- Today, at the fourth annual Final Affairs Conference, we have Sharlene Bellefeuille, Community Outreach Specialist from the Alzheimer's Association Greater Wisconsin Chapter. She is here to educate us and help us learn about healthy living for your brain and body and tips from the latest research. So please welcome Sharlene Bellefeuille.  [audience applause] - What a wonderful morning. Isn't it good to gather together? This is always such a wonderful room to be able to present in. And I'm very proud that I was invited to be able to speak this morning. When the question came of, could you speak at Final Affairs but I want you to talk about brain health, I went, Hmm. But it is very important because it allows us to prepare for the future. And that's what we need to do as we're aging. This program we're going to talk about is research-based recommendations on how we can care for our bodies and our brains so that we can age as well as possible. So when we talk about aging, there are certain caveats that we can work with and there's certain ones that we can't. We have control over certain things and certain things that we just have to let be. One of the things that we talk about is that we can control our lifestyle many times. We have a challenge in controlling our environment, and we really don't have much control at all over our genes.  What mom and dad gave us is what we have to work with, but we can adapt and adopt some of new habits that will help us change our lifestyle so that we will age better.  So, your brain. And it's important that we talk about our brain, number one, because your brain has over 100 billion nerve cells. Your brain is working hard right now. The minute you woke up this morning, your brain sparked alive, and you were able to take in the environment and take in information. There's a network of pathways through your brain that is amazing, that is able to understand thoughts, to be able to process things, to be able to look at feelings, to be able to store memories. With Alzheimer's disease, though, and many of our dementia's that are progressive, the brain slowly dies. Those brain cells come to an end, and that affects all of the progressions of your aging. So we want to look at how we can help stave that off.  When we talk about that brain in Alzheimer's disease, I did want to say one thing, that 25% of your blood that is going through your brain is bringing in so much oxygen that the brain needs to be well taken care of. It needs to get the oxygen and also the blood flow. So, why is that important? Because the two are interrelated. If we're able to look at our heart, if we take good care of our heart and we eat well and we exercise, that heart is going to assure that we have good, healthy blood to our brain. When we get to the age about 50 or 60, that's usually when we start to talk about aging. We go, oh, I better start changing and adopting new things. When we get into our 70s or 80s, we tend to have more wisdom about it and really put it into affect. But note that it doesn't matter what age you start this. We need to start today. We need to be prepared today. We know that there isn't any methods at all right now that prevent cure or even slow down the progression of Alzheimer's disease. Once the disease has begun in the brain we don't have anything that can change it. But if we adapt some habits, some healthy habits, we're able to improve our overall health. So if I do have Alzheimer's disease, at least I won't have diabetes. If I have diabetes, maybe I'll be able to stave off the Alzheimer's disease. That keeps our brain healthy for longer times. The term dementia, remember, is an umbrella term. It's a whole group of symptoms, and there are many different diseases that have dementia in it. Alzheimer's disease is just one of them. But we talk about Parkinson's disease, vascular dementia, frontotemporal lobe disease. Any of those types of things that interfere with the daily functioning of the brain, and that then affects my life.  Alzheimer's disease and the memory loss that comes along with it is not a normal part of aging. So when you hear that "Well, it's normal to forget." No, it is not normal. There is something happening in the brain, and we need to know what that is and to be able to work with that and understand that. Most of the time when you go to a physician and you're having the issues that encapsulate dementia, usually about 70% of the time it is Alzheimer's disease. But we need to be sure that we know what disease we're working with. When we talk about the risk factors for Alzheimer's disease, our number one risk factor is age. But you throw in genetics, you throw in head injuries, cardiovascular health, in fewer years of formal education, all of those that we're going to break apart. Each one of those things increase your risk factor for this disease. We do have some therapies that help with the treatment of Alzheimer's disease. Those are only treatments. They're Band-Aids on the symptoms of the disease. Nothing as of today stops or slows down that disease process. So we're gonna look at the four areas, that physical health and exercise, diet and nutrition, cognitive activity, and social engagement. And then we're gonna look at what do we enjoy? Can we make these gradual changes to move forward? And be prepared that we can start right now regardless what age we are.  And if we start to adopt these in very small increments and move forward, it's gonna maximize our age and also maximize the health benefits of these habits. So, let's get started.  Oops.  First one is physical exercise. Now, that's usually the area where I hear the, "Aw," but let's talk about it. Studies have shown, and most of the research is in exercise, that if you adopt one thing that I talk about today, it needs to be the exercise, that as we are increasing our cardiovascular system, that's going to assure that our brain stays healthier longer. Though we don't have a single recipe yet, there isn't, I can't say to you, do 25 sit-ups and that's gonna assure. But what we're looking at is 20 to 30 minutes three to four times a week that we think is going to help that brain stay more active. Along with that is pumping up that cardiovascular. Getting that heartbeat up for a little while, keeping it there, and letting it lower down. We're gonna watch a video clip here.. I'm talking before myself. I apologize. ...with Woodley. And he's going to give us some ideas.  - It's surprising how you can easily build up habits of just taking 15 to 20 minutes out of your day to go down, hit the treadmill, and just do it. Just do it. Just get on it, put my headphones on, and just walk at a nice brisk pace for myself, build up a quick heartbeat, quick sweat, and it's amazing how quickly I can go from 15 minutes to 20 minutes. And then, over time, 30 minutes and, over time, 40 minutes. Before you know it, you know, you're up to 45 minutes of walking. And even at a higher incline and also at a higher pace. And, again, it's all about incorporating habits in the choices that we make.- Creating habits and choices. That's a challenge for us. But I want you to think about starting extremely small. 10 to 15 minutes a day.  When we're doing that, we need to think of some caveats. We need to move safely. In our area, when wintertime comes, walking outside can be a challenge. So looking inside where I can walk. Am I sure that I'm wearing a helmet when I'm bicycling? Am I sure that I'm using the protective equipment that I need all the time? Am I asking my friends to join in with me so that I have that buddy that reminds me on that cold, winter day that, yes, this is a good thing and why we are doing this together. Also thinking about how you can put physical activities and mentally, socially engaging activities. I know one gal that goes to the mall. She brings her best friend. They talk as they walk. That works for her. So whatever happens and works for you, pushing the granddaughter in the stroller, that works. That's exercising. But you need to be sure to talk to your physician and say, "Is this a safe avenue for me to do?" But remember, it's never too early or too late to start adopting a program. Here are some noes. And noes have to be talked about. Smoking. We're seeing such an increase in smoking, and looking at the cardiovascular vascular system, how that restricts the blood vessels, which means it's going to restrict the blood flow to the brain. Avoiding excess alcohol. Now, we've heard that time where they said a glass of red wine a day is important. Now, it depends on how you measure that glass. You can have a goblet, and you can have a water glass. So, being sure that we're keeping it to the right ounces. But alcohol can do many other things too. You're a fall risk when you're drinking. There's some drowsiness, and we can lose memories. There's issues with balance with that fall risk. And we have to be sure that we're understanding our medications that we're taking so that the alcohol doesn't have a negative reaction to it. We need to be sure we get enough sleep. If we have sleep apnea, having that checked so that at night when we're resting we have good oxygen to that brain so that brain can rest for the next day. Being sure that we are reporting our head injuries. Each time we have a bump that our physician is aware of it. We used to to talk about that one traumatic brain injury and telling your doctor. Now it's the consistent small injuries that we have to be sure our physicians understand. We also have to monitor our stress level. Bringing that stress level down. And that's what exercise helps to do. Helps you center, bring yourself down, and feel relaxed. We have to be sure that our doctors know every medication we're using. And I'm not thinking or speaking about the medicines that we get from our pharmacy, but anything we put on or in our body, the over-the-counter eye drops, the Tylenol with a PM, whatever it is our physician is fully aware of what we're talking about and what we're using. And also be sure you shop for your physician. And shopping isn't what we did in the past, but go to a physician, see if it's someone that relates to you, that understands your concerns and your issues, and then follow up on that recommendation of that physician. There's a growing amount of evidence that suggests that heart disease and stroke is going to increase our risk for dementia. When we talk about diabetes, and that of course is a vascular issue, we're seeing an increased risk of dementia with the diabetes. And we're also talking about midlife diabetes, and how that is happening and midlife obesity. So those are two things that we need to remove. Also, research has been done on treatments to reduce midlife hypertension, but once that vascular issue is there, many times we can't reverse it, but we can work with it. And we have seen mixed results, though, in research when we talk about the relationship between high cholesterol and dementia. Some studies show that there is a risk factor together. Some studies that haven't went that far yet. But we want to be sure that if we do have Alzheimer's disease or one of the other diseases, we do not tag another one on top of it. And African Americans and Latinos and other ethnic groups that 

 - Things that have shown to lead to healthy aging would be fruits and vegetables, and in particular green, leafy vegetables and berries, as well as limited intake of high fat food items that you get through high fat dairy and cheese and red meats.  And, also, healthy vegetable oils. So this would be olive oil would be a good example, have been shown to reduce your risk of heart disease as well as dementia.- Now, didn't she mention our top food groups? The things that we all enjoy. So but we need to be able to incorporate those vegetables into those diets. Eating rich fruits. And we're really talking about the brightly colored fruits. The berries and some of the other types. And what I like to listen to and it's amazing is eating those nuts. The beans, the legumes can bring in awesome, awesome healthy habits for you. Talking about lean meats, fish and poultry, adopting that more into our diets, but really staying away from the processed foods. Getting away from the deep fried foods, the excess sugar, and the salt that comes along with eating out more often.  So, what can we do? And this is pretty interesting. Studies have shown that if we add certain vitamins into our diet, it's going to reduce our risk. One of the vitamins is vitamin E, being sure that we're taking that. Many times, putting vitamin E and vitamin C together. Adding vitamin B12 and folate may lower your risk for cognitive decline and hopefully, then, Alzheimer's disease. Of course, you need to speak with your physician and be sure it doesn't have adverse reactions with the other medications you're on. There is a lot of discussion now about dietary supplements and other kind of medical foods that are being sold. They're usually only for people that have nutritional deficiencies, and they only need to be used under the supervision of a physician. So, looking at those types of things and saying, "Hmm, is this really something that I need to use?" Some of those high protein supplements. Also, being sure that our physician knows that we are drinking or eating those types of things and being sure that many of these items are FDA approved. Also, we're looking at sometimes people will put claims on items that aren't truthful. So, being sure that we fact check as much as possible. And work with a trusted doctor that you feel comfortable asking those types of questions. But it's important always to have your physician on your side.  Cognitive activity. Now, there's been a lot of research here, and we're gonna break this one down. We need to-- Cognitive activity is a big term for challenging your brain. We want to be sure that our brain is working well and remains pliable. We know that traumatic brain injuries or diseases can compromise that brain's functioning, so we need to keep that brain healthy. We can look at, and we've talked about this for years, of playing card games, engaging in activities such as reading materials that are challenging. It doesn't work if you're doing something that your brain goes on cruise control. You want to be sure that that brain is challenged every single time you're using it. So you want to stimulate the brain. Make that brain spark more. So, one of the best ways is engaging in formal education. Classroom-based education. So being sure that you're taking a course. Taking a new program. Maybe it's an online program. It's not so much in what you learn, but it's the process of learning that allows your brain to become more pliable. And that's what we want as we age. We're gonna listen to Dr. Bennett.  - One of the most interesting factors is cognitive stimulating activities, which basically, for us, just means mental processing of information. It can be from a book. It can be from the radio. It can be a magazine. It can be from a lecture. It can actually be from watching TV. All of these things require processing information. And the old adage of, you know, "use it or lose it" is actually something that turns out, at least from the observational data, to look like it's true. So, numerous studies now have shown that being more engaged in cognitively stimulating activities is actually good for maintaining cognition. And it's true in late life, and it's true in early life. And so what we recommend is that you start early, and if you're already late, start now.  - So, what do we start with? How do we exercise our brains? How do we keep that brain active as much as possible? One of the best things to do is start something brand new. Say to yourself, what could I do that I've never done before? What is gonna challenge me? Maybe it's building a piece of furniture. You always wanted to, but you never did it. Now is the time to start. Trying a new cooking technique. Going and buying all of that wonderful thing to make Chinese food that you've never done before. Or maybe you haven't canned forever and you want to start that back up. Reading books and articles that challenge you and that inspire you. Maybe go back to poetry that you haven't looked at in years and feeling that rhythm of poetry and writing it. When you're going into learning new things, look at your local WITC, taking an evening class or an afternoon class, even online. And I want you to think, when we talk about puzzles, I want you to go beyond jigsaw puzzles and crossword puzzles that are easy for you. Challenge yourself with chess and bridge, something that's different, something that's gonna make you think in a different way. And adapting those types of new skills and hobbies. When we talk about engaging in ongoing learning, think sometimes about picking up a musical instrument.  We haven't done that forever. And that's something that will bring back good old memories in your brain. And many times even joining a book club. And it can be a book club online. Now, you can double your benefit if you're going to do that with exercise or with someone else so that you're gonna bring in that socialization. But we want to keep our minds pliable and our minds stretched. So think of it that way. How can I stretch it? Now, one of the ways you can do, and I want everybody to write, in this room, just write these few letters down: F as in Frank, so write the letter F, R, I, A, S, A. And later, during the break, I want you to write as many three- to six-letter words you can out of that. You're going to stretch your brain at break. That'll keep you busy and try something different with the brain. Everybody get the letters? No? F as in Frank, R, I, A, S, A. And practice. That's one way to keep that brain thinking. And then our final area that we're gonna talk about is social engagement. This has probably the least amount of research that follows along with it, but we know that in the past if a person is isolated, we know that their life expectancy is decreased. So by social engaging, we're connecting with others.  So, also with social engagement, we see a likelihood that's decreased for disabilities. So when we talk about visiting people that are older or getting out together and having the coffee, we know that's important. Some scientists say that the traits that enable people to build and maintain friendships act as a buffer against cognitive impairment. Regardless of the reason, we know that people don't do well in isolation. When people are feeling good about their social networks, they tend to make healthier choices in other areas of their lives. So if you're stressed, you need to reach out to a friend. You don't have a friend, you need to reach out to a support group. Somewhere where you can gain information, you can connect with other people. We need to find purpose in our lives. And as we age and many of our family moves away, our friends pass away, we need to say to ourselves, I need to start new friendships. I need to start new circles of care. I need to start new networks?  So, we start to visit. And that can be hard for us to make that initial call, that initial meeting, but how can I visit with friends and family? And it's, in one time, it was through an actual visit. Now we can make a phone call. We can Skype. We can go on the Internet and speak with each other. We can text, and many people have their cell phones.  We can meet new people and attend meetings. Coming today, if you don't know the person to your left or to your right, talk to that person. Say, "Hi, I am...", and find out why they're here with you. That's going to give you an idea of the people that are around you. Being active in your community. Going to your senior center. Visiting people in the local nursing home or the assisted living. Volunteering at your local library or your community center. Being a part of that. Being part of the political process. Whatever it is that pulls you into your community. Taking those classes. Now, I'm gonna challenge you. If you've never ever knew how to make those little fishing lures, those fly fishing lures, it's an unbelievable thing. Take a class like that. Something that you have never ever done before. And then join a walking club or start a walking club. Get everybody together, and maybe we're all gonna be over in Siren tomorrow and we're gonna take a nice walk to see the leaves. That is a way that we get together, we get to talk, we get to exercise, we get to be a part of a group. That's what we need to do.  So now we're gonna pull all four pieces together. And it's interesting in how we do that. Now, remember, each one of the pieces that we've talked about we're going to do slow and small so that we're able to adopt these. But let's listen, we're gonna flip, to Dr. Thies. He's got awesome ideas here. 

 - Recently, at the Alzheimer's Association International Conference, there was a study reported of the results of a large clinical trial that was done in the Scandinavian countries. And in this trial, they took half the people in the trial and they adjusted their exercise level, their diet, their social engagement, and their mental stimulation. They developed programs for each one of those variables, changed all of those for the people that were in the test group, and the control group just lived as they had been. And what they found was that the test group had less conversion to mild cognitive impairment, which is a preliminary stage of Alzheimer's disease. To my mind, one of the things that this has done is that it's changed the force of recommendation that we might make around the benefit of these interventions for prevention of Alzheimer's disease or for brain health. And the fact is that I think it's moved it from possibly... exercise, diet adjustments, social engagement, mental stimulation are useful, ...to probably. And that's a big change.  - So, what our physician was telling us is that we need to start now. So, today you're going to begin. Now, when you look at your lunch, eat your lunch. But after that, kind of saying maybe I'm gonna walk out to my car after lunch, get some fresh air, pull some good, healthy air in, relieve my stress, have a glass of water, talk to my neighbor, learn information, and here you've done all that you need to for the day. You've done a wonderful thing. So we need to take a very holistic approach to aging. Considering health across many components, including physical, intellectual, social, spiritual, emotional and vocational areas of your life. And remember, it's never too early and it's never too late. So you need to start with one area. Make it small and build it. Remember the first one we should always think about is exercising. But do what you enjoy. I have one gal that she can't get outside of the house. It's unsafe for her. But what she does now instead of filling that laundry basket with all the clothes and bringing them to the bedroom, she does multiple trips. That allows her to exercise in her home. I have another gal that her and her girlfriends go to the grocery store, and they go down every single aisle. Not that they have to but because they want to so they can exercise while they're in there. Parking your car in back as far as you can in the parking lot, if it's safe, and walking into that building. Just thinking the little things that you enjoy doing.  What I like, and I love this one, this little caveat here, do something that you can manage in the time you have available now. I'm the person that doesn't have time, and I'll leave it to the very end of the day and I'll say, "Oh, now I'm too tired and I can't do it." So thinking early in the morning how we can adopt it, how we can move it forward. Looking at our healthy choices in our day. Eating nutritious and reducing that stress and making your plans. So in your workbook, And if you don't have that workbook, you can always go to our website, Alz.org, and the tip sheet is on there to be able to print out. And looking at those small changes, how we can do that, and getting support from others. And we need to have that support. And here's my favorite thing of all: have fun. Do things that excite you. Do things that make you feel good and reward yourself for each one of those successes.  So, we need to talk quickly on being a savvy, savvy consumer. And I like that first line, or the second line: be cautious when you hear huge promises or reports of miracle cures. That this one pill is going to make me remember. That if I take this one class, I've got it made. It doesn't work that way with Alzheimer's disease or brain health. Something that needs to be done every single day. And many of these products that you see on the market really can arouse false hopes, and some can even be dangerous. Be sure that you go through research. If you don't know a lot of information about a product, be sure you ask. If you're unsure, connect with us, the Alzheimer's Association, and we can help find out for you. When you talk to your physician, and if they're unable to talk to you due to time frames, don't be afraid to talk to your pharmacist. When we put it all together, I want to be sure that you're aware of all of the organizations that you can reach out to and find help. And this kind of gives you an idea. But I want you to be sure you use them. Many times when we are out, Barb Engelhart and I can talk about this, the services are here but people just don't come and use the services. We want you to use the services. Find out who we are before you need us so we can help you so when the time comes you do need us, you're prepared and you know exactly what you want from us. So I want you to be secure in knowing who we are but also being secure in understanding the aging process. So continue your education. Continue to ask for help. Continue to exercise within safe means. Challenge that brain. Eat as healthy as possible, and be sure you're connected with your friends and family And ask for help when you do need help and feel secure in that. Well, thank you so much for listening to me. If you ever need assistance, don't be afraid to ask, and thank you.  [audience applause]