(Editor’s Note: this timely new report illus­trates the need for inno­v­a­tive brain fit­ness inter­ven­tions focused on main­tain­ing if not enhanc­ing tar­geted cog­ni­tive func­tion­al­ity, such as dri­ving safety or finan­cial decision-making, lever­ag­ing life­long neu­ro­plas­tic­ity and cog­ni­tive reserve. What the report presents as inex­orable, some­what genet­i­cally pre-programmed decline, it is not.)

BMO Retire­ment Insti­tute Report: Boomers’ Abil­ity to Make Finan­cial Deci­sions Often Declines With Age (Mar­ket Watch):

- “The BMO Retire­ment Insti­tute released a report today which raises aware­ness of the poten­tial impact on aging Cana­di­ans of declin­ing cog­ni­tive abil­i­ties — often caused by Alzheimer’s dis­ease and other forms of demen­tia — and describes how this decline can affect their abil­ity to make finan­cial deci­sions.” Read the rest of this entry »

Think­ing glob­ally to improve men­tal health: NIH announces inter­na­tional research ini­tia­tive (press release):

- “The Grand Chal­lenges in Global Men­tal Health Ini­tia­tive, led by the National Insti­tutes of Health and the Global Alliance for Chronic Dis­eases, has iden­ti­fied the top 40 bar­ri­ers to bet­ter men­tal health around the world. Sim­i­lar to past grand chal­lenges, which Read the rest of this entry »

In a recent post we saw that music may help peo­ple with demen­tia learn new facts. This arti­cle explores another rela­tion­ship between music and demen­tia: play­ing a musi­cal instru­ment, even as an ama­teur, may pro­tect the brain later on against dementia-related damages.

Researchers had 70 peo­ple ages 60 to 83 per­form a vari­ety of tests to mea­sure visu­ospa­tial mem­ory, abil­ity to name objects, the brain’s abil­ity to adapt to new infor­ma­tion […] those who had engaged in musi­cal activ­ity for 10 years or longer scored sub­stan­tially bet­ter than those with no musi­cal activ­ity in their past.

the longer peo­ple play instru­ments, the more ben­e­fits they may derive.

All were ama­teurs who had started play­ing when they were 10 years old. Read the rest of this entry »

Bev­erly San­born, Vice Pres­i­dent of Pro­gram Devel­op­ment at Bel­mont Senior Liv­ing and sched­uled 2011 Sharp­Brains Sum­mit Speaker, could not finally speak at the Sum­mit (she was very well replaced by col­league Jeff DeBevec), but for­tu­nately we can share her thought­ful answers to the fol­low­ing four crit­i­cal questions.

1. How would you define “brain fit­ness” vs. “phys­i­cal fit­ness”?

Brain fit­ness and phys­i­cal fit­ness are inter­linked. Each enhances the other and both are essen­tial com­po­nents of suc­cess­ful aging. As we age, the abil­ity to cope with inex­orable chal­lenge to social-emotional-economic well-being is rooted in hav­ing a high level of men­tal alert­ness and a phys­i­cal body that func­tions effi­ciently. But fit­ness is not just a happy con­se­quence of a hardy gene pool. Fit­ness for both brain and brawn requires a com­mit­ted effort, a lot of stretch and sweat, and the con­stant push to reach beyond the com­fort zone. Read the rest of this entry »

An inter­est­ing arti­cle in Nature Reviews last month reviewed sev­eral stud­ies show­ing that cog­ni­tive inter­ven­tion can be ben­e­fi­cial even for indi­vid­u­als already diag­nosed with Alzheimer’s Dis­ease (Buschert et al., 2010).

The arti­cle shows that patients with mild-to-moderate demen­tia can ben­e­fit from a range of cog­ni­tive inter­ven­tions: from train­ing of par­tially spared cog­ni­tive func­tions to train­ing on activ­i­ties of daily liv­ing. Results sug­gest that such inter­ven­tions can improve global cog­ni­tion, abil­i­ties of daily liv­ing and qual­ity of life in these patients.

Patients with moderate-to-severe demen­tia seem to ben­e­fit from gen­eral engage­ment in activ­i­ties that enhance cog­ni­tive and social func­tion­ing in a non-specific manner.

In gen­eral, for patients diag­nosed with Alzheimer’s Dis­ease, the reviewed stud­ies sug­gest that pro­grams focus­ing on global cog­ni­tive stim­u­la­tion are more effec­tive than pro­grams that train spe­cific cog­ni­tive functions.

The oppo­site seems true for peo­ple diag­nosed with Mild Cog­ni­tive Impair­ment (MCI). As you may remem­ber, MCI diag­no­sis is made upon objec­tive mem­ory deficits that do not inter­fere with activ­i­ties of daily liv­ing. 5 to 10% of peo­ple with MCI develop demen­tia within 1 year after being diagnosed.

It is inter­est­ing to see that the type of cog­ni­tive inter­ven­tion one may ben­e­fit from changes over the years, depend­ing on one’s cog­ni­tive sta­tus. This shows once again that there is no gen­eral magic pill in terms of brain fit­ness: Some inter­ven­tions or pro­grams work because they meet the needs of some spe­cific indi­vid­u­als. No pro­gram can work for everybody.

Read the rest of this entry »

Today is World Alzheimer’s Day. To raise aware­ness and funds, asso­ci­a­tions world­wide orga­nize mul­ti­ple activ­i­ties includ­ing impor­tant Mem­ory Walks, and a new report helps quan­tify the grow­ing per­sonal and eco­nomic bur­den of the disease.

Among the report findings:

• Close to 36 mil­lion peo­ple world­wide have demen­tia today
• Demen­tia care costs around 1 per­cent of the world’s gross domes­tic prod­uct (GDP), or 604 bil­lion US dol­lars. Of these, 252 bil­lion rep­re­sent indi­rect costs of care, while annual direct med­ical costs account for 96 bil­lion, and direct non-medical costs for 256 billion
• By 2030, world­wide soci­etal costs will increase by over 85 percent

The good news?

• That the num­ber 1 rea­son for the bad news is sim­ple: we live longer than ever before
• That, while there is noth­ing we can do today to pre­vent Alzheimer’s pathol­ogy, there is much we can do, as indi­vid­u­als and as a soci­ety, to build up Cog­ni­tive Reserve and sig­nif­i­cantly delay cog­ni­tive decline and Alzheimer’s symptoms

Which is why there is so much ongo­ing inno­va­tion to develop tools to effi­ciently mea­sure and enhance cog­ni­tive func­tion­ing and reserve and to fos­ter active aging.

Time per­haps for a World Cog­ni­tive Reserve’s Day?

(Editor’s Note: you may have read all the con­fus­ing –if not out­right mis­lead­ing– recent media cov­er­age on the effect of men­tal stim­u­la­tion on cog­ni­tive health and Alzheimer’s Dis­ease. To help clar­ify mat­ters, please find below part of the ongo­ing dis­cus­sion at Sharp­Brains’ group in LinkedIn, and keep tuned since in a few days we’ll be pub­lish­ing an analy­sis of the sci­en­tific study that, while bring­ing largely Good News, has been largely reported as Ter­ri­ble News.)

—

Stu­art • I just came across this arti­cle in Med­ical News…Mental Stim­u­la­tion Delays The Decline In Think­ing Skills, But May Accel­er­ate Demen­tia Later On.…
It’s the first time I have seen an arti­cle talk­ing about the poten­tial down side of men­tal stim­u­la­tion in later life…I would be inter­ested in the views of the more qual­i­fied than myself in this area…http://tinyurl.com/22ovdfv

Jenny • I wouldn’t say I was more qual­i­fied. How­ever hav­ing read this arti­cle although ini­tially it would seem a dis­ap­point­ment that hav­ing done all that men­tally stim­u­lat­ing activ­ity to build one’s cog­ni­tive reserve to then be sub­ject to a rapid down­hill decline. But in fact I think the study is good news. Firstly it sup­ports the notion that by being engaged in men­tally stim­u­lat­ing activ­i­ties we can main­tain our cog­ni­tion as we age. Sec­ondly we may be on the way to devel­op­ing demen­tia but isn’t it bet­ter to delay or defer the onset fro as long as pos­si­ble? It may be by the time the symp­toms man­i­fest them­selves we have mean­while being enjoy­ing con­tin­u­ing to live normally.

In the Nun study the autop­sies of some of the nuns brains showed they were full of Alzheimer’s dis­ease yet clin­i­cally had shown no out­ward sign. I believe this study is very impor­tant in rein­forc­ing the mes­sage that we all ben­e­fit from keep­ing men­tally fit.

The other key point is that by defer­ring the onset of symp­toms the eco­nomic and social sav­ings to the health sys­tem and soci­ety will be huge.

And lastly. If I had the choice between liv­ing for longer symp­tom free of demen­tia and then going into a rapid decline I think I would choose that any day over the pos­si­bil­ity of devel­op­ing symp­toms ear­lier and liv­ing longer with the disease.

So I don’t see this arti­cle as hav­ing a down side. Being men­tally engaged and hav­ing a big­ger cog­ni­tive reserve, does not con­fer immu­nity against demen­tia and I don’t believe has ever pur­ported to do so. Maybe that has just been Read the rest of this entry »

A few eter­nal ques­tions:
– Is caf­feine good for the brain?
– Does it boost cog­ni­tive func­tions?
– Does it pro­tect against dementia?

There is lit­tle doubt that drink­ing that morn­ing cup of cof­fee will likely increase alert­ness, but the main ques­tions that research is try­ing to answer go beyond that. Basi­cally: is there a sus­tained, life­time, ben­e­fit or harm from drink­ing cof­fee regularly?

The answer, so far, con­tains good news and bad news. The good news for cof­fee drinkers is that most of the long-term results are direc­tion­ally more pos­i­tive than neg­a­tive, so no clear harm seems to occur. The bad news is that it is not clear so far whether caf­feine has ben­e­fi­cial effects on gen­eral brain func­tions, either short-term or long-term (aged-related decline or risks of dementia).

It is impor­tant to note that many of the stud­ies show­ing an effect of cof­fee con­sump­tion on brain func­tions or risks of demen­tia report a cor­re­la­tion or asso­ci­a­tion (they are not ran­dom­ized clin­i­cal tri­als). As you know, cor­re­la­tion doesn’t prove cau­sa­tion: cof­fee drinkers may seem to do well in a num­ber in these long-term stud­ies, but there may be other rea­sons why cof­fee drinkers do better.

Q: How does caf­feine affect my brain?
A: Caf­feine is a stimulant.

It belongs to a chem­i­cal group called xan­thine. Adeno­sine is a nat­u­rally occur­ring xan­thine in the brain that slows down the activ­ity of brain cells (neu­rons). To a neu­ron, caf­feine looks like adeno­sine. It is there­fore used by some neu­rons in place of adeno­sine. The result is that these neu­rons speed up instead of slow­ing down.

This increased neu­ronal activ­ity trig­gers the release of the adren­a­line hor­mone, which will affect your body Read the rest of this entry »

In the midst of much health­care reform talk, not enough atten­tion seems focused on ensur­ing health­care sys­tems’ pre­pared­ness to deal with cog­ni­tive health issues –with Alzheimer’s Dis­ease as the most dra­matic exam­ple– which are pre­dicted to grow given aging pop­u­la­tion trends.

Today is World Alzheimer’s Day, and the USA Today com­ments on a new report that makes stark pre­dic­tions:
Global Alzheimer’s cases expected to rise sharply (USA Today)

- “The 2009 World Alzheimer’s Report, released today, esti­mates 35 mil­lion peo­ple world­wide are liv­ing with Alzheimer’s and other forms of demen­tia. The fig­ure is a 10% increase over 2005 numbers.”

- “The num­ber of peo­ple affected by Alzheimer’s is grow­ing at a rapid rate, and the increas­ing per­sonal costs will have sig­nif­i­cant impact on the world’s economies and health care sys­tems,” said Harry Johns, Pres­i­dent and CEO of the Alzheimer’s Asso­ci­a­tion. “We must make the fight against Alzheimer’s a pri­or­ity here in the United States and world­wide,” he said.

- “The report by London-based non­profit Alzheimer’s Dis­ease Inter­na­tional (ADI), an inter­na­tional fed­er­a­tion of 71 national Alzheimer orga­ni­za­tions (includ­ing the Alzheimer’s Asso­ci­a­tion), indi­cates that the num­ber of peo­ple with demen­tia is expected to grow sharply to 65.7 mil­lion in 2030 and 115.4 mil­lion in 2050.”

Link to report: Here

The Alzheimer’s Asso­ci­a­tion is orga­niz­ing mul­ti­ple Mem­ory Walks to raise aware­ness and funds. You can learn more and join Here. (Per­haps a good oppor­tu­nity to orga­nize a “walk­ing book group” as Arthur Kramer sug­gested in the Sharp­Brains Guide?)

The City of San Fran­cisco, led by its Depart­ment of Aging and Adult Ser­vices (DAAS), con­vened since 2008 an Alzheimer’s/ Demen­tia Expert Panel to iden­tify gaps and issue rec­om­men­da­tions to address the grow­ing cri­sis in demen­tia care at the city level, and is about to release a pio­neer­ing plan that may well influ­ence pub­lic health ini­tia­tives in other cities and states. An interim doc­u­ment can be found here: 2020 Foresight-Strategy For Excel­lence in Demen­tia Care (pdf)

One of the major areas of focus for that strat­egy was Edu­ca­tion & Pre­ven­tion, and below we can share a sum­mary of the pre­lim­i­nary find­ings and rec­om­men­da­tions. We will high­light the final report when ready.

ALZHEIMER’S/DEMENTIA EXPERT PANEL

EDUCATION AND PREVENTION SUBCOMMITTEE

FINDINGS AND RECOMMENDATIONS

The subcommittee’s charge was to con­sider how best to edu­cate the San Fran­cisco com­mu­nity about Alzheimer’s and related demen­tias to change atti­tudes, beliefs, behav­iors, stan­dards of prac­tice, and out­comes asso­ci­ated with the disease.

Spe­cific top­ics addressed include:
· Pro­tec­tive fac­tors relat­ing to demen­tia, includ­ing risk fac­tors and brain health
· Early iden­ti­fi­ca­tion of demen­tia
· Early access to ser­vices
· Com­mu­nity edu­ca­tion
· Edu­ca­tion of pro­fes­sion­als and non­pro­fes­sion­als, includ­ing physi­cians, psy­chi­a­trists and psy­chol­o­gists, social work­ers, nurses, and other care­givers, both paid care­givers and infor­mal care­givers such as fam­ily and friends
· Eth­i­cal issues
· Pol­icy issues

The dis­sem­i­na­tion of accu­rate infor­ma­tion about Alzheimer’s and related demen­tias can play an impor­tant role in Read the rest of this entry »

(Editor’s Note: given the grow­ing media atten­tion to three appar­ently sep­a­rate worlds –cog­ni­tive enhance­ment via drugs, brain fit­ness train­ing soft­ware, com­put­er­ized neu­rocog­ni­tive assessments-, I found it refresh­ing to see our co-founder Elkhonon Gold­berg intro­duce the topic of cog­notropic drugs with an inte­gra­tive per­spec­tive in the much updated new edi­tion of his clas­sic book, now titled The New Exec­u­tive Brain: Frontal Lobes In A Com­plex World. Below goes an excerpt).

For many neu­ropsy­chol­o­gists, like myself, sci­ence is a labor of love, but see­ing patients is bread and but­ter. Tra­di­tion­ally, the clin­i­cal con­tri­bu­tion of neu­ropsy­chol­ogy has been mostly diag­nos­tic, with pre­cious lit­tle to offer patients by way of treat­ment. Neu­ropsy­chol­ogy is not the only clin­i­cal dis­ci­pline for years con­signed to help­less voyeurism. Every dis­ci­pline con­cerned with cog­ni­tion shares this hum­bling predica­ment. A psy­chi­a­trist treat­ing a schiz­o­phrenic patient or a depressed patient finds him– or her­self in a sim­i­lar posi­tion. There are ample phar­ma­co­log­i­cal tools to treat the patient’s psy­chosis or mood, but very few to treat the patient’s cog­ni­tion. Even though psy­chi­a­trists increas­ingly rec­og­nize that cog­ni­tive impair­ment is often more debil­i­tat­ing in their patients than psy­chosis or mood dis­or­der, tra­di­tion­ally, very lit­tle direct effort has been aimed at improv­ing cognition.

A neu­rol­o­gist treat­ing a patient recov­er­ing from the effects of head injury does not fare much bet­ter. There are ade­quate means to con­trol the patient’s seizures but not his or her cog­ni­tive changes, despite the fact that cog­ni­tive impair­ment is usu­ally far more debil­i­tat­ing than an occa­sional seizure. Soci­ety has been so pre­oc­cu­pied with sav­ing lives, treat­ing hal­lu­ci­na­tions, con­trol­ling seizures, and lift­ing depres­sion that cog­ni­tion (mem­ory, atten­tion, plan­ning, prob­lem solv­ing) has been largely ignored. Granted, var­i­ous neu­rolep­tics, anti­con­vul­sants, anti­de­pres­sants, seda­tives, and stim­u­lants do have an effect on cog­ni­tion, but it is an ancil­lary effect of a drug designed to treat some­thing else.

Alzheimer’s dis­ease and other demen­tias have been society’s wake-up call. Here, in the most afflu­ent coun­try in the most afflu­ent of times, human minds were suc­cumb­ing to decay before human bod­ies, a sharp chal­lenge to the tacit pop­u­lar belief that the “body is frail but soul is for­ever.” This pro­vided an impe­tus for the devel­op­ment of an entirely new class of drugs, which can be termed famil­ially as “cog­notropic.” Their pri­mary and explicit pur­pose is to improve cognition.

Since med­ical and pub­lic pre­oc­cu­pa­tion with demen­tia focuses on mem­ory, most of the phar­ma­co­log­i­cal efforts have been directed at improv­ing mem­ory. At the time of this writ­ing, a hand­ful of drugs known as “Alzheimer’s drugs” or “mem­ory enhancers” have been approved by the U.S. Food and Drug Admin­is­tra­tion (FDA). In real­ity, both des­ig­na­tions are some­what mis­lead­ing. The drugs in ques­tion are Read the rest of this entry »