Category Archives: Alzheimers/Dementia

Caregiving For Alzheimer’s

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Caregiving for an Alzheimer’s patient is difficult and stressful. Here is a recent essay on a woman’s voyage through that journey as a caregiver, and her joy at recovering her memories of her mother at then end:
Losing My Mom to Alzheimer’s, Then Finding Her Again

Here are twenty-nine well-written articles on aspects Alzheimer’s caregiving:
Alzheimer’s Disease & Related Dementias: Alzheimer’s Caregiving

This is a collection of six valuable tips for caregiving for an Alzheimer’s patient:
Tips for Alzheimer’s and Dementia Caregivers

This page provides twenty-five lessons learned by Alzheimer’s caretakers about the caregiving process, and about their own lives:
25 Lessons Learned From Alzheimer’s Caregivers

The stress of Alzheimer’s caregiving can be alleviated by interaction with other caregivers. Here are two links providing access to Alzheimer’s caregiving support groups:
Programs and Support
The 5 Best Emotional Support Groups for Alzheimer’s Caregivers

All links have been added to Alzheimer’s > Coping & Caregivers > Caregivers.

Rethinking The Causes Of Alzheimer’s

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For many years, the majority of brain researchers have assumed that the accumulation of amyloid plaques in the brain is the principal cause of Alzheimer’s disease. It was thought the decline in cognition was caused by the development of the plaques. Yet despite many expensive attempts at developing anti-amyloid drugs, little or nothing in the way of successful therapies is available. This has led some researchers to explore whether or not the amyloid plaques, although clearly involved with the disease, are not the proximate cause. The amyloid hypothesis has been questioned, given the large number of clinical trials in which drugs targeted and successfully cleared amyloid from the brain but did not halt or reverse cognitive decline.

Recently published work seems to point in this direction. The researchers used brain scans combined with Obj-SCD (“objectively-defined subtle cognitive difficulties”), a refined set of tests for assessing cognition. Their work appears to show that development of amyloid plaques did not emerge before the development of subtle cognitive difficulties.

Here are five links to media articles on the work:
We Just Got More Evidence Our Leading Hypothesis About Alzheimer’s Could Be Wrong
Objective subtle cognitive difficulties predict amyloid accumulation and neurodegeneration
Which Comes First, Cognitive Problems Or Beta-amyloid Plaques?
Amyloid Accumulation Doesn’t Always Precede Cognitive Decline
What causes Alzheimer’s? Not toxic amyloid, new study suggests

Here is a link to the research paper:
Objective subtle cognitive difficulties predict future amyloid accumulation and neurodegeneration

All links have been added to Alzheimer’s > Neurology & Neuroplasticity.

Lifestyle Affects Both Alzheimer’s & FTD

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Alzheimer’s disease (60-80%) and Frontotemporal dementia (FTD) (10-20%) make up the two largest populations of dementia sufferers (Dementia with Lewy bodies comprises another 5%). Two fairly recently published studies have examined the effects of lifestyle changes on both Alzheimer’s and FTD. Both studies considered the participants’ physical and cognitive activities to create a definition of “active lifestyle” for the participants. For both the Alzheimer’s and FTD studies, participants with the greatest activity scores showed the greatest resistance to cognitive decline (for those not already showing mild cognitive impairment) or the greatest reduction in rate of cognitive decline (for those already showing some mild cognitive impairment).

Here are links to three media articles on lifestyle & Alzheimer’s:
People at Risk of Alzheimer’s May Improve Brain Function With Individualized Treatment
Lifestyle changes improved cognition in people at risk for Alzheimers, study shows
Could Regimented, Prescribed & Individualized Lifestyle Changes Improve Cognition in People at Risk for Alzheimer’s Disease?

Here is a link to the research article on lifestyle & Alzheimer’s:
Individualized clinical management of patients at risk for Alzheimer’s dementia

Here are links to three media articles on lifestyle & FTD:
Lifestyle changes may combat a dementia that strikes people in their 40s and 50s
Lifestyle Choices Could Slow Familial Frontotemporal Dementia
Active lifestyle may slow inherited frontotemporal dementia

Here is a link to the research report on lifestyle & FTD:
Active lifestyles moderate clinical outcomes in autosomal dominant frontotemporal degeneration

All links have been added to Health > Physical Exercise and Alzheimers > Mental Exercise.

Exercise & Brain: Four 2019 Articles

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At the end of this past December, the NY Times published an overview/review (Move Your Body, Bolster Your Brain) of four 2019 articles covering research work on physical exercise and brain health. We’ll recap these below, providing additional media links along the way.

A Single Workout Can Alter the Brain (How Exercise Affects Our Memory)

A study of healthy older adults shows that just one 30 minute session of exercise increased activation in the brain circuits associated with memory — including the hippocampus. The latter shrinks with age and is the brain region attacked first in Alzheimer’s disease.

Here are two additional media articles:
Exercise activates memory neural networks in older adults
30 Minutes of Aerobic Exercise Supercharges Semantic Memory

Here is a link to the research publication:
Semantic Memory Activation After Acute Exercise in Healthy Older Adults

How Exercise May Sharpen Memory (How Exercise May Help Keep Our Memory Sharp)

New evidence reaffirms suggestions that exercise-induced irisin, a hormone, may protect against neurodegeneration and boost memory in both humans and mice.

Here are three additional media articles:
How exercise may protect against Alzheimer’s
Exercise-Linked Irisin May Protect Against Neurodegeneration
‘Exercise Hormone’ Could Slow Progression of Alzheimer’s Disease

Here is a link to the research publication:
Exercise-linked FNDC5/irisin rescues synaptic plasticity and memory defects in Alzheimer’s models

Weight Training Changes the Brain (How Weight Training Changes the Brain)

Until recently the majority of research on exercise and brain health has been done with aerobic exercise, which indeed, has show that exercise is good for your brain. Now, new work using lab rats has demonstrated that weight training can overcome cognitive impairment and even jumpstart the creation of new neurons.

Here are three additional media articles:
Weight Training – Good for the Brain Too?
Research shows surprising link between weightlifting and cognition
Strong Rat. Smart Rat. Got That?

Here is a link to the research publication:
Resistance-exercise training ameliorates LPS-induced cognitive impairment concurrent with molecular signaling changes in the rat dentate gyrus

The Right Kind of Exercise to Lower Dementia Risk (The Right Kind of Exercise May Boost Memory and Lower Dementia Risk)

It is never too late to begin exercising. This study shows that even starting in your 60’s, you can reduce your risk of dementia. Short intense sessions may be the most helpful.

Here are three additional media articles:
Improved fitness can mean living longer without dementia
Being Physically Fit Reduces the Risk of Dementia
Robust Workouts Guard Brains & Health at Any Age

Here is a link to the research publication:
Temporal changes in cardiorespiratory fitness and risk of dementia incidence and mortality: a population-based prospective cohort study

All the links above have been added to Health > Physical Exercise

Dementia, Depression And A New Path

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It is not at all uncommon for a person suffering from mild cognitive impairment or mild to moderate dementia to also suffer from depression. There is enough overlap between the signs and symptoms of each disease that teasing apart the diagnoses, or verifying the presence of both, can be difficult for clinicians. And the presence of cognitive issues can make traditional treatments for depression, such as cognitive behavioral therapy (CBT), more difficult to practice.
Recently, a number of groups have worked to adjust CBT and related therapies to better suit those suffering from both dementia and depression. One is called Problem Adaptation Therapy (or PATH) and focuses on solving tangible problems that fuel feelings of sadness and hopelessness, incorporating tools like checklists, calendars, signs and videos, to make it accessible for people with memory issues. Another, called the Peaceful Mind program, developed for patients with anxiety and dementia, simplifies traditional cognitive behavioral therapy.

Here are links to five media articles on depression and dementia:
How are depression and dementia related?
Alzheimer’s or depression: Could it be both?
Depression | Alzheimer’s Association
New Therapies Help Patients With Dementia Cope With Depression
Cognitive behavior therapy for anxiety in people with dementia: a clinician guideline for a person-centered approach.

Here are three research articles dealing with Problem Adaptation Therapy (PATH) therapy:
Problem Adaptation Therapy for Older Adults With Major Depression and Cognitive Impairment
Problem Adaptation Therapy (PATH) for Older Adults with Major Depression and Cognitive Impairment: A Randomized Clinical Trial
Home-Delivered Problem Adaptation Therapy (PATH) for Depressed, Cognitively Impaired, Disabled Elders: A Preliminary Study

All links have been added to Neuro-Psych.

Listen Up! Hearing Aids Can Help Resist Dementia.

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In an October post (Hearing Loss and Dementia) we examined several studies of the relationship between hearing loss and the onset of dementia. The present post is a follow-up to that October post. We list three additional studies of the dementia-hearing loss relationship, together with seven media articles on that relationship, and on the ability of hearing aids to slow the possible onset of dementia due to hearing loss.

Here are the seven media articles:
For Better Brain Health, Preserve Your Hearing
Link between hearing and cognition begins earlier than once thought
Mild Hearing Loss May Be Associated with Mental Decline in Seniors
Hearing Loss Linked to Dementia
Cognitive loss and hearing loss
Hearing Loss and Dementia: Breakthrough Research Seeks Causal Link

Here are the three studies on the association of hearing losss with dementia:
Association of Subclinical Hearing Loss With Cognitive Performance.
Association of Hearing Loss With Dementia
Relationship of Hearing loss and Dementia: a Prospective, Population-based Study

All links have been added to Aging and Risk Factors.

Alzheimer’s And Sleep

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A recent study suggests a connection between the slow waves of deep sleep and a cleaning process likely clearly some of the accumulation of brain toxins, include beta-amyloid. So it is recommended that aging people try to sleep as healthy as possible.

Here are links to three media articles about the work:
How Deep Sleep May Help The Brain Clear Alzheimer’s Toxins
Scientists Now Know How Sleep Cleans Toxins From the Brain
Sleep may trigger rhythmic power washing in the brain

And here is a link to the research study:
Coupled electrophysiological, hemodynamic, and cerebrospinal fluid oscillations in human sleep

All links have been added to Neuro-Psych

Robot Pets for Dementia

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While dementia assistance dogs (Dogs And Dementia) are growing in use and popularity, live pets are not always possible or appropriate for many sufferers of dementia. In recent years, a number of companies have brought to market animatronic (preset moves and prerecorded sounds) and robotic (supporting more complex tasks) “pets” for use with dementia patients. Principally these “pets” are dogs, some cats, and even a harp seal. They can be held, petted, and brushed by dementia patients, and can produce some sounds and motion. Studies (see below) have shown that use of the robotic pets can reduce the stress and anxiety often suffered by dementia patients, and reports indicate that some patients develop emotional bonds with the pets.

Here are five media articles about the developments:
Therapy Cats for Dementia Patients, Batteries Included
Robotic pets delight patients with dementia
Robotic Pets To The Rescue? Dementia Care Gets Innovative
Is this robotic therapy pet the uncanny valley of dog?
The Second Coming of the Robot Pet

And here are a number of research articles on the use of robot pets for dementia intervention:
Pet robot intervention for people with dementia: A systematic review and meta-analysis of randomized controlled trials.
The Utilization of Robotic Pets in Dementia Care.
How do “robopets” impact the health and well‐being of residents in care homes? A systematic review of qualitative and quantitative evidence
Effect of an interactive therapeutic robotic animal on engagement, mood states, agitation and psychotropic drug use in people with dementia: a cluster-randomised controlled trial protocol
Use of a Robotic Seal as a Therapeutic Tool to Improve Dementia Symptoms: A Cluster-Randomized Controlled Trial
Robotic Pets: A Senior’s Best Friend?

All links have been added to Alzheimers > Coping & Caregivers > Dementia Assist Dogs & Robot Pets

Dogs And Dementia

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While the use of dogs as guide dogs (“seeing-eye dogs”) began in the aftermath of World War I, the last 40 years has seen the extension of service dog training into such areas as:

More recently, the last several decades have seen the development of dementia-assist dogs. Like all other therapy dogs, these dogs provide companionship and friendship for their owner. Additionaly, various trainers teach dogs a range of different behaviors, such as:

  • Since dementia patients often become agitated, some dogs are trained to interrupt this behavior by distracting their owner, and thus help reduce the owner’s anxiety and help them refocus;
  • Walk on a leash with the owner. If the owner gives the command “Home”, the dog will lead the owner back home. The dog’s collar will have a GPS device, which will allow caregivers to locate the pair if they get lost, or if the dementia patient forgets to issue the “Home” command;
  • Fetch a patient’s medication;
  • Waking their owner up each morning;
  • Trigger an alarm in the house if the patient falls and does not get up within a reasonable amount of time, or if the dog hears a choking sound.

The breeds used most often for service dogs are Labrador Retrievers, Golden Retrievers, Labrador/Golden Retriever crosses, and German Shepherds.

Here are links to several media articles about dementia-assist dogs:
The New Breed of Service Dog: Canine Caregivers for Dementia and Alzheimer’s Patients
Good Dogs: Dementia Service Dogs Provide Patients, Caregivers With Improved Quality of Life
Dementia Assistance Dogs
Assistance Dogs for Alzheimer’s and Dementia Patients

Here is one study of how use of a therapy dog can affect the quality of life of an Alzheimer’s sufferer:
Stepping out of the shadows of Alzheimer’s disease: a phenomenological hermeneutic study of older people with Alzheimer’s disease caring for a therapy dog

Here is a review of six studies (between 2016 – 2018) of the effectiveness of animal assisted therapy (AAT) with special focus on dog therapy among people with dementia, and in particular, Alzheimer’s disease:
Effectiveness of the dog therapy for patients with dementia – a systematic review

All links have been added to Alzheimers > Coping & Caregivers > Dementia Assist Dogs & Robot Pets

Hearing Loss and Dementia

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Most people can expect to deal with hearing loss in the course of normally long lives. 50% of people in their 70’s suffer from it, as do 80% of people in their 80’s. Unfortunately, besides being troublesome, it appears that hearing loss can have a direct causal effect on dementia, as well as other bad outcomes. (See the table in our post Nine Factors Contributing to Dementia — You Can Manage Them. Hearing loss, at 9%, is the largest factor.)

1,164 participants (average age 73.5) in a 24-year longitudinal study underwent assessments for hearing acuity and cognitive function between the years 1992 to 1996. All of them were followed for up to 24 years with up to five subsequent cognitive assessments at approximately four-year intervals. None used a hearing aid.

Almost half of the participants had mild hearing impairment, with almost 17% suffering moderate-to-severe hearing loss. Those with more serious hearing impairment showed worse cognitive performance at the initial visit. Hearing impairment was associated with greater decline in performance on cognitive tests over time, both for those with mild hearing impairment and those with more severe hearing impairment.

Here are two media articles on the work:
With age comes hearing loss and a greater risk of cognitive decline
How hearing impairment is associated with cognitive decline
Here is the abstract of the original research article:
Hearing impairment and cognitive decline in older, community-dwelling adults.

Similar conclusions arise from a study of 8 years of data from more than 10,000 men. The study compared the effects of hearing loss with measures of subjective cognitive decline, which is changes in memory and thinking that people notice in themselves.

The risk of subjective cognitive decline was 30 percent higher among men with mild hearing loss, compared with those with no hearing loss, while for men with moderate or severe hearing loss, the risk was between 42 and 54 percent higher.

Media article:
Hearing loss and cognitive decline: Study probes link
Research publication:
Longitudinal study of hearing loss and subjective cognitive function decline in men

In another study that covered over 154,000 adults 50 and older who had health insurance claims, but no evidence of hearing device use, researchers found that untreated hearing loss increased the risk of developing dementia by 50 percent and depression by 40 percent in just five years when compared to those without hearing loss. This study also demonstrated a clear association between untreated hearing loss and not only an increased risk of dementia and depression, but also falls and even cardiovascular diseases.

Here are three media articles on this study:
Hearing Loss Threatens Mind, Life and Limb
Higher risk of dementia and depression with an untreated hearing loss
Hearing Loss in Older Adults Linked to Depression, Dementia Among Other Comorbidities
Here is the original research publication:
Incident Hearing Loss and Comorbidity: A Longitudinal Administrative Claims Study

There is concrete evidence that using hearing aids can slow the rate of cognitive decline, as shown by two recent research studies.

Here is a review discussion of the first research publication on hearing aids:
Evidence that Hearing Aids Could Slow Cognitive Decline in Later Life
First research article:
Longitudinal Relationship Between Hearing Aid Use and Cognitive Function in Older Americans

Here are media articles about the second research publication on hearing aids:
Hearing aids linked to lower risk of dementia, depression and falls
Hearing aids lower the chance of dementia, depression, and falling
Second research article:
Can Hearing Aids Delay Time to Diagnosis of Dementia, Depression, or Falls in Older Adults?

Finally, we note a study, closely related to the “Administrative Claims Study” above, which shows that untreated hearing loss tends to lead to higher health care costs over time. (Users of hearing aids were not considered in the study, so, as yet, one cannot conclude that hearing aid use might lower costs, though that might be a reasonable inference.)

Media article:
Patients with untreated hearing loss incur higher health care costs over time
Research article:
Trends in Health Care Costs and Utilization Associated With Untreated Hearing Loss Over 10 Years

All links have been added to Aging and Alzheimers > Risk Factors