Aging in Place Planning: Groundbreaking Study- Take Charge of Your Cognitive Health with Simple Lifestyle Changes

As we age, the risk of stroke, dementia, and late-life depression threaten our independence, decision-making, and financial health. The consequences of these conditions threaten our families with burden, cost, and concern. These conditions change how we live, make decisions, and plan for the future. But here’s the good news: a groundbreaking new study from Mass General Brigham, widely covered by CNN, The New York Times, and Fox News, suggests that simple everyday steps can lower our risks.

By making small changes now, we can protect our brains, stay independent longer, and make life easier for ourselves and our loved ones. From the perspectives of estate planning, elder law, and aging in place planning, the findings offer critical insights into preventive health strategies that can enhance quality of life, reduce care giving burdens, and inform legal and financial preparations for aging. This article dives into what the study found, why it matters for planning your future, and how you can start today.

What the Study Says

The Mass General Brigham study, looked at tons of research to identify 17  modifiable risk factors shared by stroke, dementia, and late-life depression (LLD), things we can change to lower our chances of suffering from these conditions. These aren’t complicated medical fixes—they’re things like eating better, staying active, or even spending more time with friends. 

High blood pressure and kidney problems have the most profound impact, but staying active and keeping your brain engaged can make a significant difference in cutting your risk. The study found that improving just one of these areas—like going for regular walks—can help protect against all three conditions. They even created a tool called the Brain Care Score to help you track your progress. For example, boosting your score by 5 points could cut your risk by 27% over 13 years. That’s something to get excited about!

The reason that the study is groundbreaking is that these conditions, which contribute significantly to stroke, dementia and depression, share vascular and small vessel pathologies, making their overlapping risk factors critical. The 17 modifiable risk factors common to at least two of the three diseases are: blood pressure, kidney disease, fasting plasma glucose, total cholesterol, alcohol use, diet, hearing loss, pain, physical activity, purpose in life, sleep, smoking, social engagement, stress, body mass index (BMI), leisure time cognitive activity, and depressive symptoms. Among these, high blood pressure (hypertension ≥ 140/90 mm Hg) and severe kidney disease (estimated glomerular filtration rate < 30 mL/min/1.73 m²) had the greatest impact on disease incidence and burden, while physical activity and cognitive leisure activities were associated with the most significant risk reduction. The interconnected nature of these risk factors means that improving one—such as increasing physical activity—can positively impact others, like blood pressure, sleep, and social engagement.

Why This Matters for You and Your Family- Aging in Place, Estate Planning and Elderlaw Implications

As we get older, we want to stay in control of our lives—living in our own homes, making our own choices, and not leaning too heavily on our kids or loved ones. Stroke, dementia, and depression can make that harder, affecting everything from your health to your finances. This study gives us a roadmap to fight back, and it’s especially important if you’re thinking about aging in place, planning your estate, or  protecting your future.

Staying in Your Home (Aging in Place): Most of us want to stay in our own homes as we age,  surrounded by our friends, family, memories, and comfort. This study says you can make that more likely by moving your body, sleeping well, and managing stress. Here’s how to make your home work for you:

• Make It Health-Friendly: Add a place for stretching, a blood pressure cuff, or even smart lights to help you sleep better. These little changes support the habits the study recommends.  

• Fix Hearing Loss Early: Your home should not be a prison. Untreated hearing loss can make you feel isolated and raise your dementia risk. It makes you less likely to leave your home, and more likely to isolate. Get a check-up—it’s a small step with big payoffs.

• Get Family/Friends Involved: Ask your kids or grandkids to join you for walks or game nights. Invite friends over for a sports event or movie. It's fun, keeps you social, and lowers your risk of depression.  

• Use Tech: Set up reminders on your phone for meds or try a sleep-tracking or exercise app to stick with healthy habits.  Schedule Zoom or Facetime calls with families and friends to talk. Consider my article regarding the use of technology to reduce dementia risk and age in place.

Planning for Your Future (Estate Planning): Nobody wants to think about losing the ability to make decisions, but stroke or dementia can make that a reality. By taking steps like managing your blood pressure or quitting smoking, you can keep your mind sharp longer, which means you’re more likely to stay in charge of your money, your home, and your care. Here’s how you can plan smarter:

• Set Up a Routine Healthcare Plan: Work with a doctor, physicians assistant, personal trainer, deploy an online health app, and/or work with family and friends to improve your health, increase activity, and spend more active and engaging time with family and friends.  Design these around things you already enjoy or like.  Set goals, and work towards them to create a routine. 

• Advance Directives: Engage a lawyer to create a healthcare proxy and living will that says what you want if you become sick. Avoid simple minimalist forms, and actually state your intentions regarding long-term care (e.g., "if I need care I want it to be in my home," or "I do not want to burden my children financially, but hope they will provide time and support when needed").  Mention your current routines and plans (e.g., "monitor my blood pressure a few time a day," or "continue my selected supplements as they have demonstrated success" or I might qualify for Aid and Attendance because your father was a wartime vet, talk to the VA if I need help at home"). 

• Pick Someone You Trust: Choose a family member or friend to handle your finances and/or health decisions if you can’t. Make sure they know your goals, like staying healthy to avoid nursing homes and direct them to take advantage of your existing plan (e.g., if my Medicare benefit runs out, use my MA plan's "hospital at home" benefit, or pay for home care using my long-term insurance policy/short- term disability policy).   

• Deploy Trusts: Consider establishing trusts to fund healthcare needs, including home modifications or caregiver support, to facilitate aging in place, and/or to protect assets from long-term care spend down in the worst case.

• Save for Care: Set up a trust or savings to cover things like home modifications (think grab bars, ramps, a hospital bed at home, or a simple blood pressure monitor) so you can live independently longer.

• Financial and Insurance Planning: Consider aging in place planning when making other financial, insurance, or investment decisions. Consider, for example a Medicare Advantage Plan with home health care benefits, or a life insurance policy that is convertible to lifetime long-term care benefits.

Protecting Your Rights (Elder Law):  Elder law is fundamentally about making sure you’re taken care of as you age, whether that’s qualifying for Medicaid or finding community support. This study shows that simple changes—like joining a book club or getting your hearing checked—can keep you healthier, which means less stress on your wallet and your family. Here’s what you can do:  

• Stay Social: Loneliness can lead to depression, so find a local senior center or volunteer opportunity to stay connected. It’s good for your brain and your mood.  More, it protects your decision-making by providing interactions with people who know you and can alert you or your family if there are changes and/or help you if a predator or scammer attempts to take advantage of you.

• Plan for Medicaid: If you’re worried about long-term care costs, talk to an elder law attorney about protecting your savings while staying healthy to delay those costs.  

• Guardianship Protection: Implement a plan to protect you and your assets from guardianship.  Even a simple revocable trust can, in many states, be crafted to remove or frustrate guardianship control of the trust assets.

Easy Steps to Start Today

The study calls these 17 factors a “menu of options,” meaning you don’t have to do everything—just pick what works for you. Here are some ideas to get going: 

1. Check Your Blood Pressure: Get a home monitor and aim for under 120/80. Cut back on salty snacks, eat more fruits, and talk to your doctor if you think you need meds.  
2. Move More: Walk around the block, try chair exercises, or join a local tai chi class. It helps your heart, brain, and even your mood.  
3. Quit Smoking: If you smoke, call a quitline or ask your doctor for help. It’s one of the best things you can do for your brain.  
4. Stay Connected: Call a friend, join a hobby group, or volunteer. Feeling connected keeps depression at bay, and keeps you active.  
5. Challenge Your Brain: Do crosswords, read a new book, or learn a skill like painting or a new technology or device. It’s fun and keeps your mind sharp. 
6. Sleep and De-Stress: Try a bedtime routine or a quick meditation app to relax. Good sleep and less stress are brain boosters.

The Brain Care Score is a great way to see how you’re doing—just answer questions about your habits, and it’ll show you where to focus. The study says they’re working on more ways to use this tool, so keep an eye out!

How They Did the Study (And Why It’s Solid)

The researchers looked at 182 big studies from 2000 to 2023, narrowing it down to 59 that really dug into what causes these conditions. They focused on things you can actually change, like how much you exercise or how you manage stress, and figured out which ones matter most. They then employed a statistical analysis to compare how much each factor affects your risk, so you know where to put your energy.

This approach is strong because it pulls together lots of research, not just one small study. But it’s not perfect—they might’ve missed some things specific to depression, for example, and they can’t say for sure that changing these habits causes less disease (it’s more like a strong hint). Still, it’s a reliable guide for making smart choices.

What Else We Learned (And Why People Are Talking)

This study’s a big deal because it shows you don’t need a magic pill to protect your brain—just small, doable changes. People are excited about it—CNN called it a “hopeful message,” and experts say it’s empowering to know we can take control. It’s also a wake-up call: with dementia cases expected to skyrocket and strokes hitting even younger folks, starting now is key. Plus, things like finding purpose or staying social remind us that aging well isn’t just about your body—it’s about your heart and soul too.

One cool takeaway? The study’s Brain Care Score is like a personal coach for your brain. It’s already helping people, and researchers want to test it more to make it even better. For now, it’s a simple way to see what you’re doing right and where you can improve.

Wrapping It Up

Growing older doesn’t have to mean losing your independence or worrying your family. The Mass General Brigham study shows that by making small changes you can lower your chances of stroke, dementia, and depression. That means more years in your own home, more control over your future, and less stress for everyone. Whether you’re planning your estate, talking to a lawyer, or just want to age on your terms, these steps are a powerful way to take charge and implement a plan. So grab a friend, take a walk, and start building a healthier, happier future today.

Pandemic Pets, Pet Companionship, and Estate Planning Considerations

Pet companionship took on new meaning and importance during the pandemic as lock-downs, quarantines, social distancing, and social isolation impacted nearly everyone. For many, life trapped in a home would be unbearable and unthinkable without pet companions.  This blog has previously discussed how important pets are to some, and how important it is to consider pets in estate planning. 

An unanticipated effect of the pandemic has been a surge in interest for fostering and adopting abandoned pets. Although unanticipated, this effect is not surprising given the lack of social human interaction during stay-at-home orders, and subsequent social distancing. Regardless, the renewed focus on pets and pet companionship is welcome and important. 

There are at least seven quantifiable benefits to pet owners, including aging owners and owners with special needs:

1. Reducing Isolation and Loneliness; 
2. Lowering Stress and Anxiety; 
3. Improving Fitness; 
4. Increasing Social Interaction and Connection to the Community;
5. Improving Cardiovascular Health; 
6. Reducing Depression Risk, and;
7. Providing Routine and a Sense of Purpose.

Isolation

Isolation and loneliness are among the considerations for those planning to age in place. Seniors and persons with disabilities may experience feelings of isolation and loneliness if they spend a lot of time at home, sometimes because they lack mobility, security, or just comfort leaving home.  Isolation and loneliness are major risk factors for depression and increase the risk of heart disease, arthritis, diabetes, and dementia. 

Experts at the Centers for Disease Control and Prevention (CDC) agree; pet companionship eases loneliness and isolation. 

Stress and Anxiety

Relieving feelings of loneliness and isolation are not the only emotional and mental health benefits of pet ownership.  Research has shown that simply petting a dog lowers the stress hormone cortisol , while the social interaction between people and their pets actually increases levels of the feel-good hormones oxytocin and serotonin.  Oxytocin is the same hormone that bonds mothers to babies.   A University of Utah study found that even spending time near a pet can reduce stress levels and nervousness. 

The companionship of a pet can be particularly beneficial for reducing anxiety for a persons with disabilities or impairments.  In fact, an astonishing 84 percent of post-traumatic stress disorder patients paired with a service dog reported a significant reduction in symptoms, and 40 percent were able to decrease their medications, according to a recent survey.

Fitness

A pet increases opportunities for exercise. A daily exercise routine and physical activity can improve mobility the ability to perform activities of daily living.  Shelter dogs have been used for animal-assisted therapies to encourage physical activity for residents of nursing homes and assisted living facilities. A study published in Clinical Nursing Research found that people who walked with shelter dogs were more likely to go for a walk than those who walked with a human companion and even walked faster and for longer distances! 

Community

Programs that allow residents of assisted living facilities to spend time with a pet encourage interaction among the residents and give them something to look forward to.  

Pet care offers opportunities for  interaction with others, such as vets, groomers, pet care retail staff, and other pet owners.  Most folks that serve in the pet care industry are, themselves, pet lovers, which creates a community that is naturally sharing, caring, and helpful.  Pet walkers often follow a regime which affords them  insight into the routine of other owners.  A pet owner may notice that another pet owner is suddenly absent, or might observe another owner struggling physically and offer help.  

Pets can help persons with autism improve social skills by facilitating social connections with others, inspiring the person to work harder on communication skills and teaching compassion.

Cardiovascular Health

According to the American Heart Association, pet ownership is associated with lower blood pressure and lower heart rate during mental stress. A University of Utah study found that just the presence of a companion dog is associated with lower cardiovascular responses during stress. The CDC lists decreased blood pressure and reduced cholesterol levels as two benefits of pet ownership. 

Depression

The Research Center for Human/Animal Interaction has found that dog owners are less likely to suffer  depression. Animal-assisted activities and therapy have been used successfully with patients struggling with depression, loneliness, and mental illness and can reduce the symptoms of depression. The effects are particularly apparent with seniors.

Purpose

Pet care invites structure and scheduling, establishing a beneficial routine, and lots of older adults who own a pet say that their pets provide a sense of purpose and help them enjoy life.

For more information how to incorporate pet care into your estate plan, consider the following article:  Ohio Pet Trusts.

Source: Rebecca H. Miller, Pandemic Pets and Pet Companionship: Seven Benefits/Considerations for Care Coordination and Estate Planning, Chambliss Law, May 5, 2021. 

Survey Suggests 64% of Residents Don't Leave Rooms to Socialize; More Report Profound Loneliness

Nearly two-thirds of nursing home residents do not leave their rooms to socialize anymore since the onset of the coronavirus pandemic, a new survey by healthcare research group Altarum has revealed.

In addition, more than 75% of residents said they have felt lonelier following the ban on visitors implemented by the Centers for Medicare & Medicaid Services (CMS) in mid-March. In September, the agency issued new guidance that laid a framework for providers to resume in-home visitation. The agency cited the emotional and physical toll that the bans had on residents as a reason for the move. 

The survey featured responses from more than 360 residents in 36 states. Findings also showed how much social interactions, both inside and outside nursing homes, have declined during the pandemic. 

Fifty-four (54%) percent of residents said they aren’t participating in any in-home organized activities, while just 13% said they’re eating their meals in the dining room. Prior to the pandemic, 86% of residents said they were participating in activities and nearly 70% were eating in the dining room. 

Additionally, it found that 93% of residents did not leave their nursing home in a given week for routine activities, like shopping or visiting family, since the public health crisis. That number was 42% before the pandemic. 

“Hearing an elder say they feel like they are in prison is heartbreaking. We need to change this,” said Sarah Slocum, co-director of Altarum’s Program to Improve Eldercare.

Strategies to reduce loneliness 

Many facilities have offered more video chats and phone calls for residents and families since the onset of the pandemic, which is a great strategy, but there’s more they can to reduce feelings of loneliness, according to aging expert psychologist Eleanor Feldman Barbera, Ph.D. 

She suggested providers increase their number of recreation staff, if possible, and offer more safely spaced activities for residents. Examples of those types of activities include mobile fishing carts and doorway bingo.

“Engaging the community with a letter writing campaign, photos of pets, etc., is another way to promote connection with people who might not otherwise be involved with the nursing home. It’s also a way of promoting the home to those in the community,” Barbera told McKnight’s Long-Term Care News. 

She also suggested that facilities “make good use of psychologists on the team.”

“They are one of the few staff members whose job it is to actually sit down and talk with the residents for an extended amount of time on a consistent basis. Multiple residents have commented to me during this period about how I’m the only one who visits them,” she said. 

“The psychologist can monitor their moods to be sure their depression isn’t worsening, increase the frequency of sessions, refer them to the psychiatrist for antidepressants if needed, request a compassionate care visit,” she added. 

Barbera noted that providers will likely be dealing with this current situation for “far too long,” which means facilities will have to be creative about how they facilitate visits. 

“Think heated outdoor areas or plexiglass partitions in a corner of the lobby,” she explained.

Source: Mcknight's Long-Term Care News.

Taking Trips Outside the Home can Help Prevent Depression in Older Adults

Click here to see the Facebook post with a link to the article. 

Click here to proceed directly to the Consumer Affairs article.

Spouses of Hospice Residents Less Likely to Become Depressed

Symptoms of depression are less common in the spouses of hospice residents when compared to families where hospice was not involved, a recent study suggests.  Investigators at Mount Sinai's Icahn School of Medicine in New York City studied data from a national survey and Medicare claims, and followed more than 1,000 surviving spouses of deceased patients who were over age 50. They found those whose spouses were in hospice for at least three days were less depressed, and the positive effect was more prominent a year after the death.

Although they could not correlate specific services with improvement of symptoms, hospice offered medical services, symptom management, spiritual counseling, social services and bereavement counseling.  These services are provided to patients and their immediate families.

Approximately 45% of terminally ill residents die while receiving hospice care in the U.S, more than a 20% increase from the past decade.

This was the first national study to examine the mental health of spouses of residents with all types of serious illnesses.  Prior studies focused mostly on cancer patients and their families.

Source: McKnight's