stroke

Absentmindedness can be an early warning sign of silent strokes

  • A small study found that older adults with white matter damage caused by silent strokes noticed poorer attention and distractability.

A study involving 54 older adults (55-80), who possessed at least one risk factor for a stroke, found that those with white matter damage caused by silent strokes reported poor attentiveness and being distracted more frequently on day-to-day tasks. Despite these complaints, about half of these people scored within the normal range on tests of attention and executive function.

It’s suggested that adults who notice that they frequently lose their train of thought or often become sidetracked may in fact be displaying early symptoms of cerebral small vessel disease.

"Silent" strokes are so-called because they don’t have obvious effects as seen with an overt stroke. Typically, they’re not diagnosed until the damage has accumulated to such an extent that effects are seen, or by chance through MRI scans.

https://www.eurekalert.org/pub_releases/2019-02/bcfg-apt020419.php

Reference: 

Dey, A. K., Stamenova, V., Bacopulos, A., Jeyakumar, N., Turner, G. R., Black, S. E., & Levine, B. (2019). Cognitive heterogeneity among community-dwelling older adults with cerebral small vessel disease. Neurobiology of Aging, 77, 183–193. https://doi.org/10.1016/j.neurobiolaging.2018.12.011

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Perivascular space size linked to cognitive impairment in older adults

  • Enlarged perivascular spaces have been linked to poorer processing speed and executive functioning in older adults.

Perivascular spaces are fluid-filled spaces around the cerebral small vessels, commonly seen on brain scans in older adults. They have been thought to be harmless, but a new study challenges this belief.

The study, which looked at older adults who have not yet developed dementia, showed that different markers of small vessel disease reflect distinct pathways of injury. Well-studied markers of small vessel disease include white matter hyperintensities, infarcts and microbleeds, and the most frequent associations in the study unsurprisingly linked white matter hyperintensities and cognition, including language, information processing speed, executive functioning and visuospatial skills.

Much more surprisingly, though, the next most frequent links were between enlarged perivascular spaces and information processing speed and executive functioning.

https://www.eurekalert.org/pub_releases/2019-03/vumc-sv032019.php

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The right diet may slow cognitive decline in stroke survivors

  • An observational study involving over 100 stroke survivors suggests the MIND diet may help substantially slow cognitive decline in those impaired by stroke.

A pilot study involving 106 participants of the Rush Memory and Aging Project who had experienced a stroke followed participants for an average of 5.9 years, testing their cognitive function and monitoring their eating habits using food journals. It was found that those whose diets scored highest on the MIND (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay) diet score had substantially slower rates of cognitive decline than those who scored lowest. The estimated effect of the diet remained strong even after taking into account participants' level of education and participation in cognitive and physical activities. Those who instead scored high on the Mediterranean or DASH diets did not show the same slower decline.

Both the Mediterranean and DASH diets have been shown to be protective against coronary artery disease and stroke, but this finding suggests the MIND diet is better for overall brain health.

The MIND diet is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. It has 15 components: 10 “brain-healthy food groups” and five unhealthy groups (red meat, butter, cheese, pastries and sweets, and fried or fast food).

To adhere to the MIND diet, you need to

  • eat at least three daily servings of whole grains
  • eat a green leafy vegetable and one other vegetable every day
  • drink a regular glass of wine
  • snack most days on nuts
  • have beans every other day or so
  • eat poultry and berries at least twice a week
  • eat fish at least once a week
  • limit butter to less than 1 1/2 teaspoons a day
  • eat less than 5 servings a week of sweets and pastries
  • eat less than one serving per week of whole fat cheese, and fried or fast food.

The researchers stress that this is a preliminary study, observational only. They are currently seeking participants for a wider, intervention study.

https://www.eurekalert.org/pub_releases/2018-01/rumc-mdm012418.php

Reference: 

Laurel J. Cherian & Martha Clare Morris: Presentation at the American Stroke Association's International Stroke Conference 2018 in Los Angeles, January 25.

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