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Is cognitive decline preventable?
RECENT EVENTS
APR
Seminar - Menopause with Dr. Beth Donaldson, Dr. Mary
Ross & Gelina Syfchuck, RD.
APR
West Vancouver Open House April 10th
MAY Walk with your Doc - May 9th in Vancouver &
West Vancouver
MAY Seminar - HPV with Amra Dizdarevic, NP
Alzheimer’s disease is the most common form of
dementia. Although Alzheimer’s disease remains an
incurable illness there is now hope for prevention and
protection...Page 2
Train your brain with exercise
It’s well known that exercise benefits the physical
body, but what is often not considered is the effects
of exercise on brain health. Read why this is particularly
important as we age...Page 3
MAY 3 Things for Calgary (May 2nd, 15th & 23rd)
JUN Copeman Healthcare becomes Canadian Blood Services
Partners for Life
UPCOMING EVENTS
JUL
Seminar - Concussion with Dr. Shawnda Lanting & Dr.
Lynn Rennison on July 31st
JUL
Dr. Rhonda Low's 30 min health segment on CKNW
980AM Vancouver every 3rd Thursday starting July 18th
SEPT Seminar - Prostate Cancer with Dr. Steve Broughton
SEPT Calgary's 4th Annual Kidney March on September 6th
Caring for the caregiver
The primary caregiver of an Alzheimer's patient is often
overlooked and at risk for many stress related complications. The greatest gift we can give our loved ones is
to take care of ourselves first...Page 4
The importance of cognitive assessments
Regular assessments allow your Neuropsychologist
to track cognitive decline and identify early signs of
dementia and Alzheimer’s disease. Reducing your risk
factors will improve your chance of living free from the
se devastating conditions...Page 6
Health Message With Dr. Elisabeth Sherman, Director of Neuropsychology
Is cognitive
decline
preventable?
Four things you can do
to protect your brain
Alzheimer’s disease is the most common form of dementia. It
progresses slowly, but eventually leads to severe memory loss,
changes in judgment, difficulty with speech, and dependence on
others for everyday tasks. Unfortunately, no one is immune to the
threat of cognitive illness. In the last decade, many well-known
figures such as Ronald Reagan, Rita Hayworth, and most recently,
Margaret Thatcher, suffered from dementia. Although Alzheimer’s
disease remains an incurable illness, causing untold burden on
families and loved ones, there is hope for prevention.
As the normal age-related changes begin occurring (benign
forgetfulness and occasional word-finding problems), many healthy
middle-aged people begin to worry about developing dementia,
especially if they have watched family members succumb to the
illness. Until recently, prevention or delay of Alzheimer’s disease and
dementia was unheard of. It was thought that little could be done
to prevent a disease that had no conclusive cause, no effective
treatment and likely began 20 years prior to the diagnosis. Now we
know better, and there is good news. Geriatric specialist, Dr. Miia
Kivipelto and her research team studied middle-aged, healthy adults
and discovered that the following four factors greatly reduced the risk
of dementia occurring 20 years later:
1. Systolic blood pressure ≤ 140 mmg Hg
2. Total cholesterol ≤ 6.5 mmol/L
3. Body mass index ≤ 30 kg/m²
4. Exercising twice a week for 20 mins (moderate to vigorous range)
Unlike age or genetics, these four risk factors can be modified by
lifestyle changes, medication, or other interventions. Reducing
your risk factors will improve your chances of living free from the
devastating effects of Alzheimer’s disease and other dementias.
Taking charge of your brain health need not be complicated or
overwhelming, and it starts with simple, gradual steps in the right
direction. Start your path to improved brain health by following these
four tips:
KNOW YOUR NUMBERS
Do you know your systolic blood pressure, total cholesterol,
and body mass index? If not, check the results of your last
Copeman Healthcare Comprehensive Health Assessment online
(www.copemanhealthcare.com and click on Client Sign In) or contact
your Family Health Nurse.
REVISIT YOUR PERSONALIZED HEALTHCARE PLAN
Your personalized healthcare plan was created to help you reduce
your risk of disease. If you are having trouble implementing any of
the recommended changes, please book an appointment with your
Family Health Nurse to help you get on track and stay on track.
EAT RIGHT
Make sure to eat well. Your diet may contribute to 3 out of the 4 risk
factors, so speak to your dietitian if you need help setting up a healthy
eating plan and learn more about dietary factors that may be good for
the brain. See page 5 for Registered Dietitian, Lindsay Diack’s advice
on brain healthy eating.
WORK OUT
With your doctor's approval, make sure you are working out at least
twice a week, at a high intensity (e.g., you are perspiring and talking
is beginning to be difficult). If you aren’t working out, begin by walking
twice a week for 20 minutes. See page 3 for an article by Certified
Exercise Specialist, Laura Anifowose to learn the benefits of exercise
on your brain.
If you are concerned about your memory or overall cognitive
skills, please contact your nearest Copeman Healthcare Centre to
book an appointment. Let us create a plan to ensure your optimal
brain health.
Dr. Sherman is the Director of Psychological & Brain Health in Calgary, and is a clinical neuropsychologist with expertise in the neuropsychological assessment of children, adolescents and adults with complex medical and neurological conditions. She holds a doctorate in Clinical Psychology with Neuropsychology Specialization from the University of Victoria, completed her internship at London Health Sciences Center in Ontario, and completed postdoctoral
training at UCLA. Dr. Sherman has authored two books, several peer-reviewed journal articles and book chapters and has been involved in numerous
presentations at national and international conferences relating to neuropsychological assessment.
2
Fitness Forum With Laura Anifowose, Certified Exercise Physiologist
It’s well known that exercise benefits the physical body, but the
effects of exercise on brain health is often not well understood.
However, as we age it’s particularly important to build resilience in
brain function and exercise is one of the best ways to do it.
Nearly 10% of Canadians over age 65 suffer from Alzheimer’s disease
or a related dementia. Dementia is a syndrome characterized by the
progressive deterioration of cognitive function beyond that seen in
normal aging. Of the various causes of dementia, Alzheimer’s is the
most common. It is a neurologic disease of the brain leading to the
irreversible loss of neurons supporting memory function and other
cognitive abilities. Recently, non-pharmacological approaches have
been studied as a strategy to improve brain plasticity, function, and
resistance to neurodegenerative diseases. The results are in and the
science is clear. Simply stated, regular exercise promotes brain health.
Train your
brain with
exercise
What does this mean for you? Get moving!
Regular exercise has an offsetting effect on brain aging and creates
resilience to neurodegenerative processes. This is important because:
1. In healthy people, exercise in midlife is effective at preventing
cognitive decline and reducing the risk of dementia in later years.
2. In people with dementia, exercise is effective at slowing the rate
of progression and helping maintain the ability to perform activities
of daily living.
What kind of exercise should you do?
All types of exercise are beneficial. Walking, swimming, biking,
dancing, or any other activity you enjoy and know you can commit
to are good options. At minimum, complete a moderate intensity
exercise regime at least three times per week. Studies have shown
that the beneficial effects of exercise increase when a variety
of activities are performed - the most important thing is that you
exercise regularly and stick with it.
How can we help you?
The Copeman Healthcare Brain Fitness program was developed for
two reasons:
1. to optimize brain health in people aged 55+ that are in good
general health, and
2. to help improve and maintain function in people with age-related
diseases such as Alzheimer’s and other dementias.
Brain Fitness is based on current scientific evidence to help optimize
brain health and combines physical work-outs with cognitive training.
The specialized program is available at Copeman Healthcare Calgary.
If you’re interested in learning more about this exciting program
please contact Lorie Johnsen at the Calgary Centre at 403-7189191 or via email at [email protected].
Laura Anifowose completed her Bachelor of Science in Kinesiology at the
University of Waterloo. She has recently completed her Certified Exercise
Physiologist training with the Canadian Society of Exercise Physiology allowing her to expand her scope of practice into more clinical populations.
3
Health Tips With Jason Min, Registered Clinical Pharmacist
Easy ways to remember your medications
One of the challenges of any medication
regimen is to remember to take them on a
regular basis. Without any systems in place it
can be easy to forget. If this sounds familiar,
then you are not alone. Studies have shown
that a person will remember to take their
medications only 79% of the time. Fortunately,
there are several strategies that can be used
to help you manage your medications.
Smartphone apps
Dosette boxes, blister packaging, strip
pouching
Sustained-release formulations
Dosette boxes, blister packaging and strip
pouching are the most common methods
of helping you keep track of your daily
medications. Dosette boxes and blister
packaging are available from most pharmacies
and they can be used effectively to organize
your medications into breakfast/lunch/dinner/
bedtime slots. The only difference between
them is that dosette boxes need to be
organized by the patient whereas a blister
package or strip pouch can be prepared by
your pharmacist. Strip pouching is not as
readily available as blister packaging but uses
a similar system to track medications.
There are several great applications available
for download to your smartphone. RxmindMe
and Pillbox are two examples of free apps
that can be programmed to send medication
reminders, including the necessary dosage.
As a bonus, many apps also provide basic
information about each medication and some
can even help order refills from your pharmacy.
Some medications must be taken 3 or 4 times
a day to obtain the optimum results and these
can be difficult to manage. To address this
challenge a growing number of medications
are now available with delayed-release
coatings and unique delivery mechanisms
that can cut down on the number of doses
you need to take in a day. Whenever possible,
it is a great idea to switch to these sustainedrelease formulations. Whatever your strategy,
remember it is important to always take
your medications. If you are having difficulty
managing your medications please speak to
your Copeman Healthcare team or Pharmacist
about your options.
Jason Min is a Registered Clinical Pharmacist at
Copeman Healthcare Vancouver. He graduated
with a Bachelor of Science in Pharmacy from
the University of British Columbia in 2008
and completed UBC's postgraduate clinical
residency in community pharmacy in 2011. He
is a lecturer with the Faculty of Pharmaceutical
Sciences at UBC and also works in a chronic pain
management program.
Brain Check-up With Dr. Marianne Hrabok, Neuropsychologist
The importance of baseline cognitive assessments
At Copeman Healthcare we pay special
attention to your brain health. The baseline
cognitive assessment is usually the starting
point for your brain health plan and is
recommended for all clients who wish to be
vigilant about their cognitive health.
A cognitive assessment evaluates important
areas of brain function. These include:
memory, concentration, processing speed,
language, and reasoning capabilities. In
recent years, it has become clear that
baseline cognitive assessments are critical
to complete wellness because they set
a personalized benchmark of brain health
for future comparison. Just as changes
in your blood pressure or waistline help
your physician track your risk for metabolic
syndrome, regular cognitive assessments
allow your neuropsychologist to track
changes in your brain health. This enables your
team to identity early signs of problems and
take action right away. A baseline cognitive
assessment provides a reference point to
measure against in the case of problems
4
or concerns (including major illness or brain
injury). It also helps you and your team
focus on specific areas when developing a
treatment and prevention plan.
Although appropriate for clients of all ages
and in all phases of health, baseline cognitive
assessments may be of greatest interest
to those:
ō interested in early detection, prevention,
and maximization of health assessments
ō aged 55 or older
ō with cardiac, vascular or other chronic
health conditions
ō with a family history of Alzheimer’s disease,
dementia or neurological conditions
ō involved in activities that put them at
increased risk for head injuries (e.g.,
sports, workplace duties)
Note that obtaining a baseline may be
particularly important for children and
adolescents, who tend to have active
lifestyles and rapidly developing cognitive
skills. Baseline cognitive assessments may
be repeated every 1 to 5 years.
(DFKEDVHOLQHDVVHVVPHQWSDFNDJHLQFOXGHV
DClinical
consultation with a Neuropsychologist (Ph.D. expert in brain health)
DStandardized
testing
DRecommendations
to optimize brain health
(provided to the client and their family
physician)
Fees generally range from $425 to $3500,
and can be booked by contacting your
nearest Copeman Healthcare Centre Brain
Health team.
Dr. Marianne Hrabok is a clinical neuropsychologist in the Psychological and Brain Health
Programs at the Copeman Healthcare Centre
in Edmonton. Dr. Hrabok achieved her Ph.D. in
Clinical Psychology with a Neuropsychology
Specialization from the University of Victoria, her
pre-doctoral residency at BC Children’s Hospital,
and post-doctoral clinical and research fellowship
at Alberta Children’s Hospital/Research Institute.
WHAT IS
NEUROPSYCHOLOGY?
Food for Thought With Lindsay Diack, Dietitian
Clinical neuropsychology
is a sub-speciality of clinical
psychology that focuses on brain
health. Neuropsychologists assess
and treat conditions such as: stroke,
concussion and measure important
areas of cognition such as memory,
processing speed, logic, reasoning
and executive functioning, as
well as psychological health.
Eat smart to prevent Alzheimer's disease
Most of us are aware that eating a well-balanced diet including
fruits and vegetables, lean protein, whole grains and low fat dairy
products (or similar) can help reduce the risk of many chronic
diseases. What many people may not know is that this can
also help reduce the risk of diseases such as Alzheimer’s and
dementia. Studies have shown certain nutrients are particularly
beneficial to brain health.
To determine whether you are you getting enough brain-boosting
nutrients in your diet we welcome you to complete the following
quiz that will test your knowledge of brain-healthy foods.
COGNITIVE BASELINE
TESTING
The first step in any brain health
program is to understand how your
brain is functioning today in order to
develop strategies for tomorrow. Setting
a baseline and tracking your brain health
over time is critical to managing
conditions affecting cognition
or refining interventions
to address identified
challenges.
THE ANSWERS TO OUR QUIZ CAN BE FOUND ON PAGE 8
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a) Salmon
c) Trout
b) Halibut
G Black cod (sablefish)
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a) Yes, if you aren’t eating more than 8 ounces/250
grams per week
TREATMENT &
REHABILITATION
If you or a loved one are experiencing
cognitive impairment, our brain
health and psychology services are
specifically designed to help individuals
build cognitive skills, restore
emotional strength and maximize
independence.
b) Maybe, if you aren’t eating it twice per week
c) It depends on individual needs – consult your
Copeman Healthcare Dietitian.
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a) Brightly coloured fruits and vegetables provide high
levels of beneficial antioxidants
b) Cell damage (oxidation) occurs due to lifestyle factors
such as stress, pollution, alcohol consumption and
smoking
c) Kale, papaya, berries and olive oil are all great sources
of antioxidants
G All of the above
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a) Vitamin B12
c) Vitamin B3 (niacin)
b) Vitamin D
G All of the above
Live Well With Richelle Mottosky, Registered Psychologist
Minding the needs of the caregiver when cognitive decline becomes a family affair
When we are feeling good, we often take our
physical, psychological and brain health for
granted. We’ve been conditioned to believe
that if we’re mindful of our lifestyle, health
is not only our reward, but also our right.
Unfortunately, it does not always turn out that
way. Devastating diagnoses of Alzheimer’s
disease or dementia affect 1 in 11 Canadians
over the age of 65 and when a diagnosis is
made it affects not only the individual, but
the entire family. Typically a dedicated family
member becomes the primary caregiver and
their own health is often overlooked. When
this happens, it often puts the caregiver at
risk for many stress related complications.
The greatest gift we can give to our loved
ones is to take care of ourselves first. As
difficult as permission for self-care may
seem, it’s a critical piece to navigating this
complicated situation. Taking time away to
recharge is mandatory - this does not mean
time to do banking or grocery shopping.
Caregivers need to commit to something
that brings joy to their lives, such as reading,
Self-care is critical because as cognition
declines in the diagnosed, the caregiver
usually experiences increased emotional
awareness. It becomes the primary job of the
caregiver to process their own emotion so as
not to push down any resentment, anger, or
feelings of overwhelming stress. If this is not
done, feelings can impede the secondary job
of holding a loving, kind space for someone
in need.
If you or a loved one is feeling overwhelmed
from caring for a family member with
Alzheimer’s disease or dementia, or if you
are having difficulty finding a strategy to
incorporate self-care into your life, contact
your Copeman Healthcare Psychology team
and let us help you navigate these challenges.
stargazing, meditation, walking or enjoying
coffee with a close friend. These short breaks
are the gas stations that re-fuel the spirit and
allow us to make ourselves available to our
vulnerable loved one.
Richelle Mottosky is a Registered Clinical Psychologist practicing at Copeman Healthcare
Centre Calgary. Richelle has over 14 years of experience in the helping profession. She provides
counselling to individuals experiencing a variety
of difficulties including life transition issues (life
stage issues, grief, stress, anxiety, depression).
Wellness begins with a healthy brain
The importance of grey matter for healthy aging
Today, when people refer to the concept of “wellness,” they often
describe a state of integrated psychological and physical health. But
this description misses one key element – the healthy functioning of
the brain. We now know there is more to wellness than
simply a physically fit body and a healthy outlook. For
true wellness we must consider the brain as a
separate and very special organ - an organ that
is assessed and enhanced in unique ways that
fall outside the realm of primary care. Just as
the heart is often afforded special attention,
so too must we carefully look at the brain.
All too often brain health is an important yet
neglected third dimension of true wellness.
The Brain Health Program at Copeman
Healthcare is based on discoveries
concerning neurogenesis and neuroplasticity.
Based on strong scientific evidence we now
understand more completely how declining brain
health can have a profound impact on both physical
and psychological health. Basic cognitive functions like
memory, logic, reasoning and planning can now be assessed
and “baselined” in order to detect any early signs of disease or agerelated cognitive decline. More importantly, such decline in many
6
cases can be prevented, delayed or slowed down. The evidence is
now clear that brain cells continue to grow throughout our lives and
that the brain is capable of “re-wiring” itself to overcome damage
caused by injury, disease or normal age-related decline. An
increasing number of studies suggest that with proper
care dementing conditions like Alzheimer’s disease
can be prevented or delayed.
Since its inception, Copeman Healthcare’s
Brain Health Program has been able to
identify signs of diminished cognitive
function or impairment well before a change
in function manifests as clinical symptoms
(or begins affecting the daily lives of our
clients). This has afforded an opportunity for
these individuals to potentially halt this early
decline and preserve their thinking and overall
brain health into the future.
Whether your brain is completely healthy,
experiencing natural age-related changes, or showing
early signs of disease, there are things that can be done
to “anti-age” your brain to build resilience that will help you fend
off cognitive decline. Ask your Copeman Healthcare team for more
information on the Brain Health Program.
Pediatric Health
Copeman Kids Program
What is Copeman Kids?
Copeman Kids provides parents and parents-to-be
with advanced health services and helpful guidance
to ensure that their children have the best chance of
developing a sound physical, cognitive and psychological foundation.
Building a strong foundation will lower their chances of developing
health issues or health-risk behaviors as they grow into adults.
Why Copeman Kids?
The Copeman Kids program is designed to proactively help children
develop to their full physical, mental, behavioural and academic
potential. Copeman Kids is designed to closely track & monitor a
child’s health and development through;
DPrevention-focused
health screenings
DProactive
family health education
DThe
expertise of an inter-professional team
DSame
day visits and care when you need it
What to expect at a Copeman Kids visit
The Copeman Kids program provides screenings and assessments
that are appropriate to age and development from infant to young
adult. During your child’s hour-long screening we will evaluate physical
health as well as behavioral and social-emotional well-being.
You can expect:
PHYSICAL ASSESSMENT
DEVELOPMENTAL ASSESSMENTS
EDUCATION
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Your Copeman Kids Team
Copeman Kids grows with your child
The Copeman Kids team is comprised of a family health nurse, a
nurse practitioner and a physician.
Children and adolescents grow quickly and experience different challenges at each stage of their development. These challenges present
valuable opportunities for promoting personal growth or in some
cases an early intervention to prevent longer-term issues.
Note: All medically necessary diagnostic and treatment services
that may be provided by the physicians practicing from the Copeman
Healthcare Centre – or from your family doctor – are paid for by
the government under your provincial health insurance plan. The
fees charged by Copeman Healthcare are strictly for non-insured
health services.
Copeman Kids grows with your child to provide coaching on nutrition,
physical activity, sleep patterns, self-esteem, puberty, sexuality and
avoiding high-risk behaviours. At each stage, the Copeman Kids
program is designed to proactively recognize & optimize your child’s
unique potential.
7
Community Involvement
ANNOUNCEMENTS
3 Things for Calgary
This May, Calgary’s team participated in Mayor Nenshi’s challenge
known as 3 Things for Calgary. They served breakfast at the Calgary
Drop-in Centre, participated in a blood drive and cleaned up the
streets. Mayor Nenshi's initiative asks all Calgarians to think of 3
things they can do (big or small!) to make Calgary better.
CALGARY
The Calgary team welcomes new
employees, Shauna Thompson &
Marcus Ellard. We welcome back Dr.
Rod Elford who returned from his
sabbatical on April 23rd.
Client wins gold at Masters Weightlifting Championship
"We may look old, but don't let that fool you," says 75 year old
Don Vaughan. Don recently won gold at the Canadian Masters
Weightlifting Championship in Scarborough, Ontario. Don has been
a Copeman Healthcare client since 2008.
EDMONTON
The Edmonton team welcomes new
employees, Judith Salpeter and Cheryl
Robbins.
VANCOUVER
Alzheimers Society Golf Tournament Sponsorship
Copeman Healthcare was proud to support the Alzheimers Society
of BC's 19th Annual Forget Me Not Golf Tournament held on May
23rd at Northview Golf & Country Club. This year the event raised
over $580,000 for research and programs to support families
impacted by dementia.
Copeman Healthcare Medical Research
Dr. Michael Koehle and Dr. Shawnda Lanting’s article entitled: "Is poor
sleep quality at high altitude separate from acute mountain sickness?"
will be featured in the peer-reviewed journal, High Altitude Medicine
and Biology. Dr. Marianne Hrabok and Dr. Elisabeth Sherman authored
a paper entitled: "Memory and health-related quality of life in severe
pediatric epilepsy," published in the medical journal, Pediatrics.
The Vancouver team welcomes a new
Diagnostic & Screening Coordinator,
Banny Farazdaghi.
Dr. Rhonda Low's 30min health segment
airs on CKNW 980AM Vancouver every 3rd
Thursday starting July 18th.
WEST VANCOUVER
The West Vancouver team welcomes a
new business development associate,
Terri Thompson.
Calgary clinic spared by floods, closed for 5 days due to
general power outage
We would like to thank our Calgary clients for their patience and understanding during the
recent floods. Our hearts go out to the many people that were affected by water damage
and power outages. We hope that you and your families, friends & colleagues have remained
safe during these challenging times.
Thankfully, due to our location we did not experience any direct water damage and were able
to re-open again as soon as the power was restored. During the days that we were closed,
calls were forwarded to our team in Edmonton to route to the appropriate care coordinators.
Our physicians remained on-call for all urgent medical matters, we opened a temporary
triage Centre at EFW and our client service teams pulled together to re-book appointments.
We apologize for any inconvenience this may have caused you and your families and look
forward to serving you in the days ahead.
Alzheimer's prevention quiz answers:
#1 Answer: (b) Only oily fish are good sources. Halibut is not a rich source of Omega 3
fatty acids.
#2 Answer: (c) Aim to have 8 oz of fatty fish each week. If you don’t like to eat fish or have
an allergy, speak with your dietitian before taking an omega-3 supplement.
#3 Answer: (d) Antioxidants and their associated health benefits are grouped by colors, a
great reason to include a variety of different coloured fruits and vegetables each day.
Red, blue and orange coloured produce carry high antioxidant power.
#4 Answer: (d) Some studies suggest that B3, B12 and D may play some role in dementia
prevention. However, to date, no vitamin has been shown to conclusively reduce the risk
of Alzheimer’s disease. Vitamin B12 is needed to keep nerve cells healthy and functioning
and Vitamin D has an important role in the development and function of the brain. Niacin
(vitamin B3) is involved in carbohydrate and fat metabolism, nervous system function,
and promotes circulation. Speak with your dietitian who can determine if a supplement
is needed.
8
CALGARY
4th Floor, 628 12 Ave SW
Calgary, AB, T2R 0H6
403-270-CARE (2273)
EDMONTON
Suite 700, 10216 124 St.
Edmonton, AB, T5N 4A3
780-455-CARE (2273)
VANCOUVER
4th Floor, 1128 Hornby St.
Vancouver, BC, V6Z 2L4
604-707-CARE (2273)
WEST VANCOUVER
Suite 200, 545 Clyde Avenue
West Vancouver, BC, V7T 1C5
604-699-CARE (2273)
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@CopemanClinic
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