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Posts (51)

Tue, Feb 18 11:29am · Re-post: Patient Spotlight John and Ann in Living with Mild Cognitive Impairment (MCI)

This week we are doing a re-post on a special couple. We hope you enjoy reading about one of our many couples who have gone through HABIT – this pair from Arizona.

John and An

Click below to read their story.


Tue, Jan 28 10:39am · Lifestyle Choices are Critical in Maintaining Cognition: Key Take Away from the 18th Annual MCI Symposium in Living with Mild Cognitive Impairment (MCI)

actigraphI recently was able to attend the 18th Annual MCI Symposium in Miami, FL held Jan 18th and 19th.  There was a wealth of information there for providers, researchers, and the public about Mild Cognitive Impairment and dementia.  I was particularly struck by the strong evidence of the role that lifestyle factors, particularly vascular risk factors and amount of physical activity had on one’s risk of progressing to dementia.

Many studies have begun to include brain scans to look at whether an individual has amyloid (a protein in the brain that is linked to Alzheimer’s plaques) build up in their brain or not.  While finding amyloid on one of these scans does not mean the individual WILL go on to develop Alzheimer’s disease, it does identify individuals who may be at increased risk of going on to develop the disease. In looking at individuals who were cognitively normal but had elevated amyloid in their brains, Reisa Sperling, MD from Harvard Medical School presented information on how the presence of vascular risk factors (for example, high body mass index (BMI), high blood pressure, history of cardiovascular disease, smoking) significantly increased the risk of those individuals later developing cognitive decline.

Also from the Harvard Aging Brain Study, Dr. Jennifer Rabin, PhD at Sunnybrook Research Institute followed normal aging individuals with high amounts of amyloid.  She found that in addition to vascular risk factors, the amount of physical activity one gets during the day also predicts cognitive stability or decline.  In a 6 year study, they found that those who were getting on average 8300 steps a day on an actigraph (one of the many commercially available “watches” that measure your numbers of steps a day) stayed more cognitively stable, while those who got under 3,000 steps a day were more at risk of cognitive decline. You can read more about her research here.

We have been aware that getting sufficient cardiovascular activity helps reduce risk of dementia for years now, and we commonly educate on the importance of trying to get in 150 minutes of cardiovascular activity each week.  Dr. Rabin’s research adds that just being more active and less sedentary, whether you reach the level of elevated heart rate or not, is important as well.  So, in addition to striving for 150 minutes a week of cardiovascular activity, also just try to be more active and less sedentary everyday.  While their research showed 8300 steps to be the average number of steps of those doing best, if you are sedentary, any increase in walking is bound to be better than nothing. Also, keep working to control your vascular health: control your blood pressure, maintain a healthy weight, and quit smoking!

If you’d like to receive support as well as support others in a healthy lifestyle including cardiovascular activity, join the Mayo Clinic Connect Healthy Living group.




Wed, Jan 22 9:36am · HABIT Directors at the MCI Symposium in Miami in Living with Mild Cognitive Impairment (MCI)

HABIT Directors 2020Over the weekend, HABIT Directors (left to right in photo) from Mayo Clinic Health System La Crosse (Dr. Anni Shandera), the University of Florida (Dr. Glenn Smith), and Mayo Clinic Florida (Dr. Melanie Chandler) attended the 18th Annual MCI Symposium in Miami.  This conference is put on each year to share the latest research and innovations in Mild Cognitive Impairment (MCI).  Saturday and Sunday morning were spent in a traditional research conference for other clinicians and researchers.  Sunday afternoon was a “Public Forum” for members of the community to come and hear about the latest MCI information and engage in dialogue with the clinicians and researchers working to better understand and treat the condition.

Dr. Smith presented in the Public Forum on “Memory Compensation Training and Computerized Cognitive Training in Older Adults” in which he spoke of our research from HABIT on the calendar and computer training we do.  He also spoke more broadly about what we do in HABIT.  His talk was well attended, and well received.  We always get so many great comments and questions! Thanks Dr. Smith for helping get the word out to more people about HABIT (click here to learn more about what HABIT is)!

I’ll follow up next week with some of the key highlights from the meeting!

Tue, Jan 14 12:06pm · Repost: What is HABIT Healthy Action to Benefit Independence & Thinking in Living with Mild Cognitive Impairment (MCI)

We have been getting a lot of questions in response to recent posts asking us what HABIT is.  So, I thought it was a good time to repost a general description of the program we did a couple of years ago. Thanks for reading!

What is HABIT Healthy Action to Benefit Independence & Thinking?

Smiling Couple


Dec 24, 2019 · Happy Holidays! in Living with Mild Cognitive Impairment (MCI)

Warm wishes in this holiday season to all of our readers.  We look forward to sharing more with you about living well with Mild Cognitive Impairment in the New Year! 2020 – Can you believe it!?!?!


Dec 17, 2019 · Offering the Right Treatment to the Right Patient with MCI in Living with Mild Cognitive Impairment (MCI)

Keep Using the MSS

This week’s blog comes to us from Lise De Wit, MS, a graduate student at the University of Florida (UF) who has worked with the HABIT team to help analyze the results of one of our recent research trials funded by the Patient-Centered Outcomes Research Institute (PCORI). This project was led by Dr. Glenn Smith, Emeritus Professor of Mayo Clinic, who is now the Elizabeth Faulk Professor and Chair at the Department of Clinical and Health Psychology of the University of Florida. We’ve previously reported on comparative effectiveness outcomes and patient preferences for treatments in MCI from this project. Dr. Smith was also one of the original developers of the HABIT Healthy Action to Benefit Independence & Thinking®  program and continues to actively collaborate on HABIT research projects with the Mayo HABIT Team.

Memory compensation training

For this project, we explored what factors impact who benefits from the calendar system taught in HABIT, otherwise known as the Memory Support System (MSS). The MSS is a compensatory rehabilitation system that was developed by the HABIT team to help individuals with Mild Cognitive Impairment (MCI) compensate for their memory loss. (Questions about MCI?  Click here to find out more.) Briefly, during MSS training, individuals are taught to use a calendar/notebook system for compensatory written reminders.  These reminders are things like important appointments, tasks, or experiences/thoughts. The training focuses on the consistent use of this system multiple times per day. Earlier research has shown that this system improves individuals’ ability to complete daily activities and improves self-efficacy. (See what former patients are saying about the MSS calendar here, here or here!)

Who is most likely to benefit?

There is a current trend in health care that focuses on offering treatments to those who are most likely to benefit from them. This strategy also gives researchers the opportunity to develop alternative treatments for those individuals who are unlikely to benefit. So, who learns and uses the MSS calendar the best? We found that individuals with MCI that had less severe cognitive impairment were more likely to have learned the use of the MSS calendar by the end of the two-week training. This is important because those individuals who learned the use of the calendar by the end of the two week training were more likely to continue to use this system 6, 12, and 18 months post-training.

The conclusion

Overall, our results suggest that offering MSS calendar training as early as possible for those with  MCI, when cognitive impairment is mild, might be of most benefit, and might have implications for ability to benefit from the calendar long-term.  These results reinforce the notion that it is important for clinicians and researchers to find methods to detect and treat MCI as early as possible to prevent or delay progression to dementia.

A big thanks

The data generated from the PCORI trial has provided a wealth of information for research projects for several graduate students at UF. My graduate student colleagues and I would like to thank Drs.  Melanie Chandler, Dona Locke, and Julie Fields of the Mayo Clinic’s HABIT Team and our mentor Dr. Glenn Smith for allowing us to work with them as part of our doctorate research. We wish to acknowledge all the sites who participated in the trial, including Mayo Clinic Arizona, Florida, and Minnesota, and the University of Washington. Importantly, we also wish to express our gratitude to the patients and partners who were a part of this study: your participation helps us to better our treatments, and this type of research would not be possible without you.

If you wish to read the full academic paper, you can find that here.

De Wit, L., Chandler, M., Amofa, P., DeFeis, B., Mejia, A., O’Shea, D., Locke, D.E., Fields, J.A. and Smith, G.E., (2019). Memory Support System training in mild cognitive impairment: Predictors of learning and adherence. Neuropsychological rehabilitation, 1-13.

Nov 26, 2019 · Involving Caregivers in the Dementia Healthcare Team in Living with Mild Cognitive Impairment (MCI)

Family Caregiver PictureAn excellent article was recently released by USAgainstAlzheimer’s and Mayo Clinic that highlights the vital role our caregivers play in dementia care. We know how important caregivers are, and we are excited to see them getting the attention they deserve in articles like this.

They proposed seven “best practices” for engaging caregivers in treating those with dementia:

  1. Build rapport with the caregiver as well as the patient
  2. Acknowledge the caregiver’s role, and assess their capacity to be the caregiver
  3. Talk directly to the person with dementia, but also allow the caregiver separate time to share concerns
  4. Improve provider knowledge and ability to communicate their knowledge to caregivers
  5. Assess caregiver needs and provide resources for support
  6. Coordinate care between members of the healthcare team
  7. Train providers in how to resolve conflicts between caregivers and the person with dementia.

Some of these best practices seem readily achievable:  building rapport, acknowledging and giving the caregiver space to talk freely, making sure the provider is well trained and can coordinate care with a healthcare team. These are skills that most healthcare providers have, or can readily achieve.

The other best practices are important, but, in my opinion, most primary providers will likely need help from a support team to do them justice: assessing the caregiver’s capacity to care and caregiver needs and helping resolve conflicts between the caregiver and the person with dementia. Don’t get me wrong, those are IMPORTANT goals, but these goals also take more time or require a set of skills of the provider that not all primary doctors will have.  This is where nursing staff, social workers, psychologists, and neuropsychologists can come in.  This is also an important part of our work with our new caregivers in the HABIT Program.  (Don’t know about HABIT?  Click here to find out).

The input we get from our caregivers when a person with dementia is no longer able to communicate all of their needs is essential.  We also have to realize as providers that our patients don’t exist in some blackhole or isolation:  there are very often people going through this disease with them.  We need to take care of those caregivers as well so that they can help us care for their loved one with dementia.

Connect with other caregivers caring for people living with dementia in the Caregivers: Dementia group on Mayo Clinic Connect.

See the Mayo link to the article summary here:

The need for healthcare providers to engage Alzheimer’s caregivers

If you want to look up the full article, this is the reference:

Griffin JM, Riffin C, Havyer RD, Biggar VS, Comer M, Frangiosa TL, BangerterLR. Integrating Family Caregivers of People With Alzheimer’s Disease andDementias into Clinical Appointments: Identifying Potential Best Practices. JAppl Gerontol. 2019 Oct 11:733464819880449. doi: 10.1177/0733464819880449.


Nov 12, 2019 · Repost: To Medicate or Not to Medicate for MCI: That is the Question in Living with Mild Cognitive Impairment (MCI)

Man Getting Medications

As this is always a popular topic of discussion during HABIT, I thought I would re-post the link to this excellent piece Dr. Locke wrote for us earlier in the year in case you missed it: