HHS Offers Evidence-Based Materials for Conversations About Brain Health



The Brain Health Resource, recently released by the U.S. Department of Health and Human Services (HHS), is a new set of materials that highlights what people can do to help keep their brains functioning best as they age. The materials are intended to facilitate conversations on brain health and consist of: PowerPoint presentation that teaches older adults and their caregivers how to reduce risks related to brain health;

An accompanying Educator Guide that provides additional information for presenters to share with audiences;

one-page handout for older adults and caregivers called Brain Health as You Age: You Can Make a Difference; and

supplementary handout , Brain Health as You Age: Key Facts and Resources, that includes basic information and resources for the topics covered in the presentation. These resources provide ready-made materials that public health officials can use to promote brain health – as a stand-alone effort and/or by integrating the messages into existing relevant public health efforts. In addition, local public health officials should consider partnering with their local Area Agency on Aging (AAA) to present and distribute this material at places such as local senior centers. For more information on the materials or how to use them, please contact Jane Tilly with the Administration for Community Living (ACL) at jane.tilly@acl.hhs.gov. Research Roundup from the Alzheimer’s Association International Conference (AAIC) Over 4,300 scientists from 75 countries gathered in Copenhagen, Denmark for the Alzheimer’s Association International Conference® (AAIC®) 2014, the world’s leading forum on dementia research. In case you missed our daily dispatches from Copenhagen, several new research studies pointed to public health strategies to promote brain health, consistent with the Public Health Road Map. Among the highlights: disease A two-year randomized controlled clinical trial involving over 1,200 older adults who were at risk for cognitive impairment and Alzheimer'sdisease showed that overall cognitive performance as well as executive function improved significantly with a multi-component lifestyle intervention. The program, known as the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), involved physical activity, nutritional guidance, cognitive training, social activities, and management of heart health risk factors.

Any regular physical activity in midlife – whether light, moderate, or vigorous – was associated with a decreased risk of developing mild cognitive impairment (MCI). And moderate physical activity, such as brisk walking or biking, in midlife is associated with a decreased risk of progressing from MCI to dementia.

Participation in activities in midlife that promote mental activity – especially those involving games such as cards and puzzles – resulted in significantly greater brain volume in several regions involved in Alzheimer's disease (such as the hippocampus) as well as higher cognitive test scores on memory and executive function.

Data from the Framingham heart study – an ongoing, multi-generational cohort study that has existed since 1948 – showed that the age-specific incidence of dementia has declined in every decade since the 1970s. During this same period of time, researchers found that study participants had substantial improvement in educational attainment; better management of blood pressure; higher levels of HDL cholesterol (the "good cholesterol"); and a considerable decline in smoking, heart disease, and stroke. However, several researchers cautioned that the dramatic increase in midlife obesity and diabetes may halt – and could even potentially reverse – this trend when today's middle-aged Americans reach the age of greater risk of developing Alzheimer's and other dementias. New research was also presented at AAIC involving diverse populations. Through a series of focus groups and in-depth interviews with Hispanic older adults (over age 55), caregivers, and health care providers serving Hispanic older adults in Texas and Washington, DC, researchers found that many in the Hispanic community incorrectly attribute early Alzheimer's symptoms to normal aging, mental illness, or other diseases – which delays diagnosis and thus proper care. Researchers also reported that there are few resources available to assist those who seek medical help. This lack of knowledge, information, and resources leaves the Hispanic community at a severe disadvantage when dealing with Alzheimer's and highlights the importance of increasing the availability of culturally and linguistically appropriate resources for diverse populations in the United States. Additional research results related to diverse populations included: Among members of an integrated health care delivery system followed for 10 years, there were marked differences in incidence and risk of dementia by racial and ethnic group. Notably, African Americans, Native Americans, and mixed race groups had a 50-70 percent greater risk of dementia compared to Asians, and risk was intermediate for non-Hispanic whites and Latinos.

A study on factors influencing early self-identification of mild cognitive impairment (MCI) in African Americans found African Americans believe they have significantly less control over the course of the disease than their white counterparts. To increase African American participation in assessment for MCI, researchers recommend targeting beliefs about an individual’s control over the disease, focusing on the potential benefits of exercise, health maintenance, nutrition, stress reduction, social support, and planning for the future.

to cognitive complaints found vascular risks – including high blood pressure, heart disease, diabetes, and smoking – were associated with a negative impact on executive functioning and attention. This suggests that primary care physicians should be looking out for early signs of cognitive decline, even when treating older patients for other diseases, especially vascular-related conditions. A study of African Americans visiting their primary care providers for reasons unrelatedto cognitive complaints found vascular risks – including high blood pressure, heart disease, diabetes, and smoking – were associated with a negative impact on executive functioning and attention. This suggests that primary care physicians should be looking out for early signs of cognitive decline, even when treating older patients for other diseases, especially vascular-related conditions. All research from AAIC 2014 will be published in a forthcoming edition of Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. About the Alzheimer’s Association International Conference® The Alzheimer’s Association International Conference® (AAIC®) is the world’s largest conference of its kind, bringing together researchers from around the world to report and discuss groundbreaking research and information on the cause, diagnosis, treatment and prevention of Alzheimer’s disease and other dementias. Each year, the Public Health sessions at AAIC offer the opportunity to hear about the latest on prevention, risk factors for cognitive decline, epidemiology, and early detection. In July 2015, AAIC is coming to Washington, DC – a great opportunity for the public health community to attend and learn the latest on the growing Alzheimer’s public health crisis. For more information, visit the AAIC® website. The Alzheimer’s Public Health E-News is supported by Cooperative Agreement #5U58DP002945-04 from the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the Alzheimer’s Association and do not necessarily represent the official views of the CDC.



The Road Map

The CDC Healthy Aging Program and the Alzheimer's Association partnered to develop an updated Road Map for the public health community to address cognitive health, Alzheimer's disease, and the needs of caregivers through 35 actions.

Public Health Agenda

The Alzheimer's Association has identified three key elements of an Alzheimer's public health agenda: surveillance, early detection, and promotion of brain health.

The 10 Warning Signs

The Know the 10 Signs campaign is a national education effort to increase awareness of the warning signs of Alzheimer's disease and the benefits of early detection and diagnosis. Contact

For more information on the Healthy Brain Initiative, the public health agenda, or Alzheimer's disease in general, contact Alison Sinton or check out alz.org/publichealth



