seniors

No benefit in omega-3 supplements for cognitive decline

  • A large study of older adults with age-related macular degeneration found no cognitive benefit from taking omega-3 supplements, or supplements of lutein and zeaxanthin.

A large, five-year study challenges the idea that omega-3 fatty acids can slow age-related cognitive decline. The study, involving 4,000 older adults, was part of the Age-Related Eye Disease Study (AREDS), which established that daily high doses of certain antioxidants and minerals can help slow the progression of age-related macular degeneration. However, a follow-up study found the addition of omega-3 fatty acids to the AREDS formula made no difference.

Omega-3 fatty acids are believed to be responsible for the health benefits associated with regularly eating fish, which is associated with lower rates of AMD, cardiovascular disease, and possibly dementia.

In this study, participants from the AREDS study, all of whom had early or intermediate AMD, were randomly assigned to either omega-3, or lutein and zeaxanthin (nutrients found in large amounts in green leafy vegetables), or both, or a placebo. As they all had AMD, participants also took the AREDS formula, which includes vitamins C, E, beta carotene, and zinc. Cognitive testing took place at the beginning, at 2 years, and at 4 years.

There was no benefit to these supplements: all groups showed a similar rate of cognitive decline over the study period.

The researchers speculate that the failure to find a benefit may lie in the age of the participants — it may be that supplements, to be of benefit, need to be started earlier. The other possibility (and the one I myself give greater weight to, although both factors may well be influential) is that these nutrients need to be taken in food to be effective.

It should be noted that the omega-3 fatty acids taken were those found in fish, not those found in plant foods such as flaxseed, walnuts, soy products, and canola and soybean oils.

http://www.eurekalert.org/pub_releases/2015-08/nei-nss082115.php

http://www.eurekalert.org/pub_releases/2015-08/tjnj-eop082115.php

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Limited benefit of physical activity for preventing cognitive decline

  • A large study of older adults (70+) found no cognitive benefit from a regular exercise program, compared to another social & mental intervention.
  • However, a subset of participants (those over 80, and those with poor physical function at the beginning of the study) did show improvement in executive function.
  • Participants in both programs showed no cognitive decline over the two-year period, suggesting both interventions were helpful.

A large, two-year study challenges the evidence that regular exercise helps prevent age-related cognitive decline.

The study involved 1,635 older adults (70-89) who were enrolled in the Lifestyle Interventions and Independence for Elders (LIFE) study. They were sedentary adults who were at risk for mobility disability but able to walk about a quarter mile. Participants had no significant cognitive impairment (as measured by the MMSE) at the beginning of the study. Around 90% (1476) made it to the end of the study, and were included in the analysis.

Half the participants were randomly assigned to a structured, moderate-intensity physical activity program that included walking, resistance training, and flexibility exercises, and the other half to a health education program of educational workshops and upper-extremity stretching.

In the physical activity condition, participants were expected to attend 2 center-based visits per week and perform home-based activity 3 to 4 times per week. The sessions progressed toward a goal of 30 minutes of walking at moderate intensity, 10 minutes of primarily lower-extremity strength training with ankle weights, and 10 minutes of balance training and large muscle group flexibility exercises.

The health education group attended weekly health education workshops during the first 26 weeks of the intervention and at least monthly sessions thereafter. Sessions lasted 60 to 90 minutes and consisted of interactive and didactic presentations, facilitator demonstrations, guest speakers, or field trips. Sessions included approximately 10 minutes of group discussion and interaction and 5 to 10 minutes of upper-extremity stretching and flexibility exercises.

Cognitive assessments were made at the beginning of the study and at 24 months, as well as a computerized assessment at either 18 or 30 months.

At the end of the study, there was no significant difference in cognitive score, or incidence of MCI or dementia, between the two groups. However, those in the exercise group who were 80 years or older ( 307) and those with poorer baseline physical performance ( 328) did show significantly better performance in executive function.

Executive function is not only a critical function in retaining the ability to live independently, research has also shown that it is the most sensitive cognitive domain to physical exercise.

Note also that there was no absolute control group — that is, people who received no intervention. Both groups showed remarkably stable cognitive scores over the two years, suggesting that both interventions were in fact effective in “holding the line”.

While this finding is disappointing and a little surprising, it is not entirely inconsistent with the research. Studies into the benefits of physical exercise for fighting age-related cognitive decline and dementia have produced mixed results. It does seem clear that the relationship is not a simple one, and what's needed is a better understanding of the complexities of the relationship. For example, elements of exercise that are critical, and the types of people (genes; health; previous social, physical, and cognitive attributes) that may benefit.

http://www.eurekalert.org/pub_releases/2015-08/tjnj-eop082115.php

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Cardiovascular health & Cognition

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

More evidence bypass surgery not responsible for cognitive impairment

A 6-year study of 326 heart patients has found no differences in brain impairment between those who had on-pump coronary artery bypass surgery (152 patients), off-pump bypass surgery patients (75 patients), and those who had drugs and arterial stents to keep their blood vessels open instead of bypass surgery (99 patients). However, all of them were found to have experienced significant cognitive decline over the six-year study period on tests of verbal memory, visual memory, visuoconstruction, language, motor speed, psychomotor speed, attention, and executive function, when compared to 69 heart-healthy people who had no known risk factors for coronary artery disease. The findings provide more evidence that it is the disease and not the surgery that causes long-term cognitive problems.

Selnes, O.A. et al. 2009. Do Management Strategies for Coronary Artery Disease Influence 6-Year Cognitive Outcomes? Annals of Thoracic Surgery, 88, 445-454.

http://www.eurekalert.org/pub_releases/2009-08/jhmi-itl080309.php

Heart failure linked to cognitive impairment

A study of 50 patients with chronic heart failure, matched with 50 people without HF, has found that patients with HF scored significantly lower than controls on 14 of 19 cognitive tests, and 46% of the HF patients were rated as having mild to severe cognitive impairment, compared to 16% of mild impairment in controls. The degree of cognitive impairment was closely related to the number of myocardial infarctions experienced. These findings have important implications for the care of patients with HF.

Sauvé, M.J. et al. 2009. Cognitive Impairments in Chronic Heart Failure: A Case Controlled Study. Journal of Cardiac Failure, 15 (1), 1-10.

http://www.eurekalert.org/pub_releases/2009-02/e-hfl020509.php

Heart disease linked to worse cognition

Another report has come out from the large Whitehall study, this time on the subject of coronary heart disease and cognition. The study found that coronary heart disease was associated with a worse performance in mental processes such as reasoning, vocabulary and verbal fluency, and that the longer ago the heart disease had been diagnosed, the worse was the person's cognitive performance. This effect was particularly marked in men. Although there has been quite a lot of research on cardiovascular disease and impaired cognition, this is the first, large study to specifically examine the association between coronary heart disease and cognition. The major risk factors for coronary heart disease are all modifiable: cigarette smoking, diabetes, high cholesterol levels and high blood pressure. The findings also support the growing view that it is events happening in earlier life that have an impact on whether or not dementia develops in older age.

Singh-Manoux, A. et al. 2008. History of coronary heart disease and cognitive performance in midlife: the Whitehall II study. European Heart Journal, Advance Access published on July 22, 2008

http://www.eurekalert.org/pub_releases/2008-07/esoc-hdi072108.php

Long-term cognitive decline in bypass patients not due to surgery

Another study has come out supporting the view that coronary bypass patients have no greater risk of long-term cognitive decline than patients not undergoing surgery. The study involved 152 patients who had bypass surgery and 92 patients with coronary artery disease who did not have surgical intervention. Patients had memory and other cognitive tests at the beginning of the study period, and after 3, 12, 36 and 72 months. The results showed that there were no significant differences in cognitive scores between the two groups at the beginning of the study. Both groups showed modest decline in cognitive performance during the study period, but there were no significant differences in the degree of decline between the groups after six years. It was suggested that the decline in both groups was related to the presence of risk factors for vascular disease.

Selnes, O.A. et al. 2008. Cognition 6 Years After Surgical or Medical Therapy for Coronary Artery Disease. Annals of Neurology, 63, 581-590.

http://www.eurekalert.org/pub_releases/2008-05/w-lcd051908.php
http://www.eurekalert.org/pub_releases/2008-05/jhmi-bnt051908.php

Stroke risk factors may signal faster cognitive decline in elderly

Analysis of the stroke risks of over 17,000 people aged 45 and older (average 65.9) has found that a higher stroke risk score was associated with a significantly higher rate of cognitive decline. The study also identified three specific risk factors significantly associated with memory loss – high systolic blood pressure, diabetes, and left ventricular hypertrophy.

The findings were reported at the American Stroke Association’s International Stroke Conference 2008.

http://www.eurekalert.org/pub_releases/2008-02/aha-srf021408.php

Review supports link between lifestyle factors and cognitive function in older adults

A review of 96 papers involving 36 very large, ongoing epidemiological studies in North America and Europe looking at factors involved in maintaining cognitive and emotional health in adults as they age has concluded that controlling cardiovascular risk factors, such as reducing blood pressure, reducing weight, reducing cholesterol, treating (or preferably avoiding) diabetes, and not smoking, is important for maintaining brain health as we age. The link between hypertension and cognitive decline was the most robust across studies. They also found a consistent close correlation between physical activity and brain health. However, they caution that more research is needed before specific recommendations can be made about which types of exercise and how much exercise are beneficial. They also found protective factors most consistently reported for cognitive health included higher education level, higher socio-economic status, emotional support, better initial performance on cognitive tests, better lung capacity, more physical exercise, moderate alcohol use, and use of vitamin supplements. Psychosocial factors, such as social disengagement and depressed mood, are associated with both poorer cognitive and emotional health in late life. Increased mental activity throughout life, such as learning new things, may also benefit brain health.

Hendrie, H.C. et al. 2006. The NIH Cognitive and Emotional Health Project: Report of the Critical Evaluation Study Committee. Alzheimer's & Dementia, 2(1), 12-32.

http://www.eurekalert.org/pub_releases/2006-02/aa-nss021606.php

Why cardiac arrest may hinder ability to learn certain tasks

Cardiac arrest can take a particularly harsh toll on the hippocampus, the area of the brain that plays a critical role in memory and navigation. A new mouse study found that mice that had had a (surgically induced) heart attack had far more difficulty learning a new spatial task than did healthy mice (controls were given the surgery, but didn’t have a cardiac arrest induced). Mice in the heart attack group spent about eight minutes in cardiac arrest – enough time to stop the flow of oxygen to the brain. Analysis of the brain tissue found an overall 18% decrease in dendritic spine density in the hippocampus in the cardiac arrest mice compared to the control mice (dendritic spines are projections from neurons involved in sending signals throughout the central nervous system and the body). The researchers are now looking at how different types of social interactions influence the number and health of neurons that survive a heart attack.

Mervis, R.F., Bachstetter, A., Neigh, G.N., Glasper, E.R., Kofler, J., Traystman, R.J. & DeVries, A.C. 2004. Cardiac arrest with cardiopulmonary resuscitation reduces dendritic spine density in CA1 pyramidal cells and selectively alters acquisition of spatial memory. European Journal of Neuroscience, 20 (7), 1865 – 1872.

http://www.eurekalert.org/pub_releases/2004-09/osu-cam092904.php

Inflammation associated with higher risk of age-related cognitive impairment

So-called “metabolic syndrome” is characterized most obviously by wide girth about the middle (being “apple-shaped”), as well as by high blood pressure and unhealthy levels of cholesterol, triglycerides and glucose in the blood. The syndrome is a well-known risk factor for cardiovascular disease. A new study finds the syndrome is also associated with a greater risk of cognitive impairment (hardly surprising, since many studies now indicate that cardiovascular risk factors are also risk factors for age-related cognitive impairment). The study tracked 2600 people, average age 74 years, over five years. Some 26% of those with the syndrome showed significant cognitive decline, compared to 21% of those without the syndrome. However, it appears the problem is not the syndrome so much as the high levels of inflammation that can result. About 30% of those with the syndrome plus high levels of inflammatory markers in their bloodstream showed significant cognitive decline. Those with the syndrome but no inflammation showed no increased risk.

Yaffe, K., Kanaya, A., Lindquist, K., Simonsick, E.M., Harris, T., Shorr, R.I., Tylavsky, F.A. & Newman, A.B. 2004. The Metabolic Syndrome, Inflammation, and Risk of Cognitive Decline. JAMA, 292, 2237-2242.

Age-related changes in the brain's white matter affect cognitive function

From around age 60, "white-matter lesions" appear in the brain, significantly affecting cognitive function. But without cognitive data from childhood, it is hard to know how much of the difference in cognitive abilities between elderly individuals is due to aging. A longitudinal study has been made possible by the Scottish Mental Survey of 1932, which gave 11-year-olds a validated cognitive test. Scottish researchers have tracked down healthy living men and women who took part in this Survey and retested 83 participants. Testing took place in 1999, when most participants were 78 years old.
It was found that the amount of white-matter lesions made a significant contribution to general cognitive ability differences in old age, independent of prior ability. The amount of white-matter lesions contributed 14.4% of the variance in cognitive scores; early IQ scores contributed 13.7%. The two factors were independent.
Although white-matter lesions are viewed as a normal part of aging, they are linked with other health problems, in particular to circulatory problems (including hypertension, diabetes, heart disease and cardiovascular risk factors).

Deary, I.J., Leaper, S.A., Murray, A.D., Staff, R.T. & Whalley, L.J. 2003. Cerebral White Matter Abnormalities and Lifetime Cognitive Change: A 67-Year Follow-Up of the Scottish Mental Survey of 1932. Psychology and Aging, 18 (1), 140-8.

http://www.eurekalert.org/pub_releases/2003-03/apa-aci031703.php

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Strategies for Older Adults

This concerns studies into strategies specifically for older adults, but that doesn't mean other cognitive strategies can't also be useful! See also Strategies and the specific strategy pages.

See also the separate page for Mental stimulation & cognitive reserve

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

Characteristics of age-related cognitive decline in semantic memory

A study involving 117 healthy elderly (aged 60-91) has found that, while increasing age was associated with poorer memory for names of famous people, age didn’t affect memory for biographical details about them. It also found that names served as better cues to those details than faces did. A follow-up study (to be published in Neuropsychologia) found that, in contrast, those with mild cognitive impairment and early Alzheimer’s showed not only an increased inability to remember names, but also a decline in memory for biographical details.

[1308] Langlois, R., Fontaine F., Hamel C., & Joubert S.
(2009).  [The impact of aging on the ability to recognize famous faces and provide biographical knowledge of famous people].
Canadian Journal on Aging = La Revue Canadienne Du Vieillissement. 28(4), 337 - 345.

http://www.eurekalert.org/pub_releases/2009-12/uom-whn121809.php

Rote learning may improve verbal memory in seniors

A study involving 24 older adults (aged 55—70) has found that six weeks of intensive rote learning (memorizing a newspaper article or poem of 500 words every week) resulted in measurable changes in N-acetylaspartate, creatine and choline, three metabolites in the brain that are related to memory performance and neural cell health, in the left posterior hippocampus — but only after a six-week rest period, at which time the participants also showed improvements in their verbal and episodic memory, and also only in one of the two learning groups. The group that didn’t show any change were said to have low compliance with the memorization task.

McNulty, J. et al. The Identification of Neurometabolic Sequelae Post-learning Using Proton Magnetic Resonance Spectroscopy. Presented November 26 at the annual meeting of the Radiological Society of North America (RSNA).

http://www.eurekalert.org/pub_releases/2006-11/rson-rli112206.php

Actors’ memory tricks help students and older adults

The ability of actors to remember large amounts of dialog verbatim is a marvel to most of us, and most of us assume they do by painful rote memorization. But two researchers have been studying the way actors learn for many years and have concluded that the secret of actors' memories is in the acting; an actor learning lines by focusing on the character’s motives and feelings — they get inside the character. To do this, they break a script down into a series of logically connected "beats" or intentions. The researchers call this process active experiencing, which uses "all physical, mental, and emotional channels to communicate the meaning of material to another person." This principle can be applied in other contexts. For example, students who imagined themselves explaining something to somebody else remembered more than those who tried to memorize the material by rote. Physical movement also helps — lines learned while doing something, such as walking across the stage, were remembered better than lines not accompanied with action. The principles have been found useful in improving memory in older adults: older adults who received a four-week course in acting showed significantly improved word-recall and problem-solving abilities compared to both a group that received a visual-arts course and a control group, and this improvement persisted four months afterward.

[2464] Noice, H., & Noice T.
(2006).  What Studies of Actors and Acting Can Tell Us About Memory and Cognitive Functioning.
Current Directions in Psychological Science. 15(1), 14 - 18.

http://www.eurekalert.org/pub_releases/2006-01/aps-bo012506.php

'Imagination' helps older people remember to comply with medical advice

A new study suggests a way to help older people remember to take medications and follow other medical advice. Researchers found older adults (aged 60 to 81) who spent a few minutes picturing how they would test their blood sugar were 50% more likely to actually do these tests on a regular basis than those who used other memory techniques. Participants were assigned to one of three groups. One group spent one 3-minute session visualizing exactly what they would be doing and where they would be the next day when they were scheduled to test their blood sugar levels. Another group repeatedly recited aloud the instructions for testing their blood. The last group were asked to write a list of pros and cons for testing blood sugar. All participants were asked not to use timers, alarms or other devices. Over 3 weeks, the “imagination” group remembered 76% of the time to test their blood sugar at the right times of the day compared to an average of 46% in the other two groups. They were also far less likely to go an entire day without testing than those in the other two groups.

[473] Liu, L. L., & Park D. C.
(2004).  Aging and medical adherence: the use of automatic processes to achieve effortful things.
Psychology and Aging. 19(2), 318 - 325.

http://www.eurekalert.org/pub_releases/2004-06/nioa-ho060104.php

How to benefit from memory training

Brain and memory training programs are increasingly popular, but they don't work well for everyone. In particular, they tend to be much less effective for those who need them the most — those 80 and older, and those with lower initial ability. But a new study shows the problem is not intrinsic, but depends on the strategies people use.  The study found that people in their 60s and 70s used a strategy of spending most of their time on studying the materials and very little on the test, and showed large improvements over the testing sessions. By contrast, most people in their 80s and older spent very little time studying and instead spent most of their time on the test. These people did not do well and showed very little improvement even after two weeks of training.

[882] Bissig, D. [1], & Lustig C. [2]
(2007).  Who Benefits From Memory Training?.
Psychological Science. 18, 720 - 726.

http://www.eurekalert.org/pub_releases/2007-08/uom-dpt082007.php

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Physical activity saves hippocampus in people at risk of Alzheimer's

A study involving 97 healthy older adults (65-89) has found that those with the “Alzheimer’s gene” (APOe4) who didn’t engage in much physical activity showed a decrease in hippocampal volume (3%) over 18 months. Those with the gene who did exercise showed no change in the size of their

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More evidence bilingualism protects against dementia

An Indian study involving 648 dementia patients, of whom 391 were bilingual, has found that, overall, bilingual patients developed dementia 4.5 years later than the monolingual ones. There was no additional advantage to speaking more than two languages.

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Depression in the elderly linked to Alzheimer's risk

A study, involving 371 patients with mild cognitive impairment, has found that those with depressive symptoms had higher levels of amyloid-beta, particularly in the frontal cortex and the anterior and posterior cingulate gyrus (both involved in mood disorders such as depression).

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Alzheimer’s caregivers may benefit from tailored interventions

A study involving 206 spousal and adult children caregivers of dementia sufferers (mostly Alzheimer’s) has found that about 84% of caregivers reported a clinically significant burden. Three factors were significant contributors to the burden:

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Unmet needs among those living at home with dementia

A study involving 254 people with dementia living at home has found that 99% of people with dementia and 97% of their caregivers had one or more unmet needs, 90% of which were safety-related. More than half of the patients had inadequate meaningful daily activities at a senior center or at home, one-third still needed a dementia evaluation or diagnosis, and more than 60% needed medical care for conditions related or unrelated to their dementia.

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Alzheimer's a much larger cause of death than reported

A new U.S. study suggests that Alzheimer's disease and other dementias are markedly under-reported on death certificates and medical records. Death certificates tend to only provide an immediate cause, such as pneumonia, and don’t mention the underlying condition that provoked it.

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