The importance of Self-Care After a Cancer Diagnosis

By  Scott Sanders

Cancer is a vicious enemy that attacks its victims on both a physical and personal level. Standing up to this dreaded disease requires not only sound professional care but also effective self-care. In this post, we'll look at some of the common issues cancer patients face and how to manage them effectively. We'll suggest ways you can help yourself feel better right now, even in the midst of uncertainty. We'll also help you face the future by making the most of the present.


Understanding What's Going On inside Your Body


Many of the challenges cancer patients face come not only from the illness itself but from the therapies used to treat the condition. These issues can include:


●   Nausea, poor appetite, and weight loss

●   Fatigue and weakness

●   Anxiety, fear, or depression over your diagnosis


Your healthcare professional will suggest ways to minimize these problems. In the meantime, here are some things you can do for yourself:


●   Get plenty of rest. A refreshed body can fight cancer better than one that's struggling with exhaustion.

●   Avoid junk food and try to eat nutritious meals.

●   Spend time with those you love. Their caring support can make a world of difference during tough times.

●   Consider starting a journal. Writing your feelings down on paper can help you to understand and deal with them more effectively.


Managing Expectations


Undergoing cancer treatment can be an emotional roller coaster, not only now but going forward, as pointed out by the Huffington Post. One day you feel fine; the next day, not so much. A new medicine may relieve your symptoms for a time and even put your cancer in remission. But this doesn't always last. Even long-term survivors face the prospect of their illness coming back somewhere down the road. How do you deal with this constant uncertainty? Here are some strategies:


●   Live in the present as much as possible. None of us, no matter how healthy or how sick, has a guarantee of tomorrow. We can plan and dream all we want, but, in the end, all we have is right now.

●   Prioritize. Some things in life are essential, others are desirable, and still others are either trivial or of minor importance. Focusing on the first two categories rather than the last may not extend our lives, but it can help us to get the most use from our time.

●   Accept that controlling the future is impossible. We can take steps to avoid misfortunes and maximize our opportunities, of course. But we cannot change the inevitable. Coming to terms with this fact can spare us from needless worry and stress.

●   Seek medical help only from qualified medical professionals. Despite what some people may tell you, there is no secret cure for cancer. Not only do bogus cures offer false hope, in some cases they can make your condition worse, as pointed out by the American Cancer Society.


Consider Getting a Therapy Dog


Therapy dogs can make a world of difference to how you feel, both now and in the future. Here's why:


●   Nobody will show you more unconditional love than a dog. An animal will provide marvelous companionship when human company is unavailable.

●   Therapy dogs can lift your spirits even when you're feeling hopeless, which is good medicine no matter how you look at it.

●   Therapy dogs can help prevent falls, turn lights off and on, carry groceries, and summon help in case of emergency. And they ask for nothing in return, except affection and a little food and water.


Therapy dogs, living in the moment, eating nutritious food, and the other ideas in this post cannot cure cancer all by themselves. But they can help your body fight the disease while improving your quality of life. Please consider these suggestions as you deal with the issues before you, and accept our best wishes for a happy and abundant future.

Powerful and Proven Ways to Get Motivated to Exercise

Are you stuck in a slump? Do you find that you have the best intentions for a fitness plan only to get distracted, lazy, and not make it a priority? Are there many days when you struggle to get up and go?


We’ve all been there. Staying fit is tough. Netflix is always available. Sometimes you need a little something extra to push you toward your workout.


Let’s take a look at 25 proven and powerful ways to increase your motivation and set you up for success.

1. Determine Your Why

This is the important starting point. Why are you exercising? Do you need to strengthen your core muscles to prevent back pain? Do you suffer from depression and find running improves your mood? Is your health at risk due to your weight? Once you single out your “why” you will be able to come back to that mantra over and over when you’re tempted to throw in the towel.


If you don’t have a compelling reason for exercise, you’ll be more inclined to skip days and then give up altogether. Nail down your why first.

2. Make a Plan

Before you dive into 90 minute classes at the gym, sit down and plan. Make attainable goals. Start small. If you haven’t exercised in 3 years, don’t train for a marathon. If you set goals that are too high you will most likely become quickly discouraged and quit. Challenge yourself but be realistic.


Runners often make two goals: minimum and stretch. For example, if they are running a marathon, their minimum goal may be a 4 hour finish and their stretch goal may be a 3.5 hour finish.


Consider making a minimum and stretch goal for yourself. That will give you options if you find yourself either having great success or struggling.

3. Follow Fitness Bloggers and Instagrammers

There’s nothing is quite as motivating as seeing someone working hard and getting results. Fitness bloggers have lots of excellent advice, recipes, and tips. You’ll come to realize they’re just real people who have the same struggles as you and have overcome a lot of obstacles.


Many fitness Instagrammers share photos and videos of their workouts, which can give you guidance and inspiration.

4. Treat Yourself

Think of a way to reward yourself for diligently working out. Treating yourself to a half-pound loaded burger, fries, beer, and a shake will more than likely be counter-productive. Instead treat yourself to a small splurge.


Watch an episode of House of Cards or buy new workout clothes. Science shows that  extrinsic reward is extremely powerful for motivation. Your brain connects the workout to the reward and increases the chances you’ll be consistent.

5. Track Your Progress With an App

There are countless apps out there like NIke Run Club and Runkeeper that track your miles, routes, and calories burned. Its extremely gratifying to see your “Total Miles Run” slowly grow over time.


Plus, tracking progress allows you to tell when you’re slipping and then make appropriate adjustments. If you look at your app and see that you’ve been hitting the gym less frequently, it’s a reminder that you need to get back on track.

6. Train Your Brain

This is going to be hard to believe when you’re not in a routine of exercising, but once you get into a rhythm of weekly workouts you will feel rejuvenated at the end of your workout. In time that alone will be a huge reward.


Exercise releases large amounts of serotonin, which is known as the happy hormone. It’s what gives you that euphoric feeling after an intense weight session or long run. Once your brain is accustomed to having the serotonin, you’ll begin to crave it, reinforcing your workout habit.


7. Make It Legal

This may sound crazy, but draft a document committing to doing “x” exercise for a set period of time and pay a friend ten dollars every week you don’t keep your word. In a sense, create a “binding” agreement between you and your friend that you’ll exercise, and then penalize yourself if you fail to meet the contract.


For some the money is a huge motivator. For others the potential embarrassment of having to tell your friend you didn’t workout is a stronger motivator. Whether it’s one or the other or both combined this is a strategy that will keep you in line.

8. Visualizing

Taking time to think about exercise in a positive light increases motivation. When you’re sitting on the couch debating fumbling into the pantry for the Cheetos and clicking the “Next Episode” prompt on Netflix, visualize yourself running.


Think about how good it will feel when you’re done. How invigorating the sun will be. How energized you’ll be. High performing athletes use visualization to prepare them for an activity before they do it. By visualizing your workout, your can ready both your body and brain for exercise.

9. Identify Your Obstacles

You can’t overcome an obstacle you haven’t identified. Take a minute and determine what prohibits you from following through on your plan to exercise.


Are you a night owl trying to get in a 5:30 AM workout? Rearrange your schedule. Do you feel too weak or tired to run? Guzzle down a glass of water and eat a small healthy snack to energize you. Do you hate running? Get a gym membership. Do you ate the gym? Start running.


Identifying what holds you back from exercise allows you to break down walls and get moving.

10. Create a Ritual

Rituals are a way of telling your brain that something is going to happen. By creating a pre-exercise ritual which you perform repeatedly, your brain begins to associate the ritual with working out. Once this association is formed, it becomes part of your routine and thus easier.


Start your ritual the night before. Set out your sneakers and workout clothes for spin class. Clean up things that could distract you or demand your attention the next morning. When you wake up, drink coffee and eat a healthy breakfast. Getting into a routine of some sort will train your brain to avoid excuses and keep you on task.

11. Find Your Tribe

One of the most beneficial motivators for exercise is having a workout buddy or a group of friends who you’re doing a class with. The accountability is extremely effective in increasing motivation.


You’re also much more likely to stick to an exercise regimen if someone is expecting you. Who wants to call their best friend and cancel a run at six in the morning?

12. Put It In Writing

Depending on your personality there are a couple ways to use good old fashioned pen and paper to increase motivation.


Print out a calendar and mark off every day you exercise with a big, red marker. Doesn’t that sound gratifying? Keeping a log of what you do will help you stay motivated as you see the accumulation of all you’ve done over a period of time.

13. Lower Your Expectations

It’s easy to let shaming thoughts intrude even if you are already exercising. If you want to do more or get stronger or have a hotter body or workout for an hour and a half, fine.


But if you’re squeezing in a 25 minute walk into your day and find shaming “should” thoughts creep in, stop them dead in their tracks. Tell yourself you are being healthy and doing a whole lot more than most people.

14. Appreciate Your Health

The fact that you have a healthy body and can exercise and improve your health is a tremendous gift. Take time to slow down and appreciate your health. Appreciate the fact that you can exercise. Express gratitude about being able to run or lift or do Crossfit.


Gratitude reframes working out from a duty into a privilege.


15. Stop the All or Nothing Thinking

Nothing derails a consistent workout routine like allowing yourself to be defined by a bad day. The fact that you hit the snooze today doesn’t have to mean your good intentions to stick to a program are a wash.


From there you’ll just continue to spiral downward and most likely end up quitting. One snooze doesn’t have to mean it’s going to be a bad day or bad week or a bad month. Give yourself some credit and try to do better tomorrow.

16. Get Past the Scale

The scale is an useful way to measure success, but celebrate successes beyond the scale.


Celebrate your pants fitting better. Celebrate the muscle tone in your arms. Celebrate being able to move in a flexible way that was not even remotely possible a year ago.


The scale is only one very specific metric for measuring progress. Losing weight may not even be your objective, especially if you’re doing intense weight workouts. Gather a variety of ways for celebrating progress beyond stepping on the scale.

17. Don’t Compare

Unfortunately the rise of social media has made it a whole lot easier to compare your body to other people’s. Stop.


Don’t let your mind go down the rabbit trail of self-loathing. If the skinny ultra marathon runner’s daily workout updates complete with photos is making you crazy, unfollow him.


You are chasing your own personal fitness goals, not trying to be someone else.

18. Start Your Day Right

While this is not for everyone, consider starting your day with a workout. Give it a try and set the alarm clock a little earlier to allow time for a pre-work run. You may find that once you get your butt out of bed, the energy and other rewards of a morning run outweigh that extra half hour of sleep.


Additionally, starting your day with a workout means your serotonin and dopamine levels will be high, which will put you in a positive mood for the day.


19. Workout On Monday or Friday

Studies show people start the week with high levels of motivation. You’re rested from the weekend so start the week out on a good note. You’ll feel good and be much more likely to stick with your exercise plan if you start well.


Friday is another alternative. Are you low on motivation? The week’s taken its toll? Imagine how much better you’ll feel when you know you went for that jog when it was the absolute last thing you wanted to do! This is also an effective means to keep your weekend in check and to keep weekend indulging at a minimum.

20. Take a Rest Day

Do not do the same workout every day, because you will be sure to suffer from workout burnout. Your body is not made to go go go. Take rest days or work different muscles groups. If you don’t you will be much more susceptible to injury and likely quit altogether eventually.

21. Make It Fun

Why would you workout in silence when you can speed through an audio book or a good podcast while you sweat? There’s tons of easily accessible entertainment from your smartphone. And who knows. You may even start to look forward to exercising and picking up where you left off in the most recent thriller you’re listening to. Music is an obvious choice, but keep these in mind too.

22. Read Success Stories

If you find you’re overwhelmed at the state of your health, reading the success stories of other people will be a tremendous encouragement. They were in the same shoes as you are now, but look how their hard work paid off.

23. Change It Up

Sometimes you need variety to take your fitness to the next level. If you run 3 miles 3 days a week, try doing cross-fit one day. The variety will not only keep you motivated, but your overall health will improve as you will be working different muscles.


Armed with fresh motivation for exercise, you’ll find these tips will make you more consistent and and get you on the track to health you’ve always imagined for yourself.


No one said working out would be easy. It takes discipline, hard work, and pure sweat. But by implementing these suggestions, you can significantly improve your motivation levels.



This article originally appeared here at and has been republished with permission from


Virtual reality training may be as effective as regular therapy after stroke

November 15, 2017

Science Daily/American Academy of Neurology (AAN)

Using virtual reality therapy to improve arm and hand movement after a stroke is equally as effective as regular therapy, according to a study.


"Virtual reality training may be a motivating alternative for people to use as a supplement to their standard therapy after a stroke," said study author Iris Brunner, PhD, of Aarhus University, Hammel Neurocenter in Denmark. "Future studies could also look at whether people could use virtual reality therapy remotely from their homes, which could lessen the burden and cost of traveling to a medical center for standard therapy."


The study involved 120 people with an average age of 62 who had suffered a stroke on average about a month before the study started. All of the participants had mild to severe muscle weakness or impairment in their wrists, hands or upper arms. The participants had four to five hour-long training sessions per week for four weeks. The participants' arm and hand functioning was tested at the beginning of the study, after the training ended and again three months after the start of the study.


Half of the participants had standard physical and occupational therapy. The other half had virtual reality training that was designed for rehabilitation and could be adapted to the person's abilities. The participants used a screen and gloves with sensors to play several games that incorporated arm, hand and finger movements.


"Both groups had substantial improvement in their functioning, but there was no difference between the two groups in the results," Brunner said. "These results suggest that either type of training could be used, depending on what the patient prefers."


Brunner noted that the virtual reality system was not an immersive experience. "We can only speculate whether using virtual reality goggles or other techniques to create a more immersive experience would increase the effect of the training," she said.

New insights into why sleep is good for our memory

November 14, 2017

Science Daily/University of York

Researchers have shed new light on sleep's vital role in helping us make the most of our memory.


Sleep, they show, helps us to use our memory in the most flexible and adaptable manner possible by strengthening new and old versions of the same memory to similar extents.


The researchers also demonstrate that when a memory is retrieved -- when we remember something -- it is updated with new information present at the time of remembering. The brain appears not to 'overwrite' the old version of the memory, but instead generates and stores multiple (new and old) versions of the same experience.


The results of the research, carried out at York's Sleep, Language and Memory (SLAM) Laboratory, are presented in the journal Cortex today.


Lead researcher Dr Scott Cairney of York's Department of Psychology said: "Previous studies have shown sleep's importance for memory. Our research takes this a step further by demonstrating that sleep strengthens both old and new versions of an experience, helping us to use our memories adaptively.


"In this way, sleep is allowing us to use our memory in the most efficient way possible, enabling us to update our knowledge of the world and to adapt our memories for future experiences."


In the study, two groups of subjects learned the location of words on a computer screen. In a test phase, participants were presented with each of the words in the centre of the screen and had to indicate where they thought they belonged.


One group then slept for 90 minutes while a second group remained awake before each group repeated the test. In both groups, the location recalled at the second test was closer to that recalled at the first test than to the originally-learned location, indicating that memory updating had taken place and new memory traces had been formed.


However, when comparing the sleep and wake groups directly, the locations recalled by the sleep group were closer in distance to both the updated location (i.e. previously retrieved) and the original location, suggesting that sleep had strengthened both the new and old version of the memory.


Corresponding author Professor Gareth Gaskell of York's Department of Psychology said: "Our study reveals that sleep has a protective effect on memory and facilitates the adaptive updating of memories.


"For the sleep group, we found that sleep strengthened both their memory of the original location as well as the new location. In this way, we were able to demonstrate that sleep benefits all the multiple representations of the same experience in our brain."


The researchers point out that although this process helps us by allowing our memories to adapt to changes in the world around us, it can also hinder us by incorporating incorrect information into our memory stores. Over time, our memory will draw on both accurate and inaccurate versions of the same experience, causing distortions in how we remember previous events.


The study builds on a research model created by Ken Paller, Professor of Psychology at Northwestern University, USA, an eminent researcher in the field of memory and a co-author on this study.

How bacteria in the gut influence neurodegenerative disorders

Understanding the role of the microbiome may lead to better treatments for Parkinson's, Alzheimer's

November 16, 2017

Science Daily/Society for Neuroscience

Humans have roughly as many bacterial cells in their bodies as human cells, and most of those bacteria live in the gut. New research released today reveals links between the gut microbiome -- the population of microorganisms living in the gastrointestinal tract -- and brain diseases such as Parkinson's and Alzheimer's, including potential new ways to track and treat these diseases.


Almost 100 trillion microbes -- some beneficial and some harmful -- live in the human gastrointestinal tract at any time, helping to regulate immune function and inflammation, two factors hypothesized to play a role in neurodegenerative diseases like Parkinson's and Alzheimer's. As brain-focused cures for such diseases remain elusive, scientists are looking to the microbiome for new insight and novel strategies.


Today's new findings show that:

  • ·      Metabolites derived from the microbiome block protein misfolding in test tubes and prevent neurodegeneration in a fly model of a disease related to Parkinson's, hinting that gut-derived metabolites may hold therapeutic promise (Lap Ho, abstract 573.23, see attached summary).
  • ·      A rat model of Parkinson's disease displays increased levels of an inflammatory protein in the colon, identifying a possible new biomarker for the disease (Doris J. M. Doudet, abstract 133.13, see attached summary).
  • ·      Nonhuman primates that received stomach injections of a protein associated with Parkinson's disease show signs of the disease in their brains, revealing that pathology can spread from the gut to the brain (Erwan Bezard, abstract 131.02, see attached summary).
  • ·      A gene associated with risk for Alzheimer's disease influences the gut microbiome of mice, potentiating a novel treatment strategy (Ishita Parikh, abstract 476.02, see attached summary).
  • ·      Probiotic treatment corrects memory problems in an Alzheimer's mouse model, suggesting that altering the microbiome may help delay the disease (Harpreet Kaur, abstract 126.23, see attached summary).


"The results presented today add to the growing body of evidence showing the influence of the gut on the brain and the crucial relationship between the two," said press conference moderator Tracy Bale, PhD, of the University of Maryland School of Medicine and Center for Brain Development and Maternal Mental Health. "Targeting the gut introduces a different and promising angle to tackle brain disorders across the lifespan."

Memory complaints and cognitive decline: Data from the GuidAge study

A memory complaint, also called Subjective Cognitive Decline (SCD), is a subjective disorder that appears to be relatively common, especially in elderly persons

November 13, 2017

Science Daily/IOS Press

A memory complaint, also called Subjective Cognitive Decline (SCD), is a subjective disorder that appears to be relatively common, especially in elderly persons. The reports of its prevalence in various populations range from approximately 10% to as high as 88%, although it is generally thought that the prevalence of everyday memory problems lie within the range of 25% to 50%.


The McNair and Kahn Scale or Cognitive Difficulties Scale was employed to define and characterize cognitive complaints in the GuidAge study, involving a population of more than 2800 individuals aged 70 years or older having voluntarily complained of memory problems to their general practitioner (GPs). It contains items that are related to difficulties in attention, concentration, orientation, memory, praxis, domestic activities and errands, facial recognition, task efficiency, and name finding.


The results of the GuidAge study suggest that the assessment of cognitive complaint voluntarily reported to primary-care physicians, by the McNair and Kahn scale can predict a decline in cognitive performance, as 5 items out of 20 were statistically significant.


These 5 items are:

·      item 1, "I hardly remember usual phone numbers",

·      item 5, "I forget appointment, dates, where I store things",

·      item 6, "I forget to call people back when they called me",

·      item 10, "I forget the day of the week",

·      item 13, "I need to have people repeat instructions several times."


Thanks to this short scale GPs, in clinical practice, can identify which patients with memory complaints should be referred to a memory center to assess cognitive functions.

Sleep Apnea may increase risk of developing Alzheimer's disease

November 10, 2017

Science Daily/American Thoracic Society

Obstructive sleep apnea (OSA) may put elderly people at greater risk of developing Alzheimer's disease (AD), according to new research.


In "Obstructive Sleep Apnea Severity Affects Amyloid Burden in Cognitively Normal Elderly: A Longitudinal Study," researchers report that biomarkers for amyloid beta (A?), the plaque-building peptides associated with Alzheimer's disease, increase over time in elderly adults with OSA in proportion to OSA severity. Thus, individuals with more apneas per hour had greater accumulation of brain amyloid over time.


According to the authors, AD is a neurodegenerative disorder that afflicts approximately five million older Americans. OSA is even more common, afflicting from 30 to 80 percent of the elderly, depending on how OSA is defined.


"Several studies have suggested that sleep disturbances might contribute to amyloid deposits and accelerate cognitive decline in those at risk for AD," said Ricardo S. Osorio, MD, senior study author and assistant professor of psychiatry at New York University School of Medicine.


"However, so far it has been challenging to verify causality for these associations because OSA and AD share risk factors and commonly coexist."


He added that the purpose of this study was to investigate the associations between OSA severity and changes in AD biomarkers longitudinally, specifically whether amyloid deposits increase over time in healthy elderly participants with OSA.


The study included 208 participants, age 55 to 90, with normal cognition as measured by standardized tests and clinical evaluations. None of the participants was referred by a sleep center, used continuous positive airway pressure (CPAP) to treat sleep apnea, was depressed, or had a medical condition that might affect their brain function. The researchers performed lumbar punctures (LPs) to obtain participants' cerebrospinal fluid (CSF) soluble A? levels, and then used positron emission tomography, or PET, to measure A? deposits directly in the brain in a subset of participants.


The study found that more than half the participants had OSA, including 36.5 percent with mild OSA and 16.8 percent with moderate to severe OSA. From the total study sample, 104 participated in a two-year longitudinal study that found a correlation between OSA severity and a decrease in CSF A?42 levels over time. The authors said this finding is compatible with an increase in amyloid deposits in the brain; the finding was confirmed in the subset of participants who underwent amyloid PET, which showed an increase in amyloid burden in those with OSA.


Surprisingly, the study did not find that OSA severity predicted cognitive deterioration in these healthy elderly adults. Andrew Varga, MD, PhD, study coauthor and a physician specializing in sleep medicine and neurology at the Icahn School of Medicine at Mount Sinai in New York, said this finding suggests that these changes were occurring in the preclinical stages of AD.


"The relationship between amyloid burden and cognition is probably nonlinear and dependent on additional factors," he added. This study finding may also be attributable to the study's relatively short duration, highly educated participants and use of tests that fail to discern changes in cognitive abilities that are subtle or sleep-dependent, the authors wrote.


The high prevalence of OSA the study found in these cognitively normal elderly participants and the link between OSA and amyloid burden in these very early stages of AD pathology, the researchers believe, suggest the CPAP, dental appliances, positional therapy and other treatments for sleep apnea could delay cognitive impairment and dementia in many older adults.


"Results from this study, and the growing literature suggesting that OSA, cognitive decline and AD are related, may mean that age tips the known consequences of OSA from sleepiness, cardiovascular, and metabolic dysfunction to brain impairment," Dr. Osorio said. "If this is the case, then the potential benefit of developing better screening tools to diagnose OSA in the elderly who are often asymptomatic is enormous."

Close friends linked to a sharper memory

'Maintaining strong social networks seems to be linked to slower cognitive decline'

November 1, 2017

Science Daily/Northwestern University

Maintaining positive, warm and trusting friendships might be the key to a slower decline in memory and cognitive functioning, according to a new study. SuperAgers -- who are 80 years of age and older who have cognitive ability at least as good as people in their 50s or 60s -- reported having more satisfying, high-quality relationships compared to their cognitively average, same-age peers, the study reports


SuperAgers -- who are 80 years of age and older who have cognitive ability at least as good as people in their 50s or 60s -- reported having more satisfying, high-quality relationships compared to their cognitively average, same-age peers, the study reports.


Previous SuperAger research at the Cognitive Neurology and Alzheimer's Disease Center (CNADC) at Northwestern University Feinberg School of Medicine has focused on the biological differences in SuperAgers, such as discovering that the cortex in their brain is actually larger than their cognitively average, same-age peers. This study, published Oct. 23 in the journal PLOS ONE, was the first to examine the social side of SuperAgers.


"You don't have the be the life of the party, but this study supports the theory that maintaining strong social networks seems to be linked to slower cognitive decline," said senior author Emily Rogalski, associate professor at Northwestern's CNADC.


Participants answered a 42-item questionnaire called the Ryff Psychological Well-Being Scale, which is a widely used measure of psychological well-being. The scale examines six aspects of psychological well-being: autonomy, positive relations with others, environmental mastery, personal growth, purpose in life and self-acceptance. SuperAgers scored a median overall score of 40 in positive relations with others while the control group scored 36 -- a significant difference, Rogalski said.


"This finding is particularly exciting as a step toward understanding what factors underlie the preservation of cognitive ability in advanced age, particularly those that may be modifiable," said first author Amanda Cook, a clinical neuropsychology doctoral student in the laboratory of Rogalski and Sandra Weintraub.


Other research studies have reported a decline in social networks in people with Alzheimer's disease and Mild Cognitive Impairment (MCI), and previous literature has shown psychological well-being in older age to be associated with reduced risk of developing Alzheimer's dementia.


"It's not as simple as saying if you have a strong social network, you'll never get Alzheimer's disease," Rogalski said. "But if there is a list of healthy choices one can make, such as eating a certain diet and not smoking, maintaining strong social networks may be an important one on that list. None of these things by themself guarantees you don't get the disease, but they may still have health benefits."

Daydreaming is good: It means you're smart

Brain study suggests mind wandering at work and home may not be as bad as you might think

October 24, 2017

Science Daily/Georgia Institute of Technology

A new study suggests that daydreaming during meetings isn't necessarily a bad thing. It might be a sign that you're really smart and creative. People with efficient brains may have too much brain capacity to stop their minds from wandering.


"People with efficient brains may have too much brain capacity to stop their minds from wandering," said Eric Schumacher, the Georgia Tech associate psychology professor who co-authored the study.


Schumacher and his students and colleagues, including lead co-author Christine Godwin, measured the brain patterns of more than 100 people while they lay in an MRI machine. Participants were instructed to focus on a stationary fixation point for five minutes. The Georgia Tech team used the data to identify which parts of the brain worked in unison.


"The correlated brain regions gave us insight about which areas of the brain work together during an awake, resting state," said Godwin, a Georgia Tech psychology Ph.D. candidate.


"Interestingly, research has suggested that these same brain patterns measured during these states are related to different cognitive abilities."


Once they figured out how the brain works together at rest, the team compared the data with tests the participants that measured their intellectual and creative ability. Participants also filled out a questionnaire about how much their mind wandered in daily life.


Those who reported more frequent daydreaming scored higher on intellectual and creative ability and had more efficient brain systems measured in the MRI machine.


"People tend to think of mind wandering as something that is bad. You try to pay attention and you can't," said Schumacher. "Our data are consistent with the idea that this isn't always true. Some people have more efficient brains."


Schumacher says higher efficiency means more capacity to think, and the brain may mind wander when performing easy tasks.


How can you tell if your brain is efficient? One clue is that you can zone in and out of conversations or tasks when appropriate, then naturally tune back in without missing important points or steps.


"Our findings remind me of the absent-minded professor -- someone who's brilliant, but off in his or her own world, sometimes oblivious to their own surroundings," said Schumacher. "Or school children who are too intellectually advanced for their classes. While it may take five minutes for their friends to learn something new, they figure it out in a minute, then check out and start daydreaming."


Godwin and Schumacher think the findings open the door for follow-up research to further understand when mind wandering is harmful, and when it may actually be helpful.


"There are important individual differences to consider as well, such as a person's motivation or intent to stay focused on a particular task," said Godwin.


Severe stress behind self-perceived memory problems

August 31, 2017

Science Daily/University of Gothenburg

Stress, fatigue, and feeling like your memory is failing you. These are the symptoms of a growing group of patients. Result – They may need help, but they are rarely entering the initial stages of dementia.


"We are seeing a growing number of people who are seeking help because of self-perceived cognitive problems, but have no objective signs of disease despite thorough investigation," says Marie Eckerström, doctoral student at the Institute of Neuroscience and Physiology and licensed psychologist at the Memory Unit of Sahlgrenska University Hospital.


The influx of this particular group of patients, which currently represents one-third of the individuals who come to the unit, has increased the need for knowledge of who they are. In her work, Marie Eckerström followed a few hundred of them, both women and men, over an average of four years.


They are usually highly educated professionals who are relatively young in this context, between the ages of 50 and 60. When tested at the hospital, their memory functions are intact. But, in their everyday environment where they are under pressure to constantly learn new things, they think things just are not working right.


The correlation between self-perceived memory problems and stress proved to be strong. Seven out of ten in the group had experiences of severe stress, clinical burnout, or depression.


"We found that problems with stress were very common. Patients often tell us they are living or have lived with severe stress for a prolonged period of time and this has affected their cognitive functions to such an extent that they feel like they are sick and are worried about it. In some cases, this is combined with a close family member with dementia, giving the patient more knowledge but also increasing their concern," says Marie Eckerström.


The memory unit investigates suspicions of the early stages of dementia in those who seek help. Research is conducted in parallel to this.


"We primarily investigate suspected dementia. If we are able to rule this out, then the patient does not remain with us. But, there are not so many places such patients can turn and they seem to fall between the cracks."


Perceived memory problems are common and may be an early sign of future development of dementia. For those in the studied group who also had deviating biomarkers in their cerebrospinal fluid (beta-amyloid, total-tau and phospho-tau), the risk of deteriorating and developing dementia was more than double. However, the majority demonstrated no signs of deterioration after four years.


"These individuals have no objective signs of dementia. The issue instead is usually stress, anxiety or depression," says Marie Eckerström.


One out of ten with only self-perceived memory problems developed dementia during the investigated period. According to Marie Eckerström, this is a higher percentage than the population in general, but is still low.


"It is not a matter of just anyone who has occasional memory problems in everyday life. It is more a matter of individuals who sought medical attention to investigate whether they are developing serious problems," states Marie Eckerström.

New possibility of studying how Alzheimer's disease affects the brain at different ages

August 31, 2017

Science Daily/Lund University

Alzheimer’s disease can lead to several widely divergent symptoms and, so far, its various expressions have mainly been observed through the behavior and actions of patients. Researchers have now produced images showing the changes in the brain associated with these symptoms – a development which increases knowledge and could facilitate future diagnostics and treatment.


Symptoms vary in cases of Alzheimer's disease and often relate to the phase of life in which the disease first occurs. People who become ill before the age of 65 often suffer early on from diminished spatial perception and impaired orientation. Elderly patients more often suffer the symptoms traditionally associated with the disease: above all, memory impairment.


"Now we have a tool which helps us to identify and detect various sub-groups of Alzheimer's disease. This facilitates the development of drugs and treatments adapted to various forms of Alzheimer's," explains Michael Schöll, researcher at Lund University and the University of Gothenburg.


Diagnostics could also be facilitated, mainly among younger patients in whom it is particularly difficult to arrive at a correct diagnosis.


Confident in approval for clinical use


The findings, published in the journal Brain, are based on studies of around 60 Alzheimer's patients at Skåne University Hospital and a control group consisting of 30 people with no cognitive impairment.


Once Alzheimer's disease has taken hold, it gradually results in the tau protein, present in the brain, forming lumps and destroying the transport routes of the neurons. This can be clearly detected with the new imaging method.


The method includes a device known as a PET camera and a trace substance, a particular molecule, which binds to tau. The imaging method is currently only used in research, where the current study is one of several contributing to increased knowledge about the disease:


"The changes in the various parts of the brain that we can see in the images correspond logically to the symptoms in early onset and late onset Alzheimer's patients respectively," explains Oskar Hansson, professor of neurology at Lund University and consultant at Skåne University Hospital.


Oskar Hansson believes that the imaging method will be in clinical use within a few years.

Magnetic stimulation of the brain improved awareness of subject's own cognitive abilities

August 29, 2017

Science Daily/Aalto University

Researchers have succeeded for the first time ever in affecting metacognition of a tactile working memory task by combining neural pathway imaging and magnetic stimulation of the brain. Understanding brain function might help in the development of new treatments for neuropsychiatric illnesses in the future.


By combining different brain research methods in a versatile manner the researchers showed for the first time that transcranial magnetic stimulation of the brain targeting the prefrontal cortex can improve a test subject's ability to evaluate his or her performance in a tactile working memory task. The ability of human subjects to monitor and control their own cognitive processes is called metacognition.


Metacognition is important for people and in many neuropsychiatric illnesses, it is possible to recognize that it has weakened.


'The patient's reduced sense of being ill is familiar from conditions such as Alzheimer's disease, schizophrenia, and traumatic brain injury. Understanding the brain function of healthy test subjects could help in the development of new treatment methods for neuropsychiatric illnesses in the future,' says Doctoral Candidate Juha Gogulski.


Safe method

Transcranial magnetic stimulation refers to a method in which the nerve cells of the brain are activated from outside the skull with the help of a magnetic field. When used correctly the method is safe, and it is utilized in procedures such as pinpointing the location of the primary motor cortex or the speech area before brain surgery, and in the treatment of depression.


Taking part in the study as test subjects were 14 healthy volunteers. They first underwent structural magnetic resonance imaging (MRI) of the brain as well as a diffusion MRI that is sensitive to the movement of water molecules in the brain, making it possible to identify the direction of neural pathways. After the MRI, the neural pathway connections between the primary somatosensory cortex and the prefrontal cortex were determined for each individual.


In the last part of the study the test subjects completed working memory tasks in which they were asked to keep in mind the characteristics of touch sensations from the fingertip and to evaluate whether or not the touch stimulation that was just given was similar to or different from the previous stimulus. During the test they were given magnetic pulses to prefrontal cortex areas that had a neural pathway connection to the part of the somatosensory cortex representing the index finger. The test subjects also evaluated how certain they were about their answers, on which basis calculations were made on how well a person's own evaluation corresponded to the actual performance level.


Magnetic stimulation of the prefrontal cortex improved the test subjects' evaluation of their performance, as they were able to assess more accurately if their answers had been correct or incorrect.


The study was a collaboration between the Department of Neuroscience and Biomedical Engineering at Aalto University, and Department of Physiology in the Faculty of Medicine, University of Helsinki. The original article was published in the international science journal Cerebral Cortex.

Relative risk of Alzheimer's between men and women: Record corrected

Women genetically predisposed to Alzheimer's are more susceptible than men between ages 65 and 75, researchers discover

August 28, 2017

Science Daily/University of Southern California

White women whose genetic makeup puts them at higher risk for Alzheimer's disease are more likely than white men to develop the disease during a critical 10-year span in their lives. The findings from one of the world's largest big-data studies on Alzheimer's counter long-held beliefs about who is at greatest risk for the disease and when, suggesting new avenues for clinical trials.


The findings from one of the world's largest big-data studies on Alzheimer's counter long-held beliefs about who is at greatest risk for the disease and when, suggesting new avenues for clinical trials.


Study results show genetically vulnerable 55- to 85-year-old white men and women have the same odds of developing the memory-erasing disease. One exception: From their mid-60s to mid-70s, these women still face significantly higher risk. That may provide clues to disease causes and potential interventions among these women.


"Our discovery is important because it highlights how clinical trials could be weighted toward women -- a susceptible part of the population -- to help scientists more rapidly identify effective drug interventions to slow or cure Alzheimer's," said Arthur Toga, director of the USC Stevens Neuroimaging and Informatics Institute at the Keck School of Medicine -- among the nation's leaders in innovative scientific discovery.


The study was published Aug. 28 in the Journal of the American Medical Association Neurology. It included data from 57,979 North Americans and Europeans in the Global Alzheimer's Association Interactive Network (GAAIN). This big-data project provides scientists around the world with shared data and sophisticated analysis tools to address a disease that makes up about 65 percent of the 47 million cases of dementia worldwide.


Times -- and data -- have changed


The results contradict a seminal 20-year-old study that found women with one copy of ApoE4, a gene variant linked to Alzheimer's, were diagnosed with the disease 50 percent more often than men with the same genetic profile.


The findings presented in the USC-led study expand the number of participant data by ninefold and indicate the critical decade falls between 65 and 75, more than 10 years after the start of menopause. Previous studies in animals and humans have reported a relationship between ApoE4, menopause and cognitive decline.


"So much work has been dependent on one 1997 finding, but with tools like GAAIN, we now have the ability to reinvestigate with increased statistical power," Toga said.


The new findings are significant because almost two-thirds of the more than 5 million Americans now living with Alzheimer's disease are women, according to the Alzheimer's Association.


Many attribute the imbalance in disease risk to the fact that women, on average, live longer than men. However, a growing body of evidence suggests other reasons also contribute to the difference. For instance, men have higher rates of heart disease and stroke. So, men who live longer may be healthier than women of the same age and may face less risk of developing Alzheimer's, according to the USC-led study.


In the future, doctors who want to prevent Alzheimer's may intervene at different ages for men and women, said Judy Pa, co-author of the study and an assistant professor of neurology at the USC Stevens Neuroimaging and Informatics Institute.


"Menopause and plummeting estrogen levels, which on average begins at 51, may account for the difference," Pa said. "However, scientists still don't know what is responsible. Researchers need to study women 10, 15 or even 20 years before their most vulnerable period to see if there are any detectable signals to suggest increased risk for Alzheimer's in 15 years."


Worry less, work out more


Only some women are at increased risk of developing Alzheimer's in their mid-60s to mid-70s compared to men. To find out, women could have their DNA analyzed. However, Pa cautions that genetic testing for the ApoE4 variant is no crystal ball.


"There is controversy in terms of whether people should know their ApoE status because it is just a risk factor," Pa said. "It doesn't mean you're going to get Alzheimer's disease. Even if you carry two copies of ApoE4, your chances are greatly increased, but you could still live a long life and never have symptoms."


Even if some women discover they are at heightened risk, they can improve their odds by making life changes.


"Get more exercise. Work out your mind, especially in old age," Pa said. "Pick up hobbies that are cognitively or physically challenging. Reduce processed sugar intake because it's linked to obesity, which is associated with many chronic diseases."


More minorities please


Alzheimer's disease is the fifth-leading cause of death for Americans 65 and older, but it may one day outpace the nation's top two killers -- heart disease and cancer. Alzheimer's-related deaths increased by nearly 39 percent between 2000 and 2010 while heart disease-related deaths declined 31 percent and cancer deaths fell 32 percent, according to the Centers for Disease Control and Prevention.


Because Alzheimer's disease has a huge impact on lifelong health, USC has more than 70 researchers dedicated to the prevention, treatment and potential cure of the memory-erasing disease. Big data projects like this require experts across disciplines -- computer science, biology, pathophysiology, imaging and genetics -- to coordinate.


For this study, the researchers examined data from 27 different studies that assessed participants' ApoE gene variation, as well as characteristics such as sex, race, ethnicity, diagnosis (normal, mild cognitive impairment or Alzheimer's disease) and age at diagnosis.


The records of nearly 58,000 people were scrutinized. Meta-analyses were performed on 31,340 whites who received clinical diagnoses sometime between ages 55 and 85.


The proportion of minorities was so small that analysts could not draw statistically significant conclusions about their disease risk. Because of this, the study focused on whites only.


"Most of the archives around the world have insufficient numbers of underrepresented groups," Toga said. "One of the take-home messages from our study is people of all races and ethnicities need to be involved in Alzheimer's clinical trials because this disease is a problem that affects all of us."


The current findings need to be confirmed in more diverse study populations.


USC is working to build more diverse population studies related to Alzheimer's. Established in 1984, the Alzheimer Disease Research Center at the Keck School of Medicine reaches out to communities in the greater Los Angeles area to educate the city's diverse population about Alzheimer's and the clinical trials they might be interested in joining. Previous studies, for example, have focused on Latinos.


It's 2017: Time to focus on women


Historically, women have not been adequately represented in clinical trials, especially in studies on heart disease. Women need to be represented equally to men -- or even overrepresented, Pa said.


"The bottom line is women are not little men," Pa said. "A lot more research needs to target women because gender-specific variations can be so subtle that scientists often miss them when they control for gender or use models to rule out gender differences. Most research today is ignoring a big part of the equation."


The particulars


The study was made possible because of lead author Scott Neu, a leader in the development of a federated approach to analyzing metadata and assistant professor of research at the Laboratory of Neuro Imaging at the Keck School of Medicine.


"GAAIN -- the free resource we created in conjunction with the Alzheimer's Association -- allows anyone to explore data sets around the world and conduct preliminary analyses to test scientific hypotheses," Neu said. "Our goal is to connect scientists with those who have collected data to create new collaborations to further research and understanding of Alzheimer's disease."


Analysts excluded people with a history of stroke, cerebrovascular disease, abnormal proteins that contribute to Parkinson's disease and dementia, gene mutations leading to higher levels of toxic amyloid brain plaques and any known neurological diseases.


Scientists did not adjust for known Alzheimer's risk factors such as education, family history of Alzheimer's or dementia because that information was not provided in all data sets. They also were unable to adjust for sex-dependent differences such as cigarette smoking, hormonal changes with age and alcohol usage.

Less REM sleep tied to greater risk of dementia

August 23, 2017

Science Daily/American Academy of Neurology (AAN)

People who get less rapid eye movement (REM) sleep may have a greater risk of developing dementia, according to a new study. REM sleep is the sleep stage when dreaming occurs.


There are five stages of sleep. Stage one is light sleep. Stage two is when the body begins to prepare for deeper sleep, including stages three and four. Stage five is REM sleep. During this dream stage, the eyes move rapidly and there is increased brain activity as well as higher body temperature, quicker pulse and faster breathing. The first REM stage occurs about an hour to an hour-and-a-half into sleep and then recurs multiple times throughout the night as the cycles repeat.


"Sleep disturbances are common in dementia but little is known about the various stages of sleep and whether they play a role in dementia risk," said study author Matthew P. Pase, PhD, of Swinburne University of Technology in Australia. "We set out to discover which stages of sleep may be linked to dementia and while we did not find a link with deep sleep, we did with REM sleep."


For the study, researchers looked at 321 people with an average age of 67 from Massachusetts who participated in The Framingham Heart Study. During that study, sleep cycles were measured for each participant. Researchers collected the sleep data and then followed participants for an average of 12 years. During that time, 32 people were diagnosed with some form of dementia and of those, 24 were determined to have Alzheimer's disease.


The people who developed dementia spent an average of 17 percent of their sleep time in REM sleep, compared to 20 percent for those who did not develop dementia. After adjusting for age and sex, researchers found links between both a lower percentage of REM sleep and a longer time to get to the REM sleep stage and a greater risk of dementia. In fact, for every percent reduction in REM sleep there was a 9 percent increase in the risk of dementia. The results were similar after researchers adjusted for other factors that could affect dementia risk or sleep, such as heart disease factors, depression symptoms and medication use.


Other stages of sleep were not associated with an increased dementia risk.


"Our findings point to REM sleep as a predictor of dementia," said Pase. "The next step will be to determine why lower REM sleep predicts a greater risk of dementia. By clarifying the role of sleep in the onset of dementia, the hope is to eventually identify possible ways to intervene so that dementia can be delayed or even prevented."

Firmer, fitter frame linked to firmer, fitter brain

August 15, 2017

Science Daily/National Institute of Biomedical Imaging and Bioengineering

To determine why more aerobically fit individuals have better memories, scientists used magnetic resonance elastography (MRE), which measures the elasticity of organs, and found that fit individuals had a firmer, more elastic hippocampus—a region of the brain associated with memory.


Scientists have observed that more aerobically fit individuals have better memories. To investigate this phenomenon, they used magnetic resonance elastography (MRE), which measures the firmness and elasticity of organs, and found that fit individuals had a firmer, more elastic hippocampus -- a region of the brain associated with memory. The method could provide early diagnosis and potential interventions in the initial stages of neurodegenerative disease.


"MRE is a technique that has been used in organs like the liver, where it can assess the tissue stiffness and offers a reliable, non-invasive method for diagnosing hepatic fibrosis," explains Guoying Liu, Ph.D. Director of the NIBIB program on Magnetic Resonance Imaging. "This study now demonstrates the tremendous potential for MRE to provide new quantitative biomarkers for assessing brain health as it relates to physical fitness. This is particularly significant given the rise in dementia and Alzheimer's disease occurring in the U.S. and worldwide."


The research was performed by Aron K. Barbey, Associate Professor, Departments of Psychology and Bioengineering at the University of Illinois at Urbana-Champaign, along with his colleagues at Illinois, and with collaborators from Northeastern University in Boston and the University of Delaware. Their results are reported in the March issue of the journal NeuroImage.


The work was based on well-established observations of atrophy and reduced size of the hippocampus in cognitively declining seniors and developmentally delayed children. Given that long-known phenomenon, the researchers were puzzled by the fact that in young adults there was a correlation between fitness and memory, but the size of the hippocampus was the same in both groups.


"Most of the work in this area has relied on changes in the size of the hippocampus as a measure of hippocampal health and function. However, in young adults, although we see an increase in memory in more aerobically fit individuals, we did not see differences in hippocampal size," said Barbey. "Because size is a gross measure of the structural integrity of the hippocampus, we turned to MRE, which provides a more thorough and qualitative measure of changes associated with function -- in this case memory."


The investigators explained that MRE gives a better indication of the microstructure of the hippocampus -- the structural integrity of the entire tissue. And it does this by basically "bouncing" the organ, very gently, and measuring how it responds.


MRE is often described as being similar to a drop of water hitting a still pond to create the ripples that move out in all directions. A pillow under the subject's head generates harmless pulses, known as shear waves, that travel through the hippocampus. MRE instruments measure how the pulsed waves change as they move through the brain and those changes give an extremely accurate measure -- and a color-coded picture -- of the consistency of the tissue: soft, hard and stiff, or firm with some bounce or elasticity.


The healthy hippocampus is like a firm pillow that quickly bounces back into shape after you press your finger into it as opposed to a mushy pillow that would retain your finger mark and not rebound to its original shape.


The researchers studied 51 healthy adults: 25 men and 26 women ages 18-35. They measured the participants' performance on a memory test as well as their aerobic fitness levels, and used MRE to measure the elasticity of the hippocampus.


They found that those with higher fitness levels also had more elastic tissue in the hippocampus and scored the best on memory tests. Given the many studies showing the association between hippocampal health and memory in seniors and children, which was based on the size of the hippocampus, the results strongly suggest that MRE is a method that reveals that there is also an association between the health of the hippocampus and memory in young adults.


Said Barbey, "MRE turned out to be a fantastic tool that enabled us to demonstrate the importance of the hippocampus in healthy young adults and the positive effect of fitness. We are excited about using MRE to look at other brain structures and diseases, such as multiple sclerosis, that involve cognitive impairment. We hope to see if and how MRE might be a valuable tool for early diagnosis and treatment of a number of neurodegenerative diseases."


"And, of course, if these results are more widely disseminated," Barbey concludes, "they could certainly serve as tremendous motivation for people concerned about getting forgetful as they age, to get moving and try to stay fit."

Midlife cardiovascular risk factors may increase chances of dementia

Study supports link between cognition and vascular health

August 7, 2017

Science Daily/NIH/National Institute of Neurological Disorders and Stroke

A large, long-term study suggests that middle aged Americans who have vascular health risk factors, including diabetes, high blood pressure and smoking, have a greater chance of suffering from dementia later in life.


"With an aging population, dementia is becoming a greater health concern. This study supports the importance of controlling vascular risk factors like high blood pressure early in life in an effort to prevent dementia as we age," said Walter J. Koroshetz, M.D., director of NIH's National Institute of Neurological Disorders and Stroke (NINDS), which partially funded the study and created the Mind Your Risks® public health campaign to make people more aware of the link between cardiovascular and brain health. "What's good for the heart is good for the brain," he added.


The study was led by Rebecca Gottesman, M.D., Ph.D., professor of neurology at Johns Hopkins University in Baltimore. Her team analyzed the data of 15,744 people who participated in the Atherosclerosis Risk in Communities (ARIC) study, funded by the NIH's National Heart, Lung, and Blood Institute (NHLBI). From 1987-1989, the participants, who were black or white and 45-64 years of age, underwent a battery of medical tests during their initial examinations at one of four centers in four different states. Over the next 25 years they were examined four more times. Cognitive tests of memory and thinking were administered during all but the first and third exams.


Her team found that 1,516 participants were diagnosed with dementia during an average of 23 follow-up years. Initially, when they analyzed the influence of factors recorded during the first exams, the researchers found that the chances of dementia increased most strongly with age followed by the presence of APOE4, a gene associated with Alzheimer's disease. Whites with one copy of the APOE4 gene had a greater chance of dementia than blacks. Other factors included race and education: blacks had higher chance of dementia than whites; those who did not graduate from high school were also at higher risk.


In agreement with previous studies, an analysis of vascular risk factors showed that participants who had diabetes or high blood pressure, also called hypertension, had a higher chance of developing dementia. In fact, diabetes was almost as strong a predictor of dementia as the presence of the APOE4 gene.


Unlike other studies, the researchers discovered a link between dementia and prehypertension, a condition in which blood pressure levels are higher than normal but lower than hypertension. Also, race did not influence the association between dementia and the vascular risk factors they identified. Diabetes, hypertension and prehypertension increased the chances of dementia for white and black participants. Finally, smoking cigarettes exclusively increased the chances of dementia for whites but not blacks.


"Our results contribute to a growing body of evidence linking midlife vascular health to dementia," said Dr. Gottesman. "These are modifiable risk factors. Our hope is that by addressing these types of factors early, people can reduce the chances that they will suffer from dementia later in life."


Further analysis strengthened the idea that the vascular risk factors identified in this study were linked to dementia. For instance, in order to answer the question of whether having a stroke, which is also associated with the presence of vascular risk factors, may explain these findings, the team reanalyzed the data of participants who did not have a stroke and found similar results. Diabetes, hypertension, prehypertension and smoking increased the risk of dementia for both stroke-free participants and those who had a stroke.


Recently, in a separate study partially funded by the NIH's National Institute on Aging, Dr. Gottesman's team analyzed brain scans from a subgroup of ARIC participants who did not have dementia when they entered the study. They found that the presence of one or more vascular risk factors during midlife was associated with higher levels of beta amyloid, a protein that often accumulates in the brains of Alzheimer's patients. This relationship was not affected by the presence of the APOE4 gene and not seen for risk factors present in later life. The presence of vascular risk factors detected in participants older than 65 years of age during the final examination was not associated with greater levels of beta amyloid.


"With many years of data from a large and diverse population, the ARIC study is a powerful source of information for medical research," said Jacqueline D. Wright, Dr.P.H., program director at NHLBI. "This epidemiologic study aimed to improve our understanding of atherosclerosis and heart disease and, through the investigators' efforts; it has become a great resource for research on dementia and other diseases of aging. The investments in longitudinal cohort studies like ARIC will benefit all of us for many years to come."


In the future, Dr. Gottesman and her team plan to investigate ways in which subclinical, or undiagnosed, vascular problems may influence the brain and why race is associated with dementia.

Women have more active brains than men

Largest functional brain imaging study to date identifies specific brain differences between women and men, according to a new report in the Journal of Alzheimer's Disease

August 7, 2017

Science Daily/IOS Press

In the largest functional brain imaging study to date, researchers compared 46,034 brain SPECT (single photon emission computed tomography) imaging studies provided by nine clinics, quantifying differences between the brains of men and women.


Lead author, psychiatrist Daniel G. Amen, MD, founder of Amen Clinics, Inc., commented, "This is a very important study to help understand gender-based brain differences. The quantifiable differences we identified between men and women are important for understanding gender-based risk for brain disorders such as Alzheimer's disease. Using functional neuroimaging tools, such as SPECT, are essential to developing precision medicine brain treatments in the future."


The brains of women in the study were significantly more active in many more areas of the brain than men, especially in the prefrontal cortex, involved with focus and impulse control, and the limbic or emotional areas of the brain, involved with mood and anxiety. The visual and coordination centers of the brain were more active in men. SPECT can measure blood perfusion in the brain. Images acquired from subjects at rest or while performing various cognitive tasks will show different blood flow in specific brain regions.


Subjects included 119 healthy volunteers and 26,683 patients with a variety of psychiatric conditions such as brain trauma, bipolar disorders, mood disorders, schizophrenia/psychotic disorders, and attention deficit hyperactivity disorder (ADHD). A total of 128 brain regions were analyzed for subjects at baseline and while performing a concentration task.


Understanding these differences is important because brain disorders affect men and women differently. Women have significantly higher rates of Alzheimer's disease, depression, which is itself is a risk factor for Alzheimer's disease, and anxiety disorders, while men have higher rates of (ADHD), conduct-related problems, and incarceration (by 1,400%).


Editor-in-Chief of the Journal of Alzheimer's Disease and Dean of the College of Sciences at The University of Texas at San Antonio, Dr. George Perry said, "Precisely defining the physiological and structural basis of gender differences in brain function will illuminate Alzheimer's disease and understanding our partners."


The study findings of increased prefrontal cortex blood flow in women compared to men may explain why women tend to exhibit greater strengths in the areas of empathy, intuition, collaboration, self-control, and appropriate concern. The study also found increased blood flow in limbic areas of the brains of women, which may also partially explain why women are more vulnerable to anxiety, depression, insomnia, and eating disorders.


Mild cognitive impairment, Alzheimer's diagnoses trigger lower self-ratings of quality of life

August 3, 2017

Science Daily/University of Pennsylvania School of Medicine

A patient's awareness of a diagnosis of cognitive impairment may diminish their self-assessment of quality of life, suggests new research.

Researchers at Penn Medicine have discovered that a patient's awareness of a diagnosis of cognitive impairment may diminish their self-assessment of quality of life. In a study published this month in the Journal of Gerontology: Psychological Sciences the researchers report that older adults who were aware of their diagnosis -- either Mild Cognitive Impairment or mild stage Alzheimer's disease dementia -- reported greater depression, higher stress, and lower quality of life than those who were unaware. They also found that older adults who had an expectation that their disease would worsen over time reported lower overall satisfaction with daily life.


"These findings suggest that a patient's quality of life could be impacted by a diagnostic label and their expectations for the prognosis. So, when a clinician discloses the diagnosis and prognosis of Mild Cognitive Impairment or mild stage Alzheimer's disease, a patient may experience additional symptoms, like anxiety or depression," said the study's lead author, Shana Stites, PsyD, MA, MS, a clinical psychologist in the Penn Memory Center, senior research investigator for the Penn Project on Precision Medicine for the Brain (P3MB).


For many years, a diagnosis of Alzheimer's disease was often not made until a patient had substantial memory and cognitive problems -- by which time patients themselves were often unaware of their diagnosis. Advances in awareness, as well in diagnostic methods, mean doctors are diagnosing Alzheimer's disease earlier, and in the future, routine diagnosis may occur before symptoms even begin. According to Stites, early diagnosis holds the promise for opportunities to prevent cognitive and functional losses and to plan for these losses. But study results show that an early diagnosis of Alzheimer's disease can also bring challenges.


The Penn Researchers studied how awareness of diagnosis impacts on self-ratings of quality of life in people with one of two disorders, Mild Cognitive Impairment -- a disorder defined by slight but noticeable declines in cognitive abilities -- or mild stage Alzheimer's disease dementia. They compared these ratings to a group of adults above the age of 65 with normal cognition. Study participants completed measures of multiple domains of quality of life including cognitive problems, activities of daily living, physical functioning, mental wellbeing, and perceptions of one's daily life. The researchers compared the measure of quality of life by cognitive performance, diagnosis awareness, and diagnostic group.


The findings help to identify psychological processes underlying relationships between cognitive decline and quality of life. According to Stites, the study has practical implications for current and future clinical practice.


"It's not just an issue of to tell or not to tell, it's an issue of how you tell and what you tell because when you give someone a diagnosis you're also communicating, either directly or indirectly, a lot of information that can affect the activities people do in daily life, their planning for employment and lifestyle, emotional wellbeing, and social relationships with close friends and family members. These issues need to be explicitly addressed with patients," Stites said. "Maybe at this point we can't prevent cognitive decline, but we certainly have effective interventions for treating depression and for managing other symptoms."


The researchers note that further study is needed to understand what drives the impact of awareness of diagnosis and prognosis on quality of life. Future studies might include pre-clinical research that is being done in Alzheimer's disease, where clinicians are working to diagnose people who are at risk of developing the disease based on genes and biomarkers to determine how diagnosis awareness might affect an individual's sense of identity and functioning in the world if they learn that they have a high probability of developing Alzheimer's disease in the future.


A diagnosis of Alzheimer's disease can evoke assumptions, stereotypes, feelings, and attitudes that can affect a person's quality of life, how they view themselves and how they are treated by others. This study is part of the research team's ongoing efforts to understand how early diagnosis can impact a person's quality of life and wellbeing. The results add to what they've been learning about the stigma of Alzheimer's disease.

For white middle class, moderate drinking is linked to cognitive health in old age

August 1, 2017

Science Daily/University of California - San Diego

Older adults who consume alcohol moderately on a regular basis are more likely to live to the age of 85 without dementia or other cognitive impairments than non-drinkers, according to a new study.


Previous studies have found a correlation between moderate alcohol intake and longevity. "This study is unique because we considered men and women's cognitive health at late age and found that alcohol consumption is not only associated with reduced mortality, but with greater chances of remaining cognitively healthy into older age," said senior author Linda McEvoy, PhD, an associate professor at UC San Diego School of Medicine.


In particular, the researchers found that among men and women 85 and older, individuals who consumed "moderate to heavy" amounts of alcohol five to seven days a week were twice as likely to be cognitively healthy than non-drinkers. Cognitive health was assessed every four years over the course of the 29-year study, using a standard dementia screening test known as the Mini Mental State Examination.


Drinking was categorized as moderate, heavy or excessive using gender and age-specific guidelines established by the National Institute on Alcohol Abuse and Alcoholism. By its definition, moderate drinking involves consuming up to one alcoholic beverage a day for adult women of any age and men aged 65 and older; and up to two drinks a day for adult men under age 65. Heavy drinking is defined as up to three alcoholic beverages per day for women of any adult age and men 65 and older; and four drinks a day for adult men under 65. Drinking more than these amounts is categorized as excessive.


"It is important to point out that there were very few individuals in our study who drank to excess, so our study does not show how excessive or binge-type drinking may affect longevity and cognitive health in aging," McEvoy said. Long-term excessive alcohol intake is known to cause alcohol-related dementia.


The researchers said the study does not suggest drinking is responsible for increased longevity and cognitive health. Alcohol consumption, particularly of wine, is associated with higher incomes and education levels, which in turn are associated with lower rates of smoking, lower rates of mental illness and better access to health care.


The UC San Diego School of Medicine research team adjusted the statistical analyses to remove confounding variables, such as smoking or obesity, but noted the study is based only on statistical relationships between different demographic factors, behaviors and health outcomes. There remain on-going debates about whether and how alcohol impacts lifespan or potentially protects against cognitive impairments with age.


One of the study's advantages, however, is that the data derive from a relatively homogenous population in a geographically well-defined area. All of the 1,344 older adults (728 women; 616 men) who participated in the study are from Rancho Bernardo, a white-collar, middle-to-upper-middle-class suburb in San Diego County. More than 99 percent of the study participants, tracked from 1984 to 2013, are Caucasian with at least some college education.


"This study shows that moderate drinking may be part of a healthy lifestyle to maintain cognitive fitness in aging," said lead author Erin Richard, a graduate student in the Joint San Diego State University/UC San Diego Doctoral Program in Public Health. "However, it is not a recommendation for everyone to drink. Some people have health problems that are made worse by alcohol, and others cannot limit their drinking to only a glass or two per day. For these people, drinking can have negative consequences."

Green tea ingredient may ameliorate memory impairment, brain insulin resistance, and obesity

New research identifies potential therapeutic intervention for memory impairment, neuroinflammation, and brain insulin resistance induced by high-fat, high-fructose diet

July 28, 2017

Science Daily/Federation of American Societies for Experimental Biology

A new study involving mice, suggests that EGCG (epigallocatechin-3-gallate), the most abundant catechin and biologically active component in green tea, could alleviate high-fat and high-fructose (HFFD)-induced insulin resistance and cognitive impairment.


"Green tea is the second most consumed beverage in the world after water, and is grown in at least 30 countries," said Xuebo Liu, Ph.D., a researcher at the College of Food Science and Engineering, Northwest A&F University, in Yangling, China. "The ancient habit of drinking green tea may be a more acceptable alternative to medicine when it comes to combatting obesity, insulin resistance, and memory impairment."


Liu and colleagues divided 3-month-old male C57BL/6J mice into three groups based on diet:


1) a control group fed with a standard diet,


2) a group fed with an HFFD diet, and 3) a group fed with an HFFD diet and 2 grams of EGCG per liter of drinking water.


For 16 weeks, researchers monitored the mice and found that those fed with HFFD had a higher final body weight than the control mice, and a significantly higher final body weight than the HFFD+EGCG mice. In performing a Morris water maze test, researchers found that mice in the HFFD group took longer to find the platform compared to mice in the control group. The HFFD+EGCG group had a significantly lower escape latency and escape distance than the HFFD group on each test day. When the hidden platform was removed to perform a probe trial, HFFD-treated mice spent less time in the target quadrant when compared with control mice, with fewer platform crossings. The HFFD+EGCG group exhibited a significant increase in the average time spent in the target quadrant and had greater numbers of platform crossings, showing that EGCG could improve HFFD-induced memory impairment.