Posts tagged cognitive decline

Unlocking the secrets to better treating the pernicious disorders of obesity and dementia reside in the brain, according to a paper from American University’s Center for Behavioral Neuroscience. In the paper, researchers make the case for treating obesity with therapies aimed at areas of the brain responsible for memory and learning. Furthermore, treatments that focus on the hippocampus could play a role in reducing certain dementias.

"In the struggle to treat these diseases, therapies and preventive measures often fall short. This is a new way for providers who treat people with weight problems and for researchers who study dementias to think about obesity and cognitive decline," said Prof. Terry Davidson, center director and lead study author.

In the paper, published in the journal Physiology & Behavior, Davidson and colleague Ashley A. Martin review research findings linking obesity with cognitive decline, including the center’s findings about the “vicious cycle” model, which explains how weight-challenged individuals who suffer from particular kinds of cognitive impairment are more susceptible to overeating.

Obesity, Memory Deficits and Lasting Effects

It is widely accepted that overconsumption of dietary fats, sugar and sweeteners can cause obesity. These types of dietary factors are also linked to cognitive dysfunction. Foods that are risk factors for cognitive impairment (i.e., foods high in saturated fats and simple carbohydrates that make up the modern Western diet) are so widespread and readily available in today’s food environment, their consumption is all but encouraged, Davidson said.

Across age groups, evidence reveals links between excess food intake, body weight and cognitive dysfunction. Childhood obesity and consumption of the Western diet can have lasting effects, as seen through the normal aging process, cognitive deficits and brain pathologies. Several analyses of cases of mild cognitive impairment progressing to full-blown cases of Alzheimer’s disease show that the first signs of brain disease can occur at least 50 years prior to the emergence of serious cognitive dysfunction. These signs originate in the hippocampus, the area of the brain where memory, learning, decision making, behavior control and other cognitive functions come into play.

Still, most research on the role of the brain in obesity focuses on areas thought to be involved with hunger motivation (e.g., hypothalamus), taste (e.g., brain stem), reinforcement (e.g., striatum) and reward (e.g., nucleus accumbens) or with hormonal or metabolic disorders. This research has not yet been successful in generating therapies that are effective in treating or preventing obesity, Davidson says.

Vicious Cycle

Experiments in rats by Davidson and colleagues show that overconsumption of the Western diet can damage or change the blood-brain barrier, the tight network of blood vessels protecting the brain and substrates for cognition. Certain kinds of dementias are known to arise from the breakdown in these brain substrates.

"Breakdown in the blood-brain barrier is more rationale for treating obesity as a learning and memory disorder," Davidson said. "Treating obesity successfully may also reduce the incidence of dementias, because the deterioration in the brain is often produced by the same diets that promote obesity."

The “vicious cycle” model AU researchers put forth says eating a Western diet high in saturated fats, sugar and simple carbohydrates produces pathologies in brain structures and circuits, ultimately changing brain pathways and disrupting cognitive abilities.

It works like this: People become less able to resist temptation when they encounter environmental cues (e.g., food itself or the sight of McDonald’s Golden Arches) that remind them of the pleasures of consumption. They then eat more of the same type of foods that produce the pathological changes in the brain, leading to progressive deterioration in those areas and impairments in cognitive processes important for providing control over one’s thoughts and behaviors. These cognitive impairments can weaken a person’s ability to resist thinking about food, making them more easily distracted by food cues in the environment and more susceptible to overeating and weight gain.

"People have known at least since the time of Hippocrates that one key to a healthy life is to eat in moderation. Yet many of us are unable to follow that good advice," Davidson said. "Our work suggests that new therapeutic interventions that target brain regions involved with learning and memory may lead to success in controlling both the urge to eat, as well as the undesirable consequences produced by overeating."

(Source: eurekalert.org)

Older people are nearly twice as likely as their younger counterparts to have their memory and cognitive processes impaired by environmental distractions (such as irrelevant speech or written words presented along with target stimuli), according to a new study from psychologists at Rice University and Johns Hopkins University School of Medicine. Whereas other studies had found that older adults are distracted by memories of prior similar events, this was the first study to convincingly demonstrate across several tasks an impairment from environmental distractions.

“Cognitive Declines in Healthy Aging: Evidence from Multiple Aspects of Interference Resolution” appeared in a recent edition of Psychology and Aging. The study supported previous research that showed memory accuracy and the speed of cognitive processing declines with age. It also revealed that older people were at least twice as likely as younger to have irrelevant memories intrude during memory recall and also showed twice as much slowing in cognitive processing in the presence of distracting information in the environment.

The study included 102 people between the ages of 18 and 32 (average age of 21) and 60 people between the ages of 64 and 82 (average age of 71) who participated in a series of memory and cognitive tasks.

For example, when the participants were tested on remembering lists of words, individuals in the young test group remembered words on the list with an average accuracy of 81 percent; in comparison, the old test group’s accuracy was only 67 percent. When irrelevant words were introduced that were to be ignored, the young test group’s accuracy dropped to 74 percent, but the accuracy of the old test group’s performance dropped to 46 percent.

“Almost any type of memory test administered reveals a decline in memory from the age of 25 on,” said Randi Martin, the Elma W. Schneider Professor of Psychology at Rice and the study’s co-author. “However, this is the first study to convincingly demonstrate the impact of environmental interference on processing having a greater impact on older than younger adults.”

Martin hopes that the research will encourage further research of how the brain is affected by environmental distractions.

“From our perspective of studying neuroplasticity (the brain’s ability to reorganize itself after traumatic injury or neurological disorders) and testing patients with brain damage, this research is very important,” Martin said. “The tests used in this study are important tools in determining how the brain is affected by environmental interference, which is critical information in treating neurological disorders, including stroke and traumatic brain injuries.”

(Source: news.rice.edu)

Researchers at Duke-NUS Graduate Medical School Singapore (Duke-NUS) have found evidence that the less older adults sleep, the faster their brains age. These findings, relevant in the context of Singapore’s rapidly ageing society, pave the way for future work on sleep loss and its contribution to cognitive decline, including dementia.

Past research has examined the impact of sleep duration on cognitive functions in older adults. Though faster brain ventricle enlargement is a marker for cognitive decline and the development of neurodegenerative diseases such as Alzheimer’s, the effects of sleep on this marker have never been measured.

The Duke-NUS study examined the data of 66 older Chinese adults, from the Singapore-Longitudinal Aging Brain Study(1). Participants underwent structural MRI brain scans measuring brain volume and neuropsychological assessments testing cognitive function every two years. Additionally, their sleep duration was recorded through a questionnaire. Those who slept fewer hours showed evidence of faster ventricle enlargement and decline in cognitive performance.

"Our findings relate short sleep to a marker of brain aging," said Dr June Lo, the lead author and a Duke-NUS Research Fellow. "Work done elsewhere suggests that seven hours a day(2) for adults seems to be the sweet spot for optimal performance on computer based cognitive tests. In coming years we hope to determine what’s good for cardio-metabolic and long term brain health too," added Professor Michael Chee, senior author and Director of the Centre for Cognitive Neuroscience at Duke-NUS.

(Source: eurekalert.org)

Without a steady supply of blood, neurons can’t work. That’s why one of the culprits behind Alzheimer’s disease is believed to be the persistent blood clots that often form in the brains of Alzheimer’s patients, contributing to the condition’s hallmark memory loss, confusion and cognitive decline.

New experiments in Sidney Strickland’s Laboratory of Neurobiology and Genetics at Rockefeller University have identified a compound that might halt the progression of Alzheimer’s by interfering with the role amyloid-β, a small protein that forms plaques in Alzheimer’s brains, plays in the formation of blood clots. This work is highlighted in the July issue of Nature Reviews Drug Discovery.

For more than a decade, potential Alzheimer’s drugs have targeted amyloid-β, but, in clinical trials, they have either failed to slow the progression of the disease or caused serious side effects. However, by targeting the protein’s ability to bind to a clotting agent in blood, the work in the Strickland lab offers a promising new strategy, according to the highlight published in print on July 1.

This latest study builds on previous work in Strickland’s lab showing amyloid-β can interact with fibrinogen, the clotting agent, to form difficult-to-break-down clots that alter blood flow, cause inflammation and choke neurons.

“Our experiments in test tubes and in mouse models of Alzheimer’s showed the compound, known as RU-505, helped restore normal clotting and cerebral blood flow. But the big pay-off came with behavioral tests in which the Alzheimer’s mice treated with RU-505 exhibited better memories than their untreated counterparts,” Strickland says. “These results suggest we have found a new strategy with which to treat Alzheimer’s disease.”

RU-505 emerged from a pack of 93,716 candidates selected from libraries of compounds, the researchers write in the June issue of the Journal of Experimental Medicine. Hyung Jin Ahn, a research associate in the lab, examined these candidates with a specific goal in mind: Find one that interferes with the interaction between fibrinogen and amyloid-β. In a series of tests that began with a massive, automated screening effort at Rockefeller’s High Throughput Resource Center, Ahn and colleagues winnowed the 93,000 contenders to five. Then, test tube experiments whittled the list down to one contender: RU-505, a small, synthetic compound. Because RU-505 binds to amyloid-β and only prevents abnormal blood clot formation, it does not interfere with normal clotting. It is also capable of passing through the blood-brain barrier.

“We tested RU-505 in mouse models of Alzheimer’s disease that over-express amyloid-β and have a relatively early onset of disease. Because Alzheimer’s disease is a long-term, progressive disease, these treatments lasted for three months,” Ahn says. “Afterward, we found evidence of improvement both at the cellular and the behavioral levels.”

The brains of the treated mice had less of the chronic and harmful inflammation associated with the disease, and blood flow in their brains was closer to normal than that of untreated Alzheimer’s mice. The RU-505-treated mice also did better when placed in a maze. Mice naturally want to escape the maze, and are trained to recognize visual cues to find the exit quickly. Even after training, Alzheimer’s mice have difficulty in exiting the maze. After these mice were treated with RU-505, they performed much better.

“While the behavior and the brains of the Alzheimer’s mice did not fully recover, the three-month treatment with RU-505 prevents much of the decline associated with the disease,” Strickland says.

The researchers have begun the next steps toward developing a human treatment. Refinements to the compound are being supported by the Robertson Therapeutic Development Fund and the Tri-Institutional Therapeutic Discovery Institute. As part of a goal to help bridge critical gaps in drug discovery, these initiatives support the early stages of drug development, as is being done with RU-505.

“At very high doses, RU-505 is toxic to mice and even at lower doses it caused some inflammation at the injection site, so we are hoping to find ways to reduce this toxicity, while also increasing RU-505’s efficacy so smaller doses can accomplish similar results,” Ahn says.

(Source: newswire.rockefeller.edu)

New research suggests that certain types of brain cells may be “picky eaters,” seeming to prefer one specific energy source over others. The finding has implications for understanding the cognitive decline seen in aging and degenerative diseases such as Alzheimer’s and multiple sclerosis.

(Image caption: Neural stem cells differentiate into three different cell types: neurons (purple), oligodendrocytes (red), which produce axon insulation, and astrocytes (green), which also support neurons. Cell nuclei are shown in blue. Credit: Liana Roberts Stein)

Studying mice, investigators from Washington University School of Medicine in St. Louis showed that a specific energy source called NAD is important in cells responsible for maintaining the overall structure of the brain and for performing complex cognitive functions. NAD (nicotinamide adenine dinucleotide) is a molecule that harvests energy from nutrients in food and converts it into a form cells can use.

The work appears in two journal articles — in the May 8 issue of The EMBO Journal, a publication of the European Molecular Biology Organization, and in a recent issue of The Journal of Neuroscience.

“We are interested in understanding how cells make NAD and what implications that has for cellular function, especially in the context of aging and longevity,” said Shin-ichiro Imai, MD, PhD, professor of developmental biology and of medicine and senior author of both papers. “We know, for example, NAD levels decrease with age in tissues such as muscle and fat. We wanted to find out if the same is true in the brain.”

The investigators looked at two types of brain cells: adult neural stem cells, responsible for maintaining supplies of neurons and their supporting cells, and forebrain neurons, vital for performing complex cognitive tasks.

In The EMBO Journal, they reported that NAD levels decreased with age in the mouse hippocampus, a vital region of the brain for cognition. The researchers then used genetic techniques to find out what would happen when NAD manufacturing is turned off in the adult neural stem cells of the mouse brain.

“Neural stem cells are very metabolically expensive, so you might expect them to be particularly vulnerable to loss of an energy source,” said first author Liana Roberts Stein, PhD, postdoctoral researcher in Imai’s lab. “There are other energy sources for brain cells, such as glucose, but no one had ever looked at where NAD is coming from in these cells.”

According to the researchers, there are four pathways of NAD synthesis, and the scientists focused on just one. They wanted to find out whether this particular pathway — a longtime focus of Imai’s lab — is important for these cells or if the other routes could compensate.

The pathway begins with the B vitamin nicotinamide. Cells take dietary nicotinamide and, with a helper protein called Nampt, manufacture a molecule called NMN, which then is processed further to make NAD. When Stein eliminated Nampt from neural stem cells, several significant changes took place.

Levels of NAD dropped, and the neural stem cells stopped dividing; they stopped renewing themselves; and they stopped being able to create important cells that insulate axons, the “wires” that carry electrical signals throughout the brain. With less insulation, these signals slow down, impairing brain function.

Imai and Stein pointed out possible therapeutic implications of this finding, especially in light of what is known about cognitive decline in aging and certain diseases.

“Scientists have shown that with age there actually isn’t a large decrease in the total neuron population,” Stein said. “But there is quite a substantial decrease in white matter, which is primarily composed of cells that function in axon insulation. This pathway also could be relevant in conditions involving loss of cells that make this insulation, like multiple sclerosis.”

Imai and Stein also found they could prevent the loss of the neural stem cells missing Nampt by giving the mice NMN, the next molecule in the chain of events leading to NAD.

“We gave the mice NMN in their drinking water for 12 months,” Stein said. “And at the higher dose, we saw a rescue of the neural stem cell pool in aged mice.”

Imai called this finding exciting because it supports the possibility of a future NMN supplement.

“We think that NMN could convey a similar effect in people,” Imai said. “A future clinical trial for NMN will tell us if it has any efficacy in humans.”

In addition to maintaining stem cell populations and keeping the brain supplied with all its cell types, the investigators showed that NAD also is vital for the process of cognition itself.

Reporting in The Journal of Neuroscience, they showed that neurons of the mouse forebrain depend heavily on NAD in normal cognitive function. Instead of deleting Nampt in stem cells, this time Stein deleted it only in neurons of the forebrain. All other cells were normal, including those that make axon insulation.

Without Nampt and its eventual product, NAD, in forebrain neurons, the behavior of the mice changed dramatically, according to the investigators.

“The mice were really hyperactive, with a twofold increase in activity levels,” Stein said. “They also showed a loss of anxiety-like behaviors. These mice didn’t seem to sense or fear potentially threatening situations and showed fairly drastic memory defects.”

Stein pointed out that these neurons are in a region of the brain known to be particularly vulnerable to neurodegenerative conditions from Alzheimer’s disease to stroke.

“It’s possible that these neurons’ dependence on Nampt is responsible for their extreme susceptibility to these conditions,” she said. “It would be interesting to model some of these diseases in mice and see if supplementing NMN provides any benefit to their behavior or memory.”

“We haven’t done that study yet,” Imai added. “But this is the direction the entire field is going.”

(Source: news.wustl.edu)

Multiple sclerosis researchers have found that brain reserve and cognitive reserve confer a long-term protective effect against cognitive decline.

“Our research aims to answer these questions,” explained Dr. DeLuca. “Why do some people with MS experience disabling symptoms of cognitive decline, while others maintain their cognitive abilities despite neuroimaging evidence of significant disease progression? Can the theories of brain reserve and cognitive reserve explain this dichotomy? Can we identify predictors of cognitive decline?”

In this study, memory, cognitive efficiency, vocabulary (a measure of intellectual enrichment/cognitive reserve), brain volume (a measure of brain reserve), and disease progression on MRI, were evaluated in 40 patients with MS at baseline and at 4.5-year followup. After controlling for disease progression, scientists looked at the impact of brain volume and intellectual enrichment on cognitive decline.

Results supported the protective effects of brain reserve and cognitive reserve,” noted Dr. Sumowski. “Patients with greater intellectual enrichment experienced lesser degrees of cognitive decline. Those with greater brain reserve showed a protective effect for cognitive efficiency. This study not only confirms these protective effects of brain and cognitive reserve, it shows that these beneficial effects persist for years.”

(Source: kesslerfoundation.org)

Past research has long indicated that depression is a big risk factor for memory loss in aging adults. But it is still unclear exactly how the two issues are related and whether there is potential to slow memory loss by fighting depression.

A preliminary study conducted by researchers from the University of Rochester School of Medicine and Dentistry and the School of Nursing, and published in the 42nd edition of Psychoneuroendocrinology in April, delves more deeply into the relationship between depression and memory loss, and how this connection may depend on levels of insulin-like growth factor, or IGF-1.

Prior research has shown that IGF-1, a hormone that helps bolster growth, is important for preserving memory, especially among older adults.

The collaborative study found that people with lower cognitive ability were more likely to have had higher depressive symptoms if they also had low levels of IGF-1. Reversely, participants with high levels of IGF-1 had no link between depressive symptoms and memory.

Senior author Kathi L. Heffner, Ph.D., assistant professor in the School of Medicine and Dentistry’s Department of Psychiatry, had originally examined possible associations between IGF-1 and memory in a sample of 94 healthy older adults, but couldn’t find strong or consistent evidence.

Heffner then approached the study’s lead author Feng (Vankee) Lin, Ph.D, R.N., assistant professor at the School of Nursing, for input because of her expertise in cognitive aging. Lin is a young nurse researcher whose collaborative work focuses on developing multi-model interventions to slow the progression of cognitive decline in at-risk adults, and reduce their risk of developing dementia and Alzheimer’s disease.

“Vankee spearheaded the idea to examine the role of depressive symptoms in these data, which resulted in the interesting link,” Heffner said.

The association discovered between memory loss, depression and IGF-1 means that IGF-1 could be a very promising factor in protecting memory, Lin said.

“IGF-1 is currently a hot topic in terms of how it can promote neuroplasticity and slow cognitive decline,” Lin said. “Depression, memory and the IGF-1 receptor are all located in a brain region which regulates a lot of complicated cognitive ability. As circulating IGF-1 can pass through the blood-brain barrier, it may work to influence the brain in a protective way.”

Lin said more data studies are needed of people with depression symptoms and those with Alzheimer’s disease, but this study opens an important door for further research on the significance of IGF-1 levels in both memory loss and depression.

“It really makes a lot of sense to further develop this study,” Lin said. “If this could be a way to simultaneously tackle depression while preventing cognitive decline it could be a simple intervention to implement.”

Heffner said that clinical trials are underway to determine whether IGF-1 could be an effective therapeutic agent to slow or prevent cognitive decline in people at risk.

“Cognitive decline can also increase risk for depressive symptoms, so if IGF-1 protects people from cognitive decline, this may translate to reduced risk for depression as well,” Heffner said.

(Source: urmc.rochester.edu)