seniors

Brain training reverses age-related cognitive decline

August, 2010

A month's training in sound discrimination reversed normal age-related cognitive decline in the auditory cortex in old rats.

A rat study demonstrates how specialized brain training can reverse many aspects of normal age-related cognitive decline in targeted areas. The month-long study involved daily hour-long sessions of intense auditory training targeted at the primary auditory cortex. The rats were rewarded for picking out the oddball note in a rapid sequence of six notes (five of them of the same pitch). The difference between the oddball note and the others became progressively smaller. After the training, aged rats showed substantial reversal of their previously degraded ability to process sound. Moreover, measures of neuron health in the auditory cortex had returned to nearly youthful levels.

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Low vitamin D levels associated with cognitive decline

August, 2010

Another study shows that older adults with low levels of vitamin D have higher levels of cognitive decline, particularly in executive function (but not attention).

Another study has come out showing that older adults with low levels of vitamin D are more likely to have cognitive problems. The six-year study followed 858 adults who were age 65 or older at the beginning of the study. Those who were severely deficient in vitamin D were 60% more likely to have substantial cognitive decline, and 31% more likely to have specific declines in executive function, although there was no association with attention. Vitamin D deficiency is common in older adults in the United States and Europe (levels estimated from 40% to 100%!), and has been implicated in a wide variety of physical disease.

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Link among Alzheimer's disease, Down syndrome, atherosclerosis and diabetes

January, 2010

New evidence suggests that Down syndrome, Alzheimer's, diabetes, and cardiovascular disease, all share a common disease mechanism.

It’s been suggested before that Down syndrome and Alzheimer's are connected. Similarly, there has been evidence for connections between diabetes and Alzheimer’s, and cardiovascular disease and Alzheimer’s. Now new evidence shows that all of these share a common disease mechanism. According to animal and cell-culture studies, it seems all Alzheimer's disease patients harbor some cells with three copies of chromosome 21, known as trisomy 21, instead of the usual two. Trisomy 21 is characteristic of all the cells in people with Down syndrome. By age 30 to 40, all people with Down syndrome develop the same brain pathology seen in Alzheimer's. It now appears that amyloid protein is interfering with the microtubule transport system inside cells, essentially creating holes in the roads that move everything, including chromosomes, around inside the cells. Incorrect transportation of chromosomes when cells divide produces new cells with the wrong number of chromosomes and an abnormal assortment of genes. The beta amyloid gene is on chromosome 21; thus, having three copies produces extra beta amyloid. The damage to the microtubule network also interferes with the receptor needed to pull low-density lipoprotein (LDL — the ‘bad’ cholesterol) out of circulation, thus (probably) allowing bad cholesterol to build up (note that the ‘Alzheimer’s gene’ governs the low-density lipoprotein receptor). It is also likely that insulin receptors are unable to function properly, leading to diabetes.

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Hypertension linked to dementia in older women

January, 2010
  • A large study has found that women with high blood pressure had significantly higher amounts of white matter lesions (a risk factor for dementia) 8 years later.

Part of the Women's Health Initiative study looking at the effect of hormone therapy on thinking and memory in postmenopausal women, involving over 1400 women, has found those who had high blood pressure at the start of the study (eight years earlier) had significantly higher amounts of white matter lesions. Damage to white matter seems to be an independent risk factor for dementia. The finding adds to evidence suggesting that preventing hypertension helps protect against dementia. High blood pressure is common in the U.S. — of the nearly 99,000 women enrolled in the WHI study, 37.8% had hypertension. You can watch the researcher discussing the findings at http://www.eurekalert.org/multimedia/pub/19494.php?from=152110

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Kuller, L. H., Margolis, K. L., Gaussoin, S. A., Bryan, N. R., Kerwin, D., Limacher, M., et al. (2009). Relationship of Hypertension, Blood Pressure, and Blood Pressure Control With White Matter Abnormalities in the Women's Health Initiative Memory Study (WHIMS) MRI Trial. The Journal of Clinical Hypertension, 9999(9999). doi: 10.1111/j.1751-7176.2009.00234.x.

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Specific hippocampal atrophy early sign of MCI & Alzheimer's

January, 2010
  • People with MCI who later developed Alzheimer's disease showed 10-30% greater brain atrophy in two specific regions.

A three-year study involving 169 people with mild cognitive impairment has found that those who later developed Alzheimer's disease showed 10-30% greater atrophy in two specific locations within the hippocampus, the cornu ammonis (CA1) and the subiculum. A second study comparing the brains of 10 cognitively normal elderly people and seven who were diagnosed with MCI between two and three years after their initial brain scan and with Alzheimer's some seven years after the initial scan, has confirmed the same pattern of hippocampal atrophy, from the CA1 to the subiculum, and then other regions of the hippocampus.

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Apostolova, L.G. et al. In press. Subregional hippocampal atrophy predicts Alzheimer's dementia in the cognitively normal. Neurobiology of Aging, Available online 24 September 2008.

[392] Apostolova, L. G., Thompson P. M., Green A. E., Hwang K. S., Zoumalan C., Jack, Jr C. R., et al.
(2010).  3D comparison of low, intermediate, and advanced hippocampal atrophy in MCI.
Human Brain Mapping. 9999(9999), NA - NA.

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Mental fluctuations may signal Alzheimer's disease

January, 2010

A study has found that mental fluctuations were very rare in those without Alzheimer's, but occurred in nearly 12% of those with very mild or mild Alzheimer’s.

A study involving 511 older adults (average age 78) has found that 11.6% of those with very mild or mild Alzheimer’s (43% of the participants) had mental lapses, compared to only 2 of the 295 without Alzheimer’s. Those with mental lapses also tended to have more severe Alzheimer’s. Although mental lapses are characteristic of dementia with Lewy bodies, this is the first study to look at them in connection with Alzheimer’s. Having mental lapses was defined as having three or four of the following symptoms:

  • Feeling drowsy or lethargic all the time or several times per day despite getting enough sleep the night before
  • Sleeping two or more hours before 7 p.m.
  • Having times when the person's flow of ideas seems disorganized, unclear, or not logical
  • Staring into space for long periods

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Training program improves eating skills of dementia patients

January, 2010

A study using two training programs to help dementia patients regain eating skills, found spaced retrieval training was particularly effective.

Loss of memory and problems with judgment in dementia patients can cause difficulties in relation to eating and nutrition; these problems in turn can lead to poor quality of life, pressure ulcers and infections. A study used two different step-by-step training programs to help dementia patients regain eating skills. Three institutions, involving 85 patients, were assigned to one of three programs: spaced retrieval training; Montessori-based training; control. Training consisted of three 30-40 min sessions per week, for 8 weeks. Both training programs resulted in significantly improved feeding skills, however the Montessori group needed more physical and verbal assistance. Nutritional status was significantly higher in the spaced-retrieval group compared to the control.

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Lin, L., Huang, Y., Su, S., Watson, R., Tsai, B. W., & Wu, S. (2010). Using spaced retrieval and Montessori-based activities in improving eating ability for residents with dementia. International Journal of Geriatric Psychiatry, 9999(9999), n/a. doi: 10.1002/gps.2433.

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Nutritional drink may help fight Alzheimer's

January, 2010
  • A clinical trial has found improvement in verbal (but not general) memory in patients with mild Alzheimer's who drank a nutritional cocktail for 12 weeks.

A European trial involving 225 patients with mild Alzheimer's has found that those who drank Souvenaid (a cocktail of uridine, choline and the omega-3 fatty acid DHA, plus B vitamins, phosopholipids and antioxidants) for 12 weeks were more likely to improve their performance in a delayed verbal recall task. 40% of the Souvenaid group showed improved performance compared to 24% of the placebo group. Those with the mildest cases of Alzheimer’s showed the most improvement. There was no improvement on the more general ADAS-cog test. Three further clinical trials, one in the U.S. and two in Europe, are now underway.

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Scheltens, P. et al. 2010. Efficacy of a medical food in mild Alzheimer's disease: A randomized, controlled trial. Alzheimer's & Dementia, 6 (1), 1-10.

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Subjective memory loss may increase risk for MCI & dementia

January, 2010

Healthy older adults reporting subjective cognitive impairment are dramatically more likely to progress to MCI or dementia, and decline significantly faster.

Subjective cognitive impairment (SCI), marked by situations such as when a person recognizes they can't remember a name like they used to or where they recently placed important objects the way they used to, is experienced by between one-quarter and one-half of the population over the age of 65. A seven-year study involving 213 adults (mean age 67) has found that healthy older adults reporting SCI are dramatically more likely to progress to MCI or dementia than those free of SCI (54% vs 15%). Moreover, those who had SCI declined significantly faster.

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Reisberg, B. et al. 2010. Outcome over seven years of healthy adults with and without subjective cognitive impairment. Alzheimer's & Dementia, 6 (1), 11-24.

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Exercise helps prevent, improve MCI

January, 2010

Two large studies have found moderate exercise was associated with a lower risk of developing mild cognitive impairment. A small study suggests women may benefit more than men.

A German study involving nearly 4000 older adults (55+) has found that physical activity significantly reduced the risk of developing mild cognitive impairment over a two-year period. Nearly 14% of those with no physical activity at the start of the study developed cognitive impairment, compared to 6.7% of those with moderate activity, and 5.1% of those with high activity. Moderate activity was defined as less than 3 times a week.

In another report, a study involving 1,324 individuals without dementia found those who reported performing moderate exercise during midlife or late life were significantly less likely to have MCI. Midlife moderate exercise was associated with 39% reduction in the odds of developing MCI, and moderate exercise in late life was associated with a 32% reduction. Light exercise (such as bowling, slow dancing or golfing with a cart) or vigorous exercise (including jogging, skiing and racquetball) were not significantly associated with reduced risk for MCI.

And in a clinical trial involving 33 older adults (55-85) with MCI has found that women who exercised at high intensity levels with an aerobics trainer for 45 to 60 minutes per day, four days per week, significantly improved performance on multiple tests of executive function, compared to those who engaged in low-intensity stretching exercises. The results for men were less significant: high-intensity aerobics was associated only with improved performance on one cognitive task, Trail-making test B, a test of visual attention and task-switching.

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