Posts Tagged ‘Dementia’

Reading a Novel Affects the Connectivity in the Brain

December 11, 2016

This post is based on an article in BRAIN CONNECTIVITY, Volume 3, Number 6,
DOI:  10.1089/brain.2013.0166 titled “Short and Long-Term Effects of a Novel on Connectivity in the Brain.”

This study used fMRI recording resting states both before and after reading a novel.   The novel was “Pompeii: A Novel” by Robert Fawcett.  Nineteen participants read this novel over a nine day period.  Resting-state  networks (RSNs) were assessed before and after reading on each of the nine days.  Baseline RSNs were taken five days before the experiment proper and for 5 days after the conclusion of the novel.

On the days after the reading, significant increases in connectivity  were centered on hubs in the left angular/supramarginal gyri and right posterior temporal gyri.  These hubs correspond to regions previously associated with perspective taking and story comprehension, and the changes exhibited a time course that decayed rapidly after the completion of the novel.  Long-term changes in connectivity, which persisted for several days after the reading, were observed in the bilateral somatosensory cortex, suggesting a potential mechanism for “embodied semantics.”  What the authors are referring to in embodied semantics is that the body is responding emotionally to the reading.

What HM finds most interesting about this study is that it provides data showing the
changes that take place in the brain as the result of reading.  This can be regarded as “cognitive exercise” that activates brain circuits and System 2 processing building a cognitive reserve decreasing the likelihood of Alzheimer’s and dementia.

© Douglas Griffith and healthymemory.wordpress.com, 2016. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Sleep-deprived Drivers are as Dangerous as Drunk Drivers

December 9, 2016

This post is based on an article by Ashley Halsey III titled “Sleep-deprived drivers have plenty in common with drunk drivers, on page A2 of the 7 December 2016 edition of the Washington Post.  Her article is based on a report by the AAA Foundation for Traffic Safety released 6 December.   According to the Centers for Disease Control and Prevention about 35% of people get fewer than the needed seven hours of sleep, and 12% say that they sleep for five hours or less.

Previous research by the AAA Foundation found that 21% of fatal crashes involved a sleep-deprived driver.  This new report uses data from the National Motor Vehicle’s Crash Causation Survey to asses how much driving ability decreases based on the lack of sleep.  The executive director of the foundation, David Yang, says that the new research shows that a driver who has slept for less than five hours has a crash risk comparable to someone driving drunk.  The report says that those who slept for less than 4 of the past 24 hours had an 11.5% higher risk of getting into a crash; drivers who slept 4-5 hours had a 4.3% higher risk; 5-7 hours had a 1.9% higher risk; and 6-7 hours had a 1.3% higher risk.  The following caveat is added to these results:  “The study may underestimate the risk of driving while sleep-deprived, because data on crashes that occurred between midnight and 6 a.m. were not available, and other studies have shown that the effects of sleep deprivation…are greatest during the morning hours.”

Tom Calcagni of AAA’s Mid-Atlantic Office said, “The crash risk associated with having slept less than 4 hours is comparable to the crash risk associated with a blood-alcohol content of roughly .12 to .15.  The legal limit is .08.

So add driving while being sleepy to the other activities you should not do while driving:  texting and talking on the phone regardless of whether your hands are free or not, and drunk driving.

The importance of sleep to health in general should not be underestimated.  Our brains are very active while we sleep, consolidating memories and cleaning up junk in the brain.  By failing to get enough sleep we are effectively damaging our brains.  This damage might eventually lead to dementia and Alzheimer’s.

© Douglas Griffith and healthymemory.wordpress.com, 2016. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Superagers with Amazing Memories Have Alzheimer’s Brain Plaques

November 30, 2016

The title of this post is identical to an UpFront News article in the 19 November 2016 issue of the New Scientist.  HM is hoping that healthymemory blog readers are asking, “Is this news?  I thought this was well known!”   Although this is not news, it remains a little known fact in the general public about  Alzheimer’s, when it is the most substantive fact existing about Alzheimers.

The article briefly summarizes work done by Aras Rezvanian and his colleagues at Northwestern University on brain samples donated by superagers to try to understand their exceptional memories.  Of the eight donated samples, two contained so many plaques and tangles that they looked like severe cases of Alzheimer’s.

But to repeat, this finding is not new.  Many such people have died.  Moreover these two individuals were not known to have Alzheimer’s.  After all, they were superagers.  And they died not knowing that they had the definitive symptoms for a diagnosis.

It would be good go  back and read the healthymemory blog “The Myth of Alzheimer’s.”   The senior author of this book is Peter J. Whitehouse, M.D., Ph.D, who was once a researcher earning a lucrative income looking for drugs to mitigate or eradicate Alzheimer’s. He came to the conclusion that such work is fruitless and is now working as a clinician treating and mitigating dementia cases.  Here is his advice, “”It is unlikely that there will ever be a panacea for brain aging and baby boomers should not rely on extraordinary advancements being made in their lifetimes in spite of the promises of the Alzheimer’s Disease (AD) empire that make their way into our headlines. Our attention must begin shifting from mythical cure to hard-earned prevention, from expecting a symptomatic treatment for AD to choosing behaviors that may delay the effects “of cognitve decline over the course of our lives.” Many, if not most, of the behaviors he discusses have been mentioned and advocated in the Healthymemory Blog.

The explanation for people living with the physical symptoms of Alzheimer’s but absent any of the behavioral and clinical symptoms of Alzheimer’s is that they have build up a cognitive reserve.  Cognitive activity, learning new things, is what builds up this cognitive reserve.  There are healthy memory blog posts on theoretical mechanisms for building cognitive reserves, but these posts are hypothetical conjectures.

That cognitive decline can be avoided by staying active has been known at least since the time of the Romans.   The Roman statesman Cicero held a view much more in line with modern-day medical wisdom that loss of mental function was not inevitable in the elderly and “affected only those old men who were weak-willed.”  HM would substitute  “not cognitively active” in the place of “weak-willed.”

When HM taught at a university he was amazed how so many students were able to get their degrees while spending a minimum of cognitive effort.  Other HM blog posts have argued that choices of News shows and political candidates might well be indications of the desire to spend the minimum in the way of cognitive effort.
In closing this post it should be noted that Alzheimer’s is not an inevitable consequence of aging, no matter how great an age is attained.  There are numerous documented supercentenarians (people living to 110+) that experienced no serious cognitive impairment.

© Douglas Griffith and healthymemory.wordpress.com, 2016. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

More on the Hippocampus: Key to Human Memory

February 14, 2016

I neglected to mention in the previous post another, and perhaps more promising approach, than an artificial  hippocampus is to enhance neurogenesis in the hippocampus.  Neurogenesis in the hippocampus is supposed to continue throughout our lifetime, but it is likely that cognitive deficits are due to decreases or stoppages in hippocampal neurogenesis.  So restarting and/or enhancing neurogenesis might improve cognitive functioning.

© Douglas Griffith and healthymemory.wordpress.com, 2016. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

How to Develop a Healthy Memory

December 22, 2015

I get the sense that many who read the healthy memory blog are disappointed that advice is not provided on exactly what to do for a healthy memory.   If a vaccine to either prevent or cure Alzheimer’s and dementia is not in the offing, what specifically should they do.  Is there a diet that will save them?  Will physical exercise suffice, and if so, how much?  What online games do they need to play or what specific cognitive exercises need to be done and for how long?

Hints to some of these question can be found, but no definitive answers.  The reason that no definitive answers can be found is that there are no definitive answers.  The two big themes of this blog are to develop growth mindsets and to practice meditation.  Although diet and physical exercise do play a role, growth mindsets and meditation are key in my view.  The healthy memory blog presents many ideas as to how to pursue growth mindsets and meditation, as well as posts that are provided to help one think about different ideas.

No guarantees can be provided that dementia cannot be prevented.  But I strongly believe that not only reading, but pursuing some of the ideas in the healthy memory blog will greatly reduce one’s risks.  They also provide some guidance on leading a more satisfactory life.  Accordingly, the healthy memory blog should be of interest to people of all ages.

© Douglas Griffith and healthymemory.wordpress.com, 2015. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

One’s Negative View of Aging Increases Alzheimer’s Risk

December 11, 2015

An Article by Tara Bahrampour in the December 8 Washington Post summarizes two articles in the Journal Psychology and Aging.  This research shows that people who have negative beliefs about aging are more likely to have brain changes associated with Alzheimer’s.  They found that the volume of the hippocampus, measured by an MRI exam declined by three times as much among those who hold negative stereotypes about aging when compared with those who do not.  The hippocampus is a structure in the brain which is critical for memory.

The research participants were interviewed about their views on aging long  before the onset of dementia.  Here are some of the examples of the stereotypes believed by these individuals:
Old people are absent minded.
Old people are grouchy.
Old people can’t learn new things.

Readers of the healthy memory blog should be well aware that these stereotypes are false.  Readers of the healthy memory blog should also be well aware that one’s attitude is key in thwarting Alzheimer’s.  Remember the distinction between fixed and growth mindsets.  People having the above beliefs obviously have fixed mindsets.  However, those with growth mindsets would strongly disagree with these sentiments.  And those who are growing their growth mindsets would be even less prone to Alzheimer’s.

These articles also indicated that individuals holding these views showed symptoms of stress.  Stress can be reduced by practicing the Relaxation Response.

So beware of and debunk these negative views of aging.

You might want to read or reread the following healthy memory blogs:

The Myth of Alzheimer’s

The Myth of Cognitive Decline

I’m also reminded of a remark I overheard at work.  A man, who was apparently about to retire said, “When I retire I am going to to nothing—absolutely nothing.   If there are nothing but Lucy reruns on TV, then I’ll watch I Love Lucy.

Unfortunately, this man is a prime candidate for Alzheimer’s.

© Douglas Griffith and healthymemory.wordpress.com, 2015. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

The Importance of a Growth Mindset

October 13, 2015

According to the psychologist Carol Dweck in Mindset:  The New Psychology of Success, there are two types of mindsets:  fixed and growth.  People with a fixed mindset believe that we are who we are, and abilities can only be revealed, not created and developed.  They say things like “I’m bad in math” and see that as a fixed feature like being female or left-handed (and as we know, even these features can be changed).  The problem with this mindset is that it has serious consequences because a person who thinks they are poor at math will remain poor at math and won’t try hard to improve; they believe this would be pointless.  Whatever potential these people have will not be realized if they think that these skills are immutable.

However, people with growth mindsets believe that skills can be developed if they are worked at.  The growth mindset is the true mindset, that allow for personal development.  Fixed mindsets are erroneous mindsets that preclude further development.

Dweck has conducted experiments that illustrate and provide insight into this difference.  In one experiment she gave relatively easy experiments to fifth graders, which they enjoyed. Then she gave the children harder puzzles. Some children suddenly lost interest and declined an offer to take the puzzles home.  Other children loved the harder puzzles more than the easy ones and wanted to know how they could get more of these puzzles.  Dweck noted that the difference between the two groups was not “puzzle-solving talent.”  Among the equally adept children, some were turned off by the tougher challenge while others were intrigued.  They key factor was mindset.

In another experiment Dweck found that even when the fixed-minded try, they don’t get as much from the experience as those who believe they can grow.  She scanned the brains of volunteers as they answered hard questions, then were told whether  their answers were right or wrong and given information that could help them improve.  The scans showed that volunteers with a fixed mindset were fully engaged when they were told whether their answers were right or wrong, but that’s all they apparently cared about.  Information that could help them improve their answers didn’t engage them.  Even when they’d  gotten an answer wrong, they were not interested in what the right answer was.  Only people with a growth mindset paid close attention  to information that could stretch their knowledge.  For them, learning was a top priority.

Having a growth mindset is important for building and maintaining a healthy memory.  Having a growth mindset is even more important as we grow older.  See the healthy memory blog posts (yes, there are two of them) “You Can Teach an Old Dog New Tricks.  Having a growth mindset will build a cognitive reserve and assist in warding off dementia.

© Douglas Griffith and healthymemory.wordpress.com, 2015. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

The Value of Personal Time

August 15, 2015

The value of personal time is something that should not be overlooked.  I had been planning on continuing to work in lieu of retiring.  I knew that there was an inverse relationship between the age of retirement and the onset of dementia.  However, I did not find my work to be fulfilling.  On the contrary, it was aggravating.  As there was no financial need to continue working, I retired.

Since retiring my personal time has significantly increased and I’m finding that this personal time is not only enjoyable, but is also providing opportunities for personal growth.  As long as I grow cognitively, exercise, and eat a reasonable diet, there is no reason to think that my probability for dementia is increasing.  Indeed I believe that the probability of cognitive decline is not only decreasing, but it is also turning into a period of cognitive growth.

I encourage readers to value personal time.  Are you working unnecessarily?  Are you spending personal time so that it is enjoyable and is providing for personal growth?
Planning for retirement is something that should be done early in life.  Always save a portion of earnings and take advantage of plans offered by your employer to the maximum.  And never carry credit card debt.  Starting early is essential.  I get a kick out of commercials offering plans of investing for exorbitant retirements.  None of these plans can provide magic.  The most important point is to start early.  Believe me, age sneaks up on you faster than you can imagine.

Savings provide both security and control over you personal time.  Do not underestimate the value of personal time.

© Douglas Griffith and healthymemory.wordpress.com, 2015. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Loneliness and Dementia

July 27, 2015

The article on which the immediately preceding healthy memory post was based, by Fredrick Kunkle of the Washington Post (July 21, Section A, “Too much TV could raise the risk of Alzheimer’s,” ) also reported a study on how loneliness can increase the likelihood of dementia.  This study was done by Nancy C. Donovan, an associate psychiatrist at Brigham and Women’s Hospital and Harvard Medical School.  Donovan and her team traced 8311 adults in the U.S. Healthy and Retirement Study from 1998 to 2010.  The research participants were 65 and older and were given biennial assessments of their perception of loneliness using a questionnaire.  The researchers examined the participants’ cognitive performance and factored in their health status, sociodemographic status and social network characteristics.

The researchers found that the loneliest people, about 17% of the participants, experienced the most accelerated decline in cognitive performance.  The scores of these people fell 20% faster than those who did not report being lonely.  Donovan concluded that “loneliness is a form of suffering in older people that is prevalent but undetected and untreated in medical practice.  Second, loneliness has consequences.  Our work work shows that loneliness, like depression, is associated with accelerated cognitive decline in older Americans.  The finding is important because it opens up new approaches for preventing and treating Alzheimer’s Disease.”

Ideas for Increasing or Decreasing Your Risk for Alzheimer’s

July 25, 2015

An article by Fredrick Kunkle of the Washington Post (July 21, Section A), “Too much TV could raise the risk of Alzheimer’s, study suggests,”  provides ideas for both increasing or decreasing your risk for Alzheimer’s.  It summarizes the results of research done at the Northern California Institute for Research and Education.  The study tracked people  enrolled in the Coronary Artery Risk Development Study for 25 years beginning in young adulthood.    Their exercise and TV viewing habits were evaluated using questionnaires three times during the course of 25 years.  Low physical activity was defined as burning fewer than 300 calories in a 50-minute session three times a week, which by at least one measure is about 300 calories less than the equivalent of playing a round of golf while riding in a golf cart (See the healthymemory blog post, “Too Improve Your Memory, Build Your Hippocampus”).  A high amount of television watching was defined as more than four hours a day.  About 17 percent reported low physical activity, and about 11 percent qualified as heavy TV viewers.  3 percent reported both.

An analysis of the results showed that people who watch a lot television had a 1.5 percent higher risk of performing worse on cognitive tests compared with those who watched less television. Compared with participants with high physical activity and low television viewing, a relatively sedentary individual who exercises little and spends a lot of time in front of the television will be two times more likely to perform more poorly on cognitive tests in midlife.

You should note that the effects of television viewing are much lower than the effects of exercise.  It might be that not all television programs are bad.  True, it is likely that many are, but there are some programs that are cognitively challenging and educational, that is they likely benefit brain and memory health.

These results suggest that sedentary habits set early in life can perhaps have an impact on one’s dementia risk in midlife and later.  One of the researchers, Yaffe, said, “What’s is happening at one’s midlife is setting the stage for what’s happening over the next 20 or 30 years.”  Yet less than half the nation meets recommended exercise standards.   More that 28 million baby boomers are projected to develop Alzheimer’s by 2050.

So how does one increase risk for Alzheimer’s?  Do little or no exercise and much indiscriminate TV viewing.

How does one decrease risk for Alzheimer’s?  Exercise at least a moderate amount and be judicious in your television viewing.

© Douglas Griffith and healthymemory.wordpress.com, 2015. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

BABES: New Hope for Alzheimer’s

July 15, 2015

BABES, which stands for Beating Alzheimer’s By Embracing Science (BABES), is an organization founded by a registered nurse, Jamie Tyrone, who found out that she carries a gene that gives her a 91% chance of developing Alzheimer’s around age 65.  This account is taken from an article in the July 5th Washington Post by Franklin Kunkle title “Alzheimer’s spurs the fearful to change their lives to delay it.”

Jamie decided to fight back.  She exercised.  She changed her diet.  She began taking nutritional supplements, including fish oil, vitamin D, vitamin B12, curcumin, turmeric, and an antioxidant called CoQ10.  She started meditating and working mind-bending puzzles, such as Brain HQ.  She joined a health clinic whose regimen is shaped by a UCLA medical study on lifestyle changes that can reverse memory loss in people with symptoms of dementia.  And she started the nonprofit group BABES, to raise money and awareness about dementia.  I hope this money will also be used for assessing and documenting the effectiveness of these practices.

A Harris Poll found that worries about Alzheimer’s crosses all generations;  more than 75% of millennials, Generation Xers and baby boomers worry about what will happen to their memory as they age.  It would have been interesting to find out what these individuals are doing about it.  Just worrying?  Hoping that a drug will be found to prevent or cure Alzheimer’s?  Or taking action such as advocated by BABES and the healthy memory blog.?

According to the Alzheimer’s Association more than 5 million people are living with Alzheimer’s, and as the population ages, the number of cases is expected to increase to 13.5 million by 2050.  The risks for Alzheimer’s  can also be overstated, especially for early onset forms of dementia.  Unless one has a genetic predisposition, Alzheimer.s strikes the majority of people after they reach the age of 65, according to the Alzheimer’s Association.  A history of high bloom pressure, diabetes, smoking, obesity, or cardiovascular problems increases the risk of  dementia.

The article notes that aging itself is the biggest risk factor:  the longer you live, the more likely you are to develop Alzheimer’s  or another form of dementia.  Although this is true, the fundamental question is why aging is a risk factor.  True, there is neurological decline, but is this a factor?  A significant fact not mentioned in the article is that there have been autopsies of people who exhibited no symptoms of Alzheimer’s, yet whose brains were wracked with the amyloid plaque and neurofibrillary tangles that provide the definitive diagnosis of Alzheimer’s.

I think a more significant fact is that are activity levels, both cognitive and physical, tend to decline as we age.  It is likely that these are primary factors in dementia.  Programs such as BABES and activities such as those recommended in the healthymemory blog are likely preventive.   They foster both mental and physical activity. The Washington Post article hopes that these activities will likely delay but not necessarily prevent Alzheimer’s.  This is a guarded scientific statement.  In life there are no guarantees.  Yet many manage to pass away before suffering from demential.  See the healthy memory blog post, “The Myth of Alzheimer’s.”   This is the title of a book whose is author was a researcher who was reaping large financial rewards looking for drug treatments to fend of the amyloid plaque and neurofibril tangles.  He came to the conclusion that these research efforts were futile, that although there was dementia, and he is conducting research on coping with dementia, Alzheimer’s is not a disease.  It should also be realized that Alois Alzheimer, after whom the disease is named, was never convinced that it was a disease.

© Douglas Griffith and healthymemory.wordpress.com, 2015. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Today I Enter the 70th Year of My Life

May 6, 2015

Meaning that today is my 69th birthday.  My first thought is, where has all the time gone?  Time not just flies, it flies supersonically.   I can use the marvelous time travel machine in my brain, my memory, and almost instantaneously travel back to when I was four years old or to any other specific time in my life.  The purpose of memory as a time travel machine is for us to use what we have experienced and learned in our pasts and project it into our future plans and actions.  It is here that memories can disappoint.  Too often I have failed to use information from my past in the future.  That is, I have failed to use lessons learned.  I have no idea how much longer I shall live.  It is highly doubtful that it will be for another 69 years.  I have already outlived my father and my brother.  My mother made it into here 100th year.  Unfortunately, she was plagued with dementia for the last several years of her life.

It is my goal to avoid dementia and to continue to grow cognitively the remaining years of my life.  Recent research, which will be posted in the next healthymemory blog post, found that “Crystalized Intelligence,” a measure of accumulated knowledge, doesn’t peak until people are in their late 60’s or 70’s.  Now these are average data.  There are individuals whose crystalized intelligence either peaks later or when they die.

So how can this potential be enhanced?  That is the question to which the healthymemory blog is devoted, and the first answer is not to wait.  Regardless of age, engage in the practices and advice of the healthymemory blog.  There is an overwhelming amount of advice and number of practices, so choose those with which you are compatible and continue to read this blog.

Perhaps first and foremost is the importance of ikigai.  Ikigai is a Japanese word, which roughly translated means “the reason to get up in the morning.”  In other words, have reasons for living.  Knowing your purpose(s) in life is important to your well being.  Research has indicated that having a regular job  decreases the probability of suffering from dementia.  Consequently, I continue working at my regular job.  Still I need to consider whether I am better off continuing at this job, and getting up extremely early in the morning, or pursuing other activities that might be more beneficial cognitively.  In doing so, I need to draw upon my time travel machine, my memory, to be sure that I am not ignoring any lessons learned when making my decision.

© Douglas Griffith and healthymemory.wordpress.com, 2015. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Cognitive Shields Protecting Against Dementia

April 22, 2015

This post is based largely on “Cognitive Shields” by Andrew Merluzzi in the .  Psychological Science Observer (February 2015, 21-28).   There have been many previous Healthymemory blog posts about autopsies of people who have exhibited no symptoms of Alzheimer’s while alive, but who nevertheless have the so-called amyloid plaques and neurofibrillary tangles which provide the definitive basis for diagnosing the disease.  Now I have a percentage to place on this statement.  About a third of post-mortem brains with the telltale features of dementia—protein tangles or miniature strokes-came from people who never exhibited symptoms during life.

The explanation that has been offered for this is that certain individuals might build buffers over their lifetimes called cognitive reserve.  This post provides information on research on the cognitive shields that build this cognitive reserve.  Actively engaging the brain can boost older adult’s recall power.  One experiment randomly more than 200 adults (ages 60-90) to engage in a particular type of activity for 15 hours a week over the course of three months.  Some activities required significant cognitive investment such as digital photography or quilting.  The other participants engaged in more leisurely activities such as listening to classical music or completing word puzzles.  At the end of the experiment participants who engaged in digital photography or quilting showed a significant improvement in memory compared to the leisurely activity participants.

Another experiment  recruited 16 older adults to play a video game called “Neuroracer.”   Participants attempted to drive a car down a virtual road, keeping constant speed and lane position.  As they were doing this they also had to pay attention to sporadically appearing shapes, pressing a button whenever they observed a green circle.  The game became more difficult as performance improved.  The comparison group played an easier version of the game where they had to drive or pay attention to shapes, but not simultaneously.  The group who played the more difficult version of the game scored better on unrelated cognitive tests. Brain imaging with an EEG revealed noticeable differences at the neural level.  Participants who played the difficult version of the game  showed more coherent activation patterns in cognitive control networks including the prefrontal cortex.  These cognitive gains were still apparent six months later.

Physical exercise is also important as it increases the flow of oxygen to the brain.  See the healthy memory blog post “To Improve Your Memory, Build Your Hippocampus” (use the healthy memory blog search box).

Another study investigated whether exercise can induce neuroprotective effects for people who have a genetic risk for Alzheimer’s.  One hundred older adults many who carried the APOE gene which increases the risk of Alzheimer’s were studied.  The participants explained their normal exercise habits and had their brains scanned twice over a period of 18 months.  It was found that exercise was critically important for the at risk group with the APOE gene.  People with this gene who didn’t exercise exhibited a 3% decrease in hippocampal volume over time.  Those carrying the gene who did incorporate exercise into their lives—more than 15 minutes of moderate exercise at least three days a week—didn’t show any decreases in hippocampal volume.  The conjectures for this result are that staying active might reduce inflammation in the brain and promote neural growth in the hippocampus building  up cognitive and brain reserve.

Research has also found that bilingual older adults have more robust white matter then monolingual adults.  This suggests that the myelin on axons in these her bundles is more intact, which would help  to buffer against age-related changes in the size and structure of the brain.  Sone also argue that it might never be too late to learn another language.  But this does take commitment.

There are many more healthy memory blog posts on the cognitive reserve and the benefits of both cognitive and physical exercise.  It is important that this information be disseminated.  People should know that they need not be passive victims of dementia, nor should they wait for a medical treatment or vaccine to treat or prevent Alzheimer’s.  To a large exert we control our own fates and should take action.

Another Example of Misdiagnosis of Dementia

March 18, 2015

A previous healthy memory blog post, “A Treatable Condition Misdiagnosed as Alzheimer’s,”  discusses a case as being untreatable Alzheimer’s when the true diagnosis was normal pressure hydrocephalus (NPH).  An article in the March 5, 2015 Health and Science of the Washington Post, by Roni Caryn Rabin titled “Mom developed dementia:  after ten years she got better” motivated me to write this post about this often overlooked diagnosis, and because the article points to  problems in the medical system of the United States.  Even though her mother was a retired psychiatrist, and even though her mother’s mother had suffered from the same malady, it took ten years for the correct diagnosis to be made followed by successful surgery that remedied the condition.

Her symptoms were gait problems with resultant falling.  Her gait tripped her up.  It became uneven.  She was unsteady and the slightest incline threw her off stride.  Sometimes she quickened her pace involuntarily, and she sometimes bent over and then straightened back up.

She went to doctor after doctor telling them that she wanted a diagnosis telling them that she is convinced that it is something organic and that it has an underlying organic cause. Remember that this is a physician, a retired psychiatrist, speaking to other physicians.  She went to an orthopedic surgeon who said that she had stenosis, or narrowing of the open spaces of the spine, and recommended surgery.  She underwent a complicated potentially back operation, and seemed to be walking more smoothly afterward.  But this lasted for only a few months.

Her mother’s dementia  had been caused by normal pressure hydrocephalus (NPH), which is a buildup of cerebrospinal in that brain that causes difficulty walking, urinary incontinence, and cognitive loss.  Her mother floated the idea that she might ave NPH. She hoped that that would be the case because today it can often be treated by implanting a small shunt into the brain to drain off excess fluid.  Nevertheless, she had difficulty convincing her fellow physicians that her diagnosis was correct.  Eventually the correct diagnosis was made and her condition was remedied by the operation.  In total, it took ten years to correct her condition.

Now if it takes a knowledgeable physician with the correct diagnosis ten years to be successful, what are the chances for us laypeople???

There Will Be Another Brief Hiatus in New Posts

February 1, 2015

Nevertheless with more than 550 Healthymemory Blog posts I think there is sufficient reading material.  If I had to recommend one blog post to read it would be “The Myth of Cognitive Decline.”  This can be found by entering this title in the search box of the healthy memory blog.  This search block can be used to identify blog posts on the following topics.

Posts based on whom I regard as the most important cognitive psychologists:  Nobel Prize Winner Kahneman, plus Stanovich and Davidson.  There are posts on the important topics of attention and cognitive reserve.  Other topics of potential interest are The Flynn Effect, mindfulness, meditation, memory champs, contemplative computing, behavioral economics, dementia, and Alzheimer’s.

Of course, you are encouraged to enter any of your favorite topics into the healthymemory blog search block

Enjoy.  I shall return.

© Douglas Griffith and healthymemory.wordpress.com, 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Combined Effects of Interventions and Preventative Actions

June 12, 2014

Combined Effects of Interventions and Preventative Actions is another chapter in Nurturing the Older Brain and Mind by Greenwood and Parasuraman.  Unfortunately, this is a very short chapter, and the reason that this is a short chapter is that very little research has been done on this topic.  This is unfortunate as the few studies that have been done suggest that there are real benefits from combined interventions.  “The general conclusion is that lifestyle factors have greater beneficial effects on cognitive aging when they are jointly experienced than when individually experienced.”   Research has found additive effects of diet, exercise, and cognitive training.  Given this, the obvious question is why additional research into these areas has not been done.  Perhaps the obvious answer is that such research is expensive.

Here I need to put on my editorial cap.    It seems to me that it would be in the interest of the retirement home community to conduct their own research on this topic.  They are the ones best situated to conduct such research.  They already provide a community setting, and there are laws requiring certain activities be offered.  I have seen the progression my mother made from independent living to assisted living, and I have vowed not to follow this same route.  There are ads out the wazoo from many retirement communities about the paradise and freedoms their communities  offer.  I have  seen only one advertisement  for a program  nurturing the aging brain and mind.  That advertisement was for Home Care Asistance, http://www.HomeCareAssistance.com,  that offers a program for keeping the mind sharp base on a Cognitive Therapeutics Method, http://www.cognitivetherapeutics.com.  Although I have no data on the effectiveness of this program, it at least offers a program.   I want to see more advertisements offering programs to keep me cognitively engaged so that I can continue to pursue a growth mindset.  Moreover, I would like to see promises of on-going research, so that I might not only benefit but would also be contributing to new approaches.

It would be in the interest of at least the higher end communities to conduct such research, to offer such programs, and to make such commitments.  Absent any compelling commitments regarding ongoing programs and future research, I would never consider setting foot in any of these communities.

© Douglas Griffith and healthymemory.wordpress.com, 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Cognition Enhancing Drugs

June 10, 2014

Cognition Enhancing Drugs is the title of a chapter in Nurturing the oder Brain and Mind By Greenwood and Parasuaman.  They note that “there is little doubt that estrogen protects both the brain and cognitive functioning not only in younger female animals and in women undergoing surgical menopause, but also in middle-aged women around the time of natural menopause.  Unfortunately subsequent research revealed  the health risks of initiating estrogen and progesterone use in women many years after menopause.  However, the situation is confusing as  additional research has been conflicting and the situation remains unresolved.    Greenwood and Parasuraman conclude, “We should await results from newer better-designed studies before drawing conclusions about the benefits and costs of estrogen in women.”

Greenwood and Parasuraman note that the effects of other cognitive-enhancing drugs on older people have been little studied.  Perhaps this is because research has been targeted at  developing drugs that either cure of prevent Alzheimer’s.   Drugs that have been developed only slow the progression of the disease.  To my way of thinking this is only prolonging the agony.  Moreover, there is reason to believe that a drug that cures or prevents Alzheimer’s might never be developed (See the healthy memory blog post, “The Myth of Alzheimer’s”).

Greenwood and Parasuraman find it strange that the benefits of  cholinergic agonists for benefits in young people, that cholinesterase inhibitors have been so little studied in older people.  Again, in my view, this is due to the preoccupation with finding a cure or a preventive vaccine.  Perhaps as a result of their review some attention will be turned to this approach.
Caffeine is beneficial, but with this exception there is no current compelling evidence that pharmacological agents are useful for ameliorating cognitive aging.

© Douglas Griffith and healthymemory.wordpress.com, 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

 

The Benefits of Diet and Nutrition on Nurturing the Older Brain and Mind

June 8, 2014

This post draws heavily on the chapter on the benefits of diet and nutrition in Nurturing the Older Brain and Mind by Greenwood  and Parasuraman.  They do not conclude that there are no benefits of diet and nutrition on cognition.  Rather they are concluding that most evidence for this claim is weak.

Now there is strong evidence that dietary restriction with respect to calories consumed does confer significant benefits for cardiovascular health, but there is no strong evidence for its benefits on cognition.  We often read that what is good for the heart is good for the brain and cognition, but that is not necessarily so.  Consumption of foods containing reservaterol may confer benefits on healthy and cognition that are similar to dietary restriction.  Greenwood and Parasuraman are hesitant to make this recommendation due to the dangers of alcohol abuse.  Here your healthy memory blog post author will say that along as alcohol is not abused, there are benefits.  Indeed, moderate alcohol consumption, one or two drinks per day, has been found to have benefits on health in general.

Goodman and Parasuraman also note that the substitution of polyunsaturated fatty acids for saturated fat in the diet has convincing evidence for the human risk of heart disease, but the evidence for beneficial effects on human cognition is inconclusive.

Goodman and Parasumanan state that there is little evidence that B-vitamin supplementation has any beneficial efftext on the brain or cognition.

Well-controlled studies of the effects of specific foods, spices, herbs, and micronutients are few in number and the results are inconclusive, but there is some evidence for the benefits of antioxidants in the diet consistent with other evidence for a ole of oxidative stress in negative effects on aging.

The Benefits of Diet and Nutrition on Nurturing the Older Brain and Mind

This post draws heavily on the chapter on the benefits of diet and nutrition in Nurturing the Older Brain and Mind by Greenwood  and Parasuraman.  They do not conclude that there are no benefits of diet and nutrition on cognition.  Rather they are concluding that most evidence for this claim is weak.

Now there is strong evidence that dietary restriction with respect to calories consumed does confer significant benefits for cardiovascular health, but there is no strong evidence for its benefits on cognition.  We often read that what is good for the heart is good for the brain and cognition, but that is not necessarily so.  Consumption of foods containing reservaterol may confer benefits on healthy and cognition that are similar to dietary restriction.  Greenwood and Parasuraman are hesitant to make this recommendation due to the dangers of alcohol abuse.  Here your healthy memory blog post author will say that along as alcohol is not abused, there are benefits.  Indeed, moderate alcohol consumption, one or two drinks per day, has been found to have benefits on health in general.

Goodman and Parasuraman also note that the substitution of polyunsaturated fatty acids for saturated fat in the diet has convincing evidence for the human risk of heart disease, but the evidence for beneficial effects on human cognition is inconclusive.

Goodman and Parasumanan state that there is little evidence that B-vitamin supplementation has any beneficial efftext on the brain or cognition.

Well-controlled studies of the effects of specific foods, spices, herbs, and micronutients are few in number and the results are inconclusive, but there is some evidence for the benefits of antioxidants in the diet consistent with other evidence for a ole of oxidative stress in negative effects on aging.

A Neurocognitive Framework for Ameliorating Cognitive Aging

May 31, 2014

This post is taken from a chapter with the same name, “Ameliorating Cognitive Aging:  A Neurocognitive Framework”  in the book Nurturing the Older Brain and Mind  by Greenwood and Parasuraman.  Brain aging needs to be dealt with.  There is cortical shrinkage and there are white matter changes.  The shrinkage and white matter changes have a small effect on cognitive performance.  Neurotransmitter  dysfunction is a matter of more concern.  Then there are genetic factors.  First of all there is the genotype, then the gene expression from this genotype.  Although some individuals suffer from a genetic predisposition to dementia, these are not deterministic, but rather predispositions.  That is, given such and such experiences or external factors, the likelihood of dementia increases.  Then there are epigenetics, which determine how the genes are actuated.  Epigenetics are affected  by lifestyle and experiential factors such that favorable factors can enhance the probability of favorable genetic readouts.

Turning to the lifestyle and experiential factors, education, exercise, diet, learning and training, and combinations of these factors enhance the likelihood of good cognitive performance throughout one’s lifespan.   More details on these individual factors will be provided in subsequent healthymemory blog posts.

Then there is the matter of neuronal plasticity that includes neurogenesis, synaptogenesis, dendritic arborization, and network reorganization.   An example of network reorganization is the greater use of both hemispheres as we age.  When I was a graduate student I was taught that our nervous system was fixed and could not be modified when damaged or was damaged to aging.  Fortunately, what I was taught as a graduate student has been found to be woefully in error.  These processes can occur well into old age.  But they need to be activated by new learning and experiences for them to occur.

Next there is cognitive plasticity.  Top-down processing strategies can be used to make better use of our accumulated knowledge.  Then there are our well-developed prefrontal lobes for effective executive functioning.

I have often written of the importance of building a cognitive reserve.  Although advice was provided as to how to build one’s cognitive reserve, Greenwood and Parasuraman have provided the first neurocognitive framework to explain how this occurs.

© Douglas Griffith and healthymemory.wordpress.com, 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

An Important Book for All to Read

May 26, 2014

And that book is Nurturing the Older Brain and Mind by Pamela M. Greenwood and Raja Parasuraman of George Mason University.  The book is an extensive review of the literature on the older brain and mind in general, and on Alzheimer’s and dementia, in particular.  Although younger people might think this book is only for us BabyBoomers that would be WRONG WRONG WRONG!  First of all, the magnitude of the problem must be considered.  As people age the probability of suffering  Alzheimer’s increases and with aging populations it will soon reach epidemic proportions.  Hopes for drug cures or preventative vaccines are slim (see the healthy memory blog posts, “The Myth of Alzheimer’s” and “Sigmund Freud and Alzheimer’s Disease”).   Moreover actions you take now can reduce the likelihood of suffering from Alzheimer’s or dementia.  If you have parents, there are things they can do to reduce the likelihood of suffering from Alzheimer’s or dementia.  And if you have children, there are things that both you and your children can do to reduce the likelihood of Alzheimer’s and dementia.  These “activities” or “things” are described in Nurturing the Older Brain and Mind.

Greenwood and Parasuraman note that although the brain might age, cognitive aging is neither universal nor inevitable.  Most individuals do not show a decline in cognitive functioning in old age, even though the probability of suffering such a cognitive decline increases as we age.  Moreover it has been noted in many healthymemory blog posts that there are many individuals who do not suffer cognitive decline in spite of the tell-tale amyloid plaque and neurofibril tangles of Alzheimer’s.  The only explanation of this fact has been that these people have developed a cognitive reserve.  Greenwood and Parasuraman present a neurocognitive framework to describe how this might be done.

Nurtuiing the Older Brain and Mind is a  scholarly work of the highest order reviewing an extensive research literature on the topic including both human and non-human species.  Nevertheless, I believe that it is written on a level where it should be accessible to the general reader.  Even if it takes a bit of a reach for the general reader, it is a reach well worth taking.  Although the healthymemory blog will draw heavily on this work, there is no way I can even hope of doing it justice.

© Douglas Griffith and healthymemory.wordpress.com, 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

 

The only criticism I have of this work is that it does not address mindfulness, although I do understand why it was not addressed.  Part of the reason can be found in the immediately preceding blog post on random controlled trials or random clinical trials (RCTs).  The researchers do not regard the research on mindfulness as being significantly “rigorous.”  I remember when I was a graduate student there was a debate on whether we humans can control our autonomic nervous systems with out minds (heart rate, for example).  Now there were people in the east who were highly trained meditators who were able to do this.  Nevertheless, most psychologists would not accept this conclusion unless they could train someone to do it in a psychological laboratory.  They regarded these meditators as using some sort of “trick.”  Well the same thing has been said of mnemonic techniques, but these mnemonic techniques not only enhance memory, but also reveal important insights into how memory works.  Similarly mindfulness research will provide practical insights into how we can control our minds and our bodies.  These skills will be central not only to preserving cognitive functioning, but also to enhancing cognitive functioning.   I predict that mindfulness will play an increasingly strong role in nurturing the older brain and mind.

REST, Epigenesis, Neuroplasticity, Cognitive Reserve, & Alzheimer’s

April 8, 2014

The March 19 Washington Post published an article written by Angela Zimm, “Fetal brain protein reactivates in old age, may fight dementia.” The research was conducted by scientists at Harvard University and published in the journal Nature. It reported that a protein called REST is depleted in the brains of people with Alzheimer’s. It was found at a level three times as high in people who did not experience dementia even when their brains had indications of the disease. According to Yanker, a professor of genetics at Harvard Medical School in Boston, “There’s a long-standing puzzle in neurology why a large percentage of the aging population when they die have enough abnormalities in the brain to classify as Alzheimer’s, though they don’t develop the dementia.”
This is a rarely publicized fact about Alzheimer’s, that there are many people who do not exhibit the symptoms of dementia even though their brains at autopsy are found to have the so-called tell tale neurofibrillary tangles and amyloid plaques. These are the only signs that allow a conclusive diagnosis of Alzheimer’s . So it appears that these tangles and plaques might be a necessary, but not a sufficient condition for Alzheimer’s disease. Most research on Alzheimer’s has been on attacking the tangles and plaques.
The only explanation that has been offered is that the people with the tangles and plaques, but not Alzheimer’s have built up a cognitive reserve to fend off this disease. Indeed, this is one of the exhortations of the healthymemory blog, to build up a cognitive reserve/. However, what has been lacking to this point is an explanation as to how this cognitive reserve is built up. The process of epigenesis is one possible mechanism for the release and maintenance of the REST protein. Possible mechanisms for building a cognitive reserve can be found in the healthymemory blog, “What is Neuroplasticity and How Does it Work”, and include, in addition to epigenesis, synaptogenesis, myleinogenesis, and neurogenesis. The healthymemory blog post, “Supporting Neuroplasticity” lists some specific practices that could aid in building a cognitive reserve.

© Douglas Griffith and healthymemory.wordpress.com, 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

The Myth of Cognitive Decline

February 23, 2014

“The Myth of Cognitive Decline: Non-Linear Dynamics of Lifelong Learning”1 is certainly one of the most important scientific articles I have read in recent years. Contrary to the commonly accepted notion that cognitive information processing capabilities decline across adulthood, the article makes a compelling argument that older adults’ changing performance reflects memory search demands, which increase as experience grows.

This argument is based on a series of simulations that show how the performance patterns observed across adulthood emerge naturally in learning models as additional knowledge is acquired. The simulations identify greater variation in the cognitive performance of older adults, and also predict that older adults show greater sensitivity to fine-grained differences in the properties of test stimuli than younger adults. In other words, the results indicate that older adults’ performance on cognitive tests reflects the predictable consequences of learning on information processing and not cognitive decline.

Simply put, the more information we have as we age can slow down the retrieval of information and make it more difficult to distinguish differences among items in memory. Here it is wise to revisit the distinction between information availability and information accessibility. Information can be available in memory, but we simply cannot access it. Many times we know we know something, but simply cannot recall it. These are the cases when information is available but not accessible. Frequently, I try to recall some piece of information, say an actor’s name, but just can’t seem to locate it. Sometimes I shall challenge my wife and see if she remembers. Sometimes she does, and sometimes she doesn’t. Sometimes she will come up with a partial cue that leads to the desired memory. I try to resist the temptation to Googling it in these situations as I think these attempts at retrieval aid keeping the memory healthy.  They force us to revisit infrequently visited memory circuits. What is interesting is that long after I have consciously given up the search and resisted Googling it, the desired memory will suddenly pop into mind. This might occur the next day, perhaps even several days later. This is a good example of how a long latency might be mistakenly interpreted as a memory loss.

One might argue that these conclusions are based on simulations rather than on human experiments. Research into this topic is currently underway using humans. The problem with using human participants to research this problem is that it is difficult to control or estimate important variables. In these cases, simulations can actually provide more accurate answers.

There is the observation that cognitive decline really kicks in around 60 or 70. What is the basis for this observation? How can it be explained? Here is the explanation taken directly from the Ramscar article on p. 34: “If a common environmental change like retirement was to systematically reduce the variety of contexts people encounter in their lives, learning theory predicts that the amount of contextual information they learn will drop further, as the background rates of cues in the remaining contexts rise (Kruschke,2 Ramscar et al3). It follows from this that if people were to increasingly spend time in environments where any cues have high background rates already (family homes), any effects arising from their cumulative experience of learning to ignore task irrelevant contextual (background) cues will be exacerbated . In other words because discriminative learning by its very nature reduces sensitivity to everyday context, retirement is likely to make memories harder to individuate and more confusable, absent any “cognitive declines,” simply because retirement is likely to decrease contextual variety at exactly the time when the organization of older adults’ memories needs it most.”

In other words, as you have read in previous healthymemory blog posts, retirement can foster cognitive decline. So retirements need to be active, so that people can continue to grow cognitively and have social engagements in varying contexts. Obviously I am biased, but I think that reading the healthymemory blog and following some of its practices provides a good start.

It is certainly true that there can be pathologies that cause cognitive decline. Unfortunately, what is the normal performance of what are truly healthy memories can be misinterpreted as cognitive decline.

1Ramscar, M., Hendrix, P., Shaoul, C., Milin, P., & Bayan, H. (2014). Topics in Cognitive Science, 6, 5-42.

2Krushke, J.J. (1996). Base Rates in Category Learning. Journal of Experimental Psychology: Learning, Memory, & Cognition. 22, 3-26 .

3Ramscar, M., Dye, M., & Klein, J. (2013). Childrean value informativity over logic in word learning, Psychological Science, 24, 1017-1023.

© Douglas Griffith and healthymemory.wordpress.com, 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

There Will Be A Brief Hiatus in New Posts on the Healthymemory Blog

February 6, 2014

Not that you should notice. There are well over 450 posts here. That should be plenty to read, ponder, and practice. As its title, suggests this blog is devoted to the development and growth of healthy memories. You can find techniques for improving memory and controlling attention. In addition to specific memory techniques, there are posts on meditation and mindfulness. Posts in the category of transactive memory discuss how technology and interactions with our fellow humans contribute to memory health and help us grow our memories. There are also many posts on human memory and information processing. Mental growth and development should be a goal we work towards our entire lives. The earlier this is started, the better, but it is never too late. The development of a cognitive reserve is one of the best measures one can take to avoid Alzheimer’s and dementia. Use the blog’s search box to search for topics of personal interest. You will likely be pleasantly surprised by what you can find.

Good News About Alzheimer’s and Dementia

January 28, 2014

About two-thirds of dementia cases are caused by Alzheimer’s. The next most common form is vascular dementia, which is caused by deterioration of the brain’s blood vessels and often involving minor strokes. There are some other subtypes and an increasing belief that dementia at very old ages typically involves different forms of disease. Good news about Alzheimer’s and dementia. How can this be? Well, according to research1 reported in the New Scientist, there is some good news.

The good news comes from two studies published in the medical journal, The Lancet. One study compared two surveys of dementia numbers in the United Kingdom done 20 years apart. A 1994 study led to the conclusion that there were about 650,000 people with the condition. Given the increase in average age of the population over the intervening years, using exactly the same tests and definitions, should have found 900,000 people dementia, but the count came up over 200,000 people short.

The other study examined the health of two groups of Danish people in their mid-90s, born a decade apart in 1905 and 1915. Although the two groups had similar physical health, those born in 1915 markedly outperformed the earlier group in cognitive tests. This second group was not stronger, but they were smarter.

So how can this be? The conjecture is that long term trends of rising prosperity, education, and better health are good for the brain. Special attention should be paid to higher education levels. They support the notion of a cognitive reserve that keeps the brain functioning at a high level despite mild physical deterioration.

These results, while good, should not be misinterpreted. Alzheimer’s and dementia still represent significant threats that need to be addressed. The good news is a relative one. That is, matters are not as bad as they were thought to be, but they are still pretty bad.

Moreover, the conjecture as to why there has been this improvement, points to activities and practices advocated by the healthymemory blog. Good physical health and diet are definitely important. The recommended diet is the heart healthy, or Mediterranean diet, rich in fruit and vegetables, with plenty of fish and not too much red meat or high calorie junk food. An unfortunate trend which is working against this good trend is the increase in obesity with the concomitant increase in diabetes. Some have spoken of Alzheimer’s as being a form of brain diabetes.

It should be understood that formal education is not required to build a cognitive reserve. An effort to grow the mind continually by having new experiences, learning new things through reading, technology and by interacting with fellow humans all serve to build a cognitive reserve. The healthymemory blog is dedicated to these activities.

1Drew, L. (2014). Down with dementia. New Scientist, 11 january, 32-35.

© Douglas Griffith and healthymemory.wordpress.com, 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

The Complexity of the Brain and Neuroimaging

January 14, 2014

This blog post is based on the book Brainwashed: The Seductive Appeal of Mindless Neuroscience by Sally Satel and Scott O. Lillenfeld. Please bear with me as this is the second post that I’ve written based on a source viewed on my Kindle.

The notion that a specific area in the brain is solely responsible for a given mental function is intuitively appealing, and it would definitely simplify matters. Unfortunately that is rarely the case. Mental activities do not map neatly onto discrete brain regions. At one time a specific area of the brain, Broca’s area was believed to be the brain’s one and only language-production center. Subsequent research has found it to be one of the key nodes, or convergence centers, for the pathways that process language. Similarly, there is no one designated site in charge of speech comprehension as it also relies on patterns of connectivity across multiple brain regions. “Although neuroscientists regard a few cortical regions as being highly specialized for particular operations—such as the perception of faces, places, body parts, ascribing mental states to others (“theory of mind”) and processing visually presented words—most neural real estate is zoned for mixed-use development.”1 This is most fortunate as the brain can rewire itself and allows the newly discovered remarkable plasticity of the brain. So when the brain is damaged it can rewire itself to regain its lost functionality. This rewiring might partially account for those individuals whose autopsies revealed the neurofibrillary tangles and amyloid plaques of Alzheimer’s, but who never exhibited the symptoms. People who are born blind are able to use their visual cortex to perceive touch and learn to read braille letters.

This complexity of the brain should be kept in mind both when viewing images and when reading reports that draw conclusions from neuroimages. As will be seen many reports are overstated, incorrect, or only partially correct.

1Satel, S. & Lillenfold, S.L. (2013) Brainwashed: The Seductive Appeal of Mindless Neuroscience

© Douglas Griffith and healthymemory.wordpress.com, 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Is It Smart to Be Tested for Dementia?

December 21, 2013

This blog post is derived from an article1 in the Health and Science section of the Washington Post. First of all, it is difficult to distinguish early dementia from mild cognitive impairment. These are those minor memory impairments we experience as we age. About one in five people older than 75 have such blips, and most cases never progress to dementia or Alzheimer’s. I would argue further that what are experienced as mild memory impairments might not even indicate mild cognitive impairment. We experience memory failures throughout our lives, but as we age we tend to attribute these failures as cognitive impairments that we fear will lead to dementia.

Moreover, some memory lapses that might seem to be like dementia might really be something else. Danish researchers reviewed the records of almost 900 patients thought to have dementia and found that 41% of them were in error. Alcohol abuse and depression were the most common reasons for the misdiagnoses.

Small strokes that damage the arteries in the brain can cause a type of memory loss known as vascular dementia which is not Alzheimer’s. Currently, an autopsy is the only definitive test of Alzheimer’s where the telltale amyloid plaques and neurofibrillary tangels are found. However, it should be realized that autopsies have been done and found these telltale indicators in individuals who never had any of the symptoms of Alzheimer’s or dementia while they were alive.

Recent tests using brain scanning can be misleading. If, after reading this blog post, you remain worried, the first step should be to see a gerontologist or neurologist specializing in dementia. The claim is that when a full evaluation is done by somebody who knows how to do it, the accuracy of the diagnosis is supposed to be in the range of 90%.

Absent these full evaluations done by specialists, routine screening tests can be quite misleading. Even with the best screening tests, about 20% of those who turn up positive for dementia don’t actually have it. Another 30% of the people who screen positive for dementia actually have only mild cognitive impairment, which won’t progress or cause them serious problems.

Moreover, there is even some question whether early diagnosis improves outcomes. It should be acknowledged that there is no cure or preventive vaccine for Alzheimer’s. All that drugs can do is to slow the progression of the disease. Here is where I part company with the experts. What is the point of prolonging the progression of the disease? To my mind, this is simply a matter of prolonging the suffering. Our medical system is not designed to give us the best medical care, but rather the most expensive medical care. There is a strong willingness to prolong suffering so doctors and drug companies can take advantage of their last opportunity to cash in!

Moreover, little is said about the concept of a cognitive reserve. The explanation for those who have the brain damage indicative of Alzheimer’s, but not the symptoms, have built of a cognitive reserve. This healthymemory blog is filled with posts and ideas on how to build a healthy memory and a cognitive reserve.

1Christie Aschwanden (2013). Just remember this: It may not be smart to get yourself tested for dementia. The Washington Post, December 17, E5.

© Douglas Griffith and healthymemory.wordpress.com, 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Dental Health and Alzheimer’s

September 4, 2013

I never thought I would be writing about dental prophylaxes, but relevant research relating dental prophylaxes to the prevention of Alzheimer’s requires me to do so. Hence this post. A very good friend, and healthymemory blog reader, sent me the link1 to a Yahoo Health Article on how taking care of our teeth may prevent Alzheimer’s/

According to the article, there is a rapidly growing body of evidence strongly linking periodontal disease to a greatly increased risk for Alzheimer’s and possibly other types of dementia. In the Journal of Alzheimer’s Disease, British scientists reported finding signs of gum-disease bacteria in the brains of Alzheimer’s patients. Byproducts of this bacterium, Porphyromonas gingivitis (P. gingivitas) were found in brain samples of four out of ten Alzheimer’s patients, but not in the samples from ten people of similar age without dementia. Although this sample is too small for statistical conclusions, it is suggestive.

P. gingivitis is commonly found in in people with chronic periodontal disease. It can enter the bloodstream through everyday activities such as eating, brushing, and invasive dental treatments. From there, it can potentially travel to the brain. Periodontal disease is a chronic inflammatory disease of the gums and bones supporting the teeth. It affects nearly 50% of American adults over age 30, and 70% of people age 65 or older.

In a study done in 2010 involving 152 people, researchers linked inflammed gums to greatly increased risk for cognitive impairment. The study compared mental function at ages 50 and 70 and found people with gum inflammation nine times more likely to score in the lowest category of mental function compared to those with little or no inflammation. This finding held true even when risk factors such as smoking, obesity, and tooth loss unrelated to gum disease were taken into account. Gum disease made the situation even worse for people who already had impaired cognitive function at age 50.

One theory explaining the link between oral bacteria and memory loss posits that these pathogens might generate inflammation in brain cells involved in Alzheimer’s, such as the glial cells. Dr, Bale, the medical director of the Heart Health Program at Grace Clinic in Lubbock, Texas says that”One of the hallmarks of Alzheimer’s disease is activated glial cells, with high levels of inflammatory molecules that lead to nerve cell damage and destruction.”

Here are Dr. Bale’s recommendation for keeping your teeth, and likely your brain, in excellent health.

  • Brush at least twice a day, in the morning and at bedtime. He also recommends using an electric tooth brush for two minutes and fluoride toothpaste.

  • Be sure to brush the back and front of each tooth, along with your gums and tongue.

  • Floss at least once a day, being sure to wrap the floss around each tooth to remove debris and bacteria. An oral irrigator , such as Waterpik, can also be helpful for cleaning between the teeth.

  • Know the symptoms of gum disease and alert your dentist if you have any of them. The leading warning sign is bleeding when you brush or floss. Others include red, puffy, or tender gums, loose teeth. Puss between your gums and teeth, and a change in your bite (how your teeth fit together), any of which should warrant a quick dental checkup.

  • Visit your dentist at least twice a year for a checkup and professional cleaning. Even if you don’t have any symptoms of gum disease, the checkup should include measuring the pockets between your teeth, which is done painlessly with a dental probe. In the early stages gum disease may not cause any obvious symptoms.

  • Avoid smoking, which greatly increases risk for gum disease.

Another Quiz

July 3, 2013

There will be a brief hiatus in new postings to the healthymemory blog. I believe that there are already sufficient postings (more than 400) to interest readers in the interim. Here is a quiz, should you wish to challenge yourself. Remember the search block on this blog when you are looking for topics of interest or trying to finds answers to the quiz. There is also an earlier quiz, enter “quiz” into the search block, should you want to test yourself further.

  1. What are the five supermemes that threaten the collapse of civilization according to Costa

2.

3

4

5.

      1. What is the importance of ikiga?

      2. What is the best means of preventing or mitigating dementia?

      3. What is crystalized intelligence?

      4. What is the distinction between System 1 and System 2 processing?

      5. What is a paraprosdokian?

      6. What is meant by mindfulness?

      7. What is hyperpartisanship and how can it be reduced?

      8. How can transactive memory aid prospective memory?

      9. What is the relationship between meditation and attention?

      10. Why is attention important?

      11. What is the One Bun Rhyme Mnemonic?

      12. How can you remember historical dates and appointments?

      13. What are the differences between Congressman Tim Ryan and Congressman Paul Ryan?

        1. Can false memories be implanted in memory?

        2. Why is speaking on a cell phone with your hands free still dangerous?

        3. What is the relationship between the average retirement age of a country and the onset of dementia?

        4. What tragedy has resulted from a failure in prospective memory?

        5. What is the Distinctiveness Heuristic?

        6. How does incubation relate to creativity?

        7. How can you boost your brain?

        8. What memory technique was developed by Pierre Herigone”

Passing 67

May 8, 2013

What is most remarkable of reaching my 67th birthday is that I don’t feel like I’m 67. I remember when I was a child looking at my grandparents and thinking how old they look. Now that I am at my grandparents’ age, I feel the same as I did when I was young. Perhaps I am walking a tad slower. The mileage I put on my bicycle has decreased significantly, but I think this is more a matter of choice and my wanting to pursue other activities than it is a decline in my physical condition. I am fairly confident that if I put the emphasis on bicycling I could not only meet, but perhaps exceed my previous mileage. I am still working full time. Research has shown that retirement can lead to significant cognitive decline. There is a significant correlation between the mean retirement age of a country and the average age for the onset of dementia. My work keeps me cognitively active and socially engaged, two activities important to brain and memory health.

My Mom lived to be 99 and passed away six months short of her 100th birthday. Unfortunately, for the last years of her life, she was plagued by dementia. Her advice to me was not to live as long as she did. Personally, I have no interest in living after my cognitive faculties have degraded. This healthymemory blog is one indication of my desire to extend my passion for memory health to others. The immediately preceding healthymemory blog post, “How Our Mind and Brain Work” goes into some detail for building a cognitive reserve that can ward off dementia. It should be remembered that there are individuals, both living and dead, who have the signature indicators of Alzheimer’s, neurofibrillary tangles and amyloid plaques, who never evidence the behavioral symptoms of Alzheimer’s. It is believe that these individuals had built up cognitive reserves. Stine-Morrow’s Dumbledore Hypothesis is that there is a tendency to rely upon old ways of thinking as we age and to, effectively, cognitively coast as we age. I should act that proper diet, exercise, and being socially engaged, are also important, and there are healthymemory blog posts on these topics.

There are also blog posts on “Passing 65,” and “Passing 66”, if you want to see my perspective over the years.

© Douglas Griffith and healthymemory.wordpress.com, 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Alzheimer’s is the Most Expensive Malady in the United States

April 14, 2013

According to a recent Rand Study reported in the New England Journal of Medicine, Alzheimer’s is the most expensive malady in the United States, costing somewhere from $157 billion to $215 billion per year. This makes it more expensive than heart disease and cancer, the two biggest killers, but as patients ultimately die from Alzheimer’s, this is a matter of how the books are kept. It is not the drugs nor other medical treatments that is the biggest cost of Alzheimer’s and other types of dementia, but the care that is needed to get mentally impaired people through daily life. Dementia’s direct costs, including medicines and nursing homes, are $109 billion in 2010 dollars.

According to the RAND study, nearly 15% of people aged 71 or older have dementia. That is about 3.8 million people. It is estimated that by 2040 the number will balloon to 9.1 million people. According to Dr. Richard J. Hodes, the director of the National Institute on Aging, “ I don’t know of any other disease predicting such a huge increase. And as we have the baby boomer group maturing, there are going to be more older people with fewer children to be informal caregivers for them, which is going to intensify the problem even more.”

The prospects of a cure are remote and drug treatments promise only to delay the progression of the disease. 74 to 84 percent of the costs involves helping patients in nursing homes or at home manage the most basic activities of life as they become increasingly impaired cognitively and then physically. A case of dementia costs from $41,000 to $56,000 a year. The projection is that the total costs of dementia care will more than double by 2040, to a range of $379 billion to $511 billion. They ranged from $159 billion to $215 billion in 2010. It is estimated that 22 percent of the people aged 71 and older (about 5.4 million) have mild cognitive impairment. This means that the level of cognitive impairment is mild and does not reach the threshold for dementia. About 12% of these people develop dementia each year.

The preceding solely concerns the economics of dementia. The personal loss is tragic. A lifelong of learning and experiences increasingly slip from memory. Friends and family members might not be recognized. Eventually, the self is lost, and the person does not remember who he or she is or whether he or she is a he or a she.

The best hope an individual has of avoiding or mitigating this loss is to live a healthy lifestyle, not only physically, but also cognitively, and to build a cognitive reserve. Research has shown that there are individuals with plaque and neurofibril tangles who have not exhibited symptoms of dementia. The healthymemory blog is dedicated to helping individuals build this cognitive reserve.

© Douglas Griffith and healthymemory.wordpress.com, 2013. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Aging and Decline: A Self-fulfilling Prophecy?

March 24, 2013

An article in the Alexandria/Arlington Local Living insert of the March 14 Washington Post titled “Getting Stronger After a Century” inspired this healthymemory blog post. This article is about a man who did not start working out until he was 98. He is now 102 and is “able to curl 40 pounds, work out vigorously on a rowing machine and deftly pluck bouncing eight-pound kettle balls from the air with the hand-eye coordination of a much younger man.” The article later states that experts say that many people don’t realize that problems they associate with old age actually are caused by poor fitness. In other words, the experts are saying that the poor fitness aging individuals experience is, in large part, a self-fulfilling prophecy. People believe that this physical decline is a natural part of aging and start declining. If people would just start exercising, they could preclude or remediate many of these problems.

I believe that the same problem occurs with respect to mental fitness. People believe that mental decline is a natural part of aging. There are data showing that the average retirement ages of countries and the age of the onset of dementia for these same countries are correlated. That is, the earlier the retirement age, the earlier the onset of dementia. It isn’t retirement per se that is responsible, but rather the decline in social interactions, cognitive activities, and challenges (problems) that result in dementia.

So if you are retired you need to keep up social interactions and cognitive activity. Use your computer and keep learning new things. Read and take classes. And you don’t want to wait until you retire to start these activities. They should be lifelong activities. Nevertheless, it is never to late to start. Consider the gentleman in the article who did not start exercising until he was 98.

As the title of this blog implies, the healthymemory blog is devoted to healthy memories. It is constantly providing new, worthwhile information for your consideration. The category of transactive memory considers how you can employ others and technology for cognitive growth and health. The mnemonic techniques category includes articles on techniques that not only improve your memory, but also provide valuable cognitive exercise. Articles on mindfulness and meditation can also be found under this category. The Human Memory: Theory and Data includes posts on this very interesting and important topic. This is a good area in which to grow cognitively.

© Douglas Griffith and healthymemory.wordpress.com, 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Early Testing For Alzheimer’s

March 20, 2013

Alzheimer’s disease often progresses slowly. In the early stages some level of mild cognitive impairment is experienced, but life proceeds as normal. Not everyone who experiences this mild cognitive impairment will progress into Alzheimer’s. They have a twelve percent chance of developing it each year. Some will never develop dementia or will develop it from causes other than Alzheimer’s disease.1

Substantial effort has gone into developing tests to identify those with mild cognitive impairment who will progress into Alzheimer’s. This is difficult as a definite diagnosis awaits finding the amyloid plaques and neurofibril tangles. Positron emission tomography (PET) scans have been done to search for amyloid plaques in the brain that may begin to appear before symptoms manifest themselves. Research has found that healthy people with these plaques in their brains are more likely to develop Alzheimer’s related dementia later in life. However, it should be remembered that although these plaques and tangles might be a necessary condition for Alzheimer’s, they are not a sufficient condition. They have been found in autopsies of people who never exhibited any symptoms. The notion is that they had a cognitive reserve that protected them from this damage.

Tests can employ PET scans and/or Magnetic Resonance Imaging (MRI) scans along with analyses of brain fluid. I have seen no data regarding the accuracy of these tests with respect to hits (correct diagnosis) versus false alarms (incorrectly diagnosing progression into Alzheimer’s). Moreover, none of the current tests can help determine whether a person with early signs will progress quickly to dementia or continue to live normally for years.2

MRI’s have been successful in treating a condition that is frequently been misdiagnosed as Alzheimer’s (See the healthymemory blog post, “A Treatable Condition Misdiagnosed as Alzheimer’s). The condition is Normal Pressure Hydrocephalus and occurs when the cerebrospinal fluid that surrounds the brain is not re-absorped. It is estimated that 5% of the people diagnosed with dementia have this condition. Unlike Alzheimer’s, this condition can be corrected.

It is somewhat ironic that early testing for Alzheimer’s can be beneficial for the diagnoses of conditions other than Alzheimer’s. Currently Alzheimer’s cannot be cured. Drugs can slow the progression of the disease, but one should consider, is this simply prolonging the agony of the sufferer? When there are opportunities for participating in a test of a new treatment, one can volunteer in the spirit of contributing to science and the development of a possible cure, but realizing that there will likely be adverse events and the likelihood of a personal cure is quite low.

There is some evidence that people can actually reduce their risk of dementia by quitting smoking, living a heart-healthy lifestyle, and treating any diabetes or hypertension that might be present. The healthymemory blog would add being both cognitively and physically active; to continue to grow cognitively, and to build and maintain social relationships. Most healthymemory blog posts address these topics. I would hope that they all make, at least, some small contribution to cognitive growth.

1Wolfe, S.M. (ed) (2013) Early Testing for Alzheimer’s. Public Citizen Health Letter, February, Vol 29, No. 2. 4-5.

© Douglas Griffith and healthymemory.wordpress.com, 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

2Ibid.

Innovative Alzheimer’s Therapies

March 17, 2013

The follow information comes from “A Place for Mom Newsletter.” When I was looking for a place for my Mom, I found this organization to be quite helpful. And I found this information in their newsletter both interesting and potentially useful.

Customized iPads have been provided to the residents of some memory care communities. Special apps provide reminders to residents needing prompting. The iPads include puzzles that exercise the minds of the residents and games that improve dexterity. Simple properly designed puzzles and games are engrossing and promote a sense of mastery. They provide the satisfying feeling you get when you accomplish a task that is neither too easy, nor too hard.

Art therapy has also been found to be helpful. Art therapy involves both viewing and creating art. There is an organization, Artz, http://www.artistsforalzheimers.org/,which promotes art therapy for Alzheimer patients. In 2005, under the guidance of Dr. John Ziesel, the Museum of Modern Art (MoMA) in New York instituted an after-hours program for people with Alzheimer’s and other dementias called “Meet Me at MoMA.” Dr Ziesel says that out therapy brings out the best in dementia sufferers, “If you met this people when they lived on an an ordinary day, you simply would not see them being this articulate and assured.” Subsequently dozens of other museums have implemented similar programs which proponents claim have benefits that last beyond therapy sessions.

Storytelling has also been found to be beneficial. Timeslips is a new dementia therapy program that involves showing a photo to a therapy group and asking members to make up a story based on the image. The states goal of the Timeslips program is to “inspire people with dementia to hone and share the gifts of their imaginations.” It also give memory impaired people an opportunity to socialize and be creatitive without having the pressure to remember.

It has also been found that light therapy that simply involves brightening room lights during the day may benefit elders with Alzheimer’s and other kinds of dementia. A study reported in the Journal of the American Medical Association found that bright lighting improves mood and cognition in older people with memory disorders. A study at Wayne State University sugested that more intensive light therapy using UV light might also be beneficial. This involves sessions sitting by a special, full-spectrum light.

There is also a therapy known as favorite food therapy. Called a “comfort centered approach” it allow residents practically anything (excluding foods that could be harmful) that brings them comfort, from chocolate toa small bedtime drink. This has been found to reduce medication requirements.

Understand that there still is no cure for Alzheimer’s. These therapies reduce symptons and make life more comfortable for sufferers. It is the view of the healthymemory blog that mental exercise may help ward off Alzheimer’s and other dementias. It appears that mental exercise can also reduce symptoms and increase the quality of those who have already been struck by the dementia.

The Benefits of Nondrug Therapies

March 13, 2013

This February’s Public Citizen Health Letter summarized an interesting and important study published in the September 2012 American Journal of Psychiatry. Randomized controlled trials (RCTs) are regarded as the gold standard for medical studies. The study was a meta-analysis of RCT testing of nondrug therapies involving family caregivers of patients with dementia. Dementia is caused by progressive deterioration of the brain that results in impaired cognition and memory loss. These patients are unable to perform such daily activities as dressing, washing, cooking, eating, and using the toilet. Alzheimer’s disease is the most common cause of dementia among the elderly and accounts for 60 to 80 percent of all cases. Currently around 4 million people in the US suffer from Alzheimer’s disease. It is estimated that by 2050, 11 million to 16 million Americans will have it.

Some of the problems occurring in advanced cases include screaming, physical aggression, arguments between patients and caregivers, repetitive questioning, wandering, depression, resistance to being helped with daily activities, paranoia, and not sleeping at night. The meta-analysis reviewed RCTs that collectively used 3279 dementia patients and their primary caregivers. The training was provided primarily to caregivers and included printed educational materials, telephone calls, individual sessions in the health care provider/office setting, group session in a classroom setting, and in-home sessions. The interventions included such skills training for caregivers as follows: managing behavioral and psychological symptoms of dementia. Communicating better with care recipients. Using role playing videos modeling behavior management strategies, cognitive-behavioral interventions, vignettes, and live interviews They also involved enhancing care recipients quality of life, improving daily activities, increasing pleasant events.

The following education was provided to caregivers: Psychoeducation. Improving home care. Tailored advice and recommendations. Problem solving methods. Improving support networks. Computer-mediated automated interactive voice. Planning emergencies, legal, financial,

The following activity planning and environmental redesign were provided: Planning activities with caregiver and care recipient. Modifying care recipients physical and social environment.

Enhancing the following support caregivers: Social support. Web or telephone support. Strategies on how to access support, Family counseling.

Providing the following self-care techniques for caregivers: Health management. Stress management. Coping with change as a result care giving. Music therapy and counseling.

And the following miscellaneous items: Collaborative care with a health professional or care manager. Exercise for the care recipient.

Not all these delivery methods were used in all the studies reviewed, but many of the studies used a variety of these methods. The interventions in the different studies varied from 6 to 24 months.

For the 17 RCTs that measured outcomes in dementia patients, the analyses of the pooled data showed overall beneficial effects measured by reduction in the troublesome behavioral and psychological symptoms of dementia. For the 13 RCTs that measured outcomes in the caregivers, there was a significant overall improvement in measures of stress, anxiety, depression, and quality. This is no small finding for the lot of caregivers is a difficult one and interventions that ease their discomfort are most welcome.

To fully appreciate the significance of this study one must realize that there are currently no effective drug treatments for dementia and Alzheimer’s. Although there are drugs that can slow the progression of the decline, the end remains inevitable. So there is some question as to whether these drugs are truly beneficial or are a means of prolonging the agony of both the sufferer and the caregiver.

This study also adds credence to the position of the renowned Alzheimer’s researcher, Peter J. Whitehous, Ph.D, M.D, who regards a drug cure for Alzheimer’s as being extremely unlikely. He argues for more research into nondrug therapies (See the healthymemory blog post, “The Myth of Alzheimer’s).

© Douglas Griffith and healthymemory.wordpress.com, 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Type 3 Diabetes and Dementia

September 9, 2012

Type 1 diabetes usually occurs in children when an autoimmune response destroys the insulin-producing cells in the pancreas such that the body can no longer regulate levels of blood sugar. Insulin therapy is required. Type 2 diabetes, the most common type of diabetes, occurs when the pancreas either does not produce enough insulin or the muscle, liver, and fat cells ignore the insulin and fail to remove such excess sugar from the blood. High insulin levels and high blood sugar raises the risk of heart disease, stroke, blindness, nerve damage, and amputation. Being overweight increases the risk of Type 2 diabetes. Type 3 diabetes1, coined by Suzanne de la Monte, refers to the condition when brain tissue becomes resistant to insulin. This is similar to Type 2 diabetes, but the brain is injured.

Here’s the proposed toxic cycle. A high-sugar high-fat diet leads to higher levels of insulin in the brain. The high levels of insulin block the enzyme that normally eats the beta amyloid protein. It is this amyloid protein that leads to plaque buildup which is one of the symptoms of Alzheimer’s disease. These beta amyloid proteins amass in toxic quantities. Neurons become resistant to the effects of insulin. Beta amyloid protein blocks insulin receptors on neurons. The neurons make greater quantities of beta amyloid protein. Eventually insulin production becomes exhausted and drops off This leads to brain damage and dementia. Now insulin can offset beta amyloid damage by blocking its landing site on neurons. Otherwise the cell is more vulnerable to damage.

According to the New Scientist article, a variety of animal studies have supported this explanation. The article also cites two studies involving humans. One of them involves human cadavers. Steven Arnold of the University of Pennsylvania bathed various tissue samples in insulin to see how they would react. Neurons from cadavers of those who had had Alzheimer’s barely reacted at all, but the neurons from cadavers who had not had Alzheimer’s seemed to spring back to life.

Research with living humans is investigating whether a boost of insulin might improve symptoms of those with Alzheimer’s. They used a device that delivers insulin deep into the nose, where it then travels to the brain. A four month study involving 104 people found that the treatment resulted in the recall of more details of stories, longer attention spans, more interest in their hobbies and being better able to care for themselves. The treatment also improved the glucose metabolism in their brains.

There is ample evidence that a healthy diet fosters a healthy memory. However, it should be remembered that although amyloid plaque might be a necessary condition for Alzheimer’s, it is not a sufficient condition. There have been autopsies of people whose brain’s were in sad shape due to the buildup of amyloid plaque, but who had not exhibited any symptoms of Alzheimer’s while they were alive. So the buildup of a cognitive reserve through healthy cognitive activities throughout one’s lifetime is quite important. One of the primary goals of the healthymemory blog is to provide guidance on these healthy cognitive activities.

1Trivedi, B. (2012). Eat Your Way to Dementia, New Scientist, 1 September, 32-37.

© Douglas Griffith and healthymemory.wordpress.com, 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

The Benefits of Speaking a Second Language

August 29, 2012

According to an article in the New Scientist1 speaking a second language can change everything from problem-solving skills to personality. It is like having two brains or being two people. Of course, there are the obvious benefits of knowing a second language. You can converse and write to people who speak the language as well as understand what they say and read. You don’t need to rely on translations or sub-titles. It definitely enhances visits to places where the language is spoken (or in one of the many areas of the United States where the language is spoken).

But the benefits go beyond this and foster a healthy memory and enhanced cognitive skills. These benefits are enhancements of the brain’s executive system. They increase the ability to focus attention and block out irrelevant information. And they also enhance the ability to switch between tasks, to multi-task. And as we all are painfully aware, the need to multi-task has increased with the advent of new technology.

A study was done of 184 people diagnosed with dementia. Half of these people were bilingual. The symptoms of dementia started to appear in bilingual people four years later than their monolingual peers.2 Another study was done with a further sample of 200 people showing signs of Alzheimer’s disease. This time they found a five-year delay in the onset of symptoms in the bilingual patients.3 These data support the notion of a cognitive reserve built up as a result of the bilingualism that delays the onset of dementia or Alzheimer’s. It is quite possible that for some people, bilingualism might reduce the risk of dementia or Alzheimer’s to zero.

So if you are already bilingual, congratulations. You are blessed. But if you do not know a second language, you can still learn. Language learning provides ideal mental exercise. And there are plenty of resources available to help you learn another language. One resource is the Healthymemory Blog (see “More on Recoding: Learning Foreign and Strange Vocabulary Words”).

1de Lange, C. (2012), My Two Minds. New Scientist, 5 May, 31-33.

2Neuropsychologia, 45, p. 459.

3Neurology, 75, p. 1726

© Douglas Griffith and healthymemory.wordpress.com, 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

iPads for Those Suffering from Dementia

August 4, 2012

When I was looking for an assisted living facility for my Mom, I found A Place for Mom to be quite helpful. The following post is taken from the Blog on the A Place for Mom Website, http://www.aplaceformom.com/blog/9-reasons-why-ipads-are-good-for-memory-care-residents/

According to the post the director of the Health Central Park Nursing Home, Judy Skelton, “It came to us as a happy accident. What started out as one resident’s curiosity turned into something that is helping them spell, track items, make choices and read words. It’s amazing.” Mice and other control devices sometimes present problems for elders, but they find the touch pad technology easy to use, and, what I found somewhat surprising, easy to navigate. Here are nine reasons why iPads enhance the lives of seniors:

1. They’re lightweight and carry like a book.

2. They interact with residents, provide excitement and open-up a new means of communication to those who can’t express themselves in the way they desire.

3. They can monitor an elderly person’s movements, habits, temperature in their home and remind them when to take their pills.

4. Their music and music library options help to trigger memories of the past through songs of their youth and family years.

5. They encourage socialization among residents with their games, varying apps, reading and Internet search features.

6. There are apps to help encourage mobility. For example, one app shows videos of animated figures performing activities of daily living such as climbing stairs. This help patients picture themselves doing these tasks, and even mimic the behaviors.

7. Computer access allows residents more frequent contact with their children and grandchildren of the Internet generation.

8. Email updates and downloaded photos are now pride of place in residents’ rooms.

9. They encourage residents to create simple graphics and pictures and exercise their creativity.

In short, they

help improve motor skills

provide memory stimulation and cognitive function

create a positive impact on the interaction of those with dementia

More formal studies are underway, but the initial informal studies are quite positive.

Passing 66

May 23, 2012

A couple of weeks back I passed my 66th birthday. This occasion caused me to reflect on the retirement advertisements I see on TV. There is one where a couple is flying in a private plane to a lakeside villa as they view whales playing on the water. The underlying theme here is with adequate retirement funds, this is what your retirement will be; with the proper retirement plan, this can be yours.

The problem is that there are two factors critical to retirement planning that are unknown. The first is how long we will live. We might expire later today or we could live to be well into our hundreds given future medical advances. We also don’t know what will happen to our investments. The regulations that were made to our most recent financial catastrophic were fairly modest. There is also the prospect of the financial system collapsing as a result of cyberwarfare. Then there is also the prospect of a Coronal Mass Ejection wiping out all the electronic systems for over a decade. Now there is the idea of a bucket list that includes everything we want to do before expiring. This can work given adequate resources, our living long enough, and the absence of cataclysmic financial events.

My least favorite advertisement is of someone waking up on the first day of retirement joyful that they did not have to get up and that they have nothing to do. I’ll grant that person, one joyful day, perhaps two. But to live life without meaningful challenges is to increase the likelihood of dementia and to put one foot in the grave. There is a Japanese word Ikigai which roughly translated as “the reason for which we wake up in the morning” (see the Healthymemory Blog post “The Importance of Ikigai”. Countries that have lower retirement ages tend also to have lower ages for the onset of dementia. If you retire from work it is important to have activities that keep you both physically and mentally active.

A Healthymemory blog reader emailed me an article “Working 9 to 5 – at 75”1 (thank you Healthymemory Blog reader). There was a story about a 73 year old who was commuting 90 miles each way, and enjoying it. The article states that “…working well into one’s seventh decade is a scenario that has become—seemingly overnight—relatively commonplace.” Although financial pressures seemed to be the major motivating factor, they were enjoying the work they were doing. It was fulfilling. It provided Ikigai. It is also likely extending their lifespans and extending or warding off dementia.

So passing 66 is not particularly significant. I am continuing in my job. The best means of surviving a financial collapse is by having and keeping a job. More importantly, it is keeping me mentally and socially engaged, but I do need to do more physical exercise. Regardless of my employment status, I plan to stay mentally and physically active.

1http://finance.yahoo.com/news/working-9-to-5—-at-75.html

What Can an Individual Do About Alzheimer’s?

September 4, 2011

According to the authors of They Myth of Alzheimer’s1, Alzheimer’s is not a disease but rather a conglomeration of debilitating effects that can occur during aging. They offer a prescription for successful aging across the life span. This blog post cannot do their prescription justice, but can only hit the main points.

They go into a good deal of detail about diet. Perhaps the best way to summarize their recommendations is to say what is good for the heart is good for the brain. So dietary recommendations for the heart also pertain to the brain. The same can be said for exercise. Exercise benefits both the heart and the brain.

Keeping stress to a minimum is another recommendation. Of course, stress is a part of modern life, so it is real and needs to be addressed. Physical exercise reduces stress. Walking, particularly in nature, is beneficial (see the Healthymemory Blog posts “Taking Advantage of Nature to Build a Healthy Memory,” “Restoring Attentional Resources,” and “More on Restoring Attentional Resources”). Yoga and Tai Chi are helpful, as are most types of meditation (See Healthymemory Blog posts, “Change Your Brain by Transforming Your Mind,” “Does Meditation Promote a Healthy Memory?” “Costly Gadgets or Software Are Not Required for a Healthy Memory,” “The Relaxation Response,”, and “Intensive Meditation Training Increases the Ability to Sustain Attention.” ). Avoiding individuals who are annoying or argumentative can also be helpful in reducing stress.

Remember that autopsies of people who showed no indication of cognitive decline revealed the same amyloid plaques and neurofibrillary tangles that would confirm a diagnosis of Alzheimer’s. The most common explanation for these individuals is that they had built up cognitive reserves during their lifetime. The brain can use this reserve capacity to respond to damage that might occur from aging. These are the possible mechanisms offered by the authors.

“Building a higher synaptic volume of connections between neurons

Increasing cerebral blood flow

Developing resistance to the neurotoxic effects of excess levels of hormones like cortisol and other glucocorticoids

Promoting resistance against the depletion of neurotransmitters such as acetylcholine and dopamine, which occur with age

Recruiting other brain regions to perform tasks

Increasing cerebral flow and metabolism and conferring greater resistance to the neurotoxic effects of environmental toxins”2

The obvious question is how to accomplish this. Formal education is one answer. The higher the level of education, the greater the resistance to Alzheimer’s. Fortunately, returning to school is not required. Consider the following list of helpful activities: learning a new language, learning to play an instrument, playing board and card games, engaging in intellectually stimulating conversations, reading intellectually challenging books, picking up a new skill, keeping a notebook, or starting an online blog. This list is by no means exhaustive, but you should get the idea.

Building and maintaining social relationships is also beneficial to a healthy mind. The authors provide the following list of psychosocial benefits:

“Availability of emotional support

A source of information, guidance, and advice, diversion from the stresses of life and the day-to-day travails of aging

Self-esteem

A sense of coherence, purpose, usefulness, and meaning

An increased propensity to take care of yourself and seek out professionl help

A sense of intimacy and belonging

A belief in something beyond oneself”3

Depending on the job and profession, staying employed can also be beneficial. Research has found that countries with lower retirement ages also have lower ages for the onset of dementia (See the following Healthymemory Blog Posts, “Could the AARP Be Telling Us Not to Retire,” “Passing 65,” “Can Early Retirement Lead to Memory Decline,” and “Aging and Productivity.”). Retirement is not necessarily bad, provided that post-retirement activities provide the same mental and social stimulation that was provided in the workplace.

The importance of an optimistic or positive outlook is also important (See the Healthymemory Blog Post, “Positive Psychology”).

In short, the selection of the appropriate activities you pursue during your lifetime is the best means of reducing the risk of dementia. And you are never to old to start.

1Whitehouse, P.J., & George, D. (2008). The Myth of Alzheimer’s. New York: St. Martin’s Press.

2Pages 244-245.

3Pages 252-253.

Why Would Alzheimer’s Patients Perform Better on a Memory Test?

July 27, 2011

A recent study by Mickael Laisney and his colleagues that was summarized in the APS Observer1 replicated certain paradoxical results and provided an interesting explanation for the paradox. They studied the word-recognition abilities of 16 Alzheimer’s patients and eight patients with semantic dementia. Their performance was compared against healthy patients not suffering from these disorders. The patients were shown pairs of words in succession and were asked to indicate whether they recognized the second word in each pair. There is an effect known as semantic priming whereby a word is recognized more quickly (“zebra” for example) if they had recently seen a related word (“giraffe”). Patients in the early stages of Alzheimer’s disease exhibit a paradoxical “hyperpriming” effect whereby they show a more pronounced priming effect than do normal control subjects. So why should people suffering from a memory disease perform better on a memory test than people not suffering from this disease?

Laisney and his colleagues offered an explanation regarding why these patients perform better. They showed that the first elements of semantic memory to deteriorate were the distinguishing characteristics of a concept such as the stripes of a zebra or the long neck of a giraffe. Once these distinguishing characteristics are lost, zebras and giraffes become generic four-legged mammals. So the concepts become more related and the priming effect increases during the early stages of the disease. As the disease advances, this hyperpriming effect disappears.

This is an interesting effect and explanation that does provide some insight into the progress of the loss of memory in Alzheimer’s and semantic dementia. However, it should be understood that this is not a test for Alzheimer’s disease. Alzheimer’s should be diagnosed by a professional, both to increase the accuracy of the diagnosis and to begin a regimen for treating the disease.

1“When the Zebra Loses Its Stripes” APS Observer February 2011, 7.

© Douglas Griffith and healthymemory.wordpress.com, 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Dementia and Mental Stimulation

September 8, 2010

A recent article in The Economist1 presented a report on the benefits of mental stimulation in warding off dementia such as Alzheimer’s Disease. The research was lead by Robert Wilson of the University of Chicago. Research participants were asked how frequently they engaged in cognitively stimulating activities such as reading newspapers, books, and magazines. They were also asked how frequently they played challenging games like chess and visited museums. They also included watching television and listening to radio, which are typically not regarded as mentally stimulating activities. Then they followed these participants to learn what developed. They found that frequent activity of this sort seemed to slow the rate of cognitive decline. But they also found that in those who did develop Alzheimer’s Disease the decline was more rapid. This they regarded as bad news.

A number of points need to be made about this study. Most importantly, it should not be regarded as conclusive. More definitive studies will be done, and I would not be surprised if more specific types of mental activity were found that actually did ward off Alzheimer’s. But even if we take these results at face value, they provide strong evidence for the benefits of mental activity. From my perspective, even what they term as bad news, that the decline after Alzheimer’s is more precipitous, I regard as beneficial. Were I to suffer from Alzheimer’s, I would want my suffering to be as short as possible.

The Healthymemory Blog is dedicated to promoting mental activity not only to preclude or ward off mental decline, but also to provide cognitive enrichment. Although the primary audience for this blog is comprised of baby boomers, all should benefit. There are three basic categories of blog posts. The first category, Human Memory: Theory and Data, provides information on how memory works and how cognition both functions and malfunctions. Tips are provided on how to avoid common information processing errors. I find the field of human memory very interesting and I use this category to share my interests.

The second category is on mnemonic techniques. Mnemonic techniques are specific strategies for enhancing memory. In addition to enhancing memory, they also provide mental exercise. It does not appear that this type of mental stimulation was included in the Rush research. When you access this category it is important that blog post are ordered from most recent to the oldest. For this category in particular, it should be more beneficial to read them from the bottom up.

The third category is transactive memory. Transactive memory refers to external sources of information. These external sources can be found in either fellow humans or in technology. Although the newspapers, books, and magazines used in the Rush study are included, no uses of the internet were mentioned. The Healthymemory Blog believes that the internet provides resources for both mental stimulation and cognitive growth.

So mental stimulation should be regarded not only as a defensive mechanism to prevent or ward off mental decline, but also as an offensive, proactive practice to promote cognitive growth to lead to a richer and more fulfilling life.

1Brain Gain.(2010). September 4-10th p. 88.

© Douglas Griffith and healthymemory.wordpress.com, 2010. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Is Dementia an Inevitable Part of Aging?

August 22, 2010

This blog post is another in the series inspired by the book, The Scientific American Brave New Brain.1 That book presents a table contrasting the way the brain once was regarded, the way it is presently regarded, and some conjectures about what tomorrow might hold. According to Brave New Brain in the past, Alzheimer’s Disease and loss of brain function were regarded as inevitable parts of aging. Although the awareness of the widespread plague of Alzheimer’s Disease is relatively knew, many if not most people regarded the loss of brain function as a normal part of aging. It was thought that just as the body wears out, the brain wears out.

According to Brave New Brain today it is believed that “active brains retain more function than inactive ones, even to some very elderly people.” Even as parts of the brain decline, the neuroplasticity of the brain results in the enlisting of other parts of the brain to compensate for this decline. The Healthymemory Blog post “HAROLD” discussed this compensation. An important part of the current belief is that active brains retain more function than inactive ones. That is, inactive brains do decline as a result of aging. So here the old belief maintains. If you are passive and mentally inactive you can expect to lose brain function. The brain is analogous to the body: use it or lose it.

According to Brave New Brain, in the future Alzheimer’s disease is reversible and curable in many cases. Let us hope that this is also true for other forms of senile dementia. The question is how far into the future will this be the case. Are all of us baby boomers safe. I’m afraid that already some of us baby boomers have succumbed. Will the tale end of the baby boomers be safe? Let’s hope that cures and effective treatments will be developed as soon as possible. Otherwise the effects will be truly devasting.

The good news is that we do have a fighting chance. Active brains retain more function than inactive ones. Although there is no absolute guarantee that an active brain will not succumb Alzheimer’s or some other form of dementia, but the odds of succumbing are decreased by staying mentally acted. Moreover, you have the option of increasing your mental activity. Even if a cure for dementia were found, and let us up that there will be a cure, keeping mentally active and growing cognitively are still worthy goals on their own. They should result in a richer, fuller life.

The Healthymemory Blog is devoted to promoting healthy mental activity. It has three themes. One is the provision of knowledge about how memory works and how it fails to work. And it offers remedies for these failures. The blog posts are found in the Memory: Theory and Data category. Another theme is the use of mnemonic techniques. These posts are found, appropriately enough, under the category of mnemonic techniques. These techniques not only provide a means of improving memory, but also provide exercise that keeps the brain active. It is recommended to start at the beginning, bottom of this category as techniques become more difficult as you advance upwards. The third theme is Transactive Memory. Blog posts under this category provide suggestions for using technology and other people not only to maintain cognitive health, but also to foster and extend cognitive growth well into old age.

1Horstman, J. (2010). San FranciscoJossey-Bass.

© Douglas Griffith and healthymemory.wordpress.com, 2010. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.