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).
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.
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.
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.
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.
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.
“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:
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.
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.
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.
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.
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.
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.
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.
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.
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.
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 →
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.
Significant reductions in the risk of mild cognitive impairment (MCI)*, and the combination of MCI and dementia**, have been shown for the first time through aggressive lowering of systolic blood pressure in new research results from the federally-funded SPRINT MIND Study reported at the Alzheimer’s Association International Conference (AAIC) in Chicago.
“This is the first randomized clinical trial to demonstrate a reduction in new cases of MCI alone and the combined risk of MCI plus all-cause dementia,” said Jeff D. Williamson, MD, MHS, Professor of Internal Medicine and Epidemiology and Chief, Section on Gerontology and Geriatric Medicine at Wake Forest School of Medicine. Williamson reported these results at AAIC 2018.
The results of this large-scale, long-term clinical trial provide the strongest evidence to date about reducing risk of MCI and dementia through the treatment of high blood pressure, which is one of the leading causes of cardiovascular disease worldwide.
“This study shows more conclusively than ever before that there are things you can do — especially regarding cardiovascular disease risk factors — to reduce your risk of MCI and dementia,” said Maria C. Carrillo, PhD, Alzheimer’s Association Chief Science Officer. “To reduce new cases of MCI and dementia globally we must do everything we can — as professionals and individuals — to reduce blood pressure to the levels indicated in this study, which we know is beneficial to cardiovascular risk.”
Test identifies smaller brain volume and problems with thinking.
A simple saliva test could help identify thinking problems in older people, a new study finds.
The study found a connection between the stress hormone cortisol and thinking skills.
Higher cortisol levels in the evening were linked to worse thinking skills and smaller brain volumes.
Dr Lenore J. Launer, one of the study’s authors, said:
“Studies have shown that depression increases the risk for dementia, but we don’t know much about how this relationship occurs.
High levels of the stress hormone cortisol have been found in people with depression, and the theory is that cortisol has a toxic effect on the hippocampus area of the brain, which plays an important role in memory.”
The study included data from 4,244 people who did not have dementia.
Dr Launer said:
“Since this study just looked at a snapshot in time, we don’t know…
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