Artistic expression takes on so many different forms: playing an instrument, singing, performing onstage, writing, photography, knitting, sculpting, and the one that likely first comes to mind: painting/drawing. I usually focus on music in this blog, but we can mix it up a little! Therefore, in this post, I would like to share with y’all an artist who was impacted by Alzheimer’s disease: William Utermohlen. Throughout his art career, Utermohlen’s paintings can be categorized into cycles: "Mythological" paintings of 1962-63, the "Cantos" of 1965-1966 (inspired by Dante's Inferno), the "Mummers" cycle of 1969-1970 (which includes characters inspired by the South Philadelphia's New Year’s Day parade), the "War" series of 1972 (referencing the Vietnam war), the "Nudes" of 1973-74, and the "Conversation Pieces" of 1989-1991. Some believed that early signs of Alzheimer’s disease are evident in the “Conversation Pieces,” like shifting spatial perspectives and the focus on an intimate environment. This is evident in Snow, depicted below. As he aged and after being diagnosed with Alzheimer’s disease in 1995, Utermohlen continued to paint and draw. In particular, Utermohlen focused on creating self-portraits in order to document and express his inner self as Alzheimer’s disease took over his brain. The portraits show grief, pain, resignation, confusion -- it’s heartbreaking to see, but also so valuable in order to get some kind of a sense of the trauma and anguish the person being afflicted is experiencing. Utermohlen’s portraits also show evidence of deteriorating motor functions and spatial awareness, as the lines and facial proportions progressively become less defined. Nevertheless, the portraits help to preserve Utermohlen’s identity, which transcends beyond the physicality of the canvas. This post is only a brief introduction to Utermohlen, and I’d definitely like to share more about him in the future because I find his story and art so inspiring. Next, perhaps I’ll dive deeper into the “Conversation Pieces,” particularly their potential connection to signs of Alzheimer’s disease.
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Last but not least, Loma Linda is the fifth Blue Zone. It’s been so interesting exploring these different places around the world, and I hope you’ve enjoyed this series, too! So far, I’ve realized that even though the Blue Zones seem to be quite different in their locations and cultures, they definitely share many characteristics, in both the regions and the ways of life. In my initial impression of all the Blue Zones, Loma Linda stood out as potentially being the most unique, so let’s see if this holds true!
Quick facts: Population: around 25,000 Region type: city Geography: located in San Bernardino Valley, east of Los Angeles Fun fact: the city’s motto is "a city focused on health and prosperity" The aspect of Loma Linda that stands out the most is its large concentration of Seventh-day Adventists. According to Buettner, Seventh-day Adventists “lived between seven and 11 years longer than people in its Northern American counterparts.” In particular, their “Garden of Eden'' diet, which is essentially a plant-based diet, may contribute to a healthier lifestyle. The group also abstains from coffee and alcohol. Perhaps one of the most important practices is sabbath: no matter how busy they are, people will take a break from sundown on Friday to sundown on Saturday to spend time with family, connect with God and nature, self-reflect. This strong connection to church and community is essential in promoting wellness. A strong community has been evident across all the Blue Zones, but a common, specific faith makes Loma Linda particularly stand out. It could be that sharing these beliefs makes community connections run even deeper. Happy New Year, everyone! Thinking back to one year ago, I definitely could not have predicted how this year would turn out. Nevertheless, together, we’ve been able to get through some of the toughest times, and 2021 brings hope for the future. To start off this year’s posts, I will explore the fourth Blue Zone: Nicoya, Costa Rica.
Quick facts: Population: around 161,000 Region type: consists of two provinces (Guanacaste and Puntarenas) Geography: 80-mile long peninsula Fun fact: in Nicoya, men have a higher chance of becoming centenarians than women! Living in a tropical and sunny area could be a factor in the Nicoyans’ secret to living longer. The consistent sunshine helps the body produce vitamin d, which is important in the regulation of calcium and bone health. Furthermore, the water in Nicoya has a very high calcium content, which could also help in creating strong bones and therefore less falls and injuries related to frailty. Diet also contributes to the overall health of Nicoyans. Many Nicoyans follow the Mesoamerican diet, which highlights corn, squash, and beans. Other foods common in this diet include plantains, papaya, pejibaye (peach palm fruit), and yams. All these foods are highly nutritious, providing vitamins and antioxidants. Nicoya shares aspects of lifestyle that are common to most of the Blue Zones so far, like social connections, physical activity, and purpose for living. The concept that Nicoyans embrace is called plan de vida, similar to ikigai in Okinawa. However, such a ‘life plan’ doesn't have to be something grand or exceptional. In fact, most elderly focus on the simplicities of daily life, perhaps teaching their grandchildren about the way of life or checking in on their neighbors, to thrive into old age. It’s the holiday season, which is also arguably the busiest time of the year. This season is no different-- but it came with early presents and hopes for the future! Looking forward, technology will continue to be an essential part of our lives, so in this post, I will be discussing an innovative and viable use of technology in senior care: VR and reminiscence therapy.
First, let me answer the question: what is reminiscence therapy? As the name sounds, reminiscence therapy involves sharing past activities, events, and experiences, usually with other people and the help of one’s senses. For example, aural can involve listening to past favorite music, smell and taste can involve baking a childhood favorite cake, visual can involve looking at photographs, and tactile can involve painting or sewing. An important aspect of reminiscence therapy to keep in mind is that it’s different from remembering: for example, instead of asking questions as if trying to test memories, like “where did you grow up?”, reminiscing more involves sharing memories together, perhaps looking at a photo of a birthday party and recounting stories about it. Reminiscence therapy is often used for seniors with dementia, and because its implementations can vary greatly, not much definitive scientific conclusions have been drawn about it. Nevertheless, reminiscence therapy may have positive benefits on cognition, mood, and communication for those with dementia. Now, how can virtual reality be applied to reminiscence therapy? VR is particularly useful for visual techniques in reminiscence therapy. Take Inspīr senior living’s experience with VR as an example. As explained by chief clinical officer Brian Geyser, a resident with dementia at Inspīr from Sweden had a hard time communicating with others, so they decided to try using VR reminiscence therapy with her. Set up with the VR headgear, projections of the resident’s hometown and university where she taught at were displayed using Google Earth. Suddenly, the resident became attentive and excited, pointing out places in her native language to everyone around her. VR has the potential to elevate reminiscence therapy. It takes a photograph and makes it alive through immersing the patient directly into it. Furthermore, VR can take a person anywhere: from their university in Sweden to the living room they lived in their whole youth, or perhaps on a hot air balloon above Cappadocia! Such projections involve more than just one sense, combining multiple to create a captivating and more powerful experience. And as VR becomes less costly and more common in everyday life, the possibility of its application in senior care becomes a reality. Here are a couple companies with VR headsets dedicated for seniors: MyndVR Virtue Health The Wayback Wow, time definitely flies! I can’t believe Thanksgiving just ended, and there’s only about one month until a new year. This year, I’m especially thankful to be healthy. I’m also grateful for this blog, and YOU, reading right now!
Ikaria is the third blue zone I will be discussing in this series, which means this is the halfway point! I think I will continue discussing the Blue Zones in every other post, with a different topic in between. Interestingly so, all the blue zones so far have been islands, including Ikaria. Quick facts:
According to the Blue Zones website, Ikarians are “almost entirely dementia free.” How do they stay so healthy, physically and mentally? A strict mediterranean diet could be a factor. As you are probably familiar, a mediterranean diet consists of many vegetables, fruits, nuts, and whole grains, along with some seafood and poultry. The Ikarian diet focuses more on the plant-based aspects of this diet. Living in a mountainous region, Ikarians get regular physical activity simply by walking up and down the mountainside to a friend’s house or grocery store. Furthermore, Ikarians are very sociable and welcoming, and social connections are definitely important as one ages. Lasting friendships and community bonds have been a common pattern across all the blue zones so far. Another interesting point of study is the shifting through generations. Though Ikaria is isolated, creating a culture and tradition-rich atmosphere, tourism is becoming more popular, influencing people’s way of life. Younger generations could be deviating away from their ancestors’ traditional lifestyle, through adapting modern technology and a mainstream lifestyle. However, genetics also plays a role in longevity, emphasizing the need to take into account many factors with regards to the topic. Nevertheless, I think comparing the lifespans of subsequent generations will be interesting to study and could help provide a picture of the factors that influence longevity to a greater extent. Hi everyone! For this post, I just wanted to share a bit about an independent project I've been working on that is related to music and dementia. It's a project I've been working on for a while, so I hope it interests you or sparks some ideas of your own about ways to help patients with dementia!
Without our memories, who are we? From playing piano in Memory Care at the Pavilion, I’ve observed music’s powerful impact on the residents’ memories. I also wondered, which pieces are most beneficial to memory? From researching and documenting on this blog, I knew how songs from people’s youth can transport them to associated memories and emotions. However, I've recently been wondering, how do we know which pieces resonate strongest with dementia patients? For seniors who have lost cognitive ability to retrieve favorite or memorable songs from youth, it’s difficult to compile an effective list. Although caregivers may have an idea of which songs to choose, not all patients have close relatives or friends who are familiar with their youth. Although generations may have similar favorites or top songs, everyone’s background, which significantly influences music choice, is different. To solve this problem, my sister and I have been working on an invention (US 63/093,775) to build music playlists for dementia patients automatically. Here is some information about how we plan for the invention to work:
The second blue zone I will be exploring is Okinawa, Japan (the prefecture).
Quick facts:
Okinawa as a blue zone: Okinawa has around 25 centenarians per 100,000, and it’s likely that this number is accurate, as the Japanese government is pretty thorough about the data about its people. Two concepts stood out to be unique to the Japanese and longevity: moai and ikigai. Moai is a group of lifelong friends who support each other in many aspects, from social to financial interests. These groups of friends can last from childhood all the way to the 100s! Throughout their lives, these groups meet, play games, have conversations, just like any other friend group. I think what makes these groups special, though, is the lifelong commitment to each other. Especially throughout childhood, friends usually come and go— we can be close with a couple people in elementary school, but then drift apart in middle school, and that’s the way it is. However, in moais, the friends are committed to one another for life. In a way, these groups are like extended family. Ikigai loosely translates to a reason for being, having a reason to get up in the morning. It seems like gardening is very popular among older Okinawans, which is definitely a reason to get up everyday. Gardening also provides health benefits in itself, providing physical activity and healthy foods. According to Hector Garcia, co-author of the book Ikigai: The Japanese Secret to a Long and Happy Life, “your ikigai is at the intersection of what you are good at and what you love doing.” More specifically, it’s where what you love, what the world needs, what you’re good at, and what you can get paid for converge. At its core, it’s finding meaningfulness in life. These two Japanese concepts place value on living and living into old age. However, what makes Okinawa special compared to the rest of Japan? Ikigai is a popular concept throughout Japan, so perhaps it’s not the main reason Okinawa stands out as a blue zone. However, moai seems to have originated in Okinawa, only gaining attention after Buettner noted it as a characteristic of the blue zone. I also found another interesting characteristic of Okinawa that differs from other places in Japan: uchinaa (Okinawa) time. Contrasting Japan’s precision and punctuality, Okinawans pride themselves on “polite tardiness” and have a forgiving attitude towards being late. I think this may reflect a more relaxed attitude, perhaps related to people feeling less stress. Though, now that I’m thinking about it, if I lived on a tropical island with a group of lifelong friends, I’d definitely be less stressed! As I mentioned in my last post, I will be talking about the five original blue zones for these next couple of posts! The first one is Sardinia, Italy.
Quick facts:
Sardinia as a blue zone: Sardinia was the first blue zone identified by Buettner. His journey to Sardinia was sparked by interest in the M26 genetic marker, which supposedly is related to longevity. I had never heard of this genetic marker myself until researching the blue zones, so I was curious to learn more. However, there doesn’t seem to be much research on it with regards to longevity, making me cautious about the claim. I did find information about a study that found that 150 genes could be related to longevity, and wow, isn’t that a lot! Whether it’s one or many genes, Buettner was led to Sardinia, where he found almost 10x more centenarians per capita than in the United States. A particularly interesting point about Sardinia is that its ratio of male to female centenarians is around 1:1! Some characteristics of the Sardinia lifestyle that’re noted are a plant-based diet with occasional meat, emphasis on family and celebrating elders, walking daily, drinking red wine and goat’s milk, and laughing with friends. I think celebrating the elderly particularly plays a prominent role in their health. The attitude of dismissing the elderly as frail and incompetent, the common view in a society that values youth, has negative impacts to health, both mental and physical. As with anyone being stigmatized, a lowered self-esteem, social isolation, and depression can ensue. Physical health-wise, this attitude can put stress on the elderly, as they’re constantly worried about being a burden to society. The stigma around aging has even been shown to be related to a shorter life. The detrimental effects are nicely summarized in this article, discussing a systematic review done on the health consequences of ageism. Positivity: such a simple concept that can perhaps change the course of our lives. Of course, there are many other variables that contribute to our lifespan, but changing our view of the elderly can be an easy fix, if we set our minds to do so. Supporting the elderly as integral members of society and respecting them for their wisdom can lead to positive impacts on health -- like increased motivation for productivity, stress-free environment -- which may ultimately lead to a longer life. I recently came across blue zones through, believe it or not, Netflix. I was watching Down to Earth with Zac Efron, and in an episode, he visited Sardinia, a blue zone. I remember hearing about blue zones before, but they didn’t pique my interest back then as they do now. Blue zones are basically regions of the world that are home to the oldest people. Dan Buettner is the founder of this concept and named five places in the world as blue zones: Okinawa, Japan; Sardinia, Italy; Nicoya, Costa Rica; Ikaria, Greece; Loma Linda, California. Through researching, Buettner and his team discovered specific lifestyle habits that were common to all blue zones, which they call the Power 9. Blue Zones is now an organization with the mission to create healthy communities throughout the United States based on the lifestyles of people in the original blue zones.
Blue zones are not without their critics and skeptics, though. One in particular is Dr. Saul Newman. From an interview I saw here, Dr. Newman believes that there is fault in the classification of blue zones. For example, he questions why Okinawa was chosen as a blue zone, even though it has the shortest average lifespan within Japan. He also believes that there could be data fraud, like people lying about their ages in order to claim higher longevity rates. Nevertheless, I believe blue zones are interesting to discuss, as they’ve been researched extensively into. Even if they aren’t necessarily different from places that weren't dubbed as blue zones, the research done on the elderly population in these places makes it valuable to learn from. Therefore, for the next couple of blog posts, I’m excited to learn about and discuss research discoveries of a particular blue zone! Forgetting: often seen as a sign of aging. But how do we know the difference between “normal” memory loss associated with age and memory loss caused by disease? Why does memory even get worse as we age? Let’s start with the second question. Here are a few potential contributors to our forgetfulness:
Now for the first question, I found a couple comparison charts that serve as good visualizations, although please keep in mind that everyone's situation is different: Because the brain does change as we age, memory loss could be a part of aging that we can't avoid. However, there are ways to lessen the impact, by ensuring that we are keeping our brains healthy and active for as long as possible. Alzheimer's and other dementias are not a normal part of aging, so it's important to know the differences.
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