'Clever' new test gives more clues about Alzheimer's disease

Caregivers and healthcare professionals, here is some great information

Here is a great dementia resource for caregivers and healthcare professionals,

Your residents will love the Amazon Kindle Fire

Here is information on being the best caregiver you can be

Here is a way for nurses administrators, social workers and other health care  professionals to get an easyceu or two

Follow alzheimersideas on twitter

The Dementia Caregiver's Little Book of Hope [Kindle Edition

E Max Health

Scientists know mild cognitive impairment or MCI can interfere with daily functioning. In an effort to discover how even mild cognitive impairment that leads to Alzheimer’s disease affects daily living, researchers have developed a ‘clever’ new test that could lead to ways to retrain the brain.

The finding could mean increased independence for anyone on the path to Alzheimer’s and provides new insights into what processes interfere with carrying out daily activities in the presence of even mild memory deficits.

Terry Goldberg, PhD, a professor of psychiatry and behavioral science at the Hofstra North Shore-LIJ School of Medicine and director of neurocognition at the Litwin Zucker Center for Research in Alzheimer's Disease and Memory Disorders at The Feinstein Institute for Medical Research in Manhasset, NY and colleagues designed the test

The goal is to help people who will develop Alzheimer’s disease function better in their daily lives.

Goldberg explains the test involves tapping into the semantic processing system in the brain that has broader implications for how a person functions in their daily life.

Clinicians are trained to focus on short-term memory problems when screening for cognitive impairment and Alzheimer’s disease. The researchers wanted to find out if there are other memory impairments that haven’t been picked up on before.

To perform the test, the researchers needed a test that did not rely on verbal skills. “If you ask someone what is bigger, a key or an ant, they would be slower in their response than if you asked them what is bigger, a key or a house,” explained Dr. Goldberg in a news release.

The Dartmouth College of Education explains semantic processing as understanding the meaning of words: “…you might depend in part on semantic processing to know that when you read “cat” it means or refers to that warm, furry, purring thing that jumps on your lap and meows.”

For the study, researchers tested 25 patients with MCI, 27 patients with Alzheimer's and 70 people with no memory deficits.

The finding showed major differences between cognitively fit people and those with MCI and Alzheimer’s

“This finding suggested that semantic processing was corrupted,” said Dr. Goldberg. “MCI and AD (Alzheimer's disease) patients are really affected when they are asked to respond to a task with small size differences."

For the test, the scientists used factual, competitive questions. “If you ask someone what is bigger, a key or an ant, they would be slower in their response than if you asked them what is bigger, a key or a house,” explained Dr. Goldberg.

Then they threw in images designed to require more processing by showing incongruent pictures - a small ant and a big house or a big ant and a small house.

Participants with cognitive impairment or AD became confused and took longer to answer.

Mildly impaired participants functioned somewhere in between the group with no memory deficits and those with Alzheimer’s disease.

After they identified problems with semantic processing, the researchers turned to the UCSD Skills Performance Assessment scale to find out if the subtle declines seen in memory interfere with a person’s daily functioning.

The test reveals a person’s ability to write a complex check or organize a trip to the zoo on a cold day, the researchers explain.

“The semantic system is organized in networks that reflect different types of relatedness or association,” the investigators wrote in their study. “Semantic items and knowledge have been acquired remotely, often over many repetitions, and do not reflect recent learning.”

The finding is important because it gives clues that something besides memory – in this case processing existing knowledge – is slowing down.

In an accompanying editorial David P. Salmon, PhD, of the Department of Neurosciences at the University of California in San Diego points out the test shows people who will later develop Alzheimer’s disease gradually lose their ability to process knowledge and that it happens early. He agrees the finding also shows even mild memory deficits can interfere with ‘usual activities of daily living’.

Goldberg and his team plan to continue their studies to see if semantic problems get worse as the disease progresses. The finding is published in the American Journal of Psychiatry.

Finding more clues to Alzheimer’s disease with the new test suggests retraining the brain might strengthen semantic processing. It’s not episodic memory loss that interferes with daily functioning, but instead semantic memory.

North Shore-Long Island Jewish Health System

Alzheimer's Disease Early Cognitive Problems Identified

Caregivers and healthcare professionals, here is some great information

Here is a great dementia resource for caregivers and healthcare professionals,

Your residents will love the Amazon Kindle Fire

Here is information on being the best caregiver you can be

Here is a way for nurses administrators, social workers and other health care  professionals to get an easyceu or two

Follow alzheimersideas on twitter

The Dementia Caregiver's Little Book of Hope [Kindle Edition

Medical News Today

Early indicators of Alzheimer's disease have been discovered and published in the latest issue of American Journal of Psychiatry. The findings reveal that people who are beginning to develop the disease often show problems with processing semantic and knowledge based information before severe symptoms of the disease begin showing. 

The study is the first of its kind to review mild cognitive impairment (MCI) associated with Alzheimer's disease in a systematic way and reveal the early indicators, signs and symptoms. Terry Goldberg, PhD, director of neurocognition at the Litwin Zucker Center for Research in Alzheimer's Disease, and his colleagues developed a test to identify any problems with a person's ability to process semantic or knowledge based information. 

The results of the test showed that there are a number of semantic impairments that are associated with MCI. In order to prevent adding further confusion to the study, the researchers implemented an element of the test that did not require any verbal response. This part of the test measured a person's ability to make a judgment of two sets of facts by their ability to differentiate size. For example, they would be shown a picture of an ant and a house and asked which was bigger. The time it took for them to answer the question would reveal the extent of their inability to process semantic information. 

A total of 122 people were tested, of whom 25 had MCI, 27 had Alzheimer's and the other 70 were cognitively "normal". There was a big difference in the ability to process the information among the MCI and Alzheimer's patients compared to the healthy controls. According to Dr. Goldberg: "This finding suggested that semantic processing was corrupted. MCI and AD (Alzheimer's disease) patients are really affected when they are asked to respond to a task with small size differences." 

The researchers then added an element to the task by showing the participants pictures of a big house and small ant and also a big ant and small house. The MCI and AD patients were able to successfully complete the first part of this task but had a lot difficulty (unable to answer or delayed response) when shown the picture where the big ant looked just as big as the small house. The patients with MCI were functioning better than the Alzheimer's patients but not nearly as well as the healthy controls. 

They used the UCSD Skills Performance Assessment scale to determine how much of an effect impaired semantic processing has on carrying out everyday functions. It assesses stuff like a person's ability to organize day trips out and write complex checks. The authors of the study said: "The semantic system is organized in networks that reflect different types of relatedness or association. Semantic items and knowledge have been acquired remotely, often over many repetitions, and do not reflect recent learning." 

This indicates that it could well be possible to repair semantic processing connections through training. According to Dr. Goldberg: "It tells us that something is slowing down the patient and it is not episodic memory but semantic memory." 

David P. Salmon, PhD, of the Department of Neurosciences at the University of California in San Diego, said in an accompanying editorial: 

"semantic memory deficit demonstrated by this study adds confidence to the growing perception that subtle decline in this cognitive domain occurs in patients with amnestic mild cognitive impairment. Because the task places minimal demands on the effortful retrieval process, overt word retrieval, or language production, it also suggests that this deficit reflects an early and gradual loss of integrity of semantic knowledge."



He concluded: "second important aspect of this study is the demonstration that semantic memory decrements in patients with mild cognitive impairment may contribute to a decline in the ability to perform usual activities of daily living." 

A previous study carried out by researchers from The Australian National University developed a test that was able to predict Alzheimer's disease among middle aged people. The finding, along with this one opens possibilities of early detection and intervention in healthcare settings.

Written by Joseph Nordqvist 
Copyright: Medical News Today 

Does the way you walk affect your risk of getting dementia

Caregivers, and healthcare professionals, here is some great information


Here is a great dementia resource for caregivers and healthcare professinals,


Your residents will love the Amazon Kindle Fire


Here is information on being the best caregiver you can be


Here is a way for nurses administrators, social workers and other health care  professionals to get an easyceu or two


Follow alzheimersideas on twitter

The Dementia Caregiver's Little Book of Hope [Kindle Edition

CTV.ca

As the American Academy of Neurology points out, dementia is not a specific disease. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships. They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems, such as agitation, delusions, and hallucinations.  

While memory loss is a common symptom of dementia, memory loss by itself does not mean that a person has dementia. Doctors diagnose dementia only if two or more brain functions -- such as memory and language skills -- are significantly impaired without loss of consciousness.  Although it is common in very elderly individuals, dementia is not a normal part of the aging process. 

Research in this week’s issue of Neurology, shows that changes in walking speed in late life may signal the early stages of dementia known as mild cognitive impairment (MCI).

The study used a new technique that included installing infrared sensors in the ceilings of homes, a system designed to detect walking movement in hallways to get a better idea of how even subtle changes in walking speed may correlate with the development of MCI. 

The study involved 93 people age 70 or older who lived alone. Of those, 54 participants had no cognitive impairment, 31 had non-memory related MCI and eight had memory-related MCI. Participants were given memory and thinking tests and had their walking speed monitored at their homes unobtrusively over a three-year period. Participants were placed in groups of slow, moderate or fast based on their average weekly walking speed and how much their walking speed fluctuated at home.  

The study found that people with non-memory related MCI were nine times more likely to be slow walkers than moderate or fast walkers and the amount of the fluctuation in walking speed was also associated with MCI.  

As the authors point out, if we can detect dementia at its earliest phases, then we can work to maintain people's independence, provide treatments and ultimately develop ways to prevent the disease from developing.  

Presented today at the International Conference on Social Identity and Health is a study on attitude towards our age. The study looked at the how our attitude has a massive impact on the likelihood of being diagnosed with dementia. Their research shows that when seniors see themselves as 'older' their performance on a standard dementia screening test declines dramatically; making them five times more likely to meet the criteria for dementia. 

The research involved 68 people aged between 60 and 70 years, who were primed to either feel older or younger than others taking part in the study. Those in the 'older' group were told the participants ranged in age from 40 to 70, encouraging them to think of themselves as being at the upper end of the age spectrum, while those in the 'younger' group were told that participants ages ranged from 60 to 90 years, encouraging them to think of themselves at the lower end of the age spectrum. All participants were then given one of two articles to read, which either focused on the effects of age on memory loss or on the impact of ageing on general cognitive ability. 

The participants then completed a series of standard clinical tests; 70 per cent of people, who were encouraged to see themselves as older and to believe that aging was associated with a general decline in ability, met the criterion for dementia. This was compared to an average of 14 per cent in the other groups.  

The research shows that the effect of age perceptions on performance can be dramatic, and that seeing oneself as 'older' significantly increases a person's risk of being diagnosed with dementia on such tests. It highlights the importance of taking a person's attitude towards their age into account when assessing for dementia.

A New Way to Detect Alzheimer's Disease

Here is a great dementia resource for caregivers and healthcare professionals,

You will love the Amazon Kindle Fire

Here is information on being the best caregiver you can be

Here is a way for nurses administrators, social workers and other health care professionals to get an easyceu or two

Follow Alzheimers1 on twitter

Cordis Wire



APOE is the main genetic risk factor for this disease, but that is not the whole story; Xabier Elcoroaristizabal is looking for complementary genetic factors
One of our genes is apolipoprotein E (APOE), which often appears with a variation which nobody would want to have: APOEε4, the main genetic risk factor for sporadic Alzheimer’s disease (the most common form in which this disorder manifests itself and which is caused by a combination of hereditary and environmental factors). It is estimated that at least 40% of the sporadic patients affected by this disease are carriers of APOEε4, but this also means that much more still remains to be studied. The researcher at the University of the Basque Country (UPV/EHU) Xabier Elcoroaristizabal has opened up a channel for making a start by analysing candidate genes which, always in combination with APOEε4, could help to explain more cases. His thesis is entitled “Molecular markers in mild amnestic cognitive impairment and Alzheimer’s disease” (Marcadores moleculares en deterioro cognitivo leve tipo amnésico y enfermedad de Alzheimer). An initial article on this can be read in the journal BMC Neuroscience.

The long-term aim is to contribute towards the early detection of Alzheimer’s disease by identifying signs that could be detectable in the very early phases. And, as Elcoroaristizabal explains, while there is no cure for this disorder, the alternative is to get ahead of it and delay its development: “Certain preventive measures involving cognitive stimulation delay its appearance. There are even new drugs that could start to be used earlier. Today there is no solution, but the more we maintain a person’s correct cognitive state, the better.”

Mild amnestic, cognitive impairment

The individuals who develop Alzheimer’s go through a transition period first of all, and this could be the key moment for the effective application of preventive measures. This is mild cognitive impairment (MCI), in which slight cognitive alterations take place but do not affect everyday activities. Among the different types of MCI, one affects memory almost exclusively (amnestic MCI), and those people who suffer from it have a high probability of developing the disorder. The difficult and interesting part is knowing which genetic components are linked to this impairment and also in determining by what percentage the risk of developing the disease increases, a task which Elcoroaristizabal has set himself. “If we can identify which genes are involved and what susceptibility factors there are, preventive measures could be taken,” he explains.

So a contrast study has been carried out among a sample of patients with MCI, ones with Alzheimer’s and healthy people. This can be used to observe the changes and narrow down the field for the zones to be studied, so that candidate genes can be sought there. Elcoroaristizabal himself notes one example among the many others identified: “It has been observed that the brain's capacity to control cholesterol levels seems to play a key role throughout the illness. So, protein encoding genes linked to this control have been analysed.”

In this quest for candidate genes, Elcoroaristizabal has confirmed that the APOEε4 genetic variation is, in fact, the main risk factor for developing Alzheimer’s disease. But it does not end there; he has identified several genes which, as long as they are manifested in combination with APOEε4, could take us one step further towards the early detection of this disorder. “Genes that in some way are connected with neurotransmission channels, oxidative stress or the effectiveness of oestrogens seem to be linked to a greater risk for APOEε4 carriers,” he explains. Specifically, the candidate genes are as follows: COMT (neurotransmission), SOD2 (oxidative stress elimination) and ESR1 and ESR2 (oestrogen action facilitators).

Intranasal insulin treatment for Alzheimer's disease

Here is a great dementia resource for caregivers and healthcare professinals,

Here is information on being the best caregiver you can be

Here is a way for nurses administrators, social workers and other health care professionals to get an easyceu or two

Alzheimer's Association

Currently, there is no cure for Alzheimer's disease. But drug and non-drug treatments may help with both cognitive and behavioral symptoms. Researchers are looking for new treatments to alter the course of the disease and improve the quality of life for people with dementia.

In an article published September 13, 2011, in the Archives of Neurology, results from a small, short-term treatment trial (four months) of intranasal insulin in Alzheimer's disease and mild cognitive impairment (MCI) showed statistically significant benefits on certain tests of memory and functioning, but no changes on some others. In those people who showed benefits on memory tests, the researchers also measured changes in chemicals in participants' spinal fluid that may indicate a beneficial effect of the treatment on Alzheimer's.

It is important to note that, quite often, preliminary studies like this generate positive results but fail to show long-term benefit in larger trials. That said, these findings are very encouraging, and further research — longer trials with larger numbers of participants — of intranasal insulin as a therapy for Alzheimer's and MCI is warranted.

We urgently need earlier detection and better treatments for Alzheimer's, which is a devastating, heartbreaking and fatal disease, and a growing epidemic. This requires a greater commitment to research — increasing funding for Alzheimer's research and recruiting more volunteers for Alzheimer's clinical trials.



























































































































































Researchers selected 104 men and women for the study. All had either mild to moderate Alzheimer's or mild cognitive impairment, a condition that increases the risk of developing Alzheimer's, especially when memory is affected. The participants were divided into three groups. Using a nasal spray, each group received twice-daily doses of either lower or higher doses of insulin or a placebo.

The study found that men and women who used the lower dose of insulin nasal spray tended to score better on memory tests than those who used the placebo. No improvement was seen in those receiving the higher insulin dose. Both groups receiving insulin preserved their level of daily functioning, according to reports from their caregivers, while participants in the placebo group showed an overall decline in function. Few side effects occurred among those treated with the insulin spray, other than occasional light-headedness and dizziness or stuffy nose.

Related
•Minor ailments linked to Alzheimer's. Read
•Can you walk away from dementia? Read
•Eating berries may protect against dementia, Alzheimer's. Read
•Do drugs for treating early-stage Alzheimer's work? Read

The brain needs insulin

Over the past 10 years scientists have come to learn that insulin plays an important role in the brain, says clinical neuroscientist Suzanne Craft, of the Veterans Affairs Puget Sound Health Care System and the University of Washington School of Medicine. It helps the brain form memories, allows brain cells to communicate with one another and manages levels of brain chemicals.

All cells, including those that make up the brain, use glucose for energy. The hormone insulin makes it possible for glucose, aka blood sugar, to enter cells, enabling them to work properly. With age, however, many people develop a problem called insulin resistance, a condition in which the body and the brain do not use insulin effectively.

If glucose cannot enter brain cells, the cells won't carry out their tasks related to memory and thinking. "This sets the stage for problems in brain function that may develop into conditions like Alzheimer's disease," says Craft, lead author of the study. She and her colleagues set out to determine whether providing insulin directly to the brain could improve the cell's ability to use insulin.