Movement Matters: Helping Loved Ones with Dementia Stay Active

By: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist

June is Alzheimer’s & Brain Awareness Month - making it an ideal time to spotlight how purposeful movement can slow physical decline, curb agitation, and brighten the day for people living with dementia.

The Hidden Cost of Inactivity in Dementia

• Faster loss of strength, endurance, and mobility.
  People with dementia experience significantly steeper declines in muscle power, balance, gait speed, and overall endurance than their cognitively healthy peers. A 2017 systematic review found that targeted exercise can reverse many of these losses, highlighting just how much ground inactivity can cost them.

• A 2-3 fold higher fall risk.
  Up to 60–80% of individuals with dementia fall each year, double (or more) the rate seen in age-matched adults without cognitive impairment.

• More than “just weak legs.”
  Neurologic changes in the brain affect depth perception, spatial awareness, and dual-tasking, making tripping over obstacles or misjudging doorways far more likely, even in familiar environments.

Why Activity Often Fades

Research into barriers paints a clear picture:

• Low motivation and apathy.
  Dementia frequently dampens initiative, so even engaging in even once-loved hobbies may need an extra nudge.

• Safety worries - both real and perceived.
  Fear of falls, wandering, or behavioral changes can make caregivers over-cautious, unintentionally encouraging more sitting and inactivity.

• Limited guidance or support.
  When caregivers lack time, know-how, or resources, structured movement sessions often become a low priority when so many other caregiving needs exist.

The Upside of Movement: Small Steps, Big Impact

Despite the challenges, the benefits of regular movement are powerful. Studies link even modest activity to:

• Reduced agitation and anxiety

• Improved mood and quality of life

• Better executive function and attention span

The World Health Organization and Alzheimer’s Disease International recommend that older adults, including those with dementia, aim for:

• At least 150 minutes of moderate-intensity aerobic activity per week (e.g., brisk walking, dancing, cycling)

• Muscle-strengthening activities 2 or more days per week

• Balance and mobility-focused exercises at least 3 days per week, especially for those with a history of falls or unsteadiness

But here’s the most important part:
These goals don’t need to be met all at once. Even 10-minute bouts of movement count. A short daily walk, chair yoga, or marching in place while brushing teeth can build into meaningful progress over time.

And remember—something is always better than nothing. Consistency and routine matter far more than intensity.

My Top 3 Tips to Get Your Loved One Moving

1. Make It Part of the Routine

• Same time, every time.
  Repetition breeds familiarity, and familiarity feels safe. A short walk after breakfast or gentle seated exercises during nightly news on TV can become as automatic as brushing teeth.

• Leave visual “clues.”
  Place sneakers by the dining chair or set out resistance bands where they’ll be noticed. Then cue your loved one with a calm, confident “Time for our walk!”

2. Make It Meaningful

Movement can be easier, and more enjoyable, when it feels like a meaningful activity, rather than a workout. The best way to help a loved one with dementia get active? Choose activities that connect with who they are and what they’ve always loved to do.

Tie movement to personal identity and past routines:

• Gardener?
  Keep a raised-bed planter or container garden ready to go. Practice squatting or sit-to-stand movements while pulling weeds, watering plants, or sorting seed packets.

• Make household chores a team effort.
  Turn household chores into movement moments. Fold towels together while standing, carry a light basket across the room, or reach to hang clothes on a low rack or line. Involve them in safe cleaning tasks like dusting, wiping counters, or organizing drawers. These repetitive tasks offer built-in structure and gentle physical activity.

• Dancer or music fan?
  Put on their favorite music from high school or early adulthood. March in place, sway side to side, or tap feet to the beat. Even seated, this can raise the heart rate and lift the mood.

• Involve the family pets.
  Take short walks with the family dog, brush the cat, or pretend to care for a stuffed animal if pets aren't available. Caring for something else often sparks a natural desire to move.

• Crafter or artist?
  Set up a workspace that encourages posture shifts—standing to cut fabric, reaching to gather supplies, or walking to display finished pieces.

Bonus Tip: Use exercise time to engage. Talking is a great form of ‘dual-tasking’ and dual-tasking is a powerful way to improve balance. Reminisce while you move. Play cognitive games like eye-spy or categories. Ask questions about the world around you - see if they can count the passing cars or recall facts about your neighbors as you walk by.

3. Try a Group Fitness Class

• Community programs, like local strength and balance classes, add social interaction and gentle accountability.

For locals, Healthy Aging PT’s Strong and STEADI sessions blend fall-prevention drills with upbeat music and expert guidance. Ask your senior center for recommendations or check our calendar.

When to Call in for Backup

Encouraging safe, consistent movement isn’t always easy, especially when dementia is involved. You might find that your loved one resists participation, struggles to follow instructions, or becomes overwhelmed by too many choices. That’s completely normal - and it's exactly where we come in.

At Healthy Aging Physical Therapy, our licensed Physical and Occupational Therapists and certified personal trainers are experienced in working with older adults living with cognitive impairment. We understand how to blend clinical expertise with patience, creativity, and compassion.

Here’s how our Therapy and Wellness365 teams can help:

• Comprehensive Assessment
  We evaluate strength, mobility, balance, and fall risk while considering cognitive status, emotional state, and home environment. This helps us determine what’s safe, what’s realistic, and what’s meaningful.

• Personalized Movement Prescription
  One-size-fits-all exercise plans don’t work, especially in dementia care. We’ll create a tailored program that matches your loved one’s current abilities and interests, focusing on what they can do and building from there.

• Cognitive-Aware Coaching
  We train family members and paid caregivers in practical strategies: how to cue movement clearly, how to redirect attention when needed, and how to create daily routines that support success without stress.

• Progress Monitoring & Support
  Our team can check in regularly to adjust the plan, troubleshoot challenges, and provide encouragement. Even small wins, like standing up more easily or walking an extra lap around the kitchen, can be incredibly meaningful.

If your loved one is struggling with inactivity, mood changes, falls, or increasing dependence, it may be time to bring in professional support.

We’re here when you’re ready.
Call us at (617) 398-4508 or visit our website to request:

• A Medicare-covered Physical or Occupational Therapy Evaluation, or

• A private Wellness365 Personal Training session for continued fitness and support after therapy ends.

Let’s work together to keep your loved one strong, steady, and engaged - every step of the way.

The Science of Socialization

By: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist

Owner: Healthy Aging Physical Therapy

Earlier this month, I returned from a very special trip: a full week away in Sedona with my best friends — my college roommates. Since meeting back at ‘the turn of the century’ (how ridiculous does that sound ?1?), our lives have taken us in many different directions: new careers, marriages, divorces, losses, love, babies, teenagers (😫) moves across states - even moves across oceans! And like many adult friendships, the day-to-day demands of life often mean that we go far too long without seeing each other face to face.

But no matter what else is happening in our lives, we've remained religious about one thing: scheduling our annual girls weekend. Even when it’s just a long weekend over the summer, we’ve kept the tradition alive. This year was the first time we carved out a full week — and let me tell you, it was pure magic.

More than the hikes, the incredible views, or the late nights laughing until we cried, what made it so meaningful was simply the connection. That feeling of being truly known, truly supported, and truly in the moment with people who have walked beside you through all of life’s changes. And it reminded me how critical — and how scientifically essential — social connection is for our health.

What Happens Inside Your Body When You Connect

When we connect meaningfully with others, it’s not just a "nice feeling" — our bodies actually respond biologically:

• Oxytocin, sometimes called the “bonding hormone,” is released, promoting feelings of trust, belonging, and relaxation.

• Levels of cortisol, our main stress hormone, decrease when we engage in positive social interaction, helping reduce inflammation and boost immune function.

• Dopamine and serotonin — the "feel good" neurotransmitters — increase, improving mood, energy, and even pain tolerance.

• Meaningful social interaction can even lower blood pressure and support cardiovascular health over time.

In short, connection is not just emotional — it’s chemical. Your brain and body are wired to thrive on human interaction.
(Source: Harvard Health Publishing, 2021; National Institutes of Health, 2022)

How Our Social Networks Change Over Time

It’s also normal that how and when we socialize evolves throughout life:

• As children, friendships are constant and casual, woven into daily school and playtime.

• In adolescence, friendships intensify, shaping identity and emotional development.

• As new parents, social circles often shrink, with focus centered on caregiving and family demands.

• In midlife and later adulthood, social opportunities can decline as retirement, relocation, health issues, or caregiving responsibilities arise.

Without mindful effort, social isolation can sneak up, making connection even more critical as we age.

Why Socialization Matters for Healthy Aging

We often think about diet and exercise as the pillars of healthy aging (and they are), but strong social connections are just as essential to long-term health and well-being. In fact, research shows:

• More than one-third of adults over age 45 report feeling lonely, and nearly one-fourth of adults over age 65 are considered socially isolated.

• Loneliness is often considered as harmful as smoking 15 cigarettes a day and raises the risk of heart disease by 29% and stroke by 32%.

• Social isolation significantly increases the risk of premature death from all causes, comparable to risks posed by smoking, obesity, and physical inactivity.

• Older adults with strong social ties have better cognitive health, lower depression and anxiety rates, and stronger physical health overall.

(Source: National Academies of Sciences, Engineering, and Medicine, 2020)

The simple truth is: connection heals. It protects, energizes, and helps us live not just longer — but better.

Small Steps to Build (or Rebuild) Your Social Connections

If you’re feeling the need for more connection in your life — you're not alone. And it’s never too late to take steps to strengthen your social well-being:

• Reach out to an old friend you haven't spoken to in a while.

• Join a local class or club that sparks your interest — fitness, art, volunteering, book clubs, or travel groups.

• Explore virtual communities if distance or transportation is a barrier.

• Schedule regular get-togethers, even if just for a coffee or walk.

• Be open to making new friends — every stage of life can bring new connections.

Just like exercising your body or eating nourishing food, tending to your social life is an important part of caring for your health.

As I was reminded during my week in Sedona, it’s not about where you go — it’s about the people you walk beside. Connection is a vital ingredient in the recipe for healthy aging — and one of the most joyful, too.

Unlocking Cognitive Fitness: 6 Steps to Optimize Brain Health

Written by: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist, Owner of Healthy Aging PT

As we age, it’s natural to notice changes in cognitive function—whether it’s misplacing your keys or taking longer to process information. While these changes can feel concerning, there’s plenty you can do to maintain and even improve your brain health. By focusing on building cognitive reserve, you can safeguard your mind and maintain your independence as you age. Think of cognitive reserve as a savings account for your brain. The more reserve you build, the more resilient you are to cognitive challenges.

The great news? Building cognitive fitness is possible at any stage of life, and it starts with these six proven steps.

1. Exercise for Brain Health

Exercise isn’t just for physical fitness—it’s for cognitive fitness, too! Regular physical activity stimulates neurotrophin release, enhances hippocampal neurogenesis, and improves blood flow to the brain, all of which help maintain cognitive function.

• The Science: A National Institute on Aging study found that individuals who exercise 1–4 times weekly reduce their risk of memory decline by 33%.

• Action Step: Engage in moderate-to-vigorous physical activity for at least 150 minutes weekly. Activities like brisk walking, resistance training, or swimming boost brain health and physical well-being. You can check out our list of curated exercise videos for some great (and free!) workouts you can do at home. 

2. Nutrition for Cognitive Health

Your diet plays a critical role in cognitive fitness. Whole-food diets like DASH, Mediterranean, and MIND reduce inflammation and support brain function.

• The Science: According to NIH research, diets rich in fruits, vegetables, and lean proteins are linked to better cognitive outcomes and reduced risk of Alzheimer’s disease.

• Action Step: Prioritize unprocessed, whole foods. Incorporate brain-boosting foods such as leafy greens, berries, nuts, and omega-3-rich fish. For more information about evidenced-based dietary patterns that support cognitive health, I suggest checking out the Harvard School of Public Health’s ‘Nutrition Source’ page. 

3. Sleep and Brain Function

Sleep is essential for brain health, supporting memory consolidation and overall cognitive function.

• The Science: Studies reveal that individuals sleeping 6–8 hours nightly maintain greater grey matter volume, which is crucial for cognitive fitness. Both insufficient and excessive sleep can harm brain health.

• Action Step: Create a sleep-friendly environment by keeping your bedroom cool, dark, and free from screens. Aim for a consistent 6–8 hours each night. For some more information, you can download this free E-Book from the NIH about Sleep for Older Adults. We keep these on hand and ready for any of our patients who need help getting their zzzz’s and it is our go-to resource.  

4. Stress Management for Healthy Aging

Chronic stress can damage the brain, but reframing how we view stress makes a big difference. A positive mindset can reduce the negative impact of stress on cognitive health.

• The Science: Research shows that reframing stress reduces its physiological effects, helping maintain cognitive resilience.

• Action Step: Practice stress management techniques such as mindfulness, journaling, or meditation. Reframing challenges as opportunities for growth supports both cognitive and emotional well-being. Looking for more? The Free Mindfulness Project has an awesome library of guided meditation and mindfulness exercises available for everyone.  

5. Social Connections and Brain Health

Meaningful social interactions aren’t just good for the soul—they’re essential for cognitive fitness.

• The Science: NIH studies show that loneliness increases the risk of dementia by up to 40%, while maintaining social connections helps preserve brain health.

• Action Step: Strengthen your social network by joining group activities, such as Wellness365, that combine fitness and fun with community-building. Want to hit two birds with one stone? Check out our in-person Group Fitness Classes to get your exercise in while engaging with like-minded peers for the added bonus social connection.

6. Lifelong Learning and Brain Health

Your brain thrives on novelty. Learning new skills, trying different hobbies, and exposing yourself to new experiences keep your mind sharp.

• The Science: NIH-supported studies highlight that engaging in novel activities throughout life helps maintain cognitive reserve and delay decline.

• Action Step: Get curious and commit to trying one new activity each month, whether it’s taking a class, visiting a new place, or trying a new hobby. We are lucky to live in a great area - with the city, the mountains, or the beach all with in an hours drive, there is always a new adventure you can try. Looking for something closer to home? Check out your local Senior Center and Library calendars to see if they have any lectures or workshops that might pique your interest. I’ve linked my hometown’s centers above, but check out the centers closest to you!

Building a Brain-Healthy Lifestyle

Cognitive fitness isn’t a one-time achievement; it’s a lifelong commitment. By incorporating exercise, nutrition, quality sleep, stress management, social engagement, and novelty into your routine, you can boost your cognitive reserve and maintain your independence. Through our Wellness365 program, Healthy Aging Physical Therapy provides tailored support to help you achieve these goals. Our program is always individualized to meet your needs, but can include things like supported fitness to build up your physical resilience and support your brain health, nutrition guidance to enhance your cognitive and physical wellness and education about stress management strategies to maximize your emotional balance.

Your journey to better cognitive fitness begins today. Want to take Let’s the first step together? If you live in one our service areas, we’d love to help! Check out out Wellness365 Page for more information and to get signed up today!

References

1. Augusto-Oliveira, M., et al. (2023). Exercise Reshapes the Brain: Molecular, Cellular, and Structural Changes Associated with Cognitive Improvements. Molecular Neurobiology, 60(12), 6950-6974.

2. Puri, S., et al. (2023). Nutrition and Cognitive Health: A Life Course Approach. Frontiers in Public Health, 11.

3. Tai, X.Y., et al. (2022). Impact of Sleep Duration on Executive Function and Brain Structure. Communications Biology, 5(201).

4. Seward, B.L. (2017). Managing Stress: Principles and Strategies for Health and Well-Being. Jones & Bartlett Learning.

5. Sutin, A.R., et al. (2020). Loneliness and Risk of Dementia. The Journals of Gerontology: Series B, 75(7), 1414–1422.

6. Karsazi, H., et al. (2024). Which Intellectual Activities Are Related to Cognitive Reserve? Psychological Research.

7. National Institute on Aging (NIA). Brain Health and Cognitive Reserve. (Available at: https://www.nia.nih.gov)

8. Harvard Health Publishing (n.d.). Cognitive Health and Aging: How Exercise and Nutrition Protect the Brain. (Available at: https://www.health.harvard.edu)

The Overflowing Cup and Your Nervous System

By: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist, Owner: Healthy Aging Physical Therapy

I went to yoga this morning, in an attempt to regulate nervous system after a week of solo parenting while my husband was out of town. Normally, I can balance all the regular demands of my life, which as a mother, caregiver, business owner, and home owner, are many. But with him away, the balance shifts. Suddenly, it’s double the drives to the pool for swim team, only one man on deck for the morning routine, and each meal and clean up falls to yours truly. By the end of the week, my metaphorical ‘nervous system cup’ was overflowing; while I meet all the needs of my business, my kids and my home on weeks like this, I frequently deprioritize my own needs, failing to get enough water, proper nutrition, exercise or rest. While I know the cycle well, it’s still hard for me to maintain a good balance when something like this tips the scales. During my much-needed yoga session this morning, I got thinking about how interesting it is that while this phenomenon, and the resulting impact on our bodies and nervous systems is so universal, the triggers and manifestations differ from person to person. The good news is that while our own experiences of stress, overwhelm and exhaustion may differ, the ‘treatment’ is relatively simple, evidenced-based, and enjoyable. The first step is understanding your nervous system:

The Overflowing Cup Metaphor

Think of your nervous system as a cup. When it’s half full, it has room to absorb life’s stressors or give more to those around you. But when your cup is full—due to stress, pain, life’s demands or a physiologic change like an illness—even a small addition of water overflows it. As I mentioned, our individual manifestations are varied, but often lead to symptoms like fatigue, brain fog, or heightened emotional responses. Dysregulation activates the body’s "fight or flight" mode, flooding it with cortisol.

Chronic elevations of cortisol have wide-ranging effects on health. Prolonged stress and high cortisol levels can lead to systemic inflammation, insulin resistance, hypertension, and impaired immune function, ultimately increasing the risk of chronic diseases such as cardiovascular disease, diabetes, and autoimmune disorders. There is no lack of evidence in this area. Research published in Frontiers in Endocrinology emphasizes the connection between chronic stress and metabolic disorders, while findings from the National Institute on Aging highlight the role of cortisol in neurodegenerative diseases, such as Alzheimer’s.

Even if you’re "managing" well and the impacts of dysregulation haven’t yet caused physiological change, a dysregulated nervous system simply feels crappy. It leaves you less efficient in your work, less present in your relationships, and unable to be the best version of yourself. When your nervous system is dysregulated, it’s harder to focus, connect, and enjoy the things that matter most. Prioritizing nervous system regulation is not just about avoiding future health issues; it’s about improving your day-to-day experience of life. It’s about creating more space in your cup so you can thrive, not just survive.

Dysregulation in Chronic Pain, Fear of Falling, and Parkinson’s Disease

Many of the patients we see in our practice experience nervous system dysregulation, often as part of a broader health condition. These patients show patterns of heightened stress response that exacerbate their primary symptoms. Whether it’s chronic pain, fear of falling, or neurological conditions like Parkinson’s disease, the effects of dysregulation can significantly worsen their quality of life. Below are some specific examples and approaches for nervous system regulation in these populations.

Chronic Pain

Patients with chronic pain often live with a nervous system in overdrive. Long-term exposure to pain can cause the brain to become hypersensitized, interpreting even minor stimuli as significant threats. This constant activation of the sympathetic nervous system amplifies pain and perpetuates a cycle of stress and physical discomfort. Gentle movement, mindfulness-based stress reduction, and diaphragmatic breathing can help calm this cycle, retraining the brain to regulate pain responses more effectively.

Fear of Falling

In older adults, the fear of falling is not just psychological—it’s a full-body response that often keeps patients trapped in a state of hypervigilance. This fear increases muscle tension, disrupts balance, and raises the risk of further falls. Patients in this state frequently withdraw from physical activity, which only worsens functional decline. Interventions such as balance training, slow-paced walking, and grounding techniques can help mitigate these responses and restore confidence.

Parkinson’s Disease

For individuals with Parkinson’s, nervous system dysregulation exacerbates motor and non-motor symptoms, including tremors, freezing, and cognitive challenges. Stress often worsens these symptoms, creating a feedback loop that further destabilizes the nervous system. In these patients, incorporating aerobic exercise, yoga, and social connection into their routines can help regulate the nervous system and improve both physical and mental outcomes.

Evidence-Based Tools for Regulating the Nervous System

Nervous system regulation is key to maintaining physical, mental, and emotional balance. The key to regulating your nervous system isn’t always about eliminating stressors—because often, we can’t. We can’t always reduce our demands, get rid of our chronic diseases, or eliminate every source of stress. Instead, it’s about building a bigger cup. When we do things that increase our capacity, the same amount of water—the same stressors—can fit without overflowing. By expanding our nervous system’s capacity (otherwise known as our resilience), we can absorb more challenges without triggering the negative effects of dysregulation. Below is a list of simple, easy-to-incorporate strategies that are backed by research. These practices can help you expand your capacity, regulate your nervous system, and create more balance in your life.

1. Breathwork

Breathwork practices such as diaphragmatic breathing, box breathing, or the 4-7-8 method stimulate the vagus nerve and activate the parasympathetic nervous system. These techniques reduce heart rate, lower blood pressure, and counteract the effects of the "fight or flight" response. Controlled breathing has been shown to significantly reduce stress by shifting the autonomic balance to favor parasympathetic activity. For some easy-to-follow videos and tips on breathwork, check out the resources on our website here.

2. Mindfulness and Meditation

Mindfulness meditation helps bring attention to the present moment and reduces stress hormones like cortisol. Techniques like the 5-4-3-2-1 grounding method are particularly effective during acute stress. Studies, including those supported by the NIH, show that mindfulness can lower inflammation, improve emotional regulation, and enhance the nervous system's ability to adapt to stress. For a step-by-step guide to the 5-4-3-2-1 method, check out our resources here.

3. Physical Activity

Exercise, particularly rhythmic and moderate-intensity activities such as yoga, walking, or swimming, helps regulate the nervous system by releasing endorphins and improving brain plasticity. It also enhances heart rate variability (HRV), a key marker of parasympathetic activation. Research from the National Institute on Aging highlights that consistent physical activity supports the body’s stress recovery mechanisms, making it a powerful tool for nervous system balance.

4. Quality Sleep

Sleep is essential for nervous system health, allowing the brain to consolidate memories, process emotions, and clear out metabolic waste. Poor sleep disrupts the balance between the sympathetic and parasympathetic systems, exacerbating stress. Adopting sleep hygiene practices—consistent bedtimes, reducing screen exposure, and creating a restful environment—improves sleep quality and nervous system regulation. For comprehensive sleep hygiene tips, you can refer to the National Institute on Aging's guide here.

5. Nature Connection

Spending time outdoors in natural settings promotes grounding and nervous system regulation. Nature exposure has been shown to reduce cortisol levels and increase parasympathetic activity. A 2020 review in Frontiers in Psychology reported that "forest bathing" or similar nature-based activities improve mood, lower blood pressure, and enhance mental clarity. How easy is that? Feeling overwhelmed? Just go outside.

6. Socialization

Strong social connections play a critical role in nervous system regulation. Meaningful interactions with trusted friends or family members activate the parasympathetic system and promote emotional resilience. Research from the National Institute on Aging indicates that loneliness and social isolation are linked to heightened sympathetic nervous system activity and increased inflammation. In contrast, social bonds lower stress markers like cortisol and improve overall well-being. Group activities such as exercise classes or support groups are particularly effective in this regard. For this reason and many more, Healthy Aging loves teaching our group fitness classes. You can see where we teach on our Group Fitness page here.

Moving Forward: Make Nervous System Regulation a Priority

While we know these strategies sound simple, in reality, it’s the consistency that makes the difference—and that’s often the hardest part. The key is to start small and meet yourself where you are. Focus on adding just one thing at a time. Whether it’s five minutes of deep breathing, a short walk outside, or a single restorative yoga pose, small, consistent steps can begin to regulate your nervous system and create more room in your cup over time. Progress doesn’t have to be perfect; it just needs to start.

References

1. Frontiers in Psychology (2018)
   Study Title: The Effects of Controlled Breathing on Stress and Autonomic Function
   Annotation: This study highlights how breathwork techniques like diaphragmatic breathing and the 4-7-8 method can activate the parasympathetic nervous system and reduce stress-related symptoms.
   Link: Frontiers in Psychology

2. National Institute on Aging
   Resource Title: Getting a Good Night's Sleep
   Annotation: A comprehensive guide to sleep hygiene, detailing practical strategies to improve sleep quality and regulate the nervous system.
   Link: National Institute on Aging

3. National Institute of Neurological Disorders and Stroke (NINDS)
   Research Title: Deep Phenotyping of Neurologic Post-Acute Sequelae of SARS-CoV-2 Infection
   Annotation: Explores the biological mechanisms of nervous system dysfunction, including the impact of autonomic dysregulation and immune response.
   Link: NINDS

4. Therapist Aid
   Resource Title: Grounding Techniques (5-4-3-2-1 Method)
   Annotation: A clear, actionable guide for using the 5-4-3-2-1 grounding method to manage acute stress and promote mindfulness.
   Link: Therapist Aid

5. National Institutes of Health (NIH)
   Resource Title: Long COVID and Autonomic Dysfunction
   Annotation: Details autonomic nervous system regulation and strategies for improving resilience against stress-related symptoms.
   Link: NIH

6. Frontiers in Endocrinology
   Study Title: Chronic Stress and Metabolic Disorders: Insights from Recent Research
   Annotation: Discusses the long-term health effects of elevated cortisol, including systemic inflammation and increased risk for chronic disease.
   Link: Frontiers in Endocrinology

Staying Hydrated: A Vital Guide for Older Adults During the Summer Heat

While it may be ‘hot girl summer’ everywhere else you look, here over at Healthy Aging, we’re entering ‘hot patient summer’ season. Last week, as temperatures climbed, I challenged my Parkinson’s class to a drinking contest - except instead of chugging beers, we tried to finish a bottle of water between exercises. While for most people, summer heat brings thoughts of bathing suits, pool parties and barbeques, for me, and most of my home health colleagues, we go to thoughts of dehydration, low blood pressures and passing out. So, as the summer heat approaches, I want to talk to you today about staying hydrated. Hydration over the summer is crucial for everyone, but especially older adults. Dehydration can lead to serious health complications, but with a few simple strategies, it’s easy to stay hydrated and healthy throughout the season. 

Why Are Older Adults More Prone to Dehydration?

Several factors make older adults more susceptible to dehydration. Older adults tend to have a reduced thirst sensation combined with lower kidney function. With aging kidneys becoming less efficient at conserving water, while we lose more water, we also have less drive to replace it. Older adults also often take medications that impact hydration like diuretics that lead to increased urination, or anticholinergic drugs that lead to reduced sweat production. Many older adults have mobility limitations, and try to avoid the ‘extra walks’ or nighttime waking to use the bathroom that they fear may come with increased hydration. Lastly, you may also notice that you sweat less when you get older. It’s not all in your head! Older adults sweat less as they age due to reduced sweat gland function and impaired thermoregulation - this means that on top of reduced hydration, they are less able to internally cool themselves down! All these factors combined make dehydration one of the most common causes for hospitalizations in older adults - especially in the summer months.

How do I know if I’m dehydrated?

While younger adults may be able to quickly identify the signs of worsening dehydration and take quick action, the signs in older adults can be a little tricker, often leading to delayed treatment. The most common signs we see when we suspect a patient may be dehydrated are dizziness, especially when coming to stand, and confusion. Orthostatic hypotension, a drop in blood pressure related to changing position when coming from laying down to sitting, or from sitting to standing, can happen at any time, but dehydration can make this worse. Confusion or irritability, or any other changes in mental status can also be a confusing symptom especially in an older adult who may already have some form of dementia, but look for worsening confusion from their norm. Other common signs of dehydration in older adults include reduced urine output, increased muscle cramping, dry skin and a rapid heart beat.

How do I prevent dehydration?

The easiest way to treat dehydration is to PREVENT IT! Try to drink 8 glasses of water a day, choose fluid-rich fruits like watermelon and oranges, veggies like cucumbers and other foods like soup and smoothies that can give you a little extra hydration throughout the day. Keep an eye on drinks that make you LOSE fluid and avoid excessive caffeine, soda and alcohol - or at least pair them with a glass of water to off-set the fluid loss. Stay cool by dressing in light, ‘flowy’ clothes and carry a bottle of water with you wherever you go to sip on throughout the day. Try to drink BEFORE you feel thirsty, even if it’s just a few sips at a time. Prevention can make a world of difference.

How do I treat dehydration?

If you are already feeling the signs of dehydration, don’t panic! Try to move to somewhere cool and rehydrate. Rest for 30-60 minutes and see if you start to feel better. If the symptoms don’t improve, or you experience any fainting, fevers, changes in heart rate or chest pain, nausea, vomiting or diarrhea, it’s time to get some help. Call your PCP for further instruction or go to your local urgent care or emergency department. While mild dehydration may be easy to treat at home, severe or ongoing dehydration can lead to serious medical complications like kidney failure, urinary tract infections and heat stroke. The faster you get the proper care, the better!

Challenge a friend to a drinking contest!

Now that you know the signs, symptoms and treatment of dehydration - let’s have some fun. Challenge the next person (or patient) you see to a drinking contest! Suggest you both take sips of water between conversation, exercises or along a walk and see who can empty their bottles first. Try flavoring water with hydration tabs or fresh fruit or make it fun by using a special glass, straw or turning it into a summer mocktail. Want a fun recipe to try? Here’s my favorite thirst-quenching mocktail: Fill half your glass with coconut water, and top it off with a flavored seltzer or fruit juice. The cool coconut flavors will take you to a warm, sandy beach in your mind - and your body will be hydrated. Win-win:)