April 2017 Mature Lifestyles

MATURE

April 2017

Lifestyles

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2 - Mature Lifestyles - April 2017 - TheIntelligencer.com

Millennials share (bad) advice from baby boomers

By ANA VECIANA-SUAREZ Miami Herald

If you doubt there’s a generational divide, consider an AskReddit thread that features millennials sharing the worst advice —and comments — they’ve ever fielded from baby boomers, namely their parents.

The heartfelt words of wisdom were likely met with a grimace, namely because they seemed so … well, so outdated.

Advice, after all, doesn’t always translate well across the decades.

Certain subjects seemed to stand out in the missed-connection area simply because technology has changed the world so much. Here are a few examples worth a laugh, with jobs being a favorite sore spot.

ZOOMBAFOO82 When I was hunting for my first job my dad drove me around to every store and made me go in and ask the manager for a job. Every single one told me to go and get an application. That was miserable because then my dad made me get two each time, because one was for practice. My final application I had to do in pencil, then

go back over it with ink after my dad approved it. I had to do this for every store. All the while my dad blamed me for not just automagically having a job at the end of that first day.

RAICHUALOVESONG22 When I was struggling to find a job, my dad insisted that the only way it was going to happen is if I go out and “pound the pavement” and demanded I try do it. I tried on several occasions and never made it past the front desk because literally no one wants you to do that. But when I scoured the internet for jobs and created a simple system of scheduling and following up, I got a temp position that led to a full time job at a good company. ]LAEIRYN “You won’t know real happiness until you have children.”

IMACLUBPROHERE Talking to my dad recently, he was going on about “participation trophies.” When I pointed out that we wouldn’t have received said participation trophies had his generation not invented them, his response was: “Yep, that’s another problem with your generation. Always blaming your faults on other people.”

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TheIntelligencer.com - April 2017 - Mature Lifestyles - 3

Aging boomers, lack of funding may lead to Alzheimer’s crisis

By ALLIE SHAH Star Tribune (Minneapolis)

The devastating impact of Alzheimer ’s disease on his own mother — and on his father, who struggled to care for her — first prompted Gerry Richman to take a hard look at the disease.

As vice president of national productions at Twin Cities Public Television, he was the mastermind behind a 2004 Emmy-winning documentary called “The Forgetting: A Portrait of Alzheimer ’s.”

Now, Richman is back with another eye-opening film on the subject.

“Alzheimer ’s: Every Minute Counts” — airing across the country Wednesday — chronicles the struggles of people living with Alzheimer ’s and the emotional and financial challenges it poses for their families.

It also forecasts, through interviews with doctors and researchers, a looming crisis for the country as baby boomers enter their senior years and their risk of developing Alzheimer ’s increases.

“A lot of the experts use the term ‘skyrocket,’?”

Richman said, referring to the potential deluge of Alzheimer ’s cases.

The current numbers are scary enough. More than 5 million Americans have Alzheimer ’s — with one new case identified every minute.

Alzheimer ’s is a neurological disease that robs a person’s memory and ability to care for oneself. There is no known cure, and it is not reversible.

In addition to the emotional toll, it can cost tens of thousands of dollars to take care of someone with Alzheimer ’s, making it one of the most expensive diseases and provoking some health experts to predict that it will collapse both Medicare and Medicaid — and the finances of millions of people.

“This is a major wake-up call to the country about the need to find a cure and to support all efforts to find a cure, or there will be a major social and economic crisis in the United States,” Richman said.

A CALL TO ACTION Part of the problem is that for too long, Alzheimer ’s was not a recognized disease.

“It’s a weird thing because it’s not physically obvious, but it causes strange behavior,” explained Elizabeth Arledge, writer, producer and director of both “The Forgetting” and “Every Minute Counts” documentaries.

“Only within the last 20 years have people realized that it’s a disease.”

Although Alzheimer ’s can strike people younger than 65, it generally occurs in those much older. The risk of developing the disease doubles every five years after 65, according to the National Institute on Aging. It becomes much more common among people in their 80s and 90s.

With longer life spans come greater numbers of people

at risk of Alzheimer ’s.

“There hasn’t been a large population of 85-year-olds until this generation,” Arledge said.

As public awareness of Alzheimer ’s has grown, so has the amount of funding for medical research dedicated to it. Over the past four years, federal funding for the disease has doubled to $991 million. But that amount still pales in comparison with the billions the federal government spends on research for heart disease, cancer and HIV/AIDS. Death rates for those diseases have dropped.

Alzheimer ’s research advocates are hoping for a similar outcome if funding is increased. Arledge said that message comes through in the documentary.

“If there’s something that people will come away with from the film, it would be that things can change when people mobilize,” she said.

In the meantime, medical researchers are in a race against time to develop new therapies to better treat Alzheimer ’s symptoms.

“Do we cure cancer, heart disease or diabetes? No, but we can make significant progress,” said Dr. Ron Petersen, director of the Mayo Clinic Alzheimer ’s disease Research Center. “So if I’m destined to develop Alzheimer ’s disease-related changes in the brain at age 75, and I can push that to age 78 or 80, that’s a big deal.

That’s why I say delaying onset and slowing progression is a more realistic goal than a cure.”

TIPS FOR PREVENTION Despite limited research funds, some promising discoveries have been made in recent years. One finding, discussed in the film, is that sleep — particularly deep sleep — may have a protective effect on the brain and help ward off dementia.

“Part of the thought is that the proteins that are abnormal in the brain that probably cause or contribute to Alzheimer ’s disease are continually being turned over and metabolized,” Petersen explained. “They get washed out in the spinal fluid system, and metabolized, and on their way. It turns out that during sleep, there’s an important trafficking of this amyloid protein, which is thought to be one of the major culprits. And if you don’t get adequate sleep, the clearing of the protein may be impaired, and that may contribute to some of the buildup of the protein and the toxicity.”

In addition to sleep, other lifestyle behaviors may minimize your risk of dementia-related illnesses. Among them: — Regular aerobic exercise, such as brisk walking every day.

— Eating a Mediterranean diet.

— Connecting socially. “Avoid withdrawing and watching TV all day when you’re retired,” Petersen recommends. “Remain active in society. Those kinds of stimulating activities are generally good for the brain.”

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Dental insurance sometimes a hurdle for seniors

By MICHELLE ANDREWS Kaiser Health News

Aging can take a toll on teeth, and for many seniors paying for dental services is a serious concern because they can’t rely on their Medicare coverage.

Low-income seniors, in particular, are struggling.

More than a third with incomes below 200 percent of the federal poverty level (about $23,000 annually) had untreated tooth decay between 2011 and 2014, according to an analysis of federal data by the American Dental Association.

“What ends up happening is that almost everybody, when they get to be 65, is sort of on their own and they have to pay for dental care out of pocket,” said Dr. Michael Helgeson, chief executive officer of Apple Tree Dental. Apple Tree is a Minneapolis-based nonprofit organization operating eight clinics in Minnesota and California that target underserved seniors, as well as mobile units that provide on-site dental care at nursing homes and other facilities.

Traditional Medicare doesn’t usually cover dental care unless it’s related to services received in a hospital. Medicare Advantage managed care plans generally provide some dental care, but the coverage can vary, and often is minimal, dental advocates say. The plans often are “a loss leader,” said Dr. Judith Jones, a professor of dentistry at Boston University. “It’s meant to attract people. It gets people in but the coverage is really limited.”

In a way, older people are victims of dentistry’s success. Regular visits to the dentist, along with daily tooth brushing and water fluoridation, have all contributed to improvements in oral health. In the first half of the 20th century, by the time people reached their 30s or 40s many had already lost all their teeth, Helgeson said, while today more than 60 percent of people in nursing homes still have at least one tooth.

But teeth need tending. Without regular dental care, tooth problems can cause pain and limit how much and what type of food people are able to eat. Similarly, gum disease can loosen teeth and allow bacteria to enter the body. A growing body of research has linked treating periodontal disease with lower medical costs for diabetes and heart disease, among other conditions.

People’s lives are affected in other ways by their oral health. “You use your mouth to eat and kiss and smile and interact socially,” said Jones. “It’s a source of great embarrassment and suffering for many adults without access to care.”

With limited income and no insurance, seniors may skip visiting the dentist regularly, even though many report that their mouths are dry and painful, and they have difficulty biting and chewing, not to mention

avoiding smiling and social interaction if they have missing or damaged teeth.

Medicaid, the state-federal program for lower income people, covers dental care for children in every state, but coverage for adults is much spottier. Most states cover emergency dental care, but eight states offer no adult dental benefits at all, according to a study by Oral Health America, an advocacy group.

Even trying to purchase private dental insurance, which typically covers a few thousand dollars worth of dental care, may not provide good value, said Marko Vujicic, vice president of the American Dental Association’s Health Policy Institute. “When you add up the premiums and copays, for the vast majority of adults it’s not worthwhile to have dental insurance,” he said.

Seniors with traditional Medicare spent $737 on average out-of-pocket on dental care in 2012, said Tricia Neuman, director of the Program on Medicare Policy at the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)

But the figures may be much higher for people who need major restorative work.

“I know people who are spending sometimes more than $10,000 on what they consider essential dental care, like implants, none of which is covered,” Neuman said.

Seniors with limited means have few options for help affording dental care. Federally qualified health centers may provide geriatric dental services on a sliding-fee scale, and clinics like Apple Tree help a limited number of seniors who live in their service area. But they’re a band-aid, said Jones.

She and other advocates want Medicare to add a dental benefit to Medicare Part B. Their proposal would provide a basic bundle of diagnostic and preventive services through a premium increase, and seniors would only be responsible for copayments if they need pricey restorative work like crowns and bridges.

“Over the years, there has been some interest in expanding Medicare to include dental coverage,” Neuman said. But a dental benefit has faced stiff competition from other priorities, including adding a prescription drug benefit in 2006 and preventive coverage under the health law in 2010.

But some people think this time might be different.

“There are 250,000 people every month who are turning 65, and 30 percent of dentists say they could use more business,” said Beth Truett, president and CEO of Oral Health America, which supports the proposal.

“It’s a perfect storm.”

KHN’s coverage of aging and long-term care issues is supported by The SCAN Foundation.

TheIntelligencer.com - April 2017 - Mature Lifestyles - 7

What to eat to fend off Alzheimer’s

By CLAUDIA BUCK The Sacramento Bee

Put down the fork. Step away from the buffet table.

UC Davis nutrition expert Liz Applegate wants us to think about exactly what we’re shoveling down our throats. Not just to lose weight but to protect our brains.

“Brain food is real and it really does matter,” said Applegate, an author, professor and director of sports nutrition at UC Davis. She’s an advocate of the MIND diet, a combination of two long-studied diets that have been shown to reduce the risk of heart disease and Type 2 diabetes.

We talked with her recently about so-called “brain foods,” their impact on 20-somethings and baby boomers, why it’s hard to stick to a healthful diet, as well as her favorite breakfast foods. Here are some excerpts: Q: Are there really “brain foods” that help fend off Alzheimer’s or dementia?

A: Diet absolutely does play a role. The brain is like any other organ that is susceptible to (foods) that can protect against oxidation damage. … Think of oxidation like a fire getting started. These (good) foods act like little tiny fire extinguishers that help put out those fires that otherwise would cause damage leading to loss of brain function. …

For me, the research is very compelling. There is a 53 percent lower risk of Alzheimer’s if you follow the MIND diet (see box). It’s eating a diet that provides an array of antioxidant compounds (such as berries) and omega-3 fats (from fish) and avoiding certain foods that may accelerate cognitive decline, like fried foods. Fried foods appear to accelerate oxidative damage and promote inflammation.

Q: The MIND diet is lots of leafy greens, vegetables, nuts and berries, but limits on red meat, butter, cheese, sweets and fried food. How does that translate into reducing the risk of Alzheimer’s?

A: We know that people with Alzheimer’s and dementia have very similar characteristics to people with Type 2 diabetes. In fact, some researchers want to call Alzheimer’s the “Type 3” diabetes. Over years and years, if your body is insulin resistant, those high blood sugar levels cause damage to linings of blood vessels and make them more prone to gunk building up …(such as) the amyloid or plaque that we see in brain or heart disease. …

This is pulling from the research studies what particular foods show the best correlation with decrease in dementia risk. … We’re not telling people to do anything wacky.

Following this diet is a very conservative approach. But the evidence is very compelling. This type of eating can slow the inevitable cognitive decline of aging. … We don’t know how to fix Alzheimer’s. The only thing we can do is modify the risks.

Q: Is this true for 20-somethings as much as aging baby boomers?

A: I think people of all ages can eat more healthily to stave off cognitive decline. People in any age group may be eating

highly refined sugars or not many berries. Or their seafood intake isn’t much. …

Dinner might be fast food or a prepared entrée that’s high in fat, low in fiber and not a single, green leafy vegetable. I see this kind of thing a lot, in all ages. … It’s never too late to make changes. Hopefully people in their 20s and 30s will sit up and take notice. Ask yourself: What would you like the quality of life to be as you age? … This would be a great New Year’s pledge: I want to take care of my brain.

Q: Sweets, cheese: How do we live without ’em?

A: If people have only a few servings a week of sweets, it seems to be OK. But I experience people who have a couple sweet items per day. A person has toaster waffles, with syrup on top for breakfast with coffee and an egg. That’s low in fiber, no fruit.

Lunch could be a sandwich, grab a couple of cookies. Later they have a sweetened ice tea. They might have an alcoholic beverage or two mixed drinks at night. … I don’t like being a sugar Nazi, but you just have to be aware of what you’re eating. … With cheese, that’s a tough one. It doesn’t seem to be good for brain health. Saturated fat tends to be more inflammatory. Hard cheeses are better than soft. … But stay tuned.

We still have a lot to learn. Maybe other research will show that having more than 1 ounce a week of cheese is OK for us.

Q: You’re a nutritionist; what’s your typical breakfast and dinner?

A: I’m glad you asked. For breakfast, I usually flip-flop between kale, onion and two to three eggs scrambled or low-sugar granola with nuts and dried fruit, like blueberries or (golden) raisins. I’ll have it with a cup of plain kefir (cultured milk) and a piece of fruit … a banana, citrus, a mandarin orange.

For dinner, I usually have lean protein or fish a couple times a week, a baked potato, vegetables like cauliflower or Brussels sprouts and a big green salad: leafy greens, carrots, red cabbage, radishes … lots of color. I’m not big on refined carbohydrates, like sourdough bread with a meal.

Q: Breaking bad habits and switching to a healthier diet isn’t always easy. Any New Year’s get-started tips?

A: At the first of the year, everyone goes too crazy, (vowing) to follow this diet plan or that diet plan. I encourage people to take just one step at a time, baby steps. Pick one thing to work on: I’m going to eat berries twice a week. Make a berry smoothie on Tuesday and Friday or put berries on your oatmeal. Just chip away at eating more healthfully.

WHAT’S THE MIND DIET? It’s essentially a combination of two healthful food plans: the Mediterranean diet (lots of vegetables, lean meat and olive oil) and DASH diet (similar with reduced salt to prevent hypertension). Officially, MIND stands for MediterraneanDASH Intervention for Neurodegenerative Delay, based on research showing it can dramatically reduce the risk of developing Alzheimer’s.

Continued on Page 15

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University of Kansas conducts dementia research

By ERIC ADLER The Kansas City Star

LAWRENCE, Kan. (AP) — Ann Poehler’s strides quicken on the treadmill. Her feet pound. Her heart races from 150 to 160 beats per minute and more.

A plastic tube jutting from the Prairie Village woman’s mouth feeds carbon dioxide levels to a computer here inside the University of Kansas Alzheimer’s Disease Center. The computer records every respiration while an exercise physiologist coaches her to push harder, the Springfield NewsLeader (http://sgfnow.co/2goaFBT ) reports.

“Can you hang in there like for 15 more seconds?” he urges, making an initial chart of her vitals for an exercise study geared to combat what, for people over 50, is the secondmost-feared disease in the United States, just behind cancer.

“Good job. Great work. . Hang on.”

At 65, Poehler is cognitively healthy and wants to stay that way. She watched Alzheimer’s rob her grandmother of her memory and life. Now her mother is in a memory care unit.

Like millions of aging Americans, Poehler hopes to escape the cataclysm of the brain-wasting disease that now afflicts some 5.4 million people in the U.S., a number that only promises to grow as baby boomers age, if a cure or preventive is not found.

A national study, recently published in the journal JAMA Internal Medicine, offered positive signs on what has long been a bleak landscape. It showed that the rate of dementia in people 65 and older had decreased from 11.6 percent in 2000 to 8.8 percent in 2012 for reasons that, not fully understood, researchers are exploring.

The fact remains that one out of every three people over age 85 in the U.S. — and at least one out of 11 over age 65 — now has clinical Alzheimer’s.

“If there’s anything I can do to figure out this disease, to cut back on it, or to cure it, that would be great,” Poehler said before stepping onto the treadmill. “I’m worried about it. It’s in my family. So I would love for this study, or the studies that are going on right now, to affect my life. That would be the best.”

Researchers at the University of Kansas Alzheimer’s Disease Center think so, too.

Over the past five years, the center at in Fairway has established itself as one of the top research centers in the nation dedicated to attacking Alzheimer’s disease.

In 2011, the National Institute on Aging, part of the National Institutes of Health, awarded the university center $6 million over five years for research. Last month, the center won an additional $8.5 million for research through 2021.

The National Institutes of Health has designated it one of 31 national centers of excellence on Alzheimer’s.

Each center has its own Alzheimer’s research mission. At University of Kansas, the focus is on prevention — stalling or stopping the disease by looking precisely into how exercise, experimental medications and diet (including a low-carb Mediterranean diet heavy on fish, nuts and olive

oil) may boost the body’s metabolism to combat or protect against the disease.

No one has found a single cause or cure for Alzheimer’s.

Only two classes of drugs even exist to stall some symptoms, with the most recent drug approved by the Food and Drug Administration 13 years ago. But strides are being made on every front.

Research at University of Kansas has so expanded since 2011 — with nearly 1,000 volunteers taking part in some 75 Alzheimer’s studies — that the center is now actively looking to enroll 700 additional volunteers (age 60 and over, healthy people with no signs of Alzheimer’s, as well as those with some impairment) to be part of studies on exercise, diet and medication over the next three to five years.

Fourteen studies are now underway, with more coming.

In October, the Washington-based Global Alzheimer’s Platform Foundation — tasked with increasing the nation’s pool of study volunteers, thus hastening therapies to market — announced the formation of “K.C. Memory Strings Alliance” among local physicians’ groups, large area employers and others to help point volunteers toward studies.

“It (Alzheimer’s) is an enormous problem. But it is a hopeful time,” said physician and researcher Jeffrey Burns, who co-directs the center and its studies with director, physician and researcher Russell Swerdlow. “I’ve never seen more hope in the field in the 15 years I’ve been doing this.”

Some of what is being studied may even now help those fearing Alzheimer’s.

For 40 years, Rick Royer worked as a math teacher at Shawnee Mission East High School before retiring in 2012.

He coached basketball, too.

“Jeff Burns was a student of mine,” Royer, 65, said of the Alzheimer’s physician, whom Royer also coached as a player. Now it’s one of Burns’ studies putting Royer through his paces.

Like Poehler, Royer is part of a study called APEX, Alzheimer ’s Prevention Through Exercise. Also like Poehler, he is cognitively normal, with no memory problems or any other impairments. But his family has a history of Alzheimer’s.

“I have my grandfather and my mother,” Royer said.

His grandfather died of the disease in his 90s. Royer’s mother, Jill Peck Royer, now 94, began having memory problems when she was about 87. Royer first noticed it when he took his mother, a member of the Pi Beta Phi sorority at the University of Kansas , to a university in Michigan for the celebration of a chapter she helped start there some 50 years before.

“It was apparent she was slipping,” Royer said. “At that point of time, it was just forgetfulness, but it was pronounced for her..She was an impressive gal. She had a very impressive intellect, an incredible vocabulary.”

Continued on Page 11

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Research Continued from Page 10 Some six months ago, there were danger signs, Royer said, including the day she put a pot of water on the stove, forgot it was there and allowed it to boil dry. She now lives in a memory care unit in her hometown of Abilene, Kansas.

Although neither Royer nor Poehler is cognitively impaired, each received a free PET scan — positive emission tomography — to search for clues to Alzheimer’s as part of their initial work-up for the exercise study.

In the past, Alzheimer’s could be diagnosed only at death through an autopsy. But within the last three years, PET brain scans have become available at major Alzheimer’s centers.

The scans are extremely expensive, costing about $5,000.

Neither Medicare nor insurance pays for them, although a national study, known as the iDEAS study, was recently launched at centers including the University of Kansas to assess whether Medicare should pick up the cost.

For Royer and Poehler, the brain scans clearly showed low-level deposits of beta-amyloid protein plaques, one of the two main hallmarks of the disease.

The condition is named for German psychiatrist Alois Alzheimer, who made his mark on history in 1906 when he reported finding protein plaques in the autopsied brain of a 50-year-old woman who had dementia. He also found tangles of what are now known as tau (rhymes with “now”) protein.

Plaque deposits, which build up in the spaces between cells, and tangles, which clog the inside of cells, are thought to be the main culprits behind the brain cell death that leads to Alzheimer’s calamitous effects.

A vital note, however, is that just because people have plaques and tangles doesn’t mean they absolutely will develop clinical Alzheimer’s.

Right now, about one out of every three people over age 65 is thought to have elevated amyloid levels. Higher levels put individuals at higher risk. But it is not at all clear if they will be hit by the disease’s memory loss or dementia.

At the university, Burns pulled up several scans with glowing yellow areas that showed the brains to be swathed in the clogging protein. Yet the patients were cognitively normal.

Why do some people with plaques and tangles get Alzheimer’s and others do not? It could have much to do with the amount or concentration of plaques and tangles, how much they expand, the rate at which they expand or the parts of the brain they affect.

Researchers now think that for people who eventually develop Alzheimer’s, deposits of amyloid plaque may begin to build up as early as 10 to 20 years before the first signs of memory loss.

“That is 10 to 15 years where we could be doing something to either delay the onset or prevent it from occurring,” Burns said.

That something could be exercise.

The point of the APEX study is to assess whether regular and moderately intense aerobic exercise can slow the development of plaques and tangles and perhaps stall the disease.

Four times each week, Royer drives to the YMCA in Olathe.

He puts on a heart monitor and steps onto the treadmill.

There, he exercises, as the study demands, for 38 minutes each time —reaches a certain level. He will do this for a year, raising the goal for his breathing and heart rate as he goes.

“I don’t think I’m doing it for me,” Royer said after he ended his workout. “I think it’s the disease that’s probably going to be the biggest deal in our country, maybe in the world.”

Burns has good reason to think the study will be effective.

Since 2008, more than 20 studies have found that even mild physical activity can maintain and even improve cognitive function while decreasing the risk for impairment. Studies have shown that the more fit people are, the greater their aerobic capacity, the less brain shrinkage they have.

APEX will chart the differences in the accumulation of brain amyloid in those who exercise regularly and those who do not.

“We think exercise might actually modify the disease process,” Burns said. “We think it may do more than (current) medication.”

Not enrolling yet — and for which close to 639 healthy volunteers between ages 65 and 80 will be sought nationwide — is another major exercise study that the university will be part of called IGNITE, short for “Investigating Gains in Neurocognition in an Intervention Trial of Exercise.”

Burns predicted that, at its conclusion, the $21.8 million National Institutes of Health-funded study could rank as the most definitive to date on the true effects of exercise on the brains of healthy, older adults. Knowing precisely how exercise affects a healthy brain will help determine ways to keep brains healthy.

University researchers will work with Alzheimer’s researchers at Northeastern University, the University of Pittsburgh and the University of Illinois to use brain images, plaque scans, blood work and a battery of physical and psychosocial tests to measure individuals in three groups: volunteers who exercise with moderate intensity for 150 minutes per week; volunteers who exercise moderately for 225 minutes per week; and a control group of volunteers who stretch and tone for 150 minutes per week.

“Our advice we boil down to this,” Burns said. “What’s good for the heart is good for the brain. And we’re working hard to prove it.”

That a healthy diet leads to a healthy heart is uncontested.

Whether there is a precise type of diet that protects against Alzheimer’s dementia, however, is far less clear. Different studies offer differing evidence.

Most studies, and most Alzheimer’s experts, agree that smoking is a risk factor for dementia. So is diabetes.

A 2015 analysis in the American Journal of Psychiatry concluded that people with diabetes who have the kind of mild cognitive impairment seen in the early stages of Alzheimer’s tend to be more likely to progress to full Alzheimer’s dementia than those without diabetes. Monday’s study in JAMA Internal Medicine calculated that diabetes increased the risk of dementia, for which Alzheimer’s is the greatest cause, by 39 percent.

After that, data can be confusing.

For example, a variety of studies holds that people with midlife obesity are at greater risk for dementia. Yet a recent analysis that was published in 2015 in the journal The Lancet Diabetes & Endocrinology, looking at data on some 2 million people over two decades, found exactly the opposite: Overweight and perhaps even obese people at midlife were at lower risk of dementia.

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14 - Mature Lifestyles - April 2017 - TheIntelligencer.com

Beware of offers of cash for a pension advance

By DAVID LAZARUS Los Angeles Times

It was an unusual lawsuit. A mysterious business, identifying itself only as “John Doe Company” and “organized under the laws of the State of California,” sued the Consumer Financial Protection Bureau in January to keep its name and a pending investigation under wraps.

The company said in the suit that its operations “would be irreversibly damaged” if the public were to learn it was under scrutiny for possibly “unfair, deceptive, abusive and illegal” practices.

On top of that, the company wanted the court to declare that the CFPB was unconstitutional and had no authority to go poking its nose into the firm’s affairs, which involve offering cash for people’s future pension payments.

That’s known as “pension advances,” and it’s a twist on payday loans, except the company is targeting a person’s retirement funds.

Typically, a lump sum is offered in return for all or part of future pension checks, with total payments running considerably higher than the initial amount given.

John Doe lost its case, and the CFPB wasted no time in unmasking the company.

Say hello to Future Income Payments, which was based in Irvine, Calif., until state officials issued a cease-and-desist order a couple of years ago, charging that the company was issuing loans without a license.

“They insisted that they weren’t making loans, that what they were offering were ‘sales agreements,’” said Tom Dresslar, a spokesman for the California Department of Business Oversight. “That was wrong. They were loans.”

Los Angeles City Attorney Mike Feuer filed his own lawsuit against Future Income Payments last month. He alleges the company “charged interest rates as high as 96 percent, far above California’s 10 percent usury limit, and threatened borrowers, falsely, that defaulting on the loans could subject them to criminal liability.”

In a statement, Feuer called this “predatory lending” and said that such practices “can exploit the very real financial struggles of California’s most vulnerable residents, including seniors and veterans.”

Dresslar at the Department of Business Oversight minced no words. He told me straight out that Future Income Payments’ pension advances “are a scam.”

“They prey on the elderly and pensioners, including military pensioners, who are in a tough financial spot,” he said.

“We put them out of business in California.”

New York officials followed suit last year. But, like a cockroach, this company is hard to kill.

According to Nevada state records, Future Income Payments set up shop in the city of Henderson, about 16 miles southeast of Las Vegas, just a couple of months after California officials lowered the boom.

I reached out to the company. A representative took my

name and number and said someone would call me right back. No one did.

I left a message on the cellphone of Future Income Payments’ chief executive, Scott Kohn. He didn’t call me back either.

All this Scooby-Doo intrigue notwithstanding, the CFPB’s crackdown on Future Income Payments is yet another example of why it’s important to have a national agency charged solely with protecting the financial interests of consumers.

Without such oversight, a company with a dubious business model could stay in business by playing a perpetual game of Whac-a-Mole with state authorities.

The CFPB’s future is now in question as President Trump and the Republican-controlled Congress seek to make good on promises to unwind financial reforms enacted by the Obama administration.

Since the bureau started operating in 2011, it has overseen a revamping of mortgage rules, proposed new regulations for payday lenders, held dozens of financial firms accountable for questionable or illegal practices, and returned about $12 billion to consumers.

In November, the CFPB asked Future Income Payments to provide documents showing that the company’s operations were legitimate.

The company countered with a request for the order to be dismissed. When that got nowhere, it filed its lawsuit challenging the bureau’s constitutionality and demanding that the firm’s name be kept confidential.

Future Income Payments argued in its suit that complying with the bureau’s request would be “oppressive, expensive, time-consuming and exceptionally disruptive.”

A CFPB spokesman declined to comment. The bureau has filed its own lawsuit demanding that Future Income Payments come across with the requested paperwork.

Is the company trustworthy? I put that question to Jack Friley, a 20-year Navy vet living in Mobile, Ala. A couple of years ago, he ran into serious financial hardship after his wife was diagnosed with cancer.

“I was desperate,” Friley, 53, told me. “I needed money.”

He turned to Future Income Payments, which gave him a $10,000 lump-sum payment in return for a piece of his pension checks. It was only later that Friley realized it would cost him about $40,000 to pay off that $10,000 advance.

He sued, alleging that he’d been misled about the terms of the deal.

Friley said Future Income Payments settled the case by forgiving his entire debt and handing him an extra $8,000 to make him go away.

The company admitted no wrongdoing.

Raise your hand if you think these guys are upstanding citizens and the CFPB should leave them alone.

ABOUT THE WRITER David Lazarus, a Los Angeles Times columnist, writes on consumer issues. He can be reached at david.lazarus@latimes. com.

TheIntelligencer.com - April 2017 - Mature Lifestyles - 15

Falls are taking a huge toll on elderly brains NEW YORK (AP) — Elderly people are suffering concussions and other brain injuries from falls at what appear to be unprecedented rates, according to a new report from U.S. government researchers.

The reason for the increase isn’t clear, the report’s authors said. But one likely factor is that a growing number of elderly people are living at home and taking repeated tumbles, said one expert.

“Many older adults are afraid their independence will be taken away if they admit to falling, and so they minimize it,” said Dr. Lauren Southerland, an Ohio State University emergency physician who specializes in geriatric care.

But what may seem like a mild initial fall may cause concussions or other problems that increase the chances of future falls — and more severe injuries, she said.

Whatever the cause, the numbers are striking, according to the new report released Thursday by the Centers for Disease Control and Prevention.

One in every 45 Americans 75 and older suffered brain injuries that resulted in emergency department visits, hospitalizations, or deaths in 2013. The rate for that age group jumped 76 percent from 2007. The rate of these injuries for people of all ages rose 39 percent over that time, hitting a record level, the CDC found.

The report, which explored brain injuries in general, also found an increase in brain injuries from suicides and suicide attempts, mainly gunshot wounds to the head. Brain injuries from car crashes fell.

But the elderly suffered at far higher rates than any other group.

It’s well known that falls among the elderly are common.

Older people are more likely to have impaired vision, dizziness and other de-stabilizing health problems, and are less likely than younger people to have the strength and agility to find their feet once they begin to lose their balance. The CDC had already reported that falls were the top cause of injuries and deaths from injury among older people; an estimated

Diet Continued from Page 7 Origins: For years, the Mediterranean and DASH diets have been shown to reduce the risk of chronic illnesses, such as diabetes and heart disease.

The MIND diet, developed in 2015

by Chicago-based Rush University Medical Center researchers, goes further and identifies 10 good and five bad food categories that appear to affect cognitive decline. In a four-year study

27,000 Americans die each year from falls.

But even experts on elderly falls said the new numbers were striking.

Health officials have been increasing their focus on brain injuries among all ages, especially younger people. CDC investigators thought the overall rise in brain injuries might be mainly caused by rising awareness of sports-related head injuries in kids and young adults, and more diagnosis of injuries in that group that in the past were not recorded.

“But when we dug a little bit more into the numbers, we found the larger driver is older adult falls,” said the CDC’s Matt Breiding, a co-author of the new report.

The toll from elderly falls has been under-recognized by physicians and by seniors themselves, Southerland said.

When falls do occur, older people tend to downplay it, she said.

But one fall can quickly lead to others. In a study published last year, Southerland and other Ohio State researchers found that more than a third of older adults with minor head injuries end up back in the ER within 90 days.

Even when they see a doctor, the future risk may be missed.

In hospital emergency departments, it’s not unusual for a 25-year-old athlete who fell on his head to get a more thorough evaluation for concussion than an elderly retiree, said Southerland, who is trying to develop a standard for assessing concussions in geriatric ER patients.

Surveys show that most older adults want to live at home for as long as possible. Research is mixed on what the healthiest and safest setting is for a senior — often it depends on the individual. “There are people falling in nursing homes as well,” Southerland said.

Seniors are advised to have their vision checked regularly and do Tai Chi or other exercises that can strengthen legs and improve balance. Experts also advise making an elderly person’s home safer by removing loose rugs and other tripping hazards, improving lighting and installing handrails and grab bars.

of 960 seniors, those who rigorously followed the MIND diet lowered their risk of developing Alzheimer’s by up to 53 percent. Even those who consumed it only “moderately well” lowered their risk by 35 percent.

In January 2016, U.S. News & World Report ranked the MIND diet as the No. 1 easiest-to-follow diet and the No. 2 “best diet overall,” based on its evaluation of 38 well-known eating plans.

Good foods: Leafy salad greens, other colorful vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil and a daily glass of wine.

Bad foods: Red meat, butter/margarine,

cheese, pastries/sweets, fried/fast food.

Recommended: Three servings daily of whole grains (such as faro or brown rice); one daily serving (raw or cooked) of dark, leafy salad greens (spinach, broccoli, kale, collard, bok choy, etc.) and one other colorful vegetable; fish (3-4 ounces) at least once a week; poultry at least twice a week; 1/2 cup berries (frozen or fresh) at least twice a week; beans or legumes every other day. Limit red meat and sweets to fewer than 5 servings a week. Snack daily on at least 1 ounce of nuts. No more than 1 tablespoon a day of margarine or butter (use olive oil instead).

16 - Mature Lifestyles - April 2017 - TheIntelligencer.com

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