Promoting brain health
Photos by Ashley Barnas September 25, 2023
Delaware Center for Cognitive Aging Research brings brain wellness workshop to the community
Rita Willis remembers taking a cognitive screening test a few years ago, where a clinician asked her to remember five words. She recalled three of the five words and was told: 鈥淭hat鈥檚 a tad low for your age.鈥
It surprised her. As the daughter and caretaker for her mother, who died of Alzheimer鈥檚 at 97, the 86-year-old Willis wanted to do everything within her power to change her trajectory.
鈥淚 remember what it鈥檚 like to care for someone with Alzheimer鈥檚, and I鈥檇 like to spare my children from that,鈥 Willis said.
She signed up for the 91原创鈥檚 (DECCAR) Brain Wellness Information, Support, and Empowerment (Brain-WISE) workshop, which aims to educate older adults about modifiable risk factors for dementia and empower them to take the first steps toward making health behavior changes. The pilot program, made possible through generous support from the Howard W. Swank, Alma K. Swank, and Richard Kemper Swank Foundation, launched this summer at , a retirement community in West Grove, Pennsylvania, where Willis lives.
The program was born from Memory Ambassadors, a 91原创 collaboration with ChristianaCare, which saw 800+ older adults over six years and successfully increased visits to primary care doctors. But Matthew Cohen, associate director of DECCAR, saw a need to develop the program further.
鈥淪ustained lifestyle and behavior changes are needed to reduce the risk of dementia,鈥 Cohen said. 鈥淓veryone knows they鈥檙e supposed to eat right and exercise, but this in-depth education series focuses on what specifically is needed to promote good brain health and reduce dementia risk. It also includes personalized feedback and counseling about risk and protective factors.鈥
Cohen, a neuropsychologist and associate professor of communication sciences and disorders, developed the more comprehensive brain health education program in conjunction with Mindy Myers and , speech-language pathologists from 91原创鈥檚 and with input from Tara Leonard, Beth Orsega-Smith, and Donna Paulhamus, colleagues听in the Department of Health Behavior and Nutrition Sciences.
In six sessions over three weeks, Jenner鈥檚 Pond residents learned about dementia and Alzheimer鈥檚, the importance of primary care for managing chronic conditions like hypertension, and how to keep the brain healthy with exercise, nutritious eating, good sleep and stress management, memory support, and hearing health. Voluntary cognitive and hearing screenings were also available for attendees and administered by supervised graduate student clinicians.
鈥淢any people presume that genetics is the only determining factor, and if they had a parent or sibling who had Alzheimer鈥檚, they鈥檙e doomed 鈥 and for almost everyone, that鈥檚 not the case,鈥 Cohen said. 鈥淎bout 40% of cases of dementia can be delayed or prevented.鈥
The premise instills hope in Willis, who needs to focus on higher-quality sleep and improvements to her diet.听
鈥淚鈥檓 very active physically and mentally; I swim four days a week for an hour and walk my dog three times a day, but I鈥檓 high energy, so getting to bed at a regular time is difficult for me,鈥 Willis said.
鈥淚 have a salad every night, and I鈥檝e always loved berries,鈥 Willis said, but added, 鈥淚 love sugar, but I鈥檓 trying to focus more on chickpeas. I found this to be such a positive approach and real steps I could take to prevent the onset of Alzheimer鈥檚.鈥
In addition to education, the workshop offers practical tips and tricks.
鈥淪o, if you can鈥檛 enact every part of a brain-healthy diet, we help participants think of small ways to incorporate aspects of a more Mediterranean-style diet,鈥 Cohen said. 鈥淥r if you can鈥檛 fit in a full 30 minutes of exercise at once, break it up into 鈥榚xercise snacks鈥 by taking a 10-minute walk two or three times a day.鈥澨
The workshop also focuses on setting attainable goals.
鈥淲e try to drive home 鈥 nobody is helpless, and they can change their lives,鈥 said Mindy Myers, a clinical educator at 91原创鈥檚 SLH Clinic. 鈥淚t鈥檚 one thing to say, 鈥業鈥檓 going to eat better,鈥 but to set specific goals and create plans to make that happen is key.鈥澨
Len Freedman, who鈥檚 lived at Jenner鈥檚 Pond for over six years, found value in goal setting.
鈥淒iet is one aspect I鈥檝e realized I need to work on along with my flexibility and balance,鈥 Freedman said.听
The workshop also placed residents in small group discussions, where they could set attainable goals together. Graduate students in the Speech-Language Pathology (SLP) program within the Department of Communication Sciences and Disorders played a pivotal role in facilitating those conversations and conducting cognitive testing.
鈥淲orking with aging adults will make me a better clinician,鈥 Julia Cameron said. 鈥淚鈥檝e learned so much by interacting with this population; I鈥檓 just soaking it all in so I can apply the knowledge to my placement at Peninsula Regional Medical Center, where I鈥檒l work with older adults with cognitive difficulties.鈥澨
Second-year SLP student Gracie Goetz said this experience solidified that she鈥檚 on the right career path.
鈥淔ace-to-face interactions like this help you realize this is truly a helping profession,鈥 Goetz said. 鈥淵ou must want to help and talk to people; through this, I鈥檝e realized that鈥檚 something I really love. It鈥檚 powerful to have an impact on people鈥檚 lives.鈥澨
Erin Michalcewiz, who鈥檚 in her second year of the SLP master鈥檚 program, hopes to work with older adults.听听
鈥淓very person has their own story, and cognitive difficulties impact everyone differently,鈥 Michalcewiz said. 鈥淩ealizing those differing impacts is something I must be mindful of in my future practice.鈥澨
As an educator, incorporating a learning component for graduate students into these workshops was critical for Van Buren. The clinical supervisor and educator at 91原创鈥檚 SLH Clinic worked to ensure the program included experiential learning opportunities for SLP master鈥檚 students.听听听
鈥淲e need to educate the younger generation of practitioners so they understand cognitive changes and can implement strategies and practices into their therapy sessions to counsel older adults,鈥 Van Buren said.听
As a clinician, Van Buren wants to see more programs like Brain-WISE.听听听
鈥淲hen patients come to the clinic, we wonder鈥 what if they had come in five years sooner? Brain wellness must play a larger role in preventative healthcare,鈥 Van Buren said.听
The Brain-WISE workshop was so popular that there鈥檚 a waiting list at Jenner鈥檚 Pond. Cohen, Van Buren, and Myers plan to launch a second session at the retirement community this fall but also aim to expand the program to churches and senior centers in underserved communities. Brain-WISE by DECCAR and the SLH Clinic is a shining example of 91原创鈥檚 community engagement efforts to extend beyond the Newark campus and meet people where they are.听
鈥淭he public is wildly misinformed about Alzheimer鈥檚 disease and dementia, and the stigma surrounding it makes it difficult to engage with people about research,鈥 Cohen said. 鈥淥ur community outreach arm aims to build trust with diverse communities and provide high-quality, vetted health information, reduce stigma, and instill hope to encourage folks to make health behavior changes.鈥澨
The success of the program will be gauged through questionnaires immediately after the conclusion of the series of workshops and again at the three-month mark. But Cohen has already noticed positive behavior changes in Jenner鈥檚 Pond residents, whom he observed banding together to advocate for healthier dining offerings and exercise at the YMCA next door 鈥 proof the program is working.听
鈥淟aunching programs like this in places where people already live together can be empowering because we know that health behaviors are best changed together,鈥 Cohen said. 鈥淏y delivering the intervention to people who are already together, they can support and hold each other accountable more naturally.鈥
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