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purple ribbon for the world alzheimers day

The Weather of Alzheimer’s

When you are organizing an event, say, the Tacoma South Sound Alzheimer’s Walk, there can be an illusion that all moving parts are in your control, leaving you thinking: this event will be successful/fantastic/memorable (insert your favorite adjective here) so long as I check off all items on my to-do list.

We could view life as an event. The event. So the narrative goes, as long as I check-off all of the items: be respectful, do good, establish a career and so on, then I will be successful or (insert your favorite adjective here).

In today’s early Autumn event, there is at least one piece that remained uncheckable. The weather.

The weather, with all of its unknowns and impulsivity is similar to a diagnosis of Alzheimer’s.

During a two-hour period of time, 11 a.m. to 1 p.m., there was as much variation in the sky as there were people populating Todd Field, at the University of Puget Sound.

The sky was a solid sheet of arctic blue separated only by two main air streams. Within a matter of minutes, the sky shifted to an admiral blue populated by picture-book clouds and rays of sunshine. The imperceptible breeze shifted to barely detectable rain droplets.

A mildly warm autumn afternoon became disguised by a frigid rain storm too gusty even for an umbrella. In between the dramatic changes were the smaller ones too, warm became cold when some cumulus clouds blocked the now feeble sun, rain became stinging stones.

Miniature purple cowbells chimed. Pieces of synthetic orange, yellow and purple flower petals swirled in the air and decorated sidewalks. Bubbles were attempting to be blown from wands. Umbrellas flipped inside out. The announcer suggested over the loud speaker: 1-milers to the left and 2-milers to the right. Do I go left or right? Make a decision.

In the early stages of diagnosis, one may be hesitant or resistant to know more about Alzheimer’s.

For a moment, wicked freezing wind and sharp sideways rains, laughter, then silence.

You may feel anger toward or shame about a diagnosis.

Drop. Drop. Drop. The rain seems to be subsiding.

When you process new information about your diagnosis it is important to do so at your own pace – one that feels comfortable for you.

Round the corner and the sun shone.

Knowing more about Alzheimer’s can reduce the stigma and increase one’s confidence.

The sun shined and the sky lit up blue – presenting shades ranging from sapphire to cobalt to indigo. And then there were beeping cars like flashes of thoughts. Skies shifted across the gray spectrum from cinder block to pewter to forged iron much like the emotional processing of how one can feel so alone.

Then there were straight away streets, friendly faces and familiar feelings in an oh so unfamiliar state of being.

Experiences with Alzheimer’s, unlike the weather, is a checkable item.

Underneath the unknowns there is comfort in knowing and deliberate calm wrapped around impulsivity.


Adrienne Ione is a dynamic, mindful, high-fiving, cognitive behavioral therapist, certified dementia specialist and senior personal trainer. Founder of Silver Linings Integrative Health, a company with an aim of promoting health, fitness and wellbeing opportunities for people to thrive across the lifespan.

brain

Neuroplasticity and the Aging Brain

One of the greatest concerns for the aging population is cognitive decline which leads to loss of independence as well as an extreme burden on the caretakers.  Individuals worldwide are fearful of being diagnosed with any of the various cognitive issues: Dementia, Parkinson’s, Alzheimer’s, and other forms of cognitive debilities.  In 2015 there was an estimated 47 million people living with dementia and this number is expected to triple by 2050.  In 2014, the Alzheimer’s Association reported that they believe there is sufficient evidence to support the link between several modifiable risk factors and a reduced risk for cognitive decline and sufficient evidence to suggest that some modifiable risk factors may be associated with reduced risk of dementia. Specifically, that regular physical activity and management of cardiovascular risk factors (diabetes, obesity, smoking, and hypertension) reduce the risk of cognitive decline and may reduce the risk of dementia. The Association also believes there is sufficiently strong evidence to conclude that a healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive decline.

Positive association between aerobic exercise or CV fitness and executive functions is highly consistent but cannot determine causality.  Aerobic exercise (AE) has shown moderate to medium sized effects on executive function and memory. Resistance Training (RT) has improved executive function and memory. Combined AE and RT has the biggest (potentially synergistic) effect. It has been proposed that the physical and cognitive exercise might interact to induce larger functional benefits.  Larger benefits on cognitive test performance were noted for combined physical and cognitive activity than for each activity alone.  “Claims promoting brain games are frequently exaggerated and at times misleading. … To date, there is little evidence that playing brain games improves underlying broad cognitive abilities, or that it enables one to better navigate a complex realm of everyday life (Consensus statement, 2014).

Neuroplasticity is the brain’s ability to reorganize and rebuild itself by forming new neural connections. The more neural pathways you have, the more resilient your brain is. Neurogenesis is the process of creating new neurons (brain cells).

Contrary to popular belief, neurogenesis continuously occurs in the adult brain under the right conditions such as with exercise.  Substantial benefits on cognitive test performance were noted for combined physical and cognitive activity than for each activity alone. It was also noted that the physical and cognitive exercise together might interact to induce larger functional benefits.  “We assume, that physical exercise increases the potential for neurogenesis and synaptogenesis while cognitive exercise guides it to induce positive plastic change” (Bamidis, 2014).  To maximize cognitive improvement, combine physical exercise with cognitive challenges in a rich sensorimotor environment that includes social interaction and a heaping dose of fun.

Brain health is becoming extremely important as individuals live longer.  Today there is much more information available on how to train the aging brain.  Three great resources are:


Dianne McCaughey Ph.D. is an award winning fitness specialist with more than 35 years experience in personal training, group exercise, coaching, and post-rehabilitation. She is a master trainer for multiple companies and practices and teaches optimal wellness emphasizing the mind, body and spirit. She works with special populations and focuses on posture, gait, balance and corrective exercise programs for better function and health.

Cody Sipe, PhD, has an extensive background in the fitness industry with 20 years of experience as a personal trainer, fitness instructor, program director, exercise physiologist and club owner. He is currently an Associate Professor and Director of Clinical Research in the physical therapy program at Harding University. He is the co-founder and vice president of the Functional Aging Institute (FAI).

 

senior-exercise-trainer

Exercise and Dementia: Thinking Differently about Thinking

Many people are aware of the devastating effects dementia and Alzheimer’s disease (AD) has on families. I know this devastation personally, as my mother suffers from advanced stages of AD. It is very sad to have only the body present of someone you have known and loved your whole life! This article will discuss some of the newer developments in understanding and possibly reducing the disease, as well as the positive role exercise may have in slowing the onset and development of symptoms, and disabilities for any form of dementia.

The impact on family units and caretakers is even greater and can’t be measured by financial impact. Dementia is a group of symptoms that affect mental tasks like memory and reasoning. Dementia can be caused by a variety of conditions, the most common of which is Alzheimer’s disease. Alzheimer’s disease accounts for 60 to 80 percent of dementia cases (http://www.alz.org). Much of the recent attention to professional football players and the repeated brain trauma is due to the increased incidence of dementia, not Alzheimer’s. Dementia is characterized by loss of memory, intellectual capabilities and executive functions.

Alzheimer Concept.According to the Alzheimer’s Association, in 2015, 5.3 million Americans are believed to have this incurable disease. The cost of Alzheimer’s to the U.S. is $226 billion, and this figure is estimated to more than quadruple to $1.1 trillion by 2050 unless some major discoveries are made. It is the 6th leading cause of death behind heart disease, strokes, and cancer but it is the only one that cannot be prevented. One in three seniors will die with some form of dementia. Alzheimer’s is far more prevalent in women, with about 3.2 of the 5.1 million people, or 2/3rds, being women. The Baby boomer generation should cause the number of those affected to swell to 7 million, which may double by 2050. (http://www.alz.org/facts/overview.asp).

Factors Associated with Alzheimer’s Disease

While no one really knows exactly what causes Alzheimer’s disease (AD), there are several factors that are highly associated with it, and even some treatments that seem to slow its progression and onset. The two most prominent factors associated with AD are age and family history.

After age 65, the risk of Alzheimer’s doubles every five years. After age 85, the risk reaches nearly 50 percent. A type of AD is known as early onset or younger onset. This term actually is used for two types, a risk and deterministic form. Both may start in someone’s 30s or 40s and if someone has the gene it is 100%. This “determined” form is rare, accounting for only 5% of the total cases. Research has shown that those who have a parent, brother, sister or child with Alzheimer’s are more likely to develop the disease. The risk increases if more than one family member has the illness.

Biomarkers of Alzheimer’s Disease

  1. APOE genes
  2. Neuro-tangles associated with the Tau protein
  3. Beta amyloid plaques- a protein clump found in the brain- disrupting communication
  4. Inflammation
  5. Decreased brain size

(http://www.alz.org/research/science/alzheimers_research.asp)

When diseases tend to run in families, either heredity (genetics) or environmental factors, or both, may play a role. There are two categories of genes influencing a person developing a disease: risk genes and deterministic genes, both of which are present in Alzheimer’s disease.

Risk genes increase the likelihood of developing a disease, but do not guarantee it will happen. Researchers have found several genes that increase the risk of Alzheimer’s.  Apolipoprotein (APOE)-e4 is the first risk gene identified, and has the strongest impact on disease risk. APOE-e4 is one of three common forms of the APOE gene; the others are APOE-e2 and APOE-e3.

Those who inherit one copy of APOE-e4 have an increased risk of developing Alzheimer’s and those with two copies have an even higher risk, but still not a certainty. In addition to raising risk, APOE-e4 may tend to make symptoms appear at a younger age than usual (early onset). Scientists estimate that APOE-e4 is implicated in about 20 to 25% of Alzheimer’s cases.

Brain Size and Function

We often associate brain size with cognitive capacities and for the most part this relationship holds true. While it is very difficult to measure any increase in mass due to neuroplasticity, we can measure increase activity in the brain due to exercise, or decreased activity from AD and other dementias.

How can Exercise and Diet Help

senior-exercise-trainerIt is important to understand some of the limitations of exercise and diet in helping either dementia or AD. First of all, one must separate non-Alzheimer’s dementia from Alzheimer’s, and then must understand what stage of AD the individual is in. Finally, one must realize if the symptoms have already manifested (onset), and then monitoring the progression.

Exercise has a more pronounced effect on helping decrease progression and even reversing some symptoms with non-Alzheimer’s dementia.  In addition, the earlier someone is able to perform preventative actions, the greater the effect those therapeutic actions will have. Exercises that really activate the brain such as dance, yoga, and new sports or techniques are the best for prevention.

By exercising regularly throughout your life you will lower your incidence of getting Alzheimer’s by 50% and by doing mental exercises with the physical exercises may lower your chances by 70%! This reduction would not apply to those with deterministic genes but it would for others.  Some researchers believe exercise can both delay onset and reduce symptom severity no matter what the cause.

Aerobic exercise in particular causes a release of brain derived neurotropic factor, which has been labeled as “Miracle Gro for the Brain” by the author of SPARK, John Ratey, M.D. In addition, aerobic exercise causes some angiogenesis or the development of additional circulation to the brain. When the brain cells receive more blood, they get more oxygen, and thus function better.

Other side benefits of exercise are the muscle strengthening and enhanced balance and activation of postural muscles. Many Alzheimer’s patients will be at risk for falls and disturbed gait patterns. A consistent exercise program can delay and slow these issues even in somewhat advanced stages.

The dosage is the same as that for the general public or 150 minutes of moderate activity a week. It is important not to push an Alzheimer’s patient into exercise. Many AD victims can become agitated quite quickly and the stress is unwarranted. Simply walking is the best exercise. Make sure the walking path is smooth and not filled with obstructions or difficult terrain.

In an article from Science News, “Walking slows progression of Alzheimer’s”, Cyrus Raji, Ph.D., from the Department of Radiology at the University of Pittsburgh in Pennsylvania, mentions, “We found that walking five miles per week protects the brain structure over 10 years in people with Alzheimer’s and MCI, especially in areas of the brain’s key memory and learning centers. We also found that these people had a slower decline in memory loss over five years. 

The type and magnitude of exercise needs to be carefully monitored with advancing Alzheimer’s or dementia but in those with mild cognitive impairment, a “healthy dose” of both resistance and aerobic exercise is advocated.


Dr. Mark Kelly Ph.D., CSCS, FAS, CPT has been actively involved in the fitness industry spanning 30 years as a teacher of exercise physiology at academic institutions such as California State University, Fullerton, Louisiana State University, Health Science Center, Tulane University and Biola. He was an exercise physiologist for the American Council on Exercise, a corporate wellness director, boot camp company owner and master fitness trainer.

park-walk-biking

Heart-brain connection: Fitness now protects your brain in your 70s and 80s

Stay fit today; avoid dementia tomorrow

It’s well-known exercise plays a vital role in your physical health, and now studies propose staying fit in midlife may protect your brain as well, avoiding mental deteriation in later years.

A new study, published in Neurology, that followed Swedish women for more than 40 years,  suggests one’s level of physical fitness predicts the amount of protection from dementia decades later.1

Swedish dementia/exercise study began 50 years ago

At the onset of the study in 1968, 191 Swedish women ranging in age from 38 to 60 took part in a vigorous stationary cycling test to measure their exercise work capacity. Based on work capacity, women were split into low, medium, and high fitness categories. The women were followed from 1968 to 2012, and dementia diagnoses were recorded.

The measurement of exercise capacity is an important aspect of the strength of this study –  it was based on the participants’ actual performance rather than relying on participants’ subjective reports of how much, how vigorously, and how often they exercised.

Strong association between fitness and likelihood of dementia decades later

Dementia incidence correlated with fitness level, the greater the fitness level, the less the dementia: 32 percent, 25 percent, and 5 percent of women developed dementia in the low, medium, and high fitness groups, respectively.1 This particular study is one of the longest, following participants for up to 44 years, but shorter studies have come to similar conclusions.2-4

Another very interesting finding: in the subset of women whose initial exercise tests had to be stopped because of issues such as excessively high blood pressure, chest pain, or an abnormal EKG change, almost half (nine out of twenty women) developed dementia. Fit women who did develop dementia did so much later in life. Among the five percent of fit women who eventually developed dementia, the average age of development of dementia was eleven years later compared to the medium fitness group – age 90 vs. 79 – an extra eleven years of dementia-free life.

Midlife fitness also linked to brain volume 19 years later

In another study, the effects of midlife physical fitness on the brain were visualized with MRI. Participants at an average age of 40 performed a treadmill test to determine their exercise capacity. Lower exercise capacity at midlife was associated with smaller total cerebral brain volume 19 years later, suggesting having a higher fitness level helps prevent brain shrinkage with age.5

Diet determines your propensity for fitness

Important to note, one’s fitness level is strongly linked to what you eat.  People who are overweight  as well as those who don’t eat healthfully, do  not have the will, energy or capacity for regular exercise.  When you eat right, you’re more likely to get fit; when you don’t eat right it is very difficult to get fit.

A nutrient-dense, plant-rich diet (Nutritarian) is the most critical determinant influencing whether one gets dementia or not.  When you eat right  you automatically crave exercise and it becomes pleasurable to do so.

This study also demonstrates the wide variety of health benefits, including reduced risk of cardiovascular disease and several cancers when you get fit. Mixing together nutritional excellence and exercise is when the magic happens to protect yourself from the common diseases of aging.  Exercise offers additional benefits to cardiovascular health and insulin sensitivity, as well as some direct effects in the brain, such as the release of protective compounds called neurotrophins.6,7

At any age, fitness is vital for your present and future brain health.

It is never too late to start exercising and you are never too old. Studies have documented cognitive benefits from exercise (strength training and aerobic training) in all age groups, from children to the elderly.6-9  Today is the day to make sure you do both; eat right and get fit.

Originally printed on DrFuhrman.com. Reprinted with permission.


Joel Fuhrman, M.D. is a board-certified family physician, six-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient dense, plant-rich eating style.
 
For over 25 years, Dr. Fuhrman has shown that it is possible to achieve sustainable weight loss and reverse heart disease, diabetes and many other illnesses using smart nutrition. In his medical practice, and through his books and PBS television specials, he continues to bring this life-saving message to hundreds of thousands of people around the world.

References

  1. Horder H, Johansson L, Guo X, et al. Midlife cardiovascular fitness and dementia: A 44-year longitudinal population study in women. Neurology 2018.
  2. Defina LF, Willis BL, Radford NB, et al. The association between midlife cardiorespiratory fitness levels and later-life dementia: a cohort study. Ann Intern Med 2013, 158:162-168.
  3. Liu R, Sui X, Laditka JN, et al. Cardiorespiratory fitness as a predictor of dementia mortality in men and women. Med Sci Sports Exerc 2012, 44:253-259.
  4. Willis BL, Gao A, Leonard D, et al. Midlife fitness and the development of chronic conditions in later life. Arch Intern Med 2012, 172:1333-1340.
  5. Spartano NL, Himali JJ, Beiser AS, et al. Midlife exercise blood pressure, heart rate, and fitness relate to brain volume 2 decades later. Neurology 2016, 86:1313-1319.
  6. Kandola A, Hendrikse J, Lucassen PJ, Yucel M. Aerobic Exercise as a Tool to Improve Hippocampal Plasticity and Function in Humans: Practical Implications for Mental Health Treatment. Front Hum Neurosci 2016, 10:373.
  7. Kirk-Sanchez NJ, McGough EL. Physical exercise and cognitive performance in the elderly: current perspectives. Clin Interv Aging 2014, 9:51-62.
  8. Fiatarone Singh MA, Gates N, Saigal N, et al. The Study of Mental and Resistance Training (SMART) study-resistance training and/or cognitive training in mild cognitive impairment: a randomized, double-blind, double-sham controlled trial. J Am Med Dir Assoc 2014, 15:873-880.
  9. Mavros Y, Gates N, Wilson GC, et al. Mediation of Cognitive Function Improvements by Strength Gains After Resistance Training in Older Adults with Mild Cognitive Impairment: Outcomes of the Study of Mental and Resistance Training. J Am Geriatr Soc 2016.
Alzheimer Concept.

Alzheimer’s Disease, Fitness and Exercise

Alzheimer’s Disease (AD) is a neurodegenerative disease that strikes fear and terror into those who are getting on in years and family members who are in line to care for them. According to the Alzheimer’s Disease Foundation, in 2015 it is estimated that 5.3 million Americans have the disease. It is the 6th leading cause of death behind heart disease, strokes, and cancer but it is the only one that cannot be prevented (1) although some experts now estimate that it may be the third highest (2).

Health Coaching Support for Alzheimer’s Patients and Caregivers

Alzheimer Concept.The emotional journey of facing a diagnosis such as Alzheimer’s disease or dementia can be overwhelming for both the patient and their families. Feelings of fear, stress, anxiety and loss can overpower all individuals involved and the ability to have questions answered is essential to easing these emotions.

Although there are a multitude of support groups available through local community organizations, access, availability, and comfort level of participating in a group setting can all be barriers to participation. A health coach can be a crucial lifeline to supporting the needs of both the family and the patient.  Health coaching services can be made available either 1:1 with the patient, loved one or as a family in which everyone is able to process many common issues facing Alzheimer’s patients.

This can include but are not limited to:

  • Understanding and adjusting to the diagnosis
  • Future care plans/options
  • Medical options and support resources
  • Managing symptoms and keeping loved one’s safe
  • Caregiver balance and managing one’s own health needs
  • Financial planning for support and medical management

A health coach does not necessarily need to be an expert in Alzheimer’s disease per se, but rather, have the ability to connect their client to professional, expert resources in their area. Their common goal is to navigate the needs and connect families to trusted experts that can create a network of safety and security throughout the progression of the disease. The supportive ear of a trained health coach can be enough to provide assurance that help is available and neither the patient nor the caregiver(s) are alone in this journey. Often the health coach is available to meet in convenient settings (including in-home or telephonically) as they realize that transportation can be a barrier to accessing resources.

In addition to care navigation, the health coach can connect the family to therapeutic resources such as exercise facilities, memory classes, and social support systems that can contribute to overall quality of life and management of symptoms. Their expert advice can help to remove burdensome details and guide the process in a meaningful, manageable way whereby the caregiver and patient are able to focus on enjoying their time together.


Jaclyn Chadbourne, MA is a Clinical Exercise Physiologist and Principal, Director of Research and Development – ‎Universal Medical Technology, LLC and United Medical Gym, Inc in South Portland, ME. With a passion for sustainable healthy living and desire to advocate for patient-centered care, Jaclyn works to help support community resources for all special populations and to implement and oversee clinical protocols. 

Senior Man On Cross Trainer In Gym

Where to Begin When You Are Working Out With a Health Condition

The gym can be a confusing place especially for individuals with health concerns. Many times, these clients are trying to navigate their workouts by themselves because they are unsure of the appropriate questions that they need to ask.

First of all, there are two different types of trainers. There are trainers who have a four year degree and certifications. These trainers are sometimes called Fitness Specialists and have had many hours of study related to a wide variety of diseases and injuries. They are used to modifying exercises and programs based on any specific condition you may have. Fitness Specialists are usually found in a medically based fitness facility affiliated with a hospital. Please note that some Fitness Specialist’s will specialize in a certain area. Some work with individuals with diseases and disabilities and some don’t.

Personal Trainer, Gym, Pull Down Machine, Exercising, AssistanceWhen you finally narrow down who you might like to hire you will want to ask some questions. Please don’t be afraid to ask these questions as they will help you to decide which trainer is right for you. It is also recommended that you observe Fitness Specialists training clients.

First you want to make sure that the trainer has had experience with your condition. If not, they should be willing to research it and or speak with your doctor with your permission. There are exercise guidelines that all Fitness Specialists should follow when working with clients who have health conditions.

You will also want to ask about the trainers background. It is alright to ask about education, certifications, and years of experience. You also want to hire someone who is patient with you. This is extremely important as you figure out which exercises work best for your body. I would also like to add that you need to be patient with yourself as well. Try to relax and enjoy your training session.

Asking the questions from above help to keep you feeling confident. Exercise can seem frustrating in the beginning but you have to keep a positive mindset. In the beginning, set small goals and do the best you can during each training session.


Robyn Caruso is the Founder of The Stress Management Institute for Health and Fitness Professionals. She has 15 years of experience in medical based fitness.

brain food

Strategies to Enhance Cognitive Fitness

Often when we hear the term “fitness” – we automatically think of our physical health. Being mentally fit is equally as important. Cognitive fitness is a state of optimized ability to reason, remember, learn, plan and adapt that is enhanced by certain attitudes, lifestyle choices, and exercises. Better cognitive fitness translates into the ability to make better decisions, solve problems, and deal with stress and change. Neurogenesis is the process of developing new chemical messengers called neurons in the brain. This process can be profoundly affected by how you live your life. Here are eight strategies to help you facilitate the process of neurogenesis and have optimal cognitive functioning:

Daily Physical Activity: Aerobic activity for 30 minutes, three times per week helps improve brain blood flow and enhances memory performance. Regular exercise also releases brain chemicals called endorphins which reduce feelings of depression.

Be Open to New Experiences: Have you ever wanted to learn to play golf or sing in a choir? Participating in experiences that are unfamiliar and mentally challenging will strengthen neural connections in your brain.

Be Curious and Creative: Participating in arts and crafts projects leads to innovative thinking, and musical training may improve function and connectivity of different brain regions. It’s always a great time to take up painting, poetry, or piano!

Develop Meaningful Relationships: Studies have shown that the health consequences of feeling lonely can trigger psychological and cognitive decline – as well as alter immune cells and increase feelings of depression. Make every effort to engage with other people whenever possible.

Get Enough Sleep: Healthy sleep consolidates learning and memory and is necessary for clear thinking and optimal brain function. It is easier to sleep well in a peaceful and natural environment free of clutter.

Reduce Chronic Stress: Chronic stress produces a hormone called cortisol that can damage the brain. Chronic stress can also trigger long-term changes in brain structure that can lead to cognitive decline. Healthy ways to relieve stress include deep breathing, physical exercise, or talking with a trusted friend or family member.

Eat Specific Healthy Foods: Food plays a vital role in the health and proper functioning of the brain. Strive to eat real, whole foods such as fruit, vegetables, whole grains and lean meats – and drink eight 8oz bottles of water each day to keep brain cells hydrated. Apples, avocados, blueberries, unsalted nuts, broccoli and brown rice are great food choices for brain health.

Regular Learning: Continual learning is one of simplest methods to boost brain function. The size and structure of neurons and the connections between them actually change as you learn. Learning can include studying a new subject, travelling to a different place, learning a foreign language or participating in a new volunteer activity.

Practicing these strategies along with having a positive attitude will not only enhance your cognitive fitness, but also your quality of life!


Carisa Campanella, BA, AS, is an ACE Health Coach and ACSM Personal Trainer. She is the Program Manager at the Neuro Challenge Foundation for Parkinson’s. Neuro Challenge provides ongoing monthly support groups and educational programs, individualized care advising and community resource referrals to help empower people with Parkinson’s and their caregivers.