Tag Archives: cognitive impairment

Orienteering can train the brain, may help fight cognitive decline

The sport of orienteering, which draws on athleticism, navigational skills and memory, could be useful as an intervention or preventive measure to fight cognitive decline related to dementia, according to new research from McMaster University.

Researchers hypothesized that the physical and cognitive demands of orienteering, which integrates exercise with navigation, may stimulate parts of the brain that our ancient ancestors used for hunting and gathering. The brain evolved thousands of years ago to adapt to the harsh environment by creating new neural pathways. 

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Those same brain functions are not as necessary for survival today due to modern conveniences such as GPS apps and readily available food. Researchers suggest it is a case of “use it or lose it.”

“Modern life may lack the specific cognitive and physical challenges the brain needs to thrive,” says Jennifer Heisz, Canada Research Chair in Brain Health and Aging at McMaster University, who supervised the research. “In the absence of active navigation, we risk losing that neural architecture.”

Heisz points to Alzheimer’s disease, in which losing the ability to find one’s way is among the earliest symptoms, affecting half of all afflicted individuals, even in the mildest stage of the disease.

In the study, published in the journal PLoS ONE, researchers surveyed healthy adults, ranging in age from 18 to 87 with varying degrees of orienteering expertise (none, intermediate, advanced and elite).

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Machine learning gives nuanced view of Alzheimer’s stages

 A Cornell-led collaboration used machine learning to pinpoint the most accurate means, and timelines, for anticipating the advancement of Alzheimer’s disease in people who are either cognitively normal or experiencing mild cognitive impairment.

The modeling showed that predicting the future decline into dementia for individuals with mild cognitive impairment is easier and more accurate than it is for cognitively normal, or asymptomatic, individuals. At the same time, the researchers found that the predictions for cognitively normal subjects is less accurate for longer time horizons, but for individuals with mild cognitive impairment, the opposite is true.

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The modeling also demonstrated that magnetic resonance imaging (MRI) is a useful prognostic tool for people in both stages, whereas tools that track molecular biomarkers, such as positron emission tomography (PET) scans, are more useful for people experiencing mild cognitive impairment.

The team’s paper, “Machine Learning Based Multi-Modal Prediction of Future Decline Toward Alzheimer’s Disease: An Empirical Study,” published Nov. 16 in PLOS ONE. The lead author is Batuhan Karaman, a doctoral student in the field of electrical and computer engineering.

Alzheimer’s disease can take years, sometimes decades, to progress before a person exhibits symptoms. Once diagnosed, some individuals decline rapidly but others can live with mild symptoms for years, which makes forecasting the rate of the disease’s advancement a challenge.

“When we can confidently say someone has dementia, it is too late. A lot of damage has already happened to the brain, and it’s irreversible damage,” said senior author Mert Sabuncu, associate professor of electrical and computer engineering in the College of Engineering and of electrical engineering in radiology at Weill Cornell Medicine.

“We really need to be able to catch Alzheimer’s disease early on,” Sabuncu said, “and be able to tell who’s going to progress fast and who’s going to progress slower, so that we can stratify the different risk groups and be able to deploy whatever treatment options we have.”

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Music helps patients with dementia connect with loved ones – NW

People with dementia often lose their ability to communicate verbally with loved ones in later stages of the disease. But a Northwestern Medicine study, in collaboration with Institute for Therapy through the Arts (ITA), shows how that gap can be bridged with a new music intervention. 

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In the intervention — developed at ITA and called “Musical Bridges to Memory” — a live ensemble plays music from a patient’s youth such as songs from the musicals “Oklahoma” or “The Sound of Music.” This creates an emotional connection between a patient and their caregiver by allowing them to interact with the music together via singing, dancing and playing simple instruments, the study authors said. 

The program also enhanced patients’ social engagement and reduced neuropsychiatric symptoms such as agitation, anxiety and depression in both patients and caregivers.

More than 6 million people in the U.S. have Alzheimer’s disease. 

The study is unusual because it targeted patients with dementia and their caregivers, said lead study author Dr. Borna Bonakdarpour. Most prior studies using music for dementia patients have focused only on the patients. 

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Poor eyesight unfairly mistaken for brain decline

Millions of older people with poor vision are at risk of being misdiagnosed with mild cognitive impairments, according to a new study by the University of South Australia.

Cognitive tests that rely on vision-dependent tasks could be skewing results in up to a quarter of people aged over 50 who have undiagnosed visual problems such as cataracts or age-related macular degeneration (AMD).

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Age-related macular degeneration is a leading cause of vision loss for older people. It doesn’t cause complete vision loss, but severely impacts people’s ability to read, drive, cook, and even recognise faces. It has no bearing on cognition.

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Self-administered cognition test predicts early signs of dementia sooner

Many people experience forgetfulness as they age, but it’s often difficult to tell if these memory issues are a normal part of aging or a sign of something more serious. A new study finds that a simple, self-administered test developed by researchers at The Ohio State University Wexner Medical Center, College of Medicine and College of Public Health can identify the early, subtle signs of dementia sooner than the most commonly used office-based standard cognitive test.   

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This earlier detection by the Self-Administered Gerocognitive Examination (SAGE test) is critical to effective treatment, especially as new therapeutics for dementia and Alzheimer’s disease are being developed and approved.   “New disease modifying therapies are available and others are currently being evaluated in clinical trials, and we know that the earlier cognitive impairment is detected, the more treatment choices a patient has and the better the treatments work,” said Dr. Douglas Scharre, director of the Division of Cognitive and Memory Disorders in the Department of Neurology at Ohio State and lead author of the study published in the journal Alzheimer’s Research & Therapy.

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What Are the Signs and Symptoms of Alzheimer’s?

Memory problems are often one of the first signs of Alzheimer’s. Symptoms vary from person to person, and may include problems with:

  • Word-finding, or having more trouble coming up with words than other people the same age.
  • Vision and spatial issues, like awareness of the space around them.
  • Impaired reasoning or judgment, which can impact decisions.

Other symptoms may be changes in the person’s behavior, including:

  • Taking longer to complete normal daily tasks.
  • Repeating questions.
  • Trouble handling money and paying bills.
  • Wandering and getting lost.
  • Losing things or misplacing them in odd places.
  • Mood and personality changes.
  • Increased anxiety and/or aggression.

How Is Alzheimer’s Diagnosed and Treated?

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What Is Alzheimer’s Disease?

As a senior citizen one of my most serious concerns is my mental functioning. My mother and her sister were afflicted with forms of dementia, including Alzheimer’s Disease. Also, my father’s father suffered cognitive problems in the 1940’s. Finally, my father’s sister and her daughter, my cousin had forms of dementia. It runs in my family and judging by the number of cases reported, there is a chance it runs in yours, too.

Here is what Alzheimers.gov has to say on the subject:

Alzheimer’s disease is a brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. People with Alzheimer’s also experience changes in behavior and personality.

More than 6 million Americans, many of them age 65 and older, are estimated to have Alzheimer’s disease. That’s more individuals living with Alzheimer’s disease than the population of a large American city. Many more people experience Alzheimer’s in their lives as family members and friends of those with the disease.

The symptoms of Alzheimer’s disease — changes in thinking, remembering, reasoning, and behavior — are known as dementia. That’s why Alzheimer’s is sometimes referred to as “dementia.” Other diseases and conditions can also cause dementia, with Alzheimer’s being the most common cause of dementia in older adults.

Alzheimer’s disease is not a normal part of aging. It’s the result of complex changes in the brain that start years before symptoms appear and lead to the loss of brain cells and their connections.

What Causes Alzheimer’s?

The causes of Alzheimer’s disease are not yet fully understood, but probably include a combination of:

  • Age-related changes in the brain, like shrinking, inflammation, blood vessel damage, and breakdown of energy within cells, which may harm neurons and affect other brain cells.
  • Changes or differences in genes, which may be passed down by a family member. Both types of Alzheimer’s — the very rare early-onset type occurring between age 30 and mid-60s, and the most common late-onset type occurring after a person’s mid-60s — can be related to a person’s genes in some way. Many people with Down syndrome, a genetic condition, will develop Alzheimer’s as they age and may begin to show symptoms in their 40s.
  • Health, environmental, and lifestyle factors that may play a role, such as exposure to pollutants, heart disease, stroke, high blood pressure, diabetes, and obesity.

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10 Early Signs of Alzheimer’s

Your dad just asked the same question he asked — and you answered — a few minutes ago. You realize that it’s not the first time he’s repeated himself or forgotten something you just said. What does this mean? Does he have Alzheimer’s disease?

Memory changes can be scary, both as an older adult experiencing them and as a family member or caregiver noticing them. But it’s important to note that forgetfulness doesn’t necessarily equal Alzheimer’s disease.

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“The red flag is if it’s happening on a consistent basis and is paired with a change in the person’s ability to function,” says Magdalena Bednarczyk, MD, a geriatrician at Rush University Medical Center. “When a patient comes to me for an evaluation, it’s usually because family and friends have noticed uncharacteristic or concerning behaviors, not just memory issues.”

According to Bednarczyk and the Alzheimer’s Association, if you notice any of these 10 signs — especially more than one — talk to your loved one about seeing their primary care doctor or geriatrician as soon as possible:

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People with dementia at higher risk for COVID-19 – Study

Patients with dementia were at a significantly increased risk for COVID-19 — and the risk was higher still for African Americans with dementia, according to a study led by Case Western Reserve University researchers.

Reviewing electronic health records of 61.9 million adults in the United States, researchers found the risk of contracting COVID-19 was twice as high for patients with dementia than for those without it — while among those with dementia, African Americans had close to three times the risk of being infected with COVID-19 as Caucasians did.

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In addition, patients with dementia who contracted COVID-19 had significantly worse outcomes in terms of hospitalizations and deaths than those who had COVID-19 but not dementia.

The study was published Feb. 9 by the peer-reviewed Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association and highlights the need to protect people with dementia — particularly African Americans — as part of the strategy to control the pandemic.

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Hearing and Vision Loss May Speed Development of Cognitive Problems

Cognitive decline ranges in severity from mild cognitive impairment (MCI) to Alzheimer’s disease and related dementias (ADRD). It is marked by memory loss and difficulty thinking and making decisions. Cognitive decline is a significant, common challenge to older adults’ well-being and their ability to live independently.

Today, cognitive impairment and ADRD are major global public health and social concerns as the population of older adults rises around the world. By 2050, more than 152 million people will be affected by these conditions. That’s why many countries, including the United States, see the prevention of ADRD as a key public health priority and are studying programs to help stem these diseases.

One way to prevent cognitive impairment and ADRD is to treat the problems that raise the risk for developing them. Two of these risk factors are hearing and vision loss. Currently, about 60 percent of people aged 70 years or older are affected by hearing loss, 40 percent are affected by vision loss, and 23 percent of older adults have both vision and hearing loss. Some studies have suggested that having both hearing and vision loss may be linked to poorer cognitive function or to a faster rate of cognitive decline.

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Older people with early, asymptomatic Alzheimer’s at risk of falls

Falls are the leading cause of fatal injuries in older adults, causing more than 800,000 hospitalizations and about 30,000 deaths in the U.S. every year. Some risk factors are well-known — advanced age, problems with vision or balance, muscle weakness — but an under-recognized factor is early Alzheimer’s disease. Older people in the earliest stages of Alzheimer’s, before cognitive problems arise, are more likely to suffer a fall than people who are not on track to develop dementia.

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Researchers at Washington University School of Medicine in St. Louis have found that, in older people without cognitive problems who experience a fall, the process of neuro-degeneration that leads to Alzheimer’s dementia already may have begun. The findings, available online in the Journal of Alzheimer’s Disease, suggest that older people who have experienced falls should be screened for Alzheimer’s and that new strategies may be needed to reduce the risk of falling for people in the disease’s early stages.

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Poor cognitive performance predicts later impairment in daily living activities

Subtle differences in cognition may help identify individuals at risk for becoming dependent years later upon others to complete daily activities, such as managing medications or finances and other essential activities.

Writing in the September 29, 2020 online issue of the Journal of Alzheimer’s Disease, researchers at University of California San Diego School of Medicine, with colleagues elsewhere, linked poorer cognitive performance in a single testing with subsequent greater risk for impaired daily life activities nearly a decade later.

The study involved a diverse but understudied cohort of Latinos living in the United States. Outcomes were most severe for individuals 70 years and older, but gender and ethnic background, such as Mexican or Puerto Rican, were not significant differentiators. The authors said the findings in sum highlight the need for early preventive care across Latinos and Latinas of various backgrounds.

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How Diabetes and Obesity Affect the Brain

With more than 30 million Americans diagnosed with diabetes, and another 87 million diagnosed with obesity, both conditions have become national epidemics. 

The two diseases cause a number of complications, including neuropathy, which causes damage to the peripheral nerves. Neuropathy is characterized by numbness or tingling and can sometimes be accompanied by pain. 

Brian Callaghan, M.D., the Fovette E. Dush associate professor of neurology, has sounded an alarm through his recent clinical research, which has demonstrated that, in addition to peripheral nerve damagediabetes and obesity can also cause cognitive dysfunction, effecting thinking, reasoning or memory. 

Here, Callaghan discusses his latest work and ways to identify and treat the condition:

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Repeated head impacts associated with later-life depression symptoms, worse cognitive function

Scientists have long believed that a single traumatic brain injury (TBI) earlier in life may contribute to problems with memory, thinking and depression later in life. In most previous studies, however, research failed to examine the possible role of having a history of exposure to repetitive head impacts, including those leading to “subconcussive” injuries, in these later-life problems. In the largest study of its kind, an association has been found in living patients exposed to repetitive head impacts and difficulties with cognitive functioning and depression years or decades later.

Scientists from the Boston University (BU) Alzheimer’s Disease and Chronic Traumatic Encephalopathy (CTE) Centers, the University of California, San Francisco (UCSF), and San Francisco VA Healthcare System teamed up to analyze the records of 13,323 individuals age 40 and older (average age 62) who participate in the internet-based Brain Health Registry. Of those, 725 or 5 percent of participants reported exposure to previous repetitive head impacts through contact sports, abuse or military service. In addition to repetitive head impact history, the scientists also examined the effects of having a TBI with and without loss of consciousness.

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Lower hand grip strength associated with cognitive impairment

Older adults with a weaker hand grip were more likely to be cognitively impaired than those with a stronger grip, according to an NIA-funded study in the Journal of Alzheimer’s Disease. The findings suggest that hand grip strength may be a potential low-cost, easy way to help detect cognitive impairment and, in combination with other measures, to identify people who may benefit from early interventions.

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A team led by researchers from North Dakota State University looked at data over an eight-year period from almost 14,000 people, age 50 or older, in the NIA-supported Health and Retirement Study. A handheld instrument called a dynamometer was used to assess hand grip strength, and a modified screening tool from the Mini-Mental State Examination was used to measure cognitive function every two years. Of the 13,828 participants who were assessed, 1,309 had some degree of cognitive impairment. Continue reading

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Moving More in Old Age May Protect Brain from Dementia

Older adults who move more than average, either in the form of daily exercise or just routine physical activity such as housework, may maintain more of their memory and thinking skills than people who are less active than average, even if they have brain lesions or bio-markers linked to dementia, according to a study by Rush University Medical Center.adult man playing a musial instrument

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The study results were published in the online issue of Neurology, the medical journal of the American Academy of Neurology. Continue reading

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