Researchers in Iowa say changes in an Alzheimer's patients' brain can occur at least 20 years before they are diagnosed with the disease and they are calling for more education about early warning signs of dementia during Alzheimer's and Brain Awareness Month.

There are at least 7 million people age 65 and older in the U.S. living with Alzheimer's and 62,000 of them are in Iowa.

Abby Miesner, development manager for the Alzheimer's Association of Iowa, said despite time and money being spent on research, the risk is going up at a younger age and the numbers are discouraging.

"The lifetime risk for Alzheimer's at age 45 is one in five for women, and one in 10 for men," Miesner pointed out.

Miesner noted the numbers hold true across the board for Blacks and Latinos as well. She adds as doctors have learned signs and symptoms could start to occur at an earlier age, they are paying attention to signs sooner.

Miesner explained occasionally misplacing your keys or forgetting why you went into a room are not always cause for concern but repeatedly forgetting things as part of your everyday life could be.

Meisner added earlier detection gives doctors a chance to intervene sooner in a patient's life.

"As many as 40% of dementia cases may be attributed to modifiable risk factors," Meisner emphasized. "Things like having too high of blood pressure or not enough physical activity, lack of exercise. Things like that, getting good sleep. All of those things are so important."

All can be controlled by developing healthy habits. A 2022 report from the Alzheimer's Association showed 60% of people will put off seeing a doctor if they develop symptoms early on, waiting until the symptoms worsen, or family and friends encourage them to seek treatment.

The Association is holding educational events statewide all month.

Dementia, a disease with profound effects on families, loved ones and caregivers, affects more than 55 million people globally, including 6 million in the U.S.

New research shows people can reduce their risks by making even small changes in their daily routines, for example, through exercise and eating more vegetables.

Sarah Lock, senior vice president for policy at AARP, said there are also important steps policymakers can take to make it easier for people to maintain healthy behaviors.

"When we do that, we can disrupt dementia," Lock asserted. "That's a really exciting possibility, given that so many of us -- as our nation is aging -- are facing that risk."

Dementia is the third-largest cause of death in the nation for people age 70 and older, and two-thirds of Americans have at least one major potential risk factor. People who smoke five cigarettes per day have a 16% higher dementia risk than nonsmokers. People with prediabetes face a 25% increased risk, which rises to 50% with full-blown diabetes. Prolonged exposure to air pollution is also a major dementia risk factor.

Other risk factors include alcohol use, depression, high body mass index, hearing loss, hypertension, low education, physical inactivity, social isolation and traumatic brain injury. Lock pointed out policies to reduce these risks can vary by state. For example, in Colorado, physical inactivity may not be as big of a
problem as in other states, but hearing loss is relatively high.

"We can suggest to policymakers that they focus on ways to help people screen and correct for hearing loss," Lock noted. "In Colorado, that might be a wiser use of public dollars, to go after the problem that seems to be biggest in your state."

Lock added the goal of the research is to offer people pathways to better brain health and to give older Americans more quality time with their loved ones. The findings were released by the new Dementia Risk Reduction Project, a collaboration between AARP, the Alzheimer's Disease Data Initiative and the University of Washington.

Changes coming to Medicare in 2025 could be beneficial for Oregon residents who are eligible for the program.

Oregonians who qualify for Medicare are now in the open enrollment period through Dec. 7, which allows them to search for health coverage plans to best suit their needs.

Ryan Kibby, Oregon Senior Health Insurance Benefits Assistance project director for the Oregon Department of Human Services, said there will be expanded care options for dementia patients with the Guiding and Improved Dementia Experience or GUIDE program.

"Some of the resources available through GUIDE would include a 24-hour support line, caregiver training and up to $2,500 a year for respite services," Kibby outlined. "That's really just going to help benefit the people who are providing these family caregiver services."

There will also be expanded mental health benefits for people with Medicare in 2025. In 2023, nearly 920,000 Oregonians were enrolled in Medicare. People can get free help to find coverage through Oregon's SHIBA program, either on its website or at 800-722-4134.

Kibby pointed out another major improvement in 2025 is prescription drug costs will be capped.

"There will be a lower maximum to pay for covered drugs, under both Medicare Part D policies and Medicare Advantage drug coverage," Kibby explained. "The maximum amount that people will pay in 2025 is $2,000, and they won't have to pay anything for covered drugs once they reach that amount."

Prescription payment plans will be an option for people who cannot pay in full up-front. The out-of-pocket cost cap also eliminates a gap in coverage, known as the "donut hole," which some have experienced in the past. While Medicare cannot cover prescriptions specifically for weight loss, people can access these drugs for treatment of conditions like Type 2 diabetes.


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November is National Family Caregivers Month and AARP Wyoming is working to meet rising demand for caregiver resources.

About 58,000 Wyomingites provide needed care for sick or elderly family members or loved ones, estimated to be more than 54 million hours of unpaid labor per year, according to AARP Wyoming.

The group launched a "Care for Caregivers" series last year to help people navigate common issues like financial planning, safety and mobility, end-of-life decisions and more.

Stella Montano, volunteer president of AARP Wyoming, who helped develop the series and is a caregiver herself, said many people who take on such duties do not consider themselves caregivers but they should acknowledge the real workload the role can be.

"Have you noticed that maybe your parents are aging and you're assuming more responsibilities? Or has someone been diagnosed with something that you might have to have oversight of their medical needs?" Montano asked. "People don't believe they're caregivers. But they still have a lot of responsibilities."

The series was first offered in Sheridan and expanded this year to Casper, Newcastle and Cheyenne. AARP also offers resources on its website.

The structure of the workshops recognizes caregivers' needs. There are free meals for attendees and respite care offered on-site for loved ones brought along to a session. Montano noted they are designed to be as accessible as possible.

"I really stress to caregivers, to not do it alone," Montano urged. "There is help out there."

She added Sheridan's VA Medical Center has also tapped into the programming and began recording videos of the sessions this year, which will be available online soon.