Dementia update 2016

elderly_man_holding_a_custom_text_sign_12871The government has announced a pilot programme to screen 40-year olds for dementia. The government wants to make Britain “the best place in the world to live with dementia“.

There are about 850,000 in the UK who suffer from Alzheimer’s disease and other severe neurodegenerative problems (approx 70% have Alzheimer’s and 20% vascular dementia).

Only those over 65 have a mid-life MoT at present. If the pilot is a success it will be extended to all GPs allowing them to suggest ways that people can cope with it better.

Exercising more, controlling weight and blood pressure, and eating better, are a few ways that could help.

Another part of the project is to enlist people in research to allow doctors to better understand and treat the condition.

Dementia can be frightening and the Alzheimer’s Society says  more than 9 out of 10 people think hospitals are frightening places. The health secretary has pledged that people in high dependency units will be seen regular by consultants, up to twice a day if appropriate.

Dementia support groups welcomed the shift in attitude from the government which has made dementia one of its top four priorities. “Many people with dementia face stigma and a health and care system that simply does not work for them resulting in emergency hospital admissions, extended stays and desperate loneliness

Public Health England is looking at lifestyle as a risk factor and asking doctors to look at patients with high blood pressure, irregular heartbeats or early signs of type 2 diabetes (this is part of the mid-life MoT).

A study published by Cardiff University in 2013 had looked at the lifestyles of over 2,000 men aged 45-59 over 35 years.

It found that men who were non-smokers, who took exercise, kept their weight down, drank little and ate well, had a 60% drop in dementia and cognitive decline as well as 70% fewer instances of heart disease, stroke, and diabetes.

The director of research and development at the Alzheimer’s society says “What’s emerging is that what’s good for the heart, in terms of lifestyle, is also good for the head. We don’t yet understand why this is so and we need to do more research on it”

If we could delay the average age on onset of Alzheimer’s by five years we could cut patient numbers (currently 850,000 and predicted to rise to 2 million by 2050) by a third” Dementia is the leading cause of death for women in England and Wales.

Researchers at Yale University think that helping people to have a more optimistic view of old age could delay the onset. They found that people with pessimistic views of old age, thinking that the elderly are irritable, slow to learn and forgetful, are themselves more likely to acquire the disease.

However it’s hard to untangle the psychological and medical factors given that early changes can take place 15 years before symptoms show. Recent US research suggests that forgetfulness in your 60s can be a sign of a higher dementia risk

However memory loss is not the only symptom.

Walking slowly could be an early sign of dementia, according to researchers in France who measured people’s walking speed and gait. Speed of walking has also been associated with life expectancy along with other simple tasks.

The researchers acknowledge that people could also be influenced by other illnesses such as cardio-vascular disease or depression which could have an impact on the brain.

Some of the symptoms might seem more obvious – like not recognising yourself in the mirror,  forgetting how to work the microwave, or not knowing what day or year it is.

Even a warped sense of humour could be an early sign of dementia. So if you are laughing inappropriately at tragic events or enjoy slapstick humour they could be early warning signs which show up 9 years before other symptoms.

The leader of this research at UCL said “Personality and behaviour changes should be prompts for further investigation and clinicians need to be more aware of these symptoms as a potential early sign of dementia”.

There is a lot of research into this tragic condition and there is also some good news. The number of men developing the condition has dropped considerably since the 1990s when there were 42 cases per thousand population now down to 27. In older men over 85 the incidence has almost halved from 72 to 38 cases per thousand.

This has been attributed to men living healthier lifestyles than they did 20 years ago. However with obesity and diabetes on the increase among the middle-aged these gains might not be maintained. So its back to “what’s good for your heart is good for your brain”

Protect your memory

head_outline_puzzle_1600_wht_10307Apparently we are experiencing an epidemic of premature memory loss. Scientists are now saying our memory begins to fade at 45 years of age rather than at 60 as was previously believed.

Unfortunately failing mid-life memory – the occasional slips which are referred to as Mild Cognitive Impairment (MCI) – could also be an early symptom of senile dementia. This brain disease is now striking people 10 years earlier than it did 20 years ago and is regularly being diagnosed in people in their 40s.

Half of those diagnosed with MCI go on to develop senile dementia. But half don’t so what makes the difference?

There seems to be no simple explanations. Some experts have blamed environmental pollution including exhaust fumes and pesticides. Others have blamed an over-reliance on technology, junk food and our lifestyles generally.

More people are referring themselves to doctors about memory problems. The vast majority suffer from what psychologists have called “security protection overload”. They feel overwhelmed by the numbers, codes and operating systems they need to know to function in a hi-tech environment.

Who hasn’t experienced ‘PIN amnesia’? It happened to me today as I used a credit card I don’t use very often. All my cards have different PINs which I remember pretty much all the time. The stress of getting it wrong and worrying about three strikes and out is enough to interfere with memory recall anyway.

People are using their memory less as they store information on their smartphones. And we’ve seen what happens when people over-rely on sat-navs and end up in a river. The brain is like  a muscle. Use it or lose it!

We have to keep active and our brains active by doing new and different things. Keeping the blood flowing to our brains and making new connections through imagination and planning.

For those of us with middle-aged brains the upside is that we are generally calmer, less neurotic, better in social situations, wiser, and more contented. The Seattle Longitudinal Study, which has tracked the mental abilities of thousands of adults over the past 50 years, has found that middle-aged adults perform better on 4 out of 6 cognitive tests than they did as young adults.

And while middle-aged people can perform tests as well as young people in conditions of silence they are more distracted than them in noisy environments. This might also explain the “doorway amnesia” where we move from one room to another and forget why we are there. The movement breaks our concentration as we are distracted by new stimuli in the new room.

Forgetting is a healthy brain function. You don’t want your brain cluttered up by irrelevant information about previous events when you need to remember something today. People who can’t forget – it’s called hypermythesia – get confused.

Healthy brains allow us to recall information when we need it. The problem is that we don’t always retrieve it efficiently. Our library of information becomes less efficiently managed as we get older.

This post is based on an article in the Times Body and Soul segment which also suggests the following ways to protect your memory.

Walk for 30 minutes a day, three times a week. Regular exercise provides the brain with oxygen and nutrients.

Eat vegetables and nuts. We know mediterranean diets are good for us . Now nutritionists at Rush University Chicago have developed the MIND diet, a specially formulated brain-protecting diet.

Give up transfats. Found in burgers, biscuits and cakes. Designed to increase the shelf-life of food but not people.

Eat less sugar. Studies have shown that high blood glucose can damage brain function. Not to mention sugar ruins your teeth and makes you fat!

Lose weight. It’s not PC to use the F word but obesity is a killer and costs the country a fortune. Overweight people’s memory declines over 20% faster than people of normal weight.

Avoid cigarettes and beer. Middle-aged men drinking two-and-a-half pints of beer a day speed up their memory loss by 6 years. Smoking has also been linked to a faster decline in memory.

Drink strong coffee. Twice a day. It helps middle-aged people do short-term memory tests but appears to have no effect on young people. Caffeine also strengthens brain connections. So there you skinny decaff latte drinkers. Not good for you!

PS Brain training games don’t help. You might get better at the games but that’s all according the the Alzheimer’s society. Same goes for crosswords and Sudoku.

Two ways to stave off dementia

woman_reading_book_1600_wht_7865If you’re already middle-aged then this finding may come too late for you – but you can still help your grandchildren..

1 Children who get good grades at the age of 10 are significantly less likely to develop dementia in later life.

Scientists at the Karolinska Institute in Sweden – who studied 7,500 dementia-free pensioners for at least 20 years and compared their mental health against their education and work experiences – claim that children who stretch themselves in class build up a “cognitive reserve” that makes them more resilient to memory loss in old age.

Children who scored in the top fifth at school and went into jobs that involved complex analysis had a 39% lower risk of developing dementia than the rest of the group.

In a matching study of 440 people over the age of 75 over nine years it was found that pupils with the lowest grades at school were 50% more likely to suffer dementia after the age of 75 even if they went on to study at university or had intellectually challenging jobs.

This is more evidence that low IQ scores in childhood is linked to a higher risk of dementia after a similar study in Scotland in 2008 that found that people with poor academic scores as children were at a significantly higher risk of developing vascular dementia.

It is also more evidence that challenging the brain throughout its lifetime gives you more mechanisms to deal with the symptoms of dementia. Although there are mixed views about so-called “brain training”, exercise and a healthy diet can definitely improve your brainpower as you get older.

Having a cognitive reserve doesn’t protect you from the physical damage of dementia but can help people finding ways of minimising the effects.

Dr Laura Phipps from Alzheimer Research said “With some people there’s something about their brain – the way it works, how many connections they have in the brain, how easily they form these connections – that means in the face of brain damage they can find compensatory strategies and carry on with life as normal”

A neuroscientist at the Karolinska Institute said “Our findings highlight the importance of early-life cognitive performance for the late-life risk of dementia. It appears that baseline cognitive ability, even at age 10, may provide the foundation for successful cognitive ageing much later in life. Formation of cognitive reserve is a process that apparently begins early in life”

Dr Phipps was keen to stress that poor school results in childhood didn’t necessarily mean that a child was exposed to a greater risk of dementia or memory loss when they got older. More research was needed to look at other factors such as diet and genetics.

artist_mannequin_brush_1600_wht_66802 If you’re already in adulthood take up life drawing!

30 volunteers took part in an experiment at Newcastle University.

Two groups either took brisk walks or did crossword puzzles or Sudoku. The third group took an art class drawing a nude male.

All the volunteers took a series of tests over eight weeks. The walking group showed the biggest improvement in physical health and a small increase in the cognitive tests, those doing increasingly difficult crosswords and sudoku became better at them and improved their mental skills.

However the art class showed the greatest enthusiasm for the task and showed the biggest improvement in the memory tests.

The art class was also the most sociable which is also an important factor in keeping the brain sharp.

The clinical psychologist who organised the tests said learning a new skill could be a benefit in maintaining brain power. “Learning something new engages the brain in ways that seem to be the key. Your brain changes in response no matter how many years you have behind you. Capturing an image on paper is not just intellectually demanding, it also involves learning how to make the muscles in your hand guide the pencil or paintbrush in the right direction.”

An additional health benefit was that the volunteers stood in the art class for three hours a week which burns calories and improves health.

NB. Recently there has been a health campaign to get more office workers to stand up during the day to reduce the risk of heart disease and diabetes but there has been no real evidence that it has been effective.

What story are you telling yourself?

Otrazhenie

Self Portrait Hippie Peace Freaks
From Hippie Peace Freaks

“We tell ourselves stories every day. This is a story. A story of how we take the events of our lives and turn them into memories. And of how we can remake those memories by telling new stories to change our lives.

Every story is built on themes and although there can be an infinite number of stories there are a limited number of themes. The stories we tell ourselves about who we are and what our lives are about are just so. We can be the hero, antagonist or victim. Our lives can be heroic or tragic, fulfilling or empty, happy or sad. It all depends on the story we write and the stage on which we perform.

Just as a stage contains props to support a play, so do we select from life’s myriad events the bits and pieces of evidence we use to…

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Middle-age Obesity & Dementia

stick_figure_overweight_scale_1600_wht_3853Obesity in middle-age has been linked to increased risk of Alzheimer’s  in old age.

Health experts agree that dementia levels, which have been rising since the 1980s, will continue to increase as we all get older, as it’s a disease of old age.

But increasing levels of obesity are putting more people at risk and individuals who are obese in their 40s and 50s have twice the risk of getting dementia in their 70s.

Research carried out at the French medical institute – Inserm, found that obesity had an increasingly negative impact on tests of memory and reasoning.

We still don’t know enough to identify the reasons eg it could be fat travelling round the bloodstream affecting brain tissue but most researchers agree that there is a link between obesity and dementia.

See other posts on obesity

See other posts on dementia

Momnesia

is what they are calling it when new mums are focussed so much on their baby’s needs that other parts of the brain take a back seat and they can’t remember things.

Anxiety takes up a lot of the brain’s attention and stress shortens attention spans.

Breast-feeding prolongs the effect but after that there’s every chance that the mums will be even smarter having given their brains a bit of a work-out.

Shortage of sleep is the likely cause of memory loss although it can also be caused by neurological and psychiatric conditions, alcoholism, and sleep apnea.

Recent research has shown that it’s the frequent interruptions that new mums suffer that causes the problem even when the total hours of sleep are the same.

The researchers say sleep continuity is critical for memory.


So don’t rely on your memory but keep a notepad to jot down your “to do” list.

Stress and poverty definitely not good for children

Researchers at Ohio State University have been looking at stress and health for 30 years and can show that being chronically stressed wears down your immune system and makes you  more likely to become ill and disease-prone.

They also found that children who had difficult childhoods eg through being abused or neglected, could develop hyperactive stress responses which could kick in later in life making them more vulnerable when subject to stress as adults.

And at the Pittsburgh Mind-Body Centre their research shows that early childhood experiences of stress or poverty influence the chances that we’ll develop chronic diseases as adults – whether or not we have a poor diet, don’t exercise, drink in excess, or smoke.

Cardiovascular disease is a case in point. If the family rented rather than owned a home, if the parents didn’t go to college or had less prestigious jobs, then the children’s own cardiovascular health was more likely to be compromised in adulthood – regardless of how successful they became and how much they had achieved on their own as adults.

A year ago it was reported that more than 20% of American children were living in poverty, more than most industrialised nations and the highest level in America for 20 years.

The non-profit Foundation for Child Development has tracked children’s overall quality of life since 1975 using 28 indicators of well-being, according to an article in the September issue of Monitor on Psychology published by the American Psychological Association.

The foundation predicts large increases in the levels of child poverty with as many as 1/2 million children becoming homeless this year. Even if the economy recovers the impact of the recession on the poor children of today could be profound. They face an increased risk of engaging in violent crime, illegal drug use, and of experiencing chronic health problems such as obesity.

Research shows that “children who slip into poverty, even for a short time, suffer long-term setbacks even when their families regain their economic footing” according to the foundation’s president psychologist Dr Ruby Takanishi. And it is worse for children under 10 years of age who, in addition to suffering from health problems such as asthma and anaemia, are more likely to experience negative educational outcomes.

Through lack of mental stimulation and increased stress and their brains may not develop in the same way as children from higher income families. Last year research at the University of California, Berkeley, found a difference between high and low-income children. In 9 and 10 year olds from poorer homes their EEG readings showed less pre-frontal cortex brain activity compared to children from higher income families – even though there was no neural damage nor pre-natal exposure to alcohol or drugs.

As long ago as 1995 research showed that the average vocabulary of 3 year-olds from professional families was twice as large as that of 3 year-olds on welfare. Since then other research has confirmed that poverty affects children in other ways as well as in language skills including poor impulse control, poor working memory, and poorer selective attention.

These results have been attributed to the impact of stressful home environments and lack of parental education in poorer homes. There is evidence that memory ability is related to the amount of parental nurturing.

And there are programmes in place such as the Tools of the Mind curriculum, developed at Metropolitan State College at Denver, which helps children control their impulses and control behaviour so that, for example, children learn to be good listeners.

Another intervention, at the University of Oregon; Parents and Children Making Connections Highlighting Attention, trains children and parents in sustained concentration and impulse management, which enables people to learn new skills more effectively, by making them more aware of their own bodies, attention, and emotions, and how to focus on one thing at a time.

The Oregon researchers have found their programme improves IQ, message comprehension, and social skills and leaves the parents less stressed. They have produced a DVD for parents, teachers, and policy-makers that explores brain development in children. It’s available at www.changingbrains.org.

Those of you familiar with the concept of emotional intelligence will recognise common features in these programmes such as self-awareness and self-control. I have another post on this; “Emotional Intelligence, self-control, and those marshmallows”

Another factors is how often you move house.  Moving frequently as a child can have long-lasting effects on their well-being as adults.

A study of 7,000+ American adults by the University of Virginia, published in The Journal of Personality & Social Psychology (Vol 98 No 6), found that the more they had changed cities or neighbourhoods as children, the more likely they were to report lower satisfaction and well-being. They were also more likely to die younger.

And yet more evidence from researchers in Holland who have come up with the first real evidence that early nutrition effects future health (BBC news: Future heart health “shaped by diet”).

A report in the European Heart Journal looked at the impact of the 1944-45 famine in the Netherlands. Women who were between 10 and 17 at the time were followed up in 2007.

Those who had been severely affected by the famine and who survived on 400-800 calories a day had a 27% greater risk of developing heart disease than those who had sufficient food.

The British Heart Foundation said it demonstrated the need for children and young adults to have healthy diets to protect their long-term health.

Originally posted on EI 4U