it’s worth mentioning, nonetheless. Don’t leave a lot of trash lying around – anywhere. But inside the vehicle, it is impractical to expect that you can thwart your loved one’s every peculiar gesture while you’re driving the car. In other words, you may notice that mom or grandpa is straining to pick something up, but there will be little that you can do about it when you’re operating the vehicle. Before you put an Alzheimer’s sufferer in your car, double check that there is nothing dangerous (or just disgusting) within his or her visual field. If you encounter trash, discard it! If it’s something that you need to keep with you – like pepper spray or a first-aid kit, then at least put it inside of the glovebox. Most gloveboxes can be locked with your key.

4.     Consider Using a Seatbelt-Button “Guard”

I have seen a few of these. Don’t be put off if the gizmo is stocked in the childproofing section – or even in pet supplies. The last thing you want is for grandma to release her seatbelt before it is safe to do so. Placing a “guard” over the seatbelt button can make it more difficult for grandma to inadvertently (or advertently!) trigger the retraction of her safety belt. Doubtless there are various models available, but the general idea is that releasing the guard takes a bit more dexterity than just depressing the seatbelt button. Alzheimer’s certainly diminishes fine motor skills, making it less likely that grandma (or whoever) will be able to defeat the extra layer of security. Remember: we’re trying to stack the odds in our favor.

Minimizing Dangers Outside of the Car

1.     Restricting the Keys

One important consideration is going to be access to the vehicle’s keys. This is very basic. If a person has some form of dementia, such as Alzheimer’s, it may be necessary to restrict access to those keys for a number of reasons.

Why Might You Have to Restrict Key Access?

Depending upon the degree of impairment, it might be that the person in question can no longer safely or reliably operate a motor vehicle at all. So, one primary reason to restrict key access is simply to prevent your loved one from being able to drive the car on the road in the usual sense. Even starting a car and leaving it to idle in place can pose a danger (for example, with respect to things like carbon-monoxide buildup – click HERE for recommended CO detectors), especially if the vehicle is enclosed inside of a garage. (Of course, it’s a good practice to place carbon monoxide detectors inside of the garage and inside of the living space. I personally recommend getting a low-level detector, even though it costs a bit more, because of the fact that most detectors do you not report low-level conditions that can be dangerous over time.)

How Can You Restrict Access to the Keys?

A.     Never leave the keys lying around; hide them. (As a special case, especially do not leave your keys inside of the ignition!)

Alzheimer’s is peculiar. People with the condition have periods of lucidity. Do not count on your aged mom, dad, grandma or grandpa being unable to recall that these keys go with that car. The best strategy is a comprehensive one, with layers of redundancy.

The first thing to do is to place the keys inside of a lock box or inside of a locked drawer or safe.

B.      Alternatively, secure the keys some other way – for example, keep them on your person.

If it is inconvenient or otherwise infeasible to lock the car keys away someplace, another option is just to hang onto them yourself. Add your aging relative’s car key onto your own keychain, for instance. Or just keep their entire key ring in a pocket.

As I have mentioned in other places, I am a big believer in redundancy. So even after you have restricted access to the keys (e.g., by locking them safely out-of-reach or keeping hold of them), I would still recommend restricting access to the vehicle in other ways.

2.     Controlling Entry to the Garage

If the car is inside of a garage, then you can do several things. Firstly, you can secure the door from the house to the garage – if such a door exists. Of course, the obvious first pass attempt would be to keep the door locked in the typical sense. If this is the route that you wish to go, a double-keyed deadbolt would be advisable.

In my dad’s case, I found a little gadget called a door “Guardian” and installed it on the relevant door. When engaged, the ingenious device holds the door closed, even if the usual locking mechanisms have been unlocked. The Guardian can be mounted up high, which is advantageous because I found that my dad seemed not to even notice that it was there. It’s also ideal for the present application because the disengagement of the Guardian, while easily accomplished by an adult possessed of all his or her mental faculties, is complex enough to frustrate a person with diminished cognition.

It may also be necessary to stow the garage-door openers, to prevent the Alzheimer’s-afflicted individual from gaining access to the vehicle from the driveway. However, I would also recommend securing the main entryway, to lessen or eliminate the possibility that mom or grandpa will be able to get outside unsupervised.

3.     Defeating the Starting System

Another thing that you can do is install (or have installed) an inline switch between the vehicle’s battery and the starting circuit. The function of such a switch is basically to disable the car’s starter, even if dad or grandma get past your other measures. An alternative would be to have a full alarm system put on the car (which might not be such a bad idea, for other reasons). Many vehicle security systems include a “starter-interrupt relay” that prevents the car from being started – even with the key in the ignition.

(For specific product recommendations, see HERE.)

4.     Sell, Donate, or Otherwise Get Rid of the Car

A final suggestion – and a harder pill to swallow for some families – is to simply get rid of grandpa’s car. Of course, this doesn’t safeguard against the Alzheimer’s patient absconding with someone else’s car. But, truthfully, such a situation is probably out of the realm of the normal. Alzheimer’s decreases cognitive function. A sufferer is unlikely to be able to devise a plot to steal your car. What is more typical is that dad or grandma simply wants to do what he or she has always done: drive. So, they go to the usual place to find the key and try the usual things to get to the familiar car. The name of the game is Making It Difficult. But there is no substitute for supervision.

Supervise, Supervise, Supervise!

Even after you have secured the keys; even after you have interrupted the battery; even after you have secured the garage doors or emptied the garage altogether; there is no replacement for supervision. In many ways, a person with Alzheimer’s is like a child. Surrounded with environmental perils, such an individual lacks the discrimination to avoid (or get out of) danger. The bottom line? Your loved one needs your constant and watchful supervision.

When Should You Begin Alzheimer’s Proofing?

See here:

What Do We Mean by “Alzheimer’s Proofing”?