Dr Peter Morero
The burden of care for persons with Dementia falls mainly on the immediate family. This burden, already significant is forecast to grow substantially over coming years, and developed countries will almost certainly face a huge problem due to the confluence of a number of factors. The sheer growth in those expected to be diagnosed with dementia is daunting, plus the at risk population – already large - will also expand.
A recent review published in January 2019 documents the increase in dementia diagnoses from around 5 million in 2014 – representing around 1.6 % of the US population, to 5.8 million forecast in 2020. This represents an average annual growth of around 2.7 %. This is then expected to accelerate to grow at over 3 % per year with the numbers diagnosed with dementia in 2030 reaching 8.3 million and 11.1 million in 2040. From there, growth rates are forecast to reduce, but even then an estimated 13.9 million will be diagnosed in 2060, representing over 3.3 % of the US population.
Even as we continue to find improved treatment and approaches to manage these public health challenges, the demographic trends also point to an expected increase in the proportion of those needing care to those able to provide it. Families are increasingly less likely to stay within local communities, meaning that what was common in the past – ie. that spouses and children would provide the main care is becoming less and less the norm. For people to remain living at home (by and large the wish of a substantial majority) families, friends and professional caregivers will be relied on to provide ever increasing levels of care and support.
In March – National Nutrition Month, there is a focus on health and diet, and the importance of nutrition for seniors. One controversial notion that I hear often is that of the benefits of the “ketogenic” diet for Alzheimer’s and other neuro-degenerative diseases. See for example: https://www.dietdoctor.com/low-carb/benefits/alzheimers
First let’s understand a couple of basic principles. The ketogenic diet involves low or zero carbohydrates, and high fat, high protein. Because the brain runs on glucose exclusively (unlike your muscles and other body tissues that can burn fat), the brain has no capacity to do this. One aspect of aging is the gradual (sometimes rapid) progress to reduced insulin sensitivity of the cells. While this is part of normal aging and should not result in any great decline in the capacity of the brain to use glucose, it is also related to the development of type 2 diabetes.
In this scenario – even if there is adequate glucose available, the reduced insulin sensitivity means it cannot be effectively transported into the cells. In diabetes, this then leads to increased blood glucose levels – the glucose starts to accumulate in the bloodstream rather than being used as fuel. This then leads to damage to blood vessels and other tissues and the complications of diabetes, of which decreased brain function is just one.
But when the body has no glucose fuel – either because none is consumed in the diet, or through fasting or starvation, it runs on fat. The liver makes a type of fuel that the brain can use when there is no glucose – ketones, sometimes called ketone bodies, referring to simple Carbohydrates which many would know – acetone, acetoacetate, R-Beta Hydroxybutyrate.
So, for the aging/diabetic brain – ketones provide an alternative fuel to restore the brain to normal metabolism. For other not well understood reasons, this fuel also appears to result in the slow down or cessation of senescence – the gradual deterioration in the cell function.
But these effects have been well known throughout the past century. For example, there is much research to show that children with epilepsy had reduced rate of seizures on a ketogenic diet and more recent research shows symptomatic improvement in Parkinson’s and Alzheimer’s and other dementia.
So why isn’t this being implemented whole sale? The simple answer is that the keto diet (and other fad diets – like Paleo) are not necessarily healthy. For a start, a lot of the research with children with epilepsy also provided an ideal opportunity to see long term effects of the keto diets, and this shows:
So why is the keto diet so popular and promoted? Firstly, it is likely that most people who go onto these types of diets are not strictly adherent – this is common with all diets. So, most people would be spared the worst impacts. But some of the claimed benefits are less than substantiated, for example weight loss – most of which is water. Another purported benefits – reducing blood glucose and therefore improving diabetes do not stand up to scrutiny. High levels of fatty acid metabolism resulting from keto diets INCREASE insulin resistance, therefore making diabetogenic tendencies worse in the long term. And remember insulin resistance is associated with impaired brain function – so it likely doesn’t do any good after all!
But then maybe we are asking the wrong questions – another trigger for ketogenesis is fasting, or caloric restriction. We already have plenty of evidence that caloric restriction improves longevity and reduces risk of chronic disease. It also appears that it induces similar positive effects on aging brains. Low glucose means the body naturally switches to ketone metabolism in the brain – which has the same effect as operating on a keto diet but without the risks.
This can be done without starvation – for example the 5:2 method or intermittent fasting. In other words, a conventional healthy diet – Vegan / Mediterranean / Asian – based on variety and whole foods: grains, leaf and root vegetables, legumes, fruits, lean meat, fish and other protein sources combined with mild caloric restriction could maintain or restore health, plus improve brain function, while not introducing the health risks of an extreme or extended version of the ketogenic diet.
For another expert perspective, and great interview with Dr Ed Blonz, a nutritionist and professor at UCSF – see this link: https://www.beingpatient.com/an-expert-explains-the-problems-with-a-keto-diet-for-alzheimers-prevention/
Neuroprotective and disease-modifying effects of the ketogenic Diet: Behav Pharmacol. 2006 September ; 17(5-6): 431–439.
Ketogenic diets and Alzheimer’s disease: Food Science and Human Wellness 6 (2017) 1–9
Feasibility and efficacy data from a ketogenic diet intervention in Alzheimer’s disease: Alzheimer’s & Dementia: Translational Research & Clinical Interventions 4 (2018) 28-36
Systematic Review of the Use of Ketones in the Management of Acute and Chronic Neurological Disorders: JOURNAL OF NEUROLOGY AND NEUROSCIENCE ISSN 2171-6625 2017 Vol.8 No.2:188
Aging and Caloric Restriction Research: A Biological Perspective With Translational Potential: EBioMedicine 21 (2017) 37–44 http://dx.doi.org/10.1016/j.ebiom.2017.06.015
Caloric restriction increases ketone bodies metabolism and preserves blood flow in aging brain: Neurobiology of Aging 36 (2015) 2296e2303
(May 2019) Senior Helpers CEO and Co-Founder, Peter Ross, discusses some astounding outcomes from integrating home care into acute and chronic care delivery.
Listen to the full podcast here.
(May 2019) Senior Helpers CEO and Co-Founder, Peter Ross, discusses how integrating home care into the larger healthy care delivery system will solve many problems including improved outcomes and lower costs.
Listen to the full podcast here.
(March 2019) Great Place to Work® Institute has recognized Senior Helpers® as the first national in-home care company to achieve certification as a Great Place to Work. Senior Helpers' rapidly growing business is laser-focused on helping older adults age with dignity, and the company cares for tens of thousands of seniors across the globe.
(June 2018) Baltimore-based in-home care provider Senior Helpers has hired Chuck Sullivan to fill its chief marketing officer position. Senior Helpers is a provider of in-home senior services ranging from specialized care for individuals with dementia, Alzheimer’s disease and Parkinson’s, to personal and companion care to help with activities of daily living. Founded in 2011, Senior Helpers has 311 franchised businesses that provide care for tens of thousands of seniors across the United States. As chief marketing officer, Sullivan will lead Senior Helpers’ growth efforts by focusing on the company’s branding, while also driving innovation in terms of client experience and ensuring strong financial results.
(April 2018) Alzheimer’s and Dementia affect 47 million people worldwide and that number is expected to explode to 75 million by 2030. But a new treatment center that’s just opening near San Diego, California may help both patients and families deal with the devastating disease in a very unique way. Peter Ross, CEO and Co-founder of Senior Helpers says “We do think this model plays well in any country and especially when you’re looking at the Asian market you have 350 million seniors in China. That’s more than the total population of the U.S. So I’ve had conversations on the home care side in China. I think this is an even better model to bring to China, to Japan, to any part of the Asian marketplace, along with the rest of the world.”
(March 2018) A major national home care franchisor has to been tapped to staff the first U.S. version of a “dementia village.” Pioneered in the Netherlands, the concept involves the re-creation of a community from the 1950s. Senior Helpers, an in-home care franchise provider with 311 locations, has partnered with George G. Glenner Alzheimer’s Family Centers, Inc., to bring a unique experience to local seniors in the Chula Vista, California, area. Senior Helpers will be providing caregivers to an adult day care center called Town Square.
(March 2018) George G. Glenner Alzheimer’s Family Centers, Inc.®, a San Diego non-profit with over three decades of knowledge and expertise in offering dementia-related adult care centers, today announced a strategic alliance with Senior Helpers®, the nation’s premier provider of in-home senior care, to debut Town Square®, A George G. Glenner Alzheimer’s Family Center, powered by Senior Helpers®. Town Square continues Glenner’s innovative approach to Alzheimer’s and dementia care by providing a unique, interactive adult day care experience and support services program for individuals and families impacted by the disease.
(March 2018) Senior Helpers, one of the nation’s largest home care franchise companies, has joined the Healthcare Leadership Council (HLC), a coalition of chief executives from all health care disciplines that develops policies, plans and programs to achieve a greater system for quality, affordable care. The addition marks the first private duty provider on the HLC and comes at a time when private duty may be on the cusp of being included as a supplemental benefit with Medicare Advantage plans. HLC’s members include major health care players, including Aetna, Pfizer, Mayo Clinic and many more.
(February 2018) Senior Helpers, the nation's premier provider of in-home senior care, has announced that the company was recently appointed to the Healthcare Leadership Council (HLC), an exclusive alliance of leading healthcare companies from all health sectors committed to advancing the American healthcare system. As the HLC's first member specializing in in-home senior care, Senior Helpers aims to share valuable insights and ultimately help to provide improvements in the quality of care to the elderly and work in tandem with HLC to elevate care options to seniors across the U.S.
(January 2018) The technology divide between older and younger generations may not be as wide as you think. According to a recent survey of 1,000 seniors issued by Senior Helpers, the nation's premier provider of in-home senior care, more than 68 percent of people ages 65+ rate their technology skills either average or above average. The survey, which examined seniors' attitudes on everything from apps and internet usage to social media habits, also found that while most would not consider themselves "tech-savvy" (71 percent), nearly 60 percent of seniors think younger generations underestimate their knowledge and aptitude for technology.
(November 2017) - In honor of National Sleep Comfort Month in November, Senior Helpers, the nation's premier provider of in-home senior care, is offering sleep tips to promote the importance of healthy sleep habits for seniors. According to a recent survey of 1,000 senior citizens ages 65+ issued by the brand, nearly 70 percent of seniors do not meet the National Sleep Foundation's sleep duration recommendation of 7-8 hours per night for older adults.
(August 2017) - When the kids start to fly the coop, the next family members to focus your energy on are typically your aging parents. Senior Helpers—one of the largest providers of in-home senior care—conducted a national survey to gauge Baby Boomer attitudes on their aging parents. As it turns out, the kind of care our aging parents will receive is something Generation Xers and Baby Boomers are already worrying over and want to talk about.Senior Helpers, the nation's premier provider of in-home senior care, today announced it has been selected to receive the 2017 Caregiver Friendly® Award by Today's Caregiver, the first national magazine for all family and professional caregivers, and caregiver.com. The Caregiver Friendly® Awards are designed to celebrate products, services, books and media created with the needs of caregivers in mind. largest home care franchises with 298 locations across the U.S. and over a dozen more abroad. The survey tracked responses from 1,000 adult children between the ages of 45 and 64. largest home care franchises, with 298 locations across the U.S. and over a dozen more abroad. The surveytracked responses from 1,000 adult children between the ages of 45 and 64, asking various questions on the duties of elderly care. the United States. According to a recent survey of 1,000 adult children ages 45-64 issued by Senior Helpers, the nation's premier provider of in-home senior care, nearly 60 percent of Baby Boomers and Gen Xers are concerned about juggling the responsibility of caring for their families alongside of also providing for the wellbeing of their aging parents.
(September 2016) Senior Helpers®, one of the nation's premier providers of personalized in-home senior care, today announced plans to expand to Canada in an effort to offer personal care and companion services to seniors who wish to live in the comfort of their own home. Following the success of its U.S. expansion efforts, Senior Helpers will align with Stonewood Equity Fund I, who will serve as the brand's master franchise in Canada. Together they will open the first Canadian location in the Durham Region, part of the greater Toronto area, on September 15.
(August 2016) From sandwich shops to travel agencies and even hair salons, more and more franchise businesses are opening every day, and they’re here to stay. According to the International Franchise Association, franchise small businesses will once again grow at rates that exceed non-franchise business growth this year. So what’s the allure? It’s nice to buy into an already-successful business model, but beyond that there are many benefits to starting a franchise business.
(June 2016) Welcome to 21st century America, where we have longer lives than ever before and higher hopes for healthy aging. We are, happily, the beneficiaries of medical and scientific breakthroughs that have given us life spans that not long ago would have been the stuff of science fiction. But we also face serious challenges, including the number of seniors struggling to find and afford much-needed care.
(June 2016) Personalized senior care leader Senior Helpers just announced the opening of a new location in Terre Haute, Indiana. This marks the 257th location nationwide for Senior Helpers, one of the biggest in-home senior care franchise systems in the country. The new location is operated by owner Matthew Page.
(May 2016) "Parkinson's disease is a chronic and progressive movement disorder that affects nearly one million people in the U.S. alone, and that number will likely increase due to the aging Baby Boomers population," said Chris Buitron, Senior Helpers vice president of marketing. "We are proud to be the first in our industry to provide specialized caregiver training in Alzheimer's, dementia, and now, Parkinson's disease care. Over the years, Senior Helpers has established itself as the best option for navigating the challenges of in-home senior care today, and this new program further underscores our commitment to offering skilled services while allowing our aging clients to maintain the best quality of life possible in the comfort of their own homes."
(March 2016) Enter to win a Gold Violin gift card or a Senior Helpers care bag. Senior Helpers is one of the largest in-home senior care companies in the U.S. Senior Helpers offers a wide range of personal care and companion services, including Alzheimer’s and dementia care services, to assist seniors who wish to live independently.
(February 2016) Entertainment and other activities are essential for the well-being of people with Alzheimer's. They can make the difference between a deadly boring day of staring at the floor and a rich sense of purpose and contentedness. They can also help the caregiver make a connection with the person, no matter how brief. Read the full article here.
(February 2016) Senior Helpers®, one of the nation's largest in-home senior care franchised businesses, has received the highly sought after Best of Home Care Endorsed National Provider recognition for the third consecutive year. Home Care Pulse, the home care industry's leading market research firm that specializes in customer satisfaction research and quality assurance, awarded the 2016 distinction due to exceptional customer service reviews by existing clients. Read the full article here.
(January 2016) Senior Helpers®, one of the nation's largest in-home senior care franchised businesses, announced today that Rob Cantrell joined the Senior Helpers corporate team as the new Vice President of Franchise Development, taking on responsibility for continuing the growth Senior Helpers has seen in franchise unit sales. Read the full article here.