seniors

How neighborhood status affects cognitive function in older adults

November, 2011

New research confirms the correlation between lower neighborhood socioeconomic status and lower cognitive function in older adults, and accounts for most of it through vascular health, lifestyle, and psychosocial factors.

In the last five years, three studies have linked lower neighborhood socioeconomic status to lower cognitive function in older adults. Neighborhood has also been linked to self-rated health, cardiovascular disease, and mortality. Such links between health and neighborhood may come about through exposure to pollutants or other environmental stressors, access to alcohol and cigarettes, barriers to physical activity, reduced social support, and reduced access to good health and social services.

Data from the large Women’s Health Initiative Memory Study has now been analyzed to assess whether the relationship between neighborhood socioeconomic status can be explained by various risk and protective factors for poor cognitive function.

Results confirmed that higher neighborhood socioeconomic status was associated with higher cognitive function, even after individual factors such as age, ethnicity, income, education, and marital status have been taken into account. A good deal of this was explained by vascular factors (coronary heart disease, diabetes, stroke, hypertension), health behaviors (amount of alcohol consumed, smoking, physical activity), and psychosocial factors (depression, social support). Nevertheless, the association was still (barely) significant after these factors were taken account of, suggesting some other factors may also be involved. Potential factors include cognitive activity, diet, and access to health services.

In contradiction of earlier research, the association appeared to be stronger among younger women. Consistent with other research, the association was stronger for non-White women.

Data from 7,479 older women (65-81) was included in the analysis. Cognitive function was assessed by the Modified MMSE (3MSE). Neighborhood socioeconomic status was assessed on the basis of: percentage of adults over 25 with less than a high school education, percentage of male unemployment, percentage of households below the poverty line, percentage of households receiving public assistance, percentage of female-headed households with children, and median household income. Around 87% of participants were White, 7% Black, 3% Hispanic, and 3% other. Some 92% had graduated high school, and around 70% had at least some college.

Reference: 

[2523] Shih, R. A., Ghosh-Dastidar B., Margolis K. L., Slaughter M. E., Jewell A., Bird C. E., et al.
(2011).  Neighborhood Socioeconomic Status and Cognitive Function in Women.
Am J Public Health. 101(9), 1721 - 1728.

Previous:

Lang IA, Llewellyn DJ, Langa KM, Wallace RB, Huppert FA, Melzer D. 2008. Neighborhood deprivation, individual socioeconomic status, and cognitive function in older people: analyses from the English Longitudinal Study of Ageing. J Am Geriatr Soc., 56(2), 191-198.

Sheffield KM, Peek MK. 2009. Neighborhood context and cognitive decline in older Mexican Americans: results from the Hispanic Established Populations for Epidemiologic Studies of the Elderly. Am J Epidemiol., 169(9), 1092-1101.

Wight RG, Aneshensel CS, Miller-Martinez D, et al. 2006. Urban neighborhood context, educational attainment, and cognitive function among older adults. Am J Epidemiol., 163(12), 1071-1078.

Source: 

http://www.eurekalert.org/pub_releases/2011-08/rc-nsi080211.php

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tags development: 

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Which 'Senior moments' may signal mental decline

October, 2011

A very large survey of older women indicates which type of memory difficulties may signal age-related cognitive impairment possibly leading to dementia.

A telephone survey of around 17,000 older women (average age 74), which included questions about memory lapses plus standard cognitive tests, found that getting lost in familiar neighborhoods was highly associated with cognitive impairment that might indicate Alzheimer’s. Having trouble keeping up with a group conversation and difficulty following instructions were also significantly associated with cognitive impairment. But, as most of us will be relieved to know, forgetting things from one moment to the next was not associated with impairment!

Unsurprisingly, the more memory complaints a woman had, the more likely she was to score poorly on the cognitive test.

The 7 memory lapse questions covered:

  • whether they had recently experienced a change in their ability to remember things,
  • whether they had trouble remembering a short list of items (such as a shopping list),
  • whether they had trouble remembering recent events,
  • whether they had trouble remembering things from one second to the next,
  • whether they had difficulty following spoken or written instructions,
  • whether they had more trouble than usual following a group conversation or TV program due to memory problems,
  • whether they had trouble finding their way around familiar streets.

Because this survey was limited to telephone tests, we can’t draw any firm conclusions. But the findings may be helpful for doctors and others, to know which sort of memory complaints should be taken as a flag for further investigation.

Reference: 

[2513] Amariglio, R E., Townsend M. K., Grodstein F., Sperling R. A., & Rentz D. M.
(2011).  Specific Subjective Memory Complaints in Older Persons May Indicate Poor Cognitive Function.
Journal of the American Geriatrics Society. 59(9), 1612 - 1617.

Source: 

http://www.medicinenet.com/script/main/art.asp?articlekey=149393

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Timing of estrogen therapy is crucial

October, 2011

A rat study provides further evidence that the conflicting findings on the benefit of estrogen therapy stem from the importance of timing.

The very large and long-running Women's Health Initiative study surprised everyone when it produced its finding that hormone therapy generally increased rather than decreased stroke risk as well as other health problems. But one explanation for that finding might be that many of the women only received hormone replacement therapy years after menopause. There are indications that timing is crucial.

This new rat study involved female rats equivalent to human 60-65 year olds, about a decade past menopause.  An enzyme called CHIP (carboxyl terminus of Hsc70 interacting protein) was found to increase binding with estrogen receptors, resulting in about half the receptors getting hauled to the cell's proteosome to be chopped up and degraded. When some of the aged rats were later treated with estrogen, mortality increased. When middle-aged rats were treated with estrogen, on the other hand, results were positive.

In other words, putting in extra estrogen after the number of estrogen receptors in the brain has been dramatically decreased is a bad idea.

While this study focused on mortality, other research has produced similar conflicting results as to whether estrogen therapy helps fight age-related cognitive impairment in women (see my report). It’s interesting to note that this effect only occurred in the hippocampus — estrogen receptors in the uterus were unaffected.

Reference: 

[2526] Zhang, Q-guang., Han D., Wang R-min., Dong Y., Yang F., Vadlamudi R. K., et al.
(2011).  C terminus of Hsc70-interacting protein (CHIP)-mediated degradation of hippocampal estrogen receptor-α and the critical period hypothesis of estrogen neuroprotection.
Proceedings of the National Academy of Sciences. 108(35), E617 -E624 - E617 -E624.

Source: 

http://www.eurekalert.org/pub_releases/2011-08/ghsu-lp080211.php

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When age helps decision making

October, 2011

New study modifies findings that younger adults are better decision-makers by showing older adults are better when the scenarios involve multiple considerations.

Research has shown that younger adults are better decision makers than older adults — a curious result. A new study tried to capture more ‘real-world’ decision-making, by requiring participants to evaluate each result in order to strategize the next choice.

This time (whew!), the older adults did better.

In the first experiment, groups of older (60-early 80s) and younger (college-age) adults received points each time they chose from one of four options and tried to maximize the points they earned.  For this task, the younger adults were more efficient at selecting the options that yielded more points.

In the second experiment, the rewards received depended on the choices made previously.  The “decreasing option” gave a larger number of points on each trial, but caused rewards on future trials to be lower. The “increasing option” gave a smaller reward on each trial but caused rewards on future trials to increase.  In one version of the test, the increasing option led to more points earned over the course of the experiment; in another, chasing the increasing option couldn’t make up for the points that could be accrued grabbing the bigger bite on each trial.

The older adults did better on every permutation.

Understanding more complex scenarios is where experience tells. The difference in performance also may reflect the different ways younger and older adults use their brains. Decision-making can involve two different reward learning systems, according to recent thinking. In the model-based system, a cognitive model is constructed that shows how various actions and their rewards are connected to each other. Decisions are made by simulating how one decision will affect future decisions. In the model-free system, on the other hand, only values associated with each choice are considered.

These systems are rooted in different parts of the brain. The model-based system uses the intraparietal sulcus and lateral prefrontal cortex, while the model-free system uses the ventral striatum. There is some evidence that younger adults use the ventral striatum (involved in habitual, reflexive learning and immediate reward) for decision-making more than older adults, and older adults use the dorsolateral prefrontal cortex (involved in more rational, deliberative thinking) more than younger adults.

Reference: 

[2538] Worthy, D. A., Gorlick M. A., Pacheco J. L., Schnyer D. M., & Maddox T. W.
(2011).  With Age Comes Wisdom.
Psychological Science.

Source: 

http://medicalxpress.com/news/2011-08-decision-age-.html

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Memory fitness program improves memory abilities of oldest adults

October, 2011

A six-week memory fitness program offered to older adults helped improve their ability to recognize and recall words.

In a study involving 115 seniors (average age 81), those who participated in a six-week, 12-session memory training program significantly improved their verbal memory. 15-20 seniors participated in each hour-long class, which included explanations of how memory works, quick strategies for remembering names, faces and numbers, basic memory strategies such as linking ideas and creating visual images, and information on a healthy lifestyle for protecting and maintaining memory.

Most of the study participants were women, Caucasian and had attained a college degree or higher level of education.

Reference: 

[2491] Miller, K. J., Siddarth P., Gaines J. M., Parrish J. M., Ercoli L. M., Marx K., et al.
(2011).  The Memory Fitness Program.
American Journal of Geriatric Psychiatry. 1 - 1.

Source: 

http://www.eurekalert.org/pub_releases/2011-08/uoc--umf082911.php

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Depression & Cognition

Health news relating to depression

Older news items (pre-2010) brought over from the old website

Psychological distress, not depression, linked to increased risk of stroke

A study following 20,627 people for an average of 8.5 years has found that psychological distress was associated with an increased risk of stroke and that the risk of stroke increased the more distress the participants reported. This association remained the same regardless of cigarette smoking, systolic blood pressure, overall blood cholesterol, obesity, previous heart attack, diabetes, social class, education, high blood pressure treatment, family history of stroke and recent antidepressant medication use. However, there was no increased risk for people who had experienced an episode of major depression in the past year or at any point in their lifetime.

[1298] Surtees, P. G., Wainwright N. W. J., Luben R. N., Wareham N. J., Bingham S. A., & Khaw K. - T.
(2008).  Psychological distress, major depressive disorder, and risk of stroke.
Neurology. 70(10), 788 - 794.

http://www.eurekalert.org/pub_releases/2008-03/aaon-pdn022608.php

Depression increases risk of executive dysfunction in older people

A two-year study of more than 700 older adults (65 and older) has found that depression increased the risk of declining executive function (high-level mental processes, such a making decisions, organizing, planning and doing a series of things in sequence).

[1417] Cui, X., Lyness J. M., Tu X., King D. A., & Caine E. D.
(2007).  Does Depression Precede or Follow Executive Dysfunction? Outcomes in Older Primary Care Patients.
Am J Psychiatry. 164(8), 1221 - 1228.

http://www.eurekalert.org/pub_releases/2007-10/uorm-dcf100807.php

Depressed older adults more likely to become cognitively impaired

A study involving 2,220 participants in the Cardiovascular Health Study, a longitudinal prospective study of adults 65 and older, has found that 19.7% of subjects with moderate to high depression developed mild cognitive impairment within six years, compared to 10% of subjects with no depressive symptoms and 13.3% of subjects with low depressive symptoms. There was no correlation between depression and vascular disease, although it has been hypothesized that vascular disease might lead to both depression and cognitive impairment by causing inadequate blood flow to different brain structures.

[409] Barnes, D. E., Alexopoulos G. S., Lopez O. L., Williamson J. D., & Yaffe K.
(2006).  Depressive Symptoms, Vascular Disease, and Mild Cognitive Impairment: Findings From the Cardiovascular Health Study.
Arch Gen Psychiatry. 63(3), 273 - 279.

http://www.eurekalert.org/pub_releases/2006-03/uoc--doa030206.php

Treatable depression often accompanies mild memory loss

A large-scale study of older adults begun in 1989 has revealed that 43% of those with mild cognitive impairment had psychiatric symptoms (such as depression, irritability, loss of interest in activities, or changes in sleep or appetite) in the month before examination. Such symptoms are often shrugged off as emotional reactions to memory decline, but they may be due to changes in brain function, and may respond to treatment.

[1275] Lyketsos, C. G., Lopez O., Jones B., Fitzpatrick A. L., Breitner J., & DeKosky S.
(2002).  Prevalence of Neuropsychiatric Symptoms in Dementia and Mild Cognitive Impairment: Results From the Cardiovascular Health Study.
JAMA. 288(12), 1475 - 1483.

http://www.eurekalert.org/pub_releases/2002-09/wfub-tdo092702.php

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Errorless learning not always best for older brains

October, 2011

New evidence challenges the view that older adults learn best through errorless learning. Trial-and-error learning can be better if done the right way.

Following a 1994 study that found that errorless learning was better than trial-and-error learning for amnesic patients and older adults, errorless learning has been widely adopted in the rehabilitation industry. Errorless learning involves being told the answer without repeatedly trying to answer the question and perhaps making mistakes. For example, in the 1994 study, participants in the trial-and-error condition could produce up to three errors in answer to the question “I am thinking of a word that begins with QU”, before being told the answer was QUOTE; in contrast, participants in the errorless condition were simply told “I am thinking of a word that begins with QU and it is ‘QUOTE’.”

In a way, it is surprising that errorless learning should be better, given that trial-and-error produces much deeper and richer encoding, and a number of studies with young adults have indeed found an advantage for making errors. Moreover, it’s well established that retrieving an item leads to better learning than passively studying it, even when you retrieve the wrong item. This testing effect has also been found in older adults.

In another way, the finding is not surprising at all, because clearly the trial-and-error condition offers many opportunities for confusion. You remember that QUEEN was mentioned, for example, but you don’t remember whether it was a right or wrong answer. Source memory, as I’ve often mentioned, is particularly affected by age.

So there are good theoretical reasons for both positions regarding the value of mistakes, and there’s experimental evidence for both. Clearly it’s a matter of circumstance. One possible factor influencing the benefit or otherwise of error concerns the type of processing. Those studies that have found a benefit have generally involved conceptual associations (e.g. What’s Canada’s capital? Toronto? No, Ottawa). It may be that errors are helpful to the extent that they act as retrieval cues, and evoke a network of related concepts. Those studies that have found errors harm learning have generally involved perceptual associations, such as word stems and word fragments (e.g., QU? QUeen? No, QUote). These errors are arbitrary, produce interference, and don’t provide useful retrieval cues.

So this new study tested the idea that producing errors conceptually associated with targets would boost memory for the encoding context in which information was studied, especially for older adults who do not spontaneously elaborate on targets at encoding.

In the first experiment, 33 young (average age 21) and 31 older adults (average age 72) were shown 90 nouns presented in three different, intermixed conditions. In the read condition (designed to provide a baseline), participants read aloud the noun fragment presented without a semantic category (e.g., p­_g). In the errorless condition, the semantic category was presented with the target word fragment (e.g. a farm animal  p­_g), and the participants read aloud the category and their answer. The category and target were then displayed. In the trial-and-error condition, the category was presented and participants were encouraged to make two guesses before being shown the target fragment together with the category. The researchers changed the target if it was guessed. Participants were then tested using a list of 70 words, of which 10 came from each of the study conditions, 10 were new unrelated words, and 30 were nontarget exemplars from the TEL categories. Those that the subject had guessed were labeled as learning errors; those that hadn’t come up were labeled as related lures. In addition to an overall recognition test (press “yes” to any word you’ve studied and “no” to any new word), there were two tests that required participants to endorse items that were studied in the TEL condition and reject those studied in the EL condition, and vice versa.

The young adults did better than the older on every test. TEL produced better learning than EL, and both produced better learning than the read condition (as expected). The benefit of TEL was greater for older adults. This is in keeping with the idea that generating exemplars of a semantic category, as occurs in trial-and-error learning, helps produce a richer, more elaborated code, and that this is of greater to older adults, who are less inclined to do this without encouragement.

There was a downside, however. Older adults were also more prone to falsely endorsing prior learning errors or semantically-related lures. It’s worth noting that both groups were more likely to falsely endorse learning errors than related lures.

But the main goal of this first experiment was to disentangle the contributions of recollection and familiarity to the two types of learning. It turns out that there was no difference between young and older adults in terms of familiarity; the difference in performance between the two groups stemmed from recollection. Recollection was a problem for older adults in the errorless condition, but not in the trial-and-error condition (where the recollective component of their performance matched that of young adults). This deficit is clearly closely related to age-related deficits in source memory.

It was also found that familiarity was marginally more important in the errorless condition than the trial-and-error condition. This is consistent with the idea that targets learned without errors acquire greater fluency than those learned with errors (with the downside that they don’t pick up those contextual details that making errors can provide).

In the second experiment, 15 young and 15 older adults carried out much the same procedure, except that during the recognition test they were also required to mention the context in which the words were learned was tested (that is, were the words learned through trial-and-error or not).

Once again, trial-and-error learning was associated with better source memory relative to errorless learning, particularly for the older adults.

These results support the hypothesis that trial-and-error learning is more beneficial than errorless learning for older adults when the trials encourage semantic elaboration. But another factor may also be involved. Unlike other errorless studies, participants were required to attend to errors as well as targets. Explicit attention to errors may help protect against interference.

In a similar way, a recent study involving young adults found that feedback given in increments (thus producing errors) is more effective than feedback given all at once in full. Clearly what we want is to find that balance point, where elaborative benefits are maximized and interference is minimized.

Reference: 

[2496] Cyr, A-A., & Anderson N. D.
(2011).  Trial-and-error learning improves source memory among young and older adults.
Psychology and Aging. No Pagination Specified - No Pagination Specified.

Source: 

http://www.eurekalert.org/pub_releases/2011-08/bcfg-lit081811.php

Topics: 

tags development: 

tags memworks: 

tags problems: 

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Ability to remember memories' origin develops slowly

October, 2011

A study comparing the brains of children, adolescents, and young adults has found that the ability to remember the origin of memories is slow to mature. As with older adults, impaired source memory increases susceptibility to false memories.

In the study, 18 children (aged 7-8), 20 adolescents (13-14), and 20 young adults (20-29) were shown pictures and asked to decide whether it was a new picture or one they had seen earlier. Some of the pictures were of known objects and others were fanciful figures (this was in order to measure the effects of novelty in general). After a 10-minute break, they resumed the task — with the twist that any pictures that had appeared in the first session should be judged “new” if that was the first appearance in the second session. EEG measurements (event-related potentials — ERPs) were taken during the sessions.

ERPs at the onset of a test stimulus (each picture) are different for new and old (repeated) stimuli. Previous studies have established various old/new effects that reflect item and source memory in adults. In the case of item memory, recognition is thought to be based on two processes — familiarity and recollection — which are reflected in ERPs of different timings and location (familiarity: mid-frontal at 300-500 msec; recollection: parietal at 400-70 msec). Familiarity is seen as a fast assessment of similarity, while recollection varies according to the amount of retrieved information.

Source memory appears to require control processes that involve the prefrontal cortex. Given that this region is the slowest to mature, it would not be surprising if source memory is a problematic memory task for the young. And indeed, previous research has found that children do have particular difficulty in sourcing memories when the sources are highly similar.

In the present study, children performed more poorly than adolescents and adults on both item memory and source memory. Adolescents performed more poorly than adults on item memory but not on source memory. Children performed more poorly on source memory than item memory, but adolescents and adults showed no difference between the two tasks.

All groups responded faster to new items than old, and ERP responses to general novelty were similar across the groups — although children showed a left-frontal focus that may reflect the transition from analytic to a more holistic processing approach.

ERPs to old items, however, showed a difference: for adults, they were especially pronounced at frontal sites, and occurred at around 350-450 msec; for children and adolescents they were most pronounced at posterior sites, occurring at 600-800 msec for children and 400-600 msec for adolescents. Only adults showed the early midfrontal response that is assumed to reflect familiarity processing. On the other hand, the late old/new effect occurring at parietal sites and thought to reflect recollection, was similar across all age groups. The early old/new effect seen in children and adolescents at central and parietal regions is thought to reflect early recollection.

In other words, only adults showed the brain responses typical of familiarity as well as recollection. Now, some research has found evidence of familiarity processing in children, so this shouldn’t be taken as proof against familiarity processing in the young. What seems most likely is that children are less likely to use such processing. Clearly the next step is to find out the factors that affect this.

Another interesting point is the early recollective response shown by children and adolescents. It’s speculated that these groups may have used more retrieval cues — conceptual as well as perceptual — that facilitated recollection. I’m reminded of a couple of studies I reported on some years ago, that found that young children were better than adults on a recognition task in some circumstances — because children were using a similarity-based process and adults a categorization-based one. In these cases, it had more to do with knowledge than development.

It’s also worth noting that, in adults, the recollective response was accentuated in the right-frontal area. This suggests that recollection was overlapping with post-retrieval monitoring. It’s speculated that adults’ greater use of familiarity produces a greater need for monitoring, because of the greater uncertainty.

What all this suggests is that preadolescent children are less able to strategically recollect source information, and that strategic recollection undergoes an important step in early adolescence that is probably related to improvements in cognitive control. But this process is still being refined in adolescents, in particular as regards monitoring and coping with uncertainty.

Interestingly, source memory is also one of the areas affected early in old age.

Failure to remember the source of a memory has many practical implications, in particular in the way it renders people more vulnerable to false memories.

Reference: 

[2494] Sprondel, V., Kipp K. H., & Mecklinger A.
(Submitted).  Developmental Changes in Item and Source Memory: Evidence From an ERP Recognition Memory Study With Children, Adolescents, and Adults.
Child Development.

Source: 

http://www.eurekalert.org/pub_releases/2011-08/sfri-atr082311.php

Topics: 

tags development: 

tags memworks: 

tags problems: 

Helping Alzheimer's sufferers

Behavioral and cognitive strategies that can help those suffering from Alzheimer's.

Older news items (pre-2010) brought over from the old website

Memory grows less efficient very early in Alzheimer's

A study of 109 healthy older adults (average age 75), 41 older adults with very early Alzheimer's, 13 with early Alzheimer's, and 35 younger adults (25 or younger) has found that those with Alzheimer’s — even those in the very early stages — were significantly less efficient than their healthy age peers at remembering items according to their value. It may be that Alzheimer's makes it harder for people to encode what they learn in a strategic way. This research suggests the potential for improved memory training.

Castel, A.D., Balota, D.A. & McCabe, D.P. 2009. Memory Efficiency and the Strategic Control of Attention at Encoding: Impairments of Value-Directed Remembering in Alzheimer's Disease. Neuropsychology, 23 (3), 297-306.

http://www.eurekalert.org/pub_releases/2009-05/apa-mgl042909.php

Pictures better than words for memory-damaged patients

We’ve long known that pictures are remembered better than words. Now a study has found that this picture superiority still exists in those with mild cognitive impairment and very mild Alzheimer’s disease. Moreover, frontally-based brainwave patterns were similar to those of controls when pictures were being retrieved, but not for words. The findings support the idea that those with mild Alzheimer’s can successfully use implicit memory (memory without conscious awareness) to support recognition, and this may point to new strategies for dealing with their memory problems.

Castel, A.D., Balota, D.A. & McCabe, D.P. 2009. Memory Efficiency and the Strategic Control of Attention at Encoding: Impairments of Value-Directed Remembering in Alzheimer's Disease. Neuropsychology, 23 (3), 297-306.

http://www.physorg.com/news160307482.html

Treating sleep apnea in Alzheimer's patients helps cognition

A study of 52 men and women with mild to moderate Alzheimer's disease and obstructive sleep apnea (OSA) has found significant improvement in patients' neurological test scores after continuous positive airway pressure (CPAP) treatment. CPAP also reduced daytime sleepiness, a common complaint of Alzheimer's patients and their caregivers. The prevalence of OSA in patients with dementia has been estimated to be as high as 70 to 80%.

Ancoli-Israel, S. et al. 2008. Cognitive Effects of Treating Obstructive Sleep Apnea in Alzheimer's Disease: A Randomized Controlled Study. Journal of the American Geriatrics Society, 56 (11),2076-2081.

http://www.eurekalert.org/pub_releases/2008-12/uoc--tsa120308.php

Hypnosis shown to reduce symptoms of dementia

This one’s really quite weird. A study found that people living with dementia who received hypnosis therapy over a nine month period showed an improvement in concentration, memory and socialization compared to groups receiving the normal treatment (who declined in these measures) and those attending a regular discussion group (who stayed the same). Relaxation, motivation and daily living activities also improved with the use of hypnosis. The findings point to the role of depression and anxiety in worsening the symptoms of dementia. The latest follow-up study has found that many of the benefits in the hypnosis group were maintained 12 months later.

Duff, S.C. & Nightingale, D.J. 2008. Long-term outcomes of hypnosis in changing the quality of life in patients with dementia. European Journal of Clinical Hypnosis, 7 (1)

http://www.eurekalert.org/pub_releases/2008-07/uol-hst072808.php
http://www.sciencedaily.com/releases/2008/07/080728111402.htm

More sleep improves cognition in Alzheimer patients with OSA

A study involving 52 participants with an average age of 77.8 years who had Alzheimer disease and obstructive sleep apnea (OSA) has found that it was increases in total sleep time in those given continuous positive airway pressure treatment that was associated with improvements in cognition, rather than improvement in oxygen levels. This suggests that the cognitive dysfunction associated with OSA in patients with dementia may be in part an effect of short sleep time.

The findings were presented at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS).

http://www.eurekalert.org/pub_releases/2008-06/aaos-iit050708.php

Mediterranean diet may help Alzheimer's patients live longer

A study of 192 people with Alzheimer's disease has found that those who most closely followed a Mediterranean diet were 76% less likely to die during the 4 ½ year study period compared to those who followed the diet the least. A previous study by the same researchers found that healthy people who eat a Mediterranean diet lowered their risk of developing Alzheimer's disease. The Mediterranean diet includes a high intake of vegetables, legumes, fruits, cereals, fish, monounsaturated fatty acids; a low intake of saturated fatty acids, dairy products, meat and poultry; and a mild to moderate amount of alcohol.

Scarmeas, N., Luchsinger, J.A., Mayeux, R. & Stern, Y. 2007. Mediterranean diet and Alzheimer disease mortality. Neurology, 69, 1084-1093.

http://www.sciencedaily.com/releases/2007/09/ 070910162411.htm
http://www.eurekalert.org/pub_releases/2007-09/aaon-mdm090407.php

Alzheimer's weight gain initiative improved patients' intellectual abilities

In a small, three-month study, Swedish researchers have found a way to increase the weight of people with Alzheimer's, with consequent improved intellectual abilities, by improving communication and patient involvement, altering meal routines and providing a more homely eating environment.

Mamhidir et al. 2007. Weight increase in patients with dementia and alteration in meal routines and meal environment after integrity promoting care. Journal of Clinical Nursing, 16, 987-996.

http://www.eurekalert.org/pub_releases/2007-05/bpl-awg051507.php

Enhanced environment restores memory in mice with neurodegeneration

Research involving genetically engineered mice has found that mice whose brains had lost a large number of neurons due to neurodegeneration regained long-term memories and the ability to learn after their surroundings were enriched with toys and other sensory stimuli. The same effect was also achieved through the use of a drug that encourages neuronal growth. The findings suggest not only new approaches to treatment for those with Alzheimer's or other neurodegenerative diseases, but also supports recent suggestions that "memory loss" may be an inaccurate description of the kinds of mental deficits associated with neurodegenerative diseases. The memories are still there; they are simply inaccessible.

Fischer, A., Sananbenesi, F., Wang, X., Dobbin, M. & Tsai, L-H. 2007. Recovery of learning and memory is associated with chromatin remodelling. Nature, 447, 178-182.

http://www.eurekalert.org/pub_releases/2007-04/hhmi-eer042507.php

Computer-based 'games' enhance mental function in Alzheimer's patients

An interactive multimedia internet-based game has been shown to benefit cognition in patients with Alzheimer's disease more than classic exercises of mental stimulation commonly used with dementia patients. The study compared patients receiving no cognitive intervention, those enrolled in a daily program that included 2.5 to 3.5 hours of cognitive stimulation tasks, musical therapy, arts and crafts, physical activity and programs that reinforced instrumental activities of daily living, and those who also used an interactive multimedia internet-based system which allowed them to carry out a variety of different cognitive stimulation tasks at varying levels of difficulty throughout the day. After 12 weeks, both intervention groups performed better on tests than the control group; at 24 weeks, the dual-intervention group did better than the program-only group. The study points to the value of cognitive stimulation to slow the rate of cognitive loss.

Tárraga, L. et al. 2006. A randomised pilot study to assess the efficacy of an interactive, multimedia tool of cognitive stimulation in Alzheimer’s disease. Journal of Neurology, Neurosurgery and Psychiatry, 77, 1116-1121.

http://www.eurekalert.org/pub_releases/2006-10/uopm-ce102306.php

Elders with dementia can tap into memory stores to give advice

Surprisingly, it appears that the best way to converse with an Alzheimer’s patient may be to ask them for advice. In two studies, researchers found that adults with moderate to severe symptoms of dementia can still be quite coherent and informative when asked for advice. In the first study, 14 people with early to advanced stages of dementia were asked about marriage, children and church in a purely social way, such as "Tell me about your children," and then later were asked for advice on the same topics, as in, "I'm thinking about having children. What kind of advice can you give me on that?" Patients were more coherent, informative and focused on the topic when asked for advice as opposed to when they were simply asked about their children, church or marriage. In the second study, six adults with dementia and six older adults without dementia, were given a booklet of pictures to guide them in teaching someone a simple recipe. Both groups successfully taught students to prepare the recipes, although those with dementia did need more prompting to finish the task.

Dijkstra, K., Bourgeois, M., Youmans, G. & Hancock, A. 2006. Implications of an Advice-Giving and Teacher Role on Language Production in Adults With Dementia. Gerontologist, 46, 357-366.

http://www.eurekalert.org/pub_releases/2006-07/fsu-sew071706.php

Missing eyeglasses impair activities for a third of nursing home patients with Alzheimer's disease

A study of nearly 100 Alzheimer’s patients in nursing homes has determined that one third of them were not using or did not have glasses that were strong enough to correct their eyesight. Apart from causing disorientation, limiting mobility and increasing the chance of falls, the loss of vision is likely to impact on mental stimulation, by making it difficult or impossible to engage in mentally stimulating activities such as reading or watching television.

Koch, J.M., Datta, G., Makhdoom, S. & Grossberg, G.T. 2005. Unmet Visual Needs of Alzheimer’s Disease Patients in Long-term Care Facilities. Journal of the American Medical Directors Association, 6(4), 233-237.

http://www.eurekalert.org/pub_releases/2005-07/slu-mem071905.php

New memory aid helps dementia sufferers remember

An innovative memory aid based on an interactive multimedia computer system aims to stimulate more enjoyable, rewarding conversation between sufferers and those who care for them. CIRCA (Computer Interactive Reminiscence and Conversation Aid) involves a simple touch-screen with easy-to-follow instructions; it displays a choice of three random categories (entertainment, local life etc) and three media (music, photo, video). The images, video or sound clips then act as a memory trigger and conversation prompt. During development, CIRCA was tested on 40 dementia sufferers with very encouraging results. CIRCA could become available on the market in 2-3 years.

http://www.eurekalert.org/pub_releases/2005-06/eaps-nma061505.php

Weight loss may be an early sign of dementia in the elderly

An analysis of data from 1,890 men who were participants in The Honolulu-Asia Aging Study has found that the weight loss common in people with dementia begins 2-4 years before the onset of clinical dementia symptoms. It’s possible that treatment interventions directed toward maintaining optimal nutrition and preventing excess weight loss could slow the disease.

Stewart, R., Masaki, K., Xue, Q-L., Peila, R., Petrovitch, H., White, L.R. & Launer, L.J. 2005. A 32-Year Prospective Study of Change in Body Weight and Incident Dementia: The Honolulu-Asia Aging Study. Archives of Neurology, 62, 55-60.

http://www.eurekalert.org/pub_releases/2005-01/jaaj-wlm010505.php

Studies suggest people with early AD can still learn

A new study suggests that people who have early stage Alzheimer's disease could be more capable of learning than previously thought. The study found that mildly impaired Alzheimer’s patients who participated in 3-to-4 months of cognitive rehabilitation had a 170% improvement, on average, in their ability to recall faces and names and a 71% improvement in their ability to provide proper change for a purchase. The participants also could respond to and process information more rapidly and were better oriented to time and place. These improvements were still evident 3 months after the cognitive training ended.

Loewenstein, D.A., Acevedo, A., Czaja, S.J. & Duara, R. 2004. Cognitive Rehabilitation of Mildly Impaired Alzheimer Disease Patients on Cholinesterase Inhibitors. American Journal of Geriatric Psychiatry, 12(4), 395-402.

http://www.eurekalert.org/pub_releases/2004-07/nioa-ssp062904.php

Alzheimer's may leave some forms of memory intact

A new study has demonstrated that people with Alzheimer's disease retain the capability for a specific form of memory used for rote learning of skills, despite their other memory loss. The finding suggests new strategies to improve training and rehabilitative programs for Alzheimer's sufferers. It also confirms other studies suggesting that a number of brain systems are more intact in Alzheimer's than previously thought.

[1219] Lustig, C., & Buckner R. L.
(2004).  Preserved Neural Correlates of Priming in Old Age and Dementia.
Neuron. 42(5), 865 - 875.

http://www.eurekalert.org/pub_releases/2004-06/hhmi-als060404.php
http://www.eurekalert.org/pub_releases/2004-06/cp-ssh060304.php

Program helps physical and behavioral well-being of Alzheimer's patients

A controlled trial of 153 community-dwelling patients diagnosed with Alzheimer’s examined the effectiveness of a home-based exercise program combined with caregiver training in behavioral management techniques in reducing functional dependence and delay institutionalization. The program resulted in improved physical health and less depression. Specifically, after three months, those receiving the training were more likely to exercise at least 60 minutes a week, to have fewer days of restricted activity, to have improved scores for physical role functioning, and improved Cornell Depression Scale for Depression in Dementia scores, and have less institutionalization due to behavioral disturbance.

Teri, L. et al. 2003. Exercise Plus Behavioral Management in Patients With Alzheimer Disease: A Randomized Controlled Trial. JAMA, 290, 2015-2022.

Alzheimer patients who scored well on memory tests show unique compensatory brain activity

A study of 12 healthy older adults and 11 older patients with probable early-stage Alzheimer's compared their performance in a series of semantic and episodic memory tasks on a computer screen, using PET scans. Overall, Alzheimer's patients performed less accurately on the semantic and episodic tasks compared to the normal controls. However, the range of scores was quite large in the Alzheimer group, with some performing poorly and others performing within the normal range. For those patients who did better on the memory tasks, researchers found that their prefrontal network activity was more expansive compared to the error-prone patients. This additional activity was happening in the right frontal and temporoparietal areas. It was a unique neural pattern not found in the controls either. This provides the most direct evidence to date that Alzheimer's patients can use additional neural resources in the prefrontal cortex to compensate for losses attributable to the degenerative process of the disease.

Grady, C.L., McIntosh, A.R., Beig, S., Keightley, M.L., Burian, H. & Black, S.E. 2003. Evidence from Functional Neuroimaging of a Compensatory Prefrontal Network in Alzheimer's Disease. Journal of Neuroscience, 23, 986-993.

http://www.eurekalert.org/pub_releases/2003-02/bcfg-apw013103.php

Memory training may help some Alzheimer's patients

Following anecdotal "success stories" of memory training provided by rehabilitation experts, researchers in London conducted a controlled study to see whether such training could be standardized for a larger group of people, and whether the benefits of training endured. The study involved 12 participants with probable Alzheimer's Disease (AD) at the minimal or mild stage, when they still had some capacity for learning. The researchers then trained participants to remember the names of people whom they had difficulty naming from a set of 12 photos that included people in their social network and famous people. They used such memory aids as mnemonic devices, which use the image to jog memory through some kind of meaningful association; "vanishing cues," a method in which participants fill in more and more letters in the person's name, until they can recall that name without any help; and "expanding rehearsal," in which people test themselves on what they've learned, in spaced intervals over time. All training minimized the chance of errors, which helped to reduce distress and raise confidence. By training participants' memory for just half of their photo sets, researchers were able to compare memory training with no training, for each participant. Participants learned the face-name association at the rate of one per week, adding each new pair to their practice until they worked at all six pairs. They continued practicing until a one-month follow-up test of the face-name pairs. Testing was repeated at three, six and 12 months. The memory training produced a statistically significant improvement in group performance on free recall of trained items. Participants kept their memory gains six months after training, and scores remained above baseline levels after 12 months -- even without further practice. Not all participants benefited from the training. Further research is needed to discover what distinguishes those who benefitted from those who didn’t. One factor that was found, was that those who were more aware of their memory problems were more likely to respond well to memory training.

Clare, L.,Wilson, B.A., Carter, G., Roth, I., Hodges & J.R. 2002. Relearning Face-Name Associations in Early Alzheimer's Disease. Neuropsychology, 16 (4), 538-47.

http://www.eurekalert.org/pub_releases/2002-10/apa-mtm101502.php

Helping Alzheimer's sufferers remember

Alzheimer sufferers recalled significantly more details of long-ago events when music was played during recall. Recent memory was not affected. It is suggested that music could be played at particular times when better recall is desirable, such as when relatives visit.

The study involved 23 older adults with mild-to-moderate dementia. Participants were tested in each of four auditory background conditions presented randomly, one week apart: quiet; cafeteria noise; familiar music (first movement of Vivaldi's “The Four Seasons”); novel music (Fitkin's “Hook”). Questions were drawn from three life eras: up to age 20; around ages 20—50; and recent past and present. Sound conditions (music or noise) were significantly better than quiet (mean recall 67% vs 61%). There was no difference between familiar and novel music, but there was a small difference between noise and music (66% vs 68%). This difference was greater for remote memory; there was no difference between noise and music for memory of recent past. Overall, the Alzheimer's patients had much better recall for older memories.

The improvement in recall for the sound conditions over quiet, and the similarity between all sound conditions, points to arousal as the crucial factor. The greater effectiveness of music compared to noise may signal an associational effect. Further research exploring the effects of different pieces of music would help clarify this.

Valentine, E. & Foster, N. 2000. Reported at the British Psychological Society's London Conference, December 20.

http://www.guardian.co.uk/uk/2000/dec/24/paulharris.theobserver1

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One cause of damage in older brains, and how exercise can help

September, 2011

Two mice studies indicate that an increase in a protein involved in immune response may be behind the reduced ability of older brains to create new neurons, and that exercise produces a protein that helps protect against damage caused by illness, injury, surgery and pollutants.

In the first mouse study, when young and old mice were conjoined, allowing blood to flow between the two, the young mice showed a decrease in neurogenesis while the old mice showed an increase. When blood plasma was then taken from old mice and injected into young mice, there was a similar decrease in neurogenesis, and impairments in memory and learning.

Analysis of the concentrations of blood proteins in the conjoined animals revealed the chemokine (a type of cytokine) whose level in the blood showed the biggest change — CCL11, or eotaxin. When this was injected into young mice, they indeed showed a decrease in neurogenesis, and this was reversed once an antibody for the chemokine was injected. Blood levels of CCL11 were found to increase with age in both mice and humans.

The chemokine was a surprise, because to date the only known role of CCL11 is that of attracting immune cells involved in allergy and asthma. It is thought that most likely it doesn’t have a direct effect on neurogenesis, but has its effect through, perhaps, triggering immune cells to produce inflammation.

Exercise is known to at least partially reverse loss of neurogenesis. Exercise has also been shown to produce chemicals that prevent inflammation. Following research showing that exercise after brain injury can help the brain repair itself, another mouse study has found that mice who exercised regularly produced interleukin-6 (a cytokine involved in immune response) in the hippocampus. When the mice were then exposed to a chemical that destroys the hippocampus, the interleukin-6 dampened the harmful inflammatory response, and prevented the loss of function that is usually observed.

One of the actions of interleukin-6 that brings about a reduction in inflammation is to inhibit tumor necrosis factor. Interestingly, I previously reported on a finding that inhibiting tumor necrosis factor in mice decreased cognitive decline that often follows surgery.

This suggests not only that exercise helps protect the brain from the damage caused by inflammation, but also that it might help protect against other damage, such as that caused by environmental toxins, injury, or post-surgical cognitive decline. The curry spice cucurmin, and green tea, are also thought to inhibit tumor necrosis factor.

Reference: 

[2504] Villeda, S. A., Luo J., Mosher K. I., Zou B., Britschgi M., Bieri G., et al.
(2011).  The ageing systemic milieu negatively regulates neurogenesis and cognitive function.
Nature. 477(7362), 90 - 94.

[2501] Funk, J. A., Gohlke J., Kraft A. D., McPherson C. A., Collins J. B., & Jean Harry G.
(2011).  Voluntary exercise protects hippocampal neurons from trimethyltin injury: Possible role of interleukin-6 to modulate tumor necrosis factor receptor-mediated neurotoxicity.
Brain, Behavior, and Immunity. 25(6), 1063 - 1077.

Source: 

http://the-scientist.com/2011/08/31/blood%E2%80%99s-role-in-the-aging-br... http://www.eurekalert.org/pub_releases/2011-08/e-emh081511.php

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