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Diabetes and dementia are two prevalent health conditions that have been the focus of extensive research in recent years. While each condition has its own distinct characteristics, emerging evidence suggests a strong correlation between diabetes and an increased risk of developing dementia.  As Head of Learning at Epoch Elder Care, **[an assisted senior living facility](https://www.epocheldercare.com/assisted-living)**, I am deeply committed to promoting preventive health measures. Through this blog, I will delve into the correlation between diabetes and dementia, exploring the shared risk factors and the vital role of lifestyle choices in preventing these conditions. Join me on this journey to uncover the best strategies for optimal brain health and well-being, especially for elders. 

#### **Understanding the Correlation:**

-  **Impact of High Blood Sugar Levels on Brain Health**

Chronic hyperglycemia promotes cognitive decline through glycation, where excessive sugar molecules react with brain proteins, forming harmful compounds that negatively affect brain tissue and cognitive function. Maintaining stable blood sugar levels is vital to safeguard cognitive abilities and reduce the risk of neurodegenerative conditions. 

-  **Insulin Resistance and Cognitive Decline**

Insulin resistance and impaired signaling are linked to dementia and cognitive decline, affecting brain cells and increasing vulnerability to neurodegenerative processes. Insulin plays a crucial role in brain health and neuroprotection, emphasizing the importance of maintaining proper sensitivity to support cognitive function and reduce the risk of cognitive disorders.

#### **Shared Risk Factors:**

**Age as a Common Risk Factor**

Advancing age is a shared risk factor for diabetes and dementia, leading to higher prevalence in older adults. Age-related changes in insulin sensitivity and brain function are crucial in this relationship, and the cumulative effects of long-term diabetes can significantly impact cognitive health in the elderly, potentially contributing to cognitive decline and neurodegenerative diseases


**Genetic Predisposition**

Genetic predisposition significantly influences the development of diabetes and dementia, with strong familial links and shared genetic factors involved in these conditions. Specific gene variants associated with both diseases highlight the impact of shared genetic pathways on metabolic regulation and brain function.

**Vascular Health and the Diabetes-Dementia Connection**

Diabetes profoundly affects blood vessels and the brain's vascular system, leading to microvascular complications that contribute to cognitive impairment. The interplay between diabetes, hypertension, and cerebrovascular disease increases the risk of dementia, as these conditions collectively harm the brain's blood supply and overall vascular health.

**Alzheimer's Disease and Diabetes: A Key Link**

_(Alzheimer's disease is a specific type of dementia, characterized by progressive memory loss and cognitive decline.)_

Diabetes (specially Type 2) and Alzheimer's disease have a bi-directional relationship, with insulin resistance promoting amyloid beta and tau pathology in the brain. Common pathophysiological mechanisms suggest that addressing one condition may impact the management or prevention of another. Diabetes is also associated with structural and functional brain changes, leading to cognitive decline. It affects hippocampal integrity, memory function, and executive abilities, primarily due to disruptions in glucose metabolism and cerebral energy utilization.

**What non-pharmacological measures can be employed to manage and mitigate the risk of developing diabetes and dementia?**

According to various researches, dietary and lifestyle changes can help to avoid neurodegeneration and promote brain health. Enhancing blood glucose levels may aid in both the prevention and **[treatment of dementia](https://www.epocheldercare.com/epoch-dementia-care-program)**. 

-  **Nutrition**

We should aim to adopt a dietary approach that promotes stable blood sugar and insulin levels (low glycemic), while also minimizing inflammation and providing essential nutrients for optimal brain health.

The following are tips for proper nutrition that should be considered in elder care: 

- Small amounts of nutrient-rich carbohydrates like sweet potatoes, steel-cut oats, buckwheat, etc.
- Whole, unprocessed foods like vegetables, legumes, nuts, etc.
- Whole fruits per day for at least two days in a day
- Use of high-quality oils such as cold-pressed olive oil and oils of nuts and seeds
- Omega-rich foods twice a week
- High-protein foods that can be animal- or plant-sourced
- 8–10 servings of non-starchy vegetables in a day

Apart from that, there are many nutrients that are essential for the brain and its cognitive function. They are as follows:

1. Vitamin A (Essential for neurogenesis and resiliency of the brain)
2. Vitamin C (essential for the growth of neurons, the formation of the myelin sheath, and neurotransmitter synthesis)
3. Vitamin D (essential for cognitive function)
4. Vitamin E (which protects cells from oxidative stress and may help prevent or delay cognitive loss)

At our **[Epoch Elder Care Facilities](https://www.epocheldercare.com/)**, we offer a comprehensive cyclic menu tailored for the elderly, with both vegetarian and non-vegetarian options. Our small, intermittent meal approach fosters better digestion and nutrient absorption. For residents with diabetes, we provide a specialized diabetic diet with low glycemic foods and careful sugar monitoring. We are dedicated to promoting the health and well-being of our elderly residents through nutritious and delicious meals tailored to their needs and preferences.

-  **Monitoring of Blood Glucose Levels**

Blood glucose monitoring is essential in managing diabetes, enabling regular tracking of blood sugar levels. Using a glucose meter, a small blood sample is analyzed, helping individuals understand their body's response to food, activity, and medications for informed decisions. Regular monitoring empowers diabetes management, leading to personalized treatment plans for better health outcomes.

Regular blood glucose monitoring is crucial for elderly individuals with diabetes. To minimize discomfort, we rotate testing sites and follow the doctor's advice on frequency. Periodic HbA1c testing enhances accuracy, ensuring effective diabetes management for our elderly residents' health and well-being.

-  **Stress**

When a body is under chronic stress, it releases hormones that can increase blood glucose level. Apart from the fact that stress causes inflammation of the brain cells, According to a study published in the Alzheimer's & Dementia Journal, brain inflammation is a significant neuropathological route that is relevant to the cognitive decline brought on by Alzheimer's disease.

At **[Epoch](https://www.epocheldercare.com/)**, we firmly believe in the power of engaging activities to prevent stress and promote well-being in individuals with diabetes and dementia. As one of our activities, we thoughtfully plan "Movie Time" on Sundays, featuring movies from their era, which serves as an effective stress-relieving activity. By immersing our elderly residents in the nostalgia of familiar films, we create an emotionally comforting environment, which can reduce anxiety and tension.

-  **Exercises**

A study of the literature turned up 27 studies looking at how exercise affects cognitive performance in adults above 60 years. A strong correlation between physical activity levels and cognitive function was found in 26 of the investigations, indicating that exercise may be a useful strategy to slow down cognitive aging.

At our **[Epoch homes](https://www.epocheldercare.com/our-homes)**, we prioritize the well-being and physical health of our residents at all levels. In our setting, our dedicated caregivers provide  support by assisting residents in both active and passive exercises, tailored to their individual needs and abilities. Additionally, our in-house physiotherapists play a crucial role in conducting personalized physiotherapy exercises, both one-on-one and in group sessions, to enhance mobility, flexibility, and overall physical function. This comprehensive approach ensures that our residents receive the specialized care they require, promoting their independence and improving their overall quality of life.

- **Sleep**

According to a recent study in the journal PLoS (Public Library of Science) Medicine, those over 50 years old who sleep less than five hours a night are more likely to acquire numerous chronic conditions like diabetes and cardiovascular diseases.

At **[Epoch](https://www.epocheldercare.com/)**, we recognize the importance of proper sleep for the well-being of our elderly residents. To address circadian rhythm disturbances, we actively engage them in a variety of activities and exercises within our facility. By providing a stimulating and fulfilling environment, we aim to promote a healthier sleep-wake cycle and improve their overall sleep quality. This approach not only enhances their physical and mental health but also contributes to a more vibrant and fulfilling lifestyle during their stay at our facility.

Besides the non-pharmacological approach, we adhere to the drug/insulin regimen as prescribed by the endocrinologist.

**To Sum Up**

Regular blood glucose monitoring, prescribed medications, balanced diet, physical activity, brain-stimulating activities, stress reduction, social interactions, and emotional support are vital in managing diabetes and dementia holistically. With this comprehensive approach and with proper treatment and guidance from specialists (like endocrinologists and neurologists), we can address physical, mental and emotional aspects, optimizing brain health, preventing complications, and improving the quality of life for individuals with these conditions.

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The Correlation Between Diabetes and Dementia: Unraveling the Intricate Connection

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There’s the music of sarod playing in the background while I write this, helps me write my memoirs!

When I was a child, I used to write diaries. What’s enticing to me at that point in time was the smell of new vintage-looking pages, and a unique feeling to ink it down. It all started then. Who knew the passion for writing would grow so strongly on me!

Hi, I’m Sneha, Business Assistant & Content Writer at Epoch. Yes, I own these words and wear them with pride. The journey to earn this was pretty savage, and I’ll like you to be a part of this! Hence, sharing a page from my memoir.

It was the dawn of the year 2020 when I promised myself to come out of the University with a Mass Communication and Journalism degree in one hand and a placement in other. Things started turning upside down when the covid wave came along and washed away all the aspirations I had of starting my career in a corporate world. Later that year, after graduating, I started freelancing.

Little did I know that the universe had something else up in its sleeves.  On 1st Feb, I started my journey at Epoch, and it’s already a year now! I’ll need pinches from myself to believe so. When I stepped out of my comfort zone, came to a new city, I met amazing people, especially women, who inspired me in the most unusual ways. It is my sheer luck and fortune that I landed in Epoch right after college. The journey of amazement and learning didn’t stop for me, I would say.

How often does it happen that a CEO of an organization holds your hand, mentors you, and walks you through your journey? Well, happened to me and to all those who started anew! Here, at Epoch, I saw myself under the guidance of domain experts. From each one of them, I learnt something, both applicable in personal and professional lives. My team pushed me one notch beyond my threshold, surprisingly that brought different colours to my work. To date, I am told to be the owner of not only my projects, but also my decisions, successes, and failures. I am learning.

Epoch has played a vast role in shaping me into Sneha 2.0. If you know me and don’t believe, let’s go out for a cup of coffee! A confident and radiant Sneha, you’ll see.

Epoch homes abode elderly those who need dementia care and assisted daily living support. When I started, I was briefed about dementia but the understanding of the daily life of a senior 75+, came to me when I was in their presence. Recently through one of the Epoch webinars, I heard a doctor/geriatrician say, and I quote, “there’s a person still behind the dementia patient”, and this made me realize how naïve are we to not notice this in our elderly loved ones!

Amidst the pandemic, there were fewer interactions with our elderly residents, regarding their own safety. But whenever I got the chance, covered in PPE kit, I would jump to know each one of them. With some I sang era old songs, with some I recited poems of Harivansh Rai Bachchan, Dinkar, Nirala, with some I learnt the concept of perspective, with some I learnt fashion, some taught me to live life with a bang, and that’s what I am doing!

Epoch in a way turned out to be a blessing in disguise. I would like to stop the roller coaster of my emotions here by simply being grateful. One day, when I close my eyes, I would love the memories with Epoch to roll in the cassette of my life. 

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To Epoch, a cassette of my life

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I want to share my unique professional journey with you. Personally, I have been someone who is always up for trying new things.

In August 2014, after completing my training as a General Duty Assistant, I got placed at Epoch Elder Care as a care attendant.  Even though I had prior care training, being a care attendant in an assisted living home was new for me and there was much to learn, especially about dementia care. At Epoch, everyone is encouraged to ask questions whenever they do not understand, your colleagues and seniors will answer them patiently and help you understand your issues. I realised how tough life can be with dementia and at Epoch I was able to increase the quality of life of elders with dementia and this was very satisfactory for me. 

Given my inclination to try new roles, back in 2018, I was chosen for the role of Admin Assistant which was a huge change for me professionally as I was moving from  care to an administrative role. With much support of senior colleagues, I was able to manage this role with confidence. Here I learnt new skills like vendor management, maintenance planning, and working with multiple departments. Being an ex-care attendant, I was able to understand the importance of this role where I had to ensure the upkeep of Epoch homes and how crucial it was for our care attendants to take care of our residents. Iss dauran maine apni life ko bahut hadd tak personally, professionally and financially grow bhi kiya hai (During this time, I was able to grow personally, professionally and financially). 

Then in January 2020, I saw an opportunity to move to a new role within Epoch as a Human Resource (HR) assistant and I confidently took the leap. Given my prior experience as a care attendant, I was quickly able to connect to prospective candidates for Care Attendant role and understand who could be a good fit at Epoch, and I learnt the aspect of people management. Ab dedication and guidance of my manager and colleagues ke sath grow kar raha hun or hope aage bhi yun hi grow karta rahunga. (With the dedication and guidance of my manager and colleagues, I am learning & growing  ,and will continue doing so!)

Thanks to Epoch, I have been able to understand this industry well and grow myself professionally in many different perspectives by gaining many new skills.

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Trying new roles and gaining new skills at Epoch

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I want to share my journey so far with Epoch Elder Care. I started my journey as a care attendant with Epoch’s Monet house at Pune location on 15th May 2016 and sab kuch naya tha mere liye (everything was new to me). It was a great year well spent at Monet house; and bohot kuch sikhne ko mila (great learnings came along). Under the guidance of our Facility Managers and Facility Nurses and other care attendants, I was properly trained to look after our residents. Epoch work culture bohot welcoming and unique tha mere liye (Epoch culture was welcoming and unique for me) - where the team was great & they treated me like a family member. Not only this, the relationship and bond I developed with residents was an amazing feeling. The concept of dementia and its management was something jo mujhe dhire dhire samajh aya. (The concept of dementia and its management was something I learned over a period of time).

After the completion of one year, the management decided to transfer me to Epoch’s other home (Vermeer House) in Gurugram. I was happy with the decision for two reasons. Firstly, my learning was about to expand and secondly, my hometown was nearby. After working as a care attendant for a year and a half at the Vermeer House, the management decided to promote me to the role of Head Care Attendant. Finally, my dedication & honesty paid off. My responsibilities increased and I had to oversee all errands related to our residents, other care team members, and the house overall, which I enjoyed throughout.

Then again on 1st May 2019, I was offered a role change based on my skills and eagerness to work. This time the management decided to offer me the role of Admin Assistant, which I accepted confidently. It was challenging at first, but with the constant guidance of the then corporate team, I managed with quite ease.

Epoch has not only helped me professionally but also personally. It is here that I met Sarita (Care Attendant at Vermeer House), married her and started another chapter of my life. She is always there to support & motivate me. 

During the outbreak of COVID-19, around Feb 2020, I was handed over the role & responsibilities of an Office Assistant in the new Vermeer house at Gurgaon. Covid ke first wave me hume bohot kuch naya experience karne ko and samajhne ko mila. Ye time humare liye bohot difficult tha but hum sabne milkar Epoch and ek doosre ko sambhala. (New learnings came along whilst managing and experiencing the first wave of coronavirus. It was a difficult time, but we managed to pull through). I was presented with the COVID warrior award. Epoch ke saath ab itne memories jud gaye hain ki yahan har koi apna sa lagta hai. 

Epoch me hamesha kuch na kuch naya sikhne ko and samajhne ko milta hi hai and mere liye bohot unique experience banta raha hai.

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My journey of multiple roles at Epoch

Diabetes and dementia are two prevalent health conditions that have been the focus of extensive research in recent years. While each condition has its own distinct characteristics, emerging evidence suggests a strong correlation between diabetes and an increased risk of developing dementia.

The Correlation Between Diabetes and Dementia: Unraveling the Intricate Connection

Anju Bobin , Head - Learning & Quality

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