seniors

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.

Reference: 

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.

Reference: 

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.

Reference: 

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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Connection between navigation, object location, & autobiographical memory

January, 2010
  • The existence of specialized neurons involved in spatial memory has now been found in humans, and appear to also help with object location and autobiographical memory.

Rodent studies have demonstrated the existence of specialized neurons involved in spatial memory. These ‘grid cells’ represent where an animal is located within its environment, firing in patterns that show up as geometrically regular, triangular grids when plotted on a map of a navigated surface. Now for the first time, evidence for these cells has been found in humans. Moreover, those with the clearest signs of grid cells performed best in a virtual reality spatial memory task, suggesting that the grid cells help us to remember the locations of objects. These cells, located particularly in the entorhinal cortex, are also critical for autobiographical memory, and are amongst the first to be affected by Alzheimer's disease, perhaps explaining why getting lost is one of the most common early symptoms.

Reference: 

[378] Doeller, C. F., Barry C., & Burgess N.
(2010).  Evidence for grid cells in a human memory network.
Nature. 463(7281), 657 - 661.

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HIV infection prematurely ages the brain

January, 2010

New evidence suggests that for that those with HIV, the disease, medications, or both, are accelerating what is a normal age-related process.

Although HIV doesn't directly infect neurons, it appears that once it has crossed the blood-brain barrier, it affects supporting cells that can release immune factors that harm neurons. New techniques used on 26 subjects with HIV and 25 matched controls have now found that those with HIV showed decreased brain blood flow to levels roughly equivalent to readings seen for uninfected individuals 15 to 20 years older. It is suggested that HIV, medications, or both, are accelerating what is a normal age-related process. It’s estimated that 14-18% of AIDS patients in the U.S. are more than 50 years old, and this proportion is rapidly growing.

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Cognitive activity protects against age-related decline

January, 2010

A large study has found evidence that frequent cognitive activity can counteract the detrimental effect of poor education on at least one aspect of age-related cognitive decline -- episodic memory.

A study (“Midlife in the United States”) assessing 3,343 men and women aged 32-84 (mean age 56), of whom almost 40% had at least a 4-year college degree, has found evidence that frequent cognitive activity can counteract the detrimental effect of poor education on age-related cognitive decline. Although, as expected, those with higher education engaged in cognitive activities more often and did better on the memory tests, those with lower education who engaged in reading, writing, attending lectures, doing word games or puzzles once or week or more had memory scores similar to people with more education on tests of episodic memory (although this effect did not occur for executive functioning).

Reference: 

[651] Lachman, M. E., Agrigoroaei S., Murphy C., & Tun P. A.
(2010).  Frequent cognitive activity compensates for education differences in episodic memory.
The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry. 18(1), 4 - 10.

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Helping older adults remember whether they’ve done something

January, 2010

Older adults are more likely to forget that they've done something. A new study has found that doing something unusual (such as putting a hand on their head) at the same time helps seniors remember having done the task.

Previous research has shown that older adults are more likely to incorrectly repeat an action in situations where a prospective memory task has become habitual — for example, taking more medication because they’ve forgotten they’ve already taken it. A new study has found that doing something unusual at the same time helps seniors remember having done the task. In the study, older adults told to put a hand on their heads whenever they made a particular response, reduced the level of repetition errors to that of younger adults. It’s suggested that doing something unusual, like knocking on wood or patting yourself on the head, while taking a daily dose of medicine may be an effective strategy to help seniors remember whether they've already taken their daily medications.

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Older brains make good use of 'useless' information

January, 2010

A new study finds a decision-making advantage to the increased difficulty older brains have in filtering out irrelevant information.

It’s now well established that older brains tend to find it harder to filter out irrelevant information. But now a new study suggests that that isn’t all bad. The study compared the performance of 24 younger adults (17-29) and 24 older adults (60-73) on two memory tasks separated by a 10-minute break. In the first task, they were shown pictures overlapped by irrelevant words, told to ignore the words and concentrate on the pictures only, and to respond every time the same picture appeared twice in a row. The second task required them to remember how the pictures and words were paired together in the first task. The older adults showed a 30% advantage over younger adults in their memory for the preserved pairs. It’s suggested that older adults encode extraneous co-occurrences in the environment and transfer this knowledge to subsequent tasks, improving their ability to make decisions.

Reference: 

[276] Campbell, K. L., Hasher L., & Thomas R. C.
(2010).  Hyper-binding: a unique age effect.
Psychological Science: A Journal of the American Psychological Society / APS. 21(3), 399 - 405.

Full text available at http://pss.sagepub.com/content/early/2010/01/15/0956797609359910.full

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