Posts tagged dementia
Articles and news from the latest research reports.
Chewing Ability Linked to Reduced Dementia Risk
The population is aging, and the older we become the more likely it is that we risk deterioration of our cognitive functions, such as memory, decision-making and problem solving. Research indicates several possible contributors to these changes, with several studies demonstrating an association between not having teeth and loss of cognitive function and a higher risk of dementia.
One reason for this could be that few or no teeth makes chewing difficult, which leads to a reduction in the blood flow to the brain. However, to date there has been no direct investigation into the significance of chewing ability in a national representative sample of elderly people.
Now a team comprised of researchers from the Department of Dental Medicine and the Aging Research Center (ARC) at Karolinska Institutet and from Karlstad University in Sweden have looked at tooth loss, chewing ability and cognitive function in a random nationwide sample of 557 people aged 77 or older. They found that those who had difficulty chewing hard food such as apples had a significantly higher risk of developing cognitive impairments. This correlation remained even when controlling for sex, age, education and mental health problems, variables that are often reported to impact on cognition. Whether chewing ability was sustained with natural teeth or dentures also had no bearing on the effect.
The results are published in the Journal of the American Geriatrics Society (JAGS).
Home-Based Assessment Tool for Dementia Screening
Georgia Tech researchers have created a tool that allows adults to screen themselves for early signs of dementia. The home-based computer software is patterned after the paper-and-pencil Clock Drawing Test, one of health care’s most commonly used screening exams for cognitive impairment.
“Technology allows us to check our weight, blood-sugar levels and blood pressure, but not our own cognitive abilities,” said project leader Ellen Yi-Luen Do. “Our ClockMe System helps older adults identify early signs of impairment, while allowing clinicians to quickly analyze the test results and gain valuable insight into the patient’s thought processes.”
Georgia Tech’s ClockMe system eliminates the paper trail and computerizes the test into two main components: the ClockReader Application and the ClockAnalyzer Application. Click here to see a video demo.
Benzodiazepine use and risk of dementia: prospective population based study
Objective To evaluate the association between use of benzodiazepines and incident dementia.
Design Prospective, population based study.
Setting PAQUID study, France.
Participants 1063 men and women (mean age 78.2 years) who were free of dementia and did not start taking benzodiazepines until at least the third year of follow-up.
Main outcome measures Incident dementia, confirmed by a neurologist.
Results During a 15 year follow-up, 253 incident cases of dementia were confirmed. New use of benzodiazepines was associated with an increased risk of dementia (multivariable adjusted hazard ratio 1.60, 95% confidence interval 1.08 to 2.38). Sensitivity analysis considering the existence of depressive symptoms showed a similar association (hazard ratio 1.62, 1.08 to 2.43). A secondary analysis pooled cohorts of participants who started benzodiazepines during follow-up and evaluated the association with incident dementia. The pooled hazard ratio across the five cohorts of new benzodiazepine users was 1.46 (1.10 to 1.94). Results of a complementary nested case-control study showed that ever use of benzodiazepines was associated with an approximately 50% increase in the risk of dementia (adjusted odds ratio 1.55, 1.24 to 1.95) compared with never users. The results were similar in past users (odds ratio 1.56, 1.23 to 1.98) and recent users (1.48, 0.83 to 2.63) but reached significance only for past users.
Conclusions In this prospective population based study, new use of benzodiazepines was associated with increased risk of dementia. The result was robust in pooled analyses across cohorts of new users of benzodiazepines throughout the study and in a complementary case-control study. Considering the extent to which benzodiazepines are prescribed and the number of potential adverse effects of this drug class in the general population, indiscriminate widespread use should be cautioned against.
Delirium has a dramatic impact on older people but is frequently undiagnosed
Delirium is widespread among older people but often goes ignored and untreated, according to new research by US and UK researchers including the University of East Anglia.
Published in the September issue of the Journal of Hospital Medicine, the findings show that delirium - or acute confusion – is common among older adults in hospitals and nursing homes. It has a negative impact on cognition and independence, significantly increases the risk of developing dementia, and triples the likelihood of death. Yet this common, acute condition is frequently either undiagnosed or accepted as inevitable.
Led by the Regenstrief Institute and Indiana University, the research team reviewed 45 years of research encompassing 585 studies. They found that one in three cases of delirium were preventable and are calling for delirium to be identified and treated early to prevent poor long-term prognosis.
“As a geriatric psychiatrist I have seen that around 50 per cent or people with dementia in hospital develop delirium,” said co-author Dr Chris Fox, of Norwich Medical School at the University of East Anglia.
“This is because in addition to having dementia, they have multiple risk factors that can predispose and precipitate delirium – including serious illnesses and pre-existing cognitive impairment. In addition, hospital staff commonly label the signs as dementia related and do not pick up the delirium.”
“We need to develop better mechanisms for diagnosing delirium so that prompt treatment regimes can be initiated.”
In general patient groups, more than 60 per cent of delirium cases are not recognised or treated, and significant numbers of elderly patients leave hospital with ongoing delirium which has been missed.
The authors, led by Dr Babar Khan of the Regenstrief Institute and Indiana University School of Medicine, said that delirium could be prevented by eliminating restraints, treating depression, ensuring that patients have access to glasses and hearing aids, and prescribing classes of antipsychotics that do not negatively affect the aging brain. They also noted the need for a more sensitive screening tool for delirium, especially when administered by a non-expert.
“Delirium is extremely common among older adults in intensive care units and is not uncommon in other hospital units and in nursing homes, but too often it is ignored or accepted as inevitable,” said Dr Khan. “Delirium significantly increases risk of developing dementia and triples likelihood of death. It cannot be ignored.”
Co-author Dr Malaz Boustani, of the Regenstrief Institute, Indiana University School of Medicine and Wishard Healthy Aging Brain Center, said: “Having delirium prolongs the length of a hospital stay, increases the risk of post-hospitalization transfer to a nursing home, increases the risk of death and may lead to permanent brain damage.”
(Source: uea.ac.uk)
Having access to a personal computer lowers or decreases the risk of cognitive decline and dementia in older men by up to 40 per cent, according to researchers at The University of Western Australia.
Winthrop Professor Osvaldo Almeida and his colleagues undertook an eight-year study of more than 5000 Perth men aged from 65 to 85. The results are published in the journal PLoSOne.
Study examines effects of growth hormone-releasing hormone on cognitive function
6-Aug-2012
Treatment with growth hormone-releasing hormone appears to be associated with favorable cognitive effects among both adults with mild cognitive impairment and healthy older adults, according to a randomized clinical trial published Online First by Archives of Neurology, a JAMA Network publication.
"Growth hormone-releasing hormone (GHRH), growth hormone and insulinlike growth factor 1 have potent effects on brain function, their levels decrease with advancing age, and they likely play a role in the pathogenesis of Alzheimer disease," the authors write as background information in the study.
To examine the effects of GHRH on cognitive function in healthy older adults and in adults with mild cognitive impairment (MCI), Laura D. Baker, Ph.D., of the University of Washington School of Medicine and Veterans Affairs Puget Sound Health Care System, Seattle, and colleagues, conducted a randomized, double-blind, placebo-controlled trial in which participants self-administered daily injections of a form of human GHRH (tesamorelin), or placebo.
The authors enrolled 152 adults ranging in age from 55 to 87 years (average age, 68 years) and 137 participants (76 healthy patients and 61 patients with MCI) successfully completed the study. At baseline, at 10 and 20 weeks of treatment, and after a 10-week washout (30 weeks total), the authors collected blood samples and administered parallel versions of cognitive tests.
Among the original 152 patients enrolled in the study, analysis indicated a favorable effect of GHRH on cognition, which was comparable in adults with MCI and healthy older adults. Analysis among the 137 patients who successfully completed the trial also showed that treatment with GHRH had a favorable effect on cognition among both groups of patients. Although the healthy adults outperformed those with MCI overall, the cognitive benefits relative to placebo was comparable among both groups.
Treatment with GHRH also increased insulin like growth factor 1 levels by 117 percent, which remained within the physiological range, and increased fasting insulin levels within the normal range by 35 percent in adults with MCI but not in healthy adults.
"Our results replicate and expand our earlier positive findings, demonstrating that GHRH administration has favorable effects on cognitive function not only in healthy older adults but also in adults at increased risk of cognitive decline and dementia," the authors conclude. "Larger and longer-duration treatment trials are needed to firmly establish the therapeutic potential of GHRH administration to promote brain health in normal aging and ‘pathological aging.’"
Source: EurekAlert!
Donepezil found helpful in dementia with lewy bodies
July 31, 2012
(HealthDay) — For patients with dementia with Lewy bodies (DLB), treatment with 5 or 10 mg/day donepezil is associated with significant cognitive, behavioral, and global function improvements, according to research published in the July issue of the Annals of Neurology.
Etsuro Mori, M.D., Ph.D., of the Tohoku University Graduate School of Medicine in Sendai, Japan, and colleagues conducted a randomized, double-blind, placebo-controlled trial involving 140 patients with DLB who received either placebo or 3, 5, or 10 mg of donepezil hydrochloride per day for 12 weeks (35, 35, 33, and 37 patients, respectively). Cognitive function was measured using the Mini-Mental State Examination (MMSE); behavioral changes were measured using the Neuropsychiatric Inventory; global function was evaluated using the Clinician’s Interview-Based Impression of Change-plus Caregiver Input (CIBIC-plus); and caregiver burden was also assessed.
The researchers found that, compared with placebo treatment, the MMSE scores were significantly better with donepezil 5 mg (mean difference, 3.8) and 10 mg (mean difference, 2.4), but the 3 mg/day dose was not significantly better than placebo (P = 0.017). Donepezil at doses of 3, 5, and 10 mg/day correlated with significant improvements versus placebo on CIBIC-plus. Both the 5 and 10 mg doses of donepezil resulted in significant improvements in behavioral measures. Caregiver burden also improved, but only with the 10 mg/day dose. The safety results were similar among the groups and were consistent with the known profile.
"Donepezil at 5 and 10 mg/day produces significant cognitive, behavioral, and global improvements that last at least 12 weeks in DLB patients, reducing caregiver burden at the highest dose," the authors write. Several authors disclosed financial ties to pharmaceutical companies, including Eisai Co., which funded the study and manufactures donepezil.
Source: medicalxpress.com
Shortened telomere length tied to dementia, mortality risk
July 25, 2012
(HealthDay) — Shortened telomere length (TL) is associated with risks for dementia and mortality in a population of older adults, according to a study published online July 23 in the Archives of Neurology.
Lawrence S. Honig, M.D., Ph.D., from the Columbia University College of Physicians and Surgeons in New York City, and colleagues used real-time polymerase chain reaction analysis to determine TL in stored leukocyte DNA from 1,983 participants in a community-based study of aging. Participants were 65 years or older and blood was drawn at a mean age of 78.3 years. Participants were followed for a median of 9.3 years for mortality, and 9.6 percent developed incident dementia.
The researchers found that TL correlated inversely with age and was shorter in men than women. TL was significantly shorter in persons dying during follow-up compared with survivors, even after adjusting for age, sex, education, and apolipoprotein E genotype. TL was significantly shorter in the participants with incident and prevalent dementia, compared with those who remained dementia-free. Shorter TL correlated with earlier onset of dementia but this association was significant in women only.
"Our results show an association between shortened TL and mortality, and more specifically an association of shortened TL with Alzheimer’s disease, and are consistent with but not indicative of the possibility that TL may be a factor indicative of biological age," the authors conclude.
Source: medicalxpress.com
Yoga Reduces Stress; Now It’s Known Why
Six months ago, researchers at UCLA published a study that showed using a specific type of yoga to engage in a brief, simple daily meditation reduced the stress levels of people who care for those stricken by Alzheimer’s and dementia. Now they know why.
“The goal of the study was to determine if meditation might alter the activity of inflammatory and antiviral proteins that shape immune cell gene expression,” said Lavretsky. “Our analysis showed a reduced activity of those proteins linked directly to increased inflammation.
“This is encouraging news. Caregivers often don’t have the time, energy, or contacts that could bring them a little relief from the stress of taking care of a loved one with dementia, so practicing a brief form of yogic meditation, which is easy to learn, is a useful too.”
Perceptions trick memory
July 11, 2012
An inflated sense of memory function in people with dementia may influence their likelihood of seeking help, new Flinders University research shows.
As part of her PhD, Flinders research associate Dr. Chris Materne studied the disparity between memory perception and performance in people with dementia.
In the first stage of the project, Dr. Materne analysed data from the Australian Longitudinal Study of Aging which showed that most survey participants believed their memory had remained stable over the 11-year assessment, despite tests showing a decline in memory performance.
She then conducted an intervention with 13 individuals, from a larger group of 23 people with dementia, using spaced retrieval memory training to help them achieve a specific task or activity, such as remembering to lock the front door or keep their glasses in the same spot.
“Spaced retrieval works by helping people remember specific information or tasks by getting them to respond to a prompt question over progressively increasing intervals of time,” Dr. Materne said.
“In one case we helped a man remember to put his glasses in the same place because he was always losing them which made both him and his wife quite distressed,” she said.
“We think the training taps into procedural memory so it becomes habitual rather than explicit memory, such as memory for facts, which tends to decline before procedural memory when you have dementia.”
The technique was conducted once a week for six weeks, with seven out of the 13 participants still able to perform their nominated activity or task after six months.
The 23 participants were also asked to rate their performance based on a specific question, such as how many people they could name in a photo with 10 faces.
While most respondents were initially over-confident in their abilities, with some claiming to be able to name all 10 faces, their perceptions did change over time to more accurately reflect their cognitive function.
About one third of family carers, however, initially considered their loved ones memory to be better than what the person with dementia actually reported.
“In the longitudinal sample people didn’t feel their memory had changed over time because the questions were more general but when we asked specific, detailed questions about memory in the smaller study, the respondents came to recognise their declining performance.”
Dr. Materne said the research highlighted the need for more comprehensive assessments when diagnosing dementia to increase the accuracy of peoples’ perceptions, and therefore their likelihood of seeking help.
Provided by Flinders University
Source: medicalxpress.com