aging

Smaller life space linked to greater risk of cognitive decline

June, 2011

A study of healthy seniors reveals that homebodies have faster cognitive decline and more risk of developing Alzheimer’s and MCI, than those who have a wider life-space.

Growing evidence has pointed to the benefits of social and mental stimulation in preventing dementia, but until now no one has looked at the role of physical environment.

A study involving 1294 healthy older adults found that those whose life-space narrowed to their immediate home were almost twice as likely to develop the condition as those with the largest life-space (out-of-town). The homebound also had an increased risk of MCI and a faster rate of global cognitive decline.

By the end of the eight-year study (average follow-up of 4.4 years), 180 people (13.9%) had developed Alzheimer’s. The association remained after physical function, disability, depressive symptoms, social network size, vascular disease burden, and vascular risk factors, were taken into account.

It may be that life-space is an indicator of how engaged we are with the world, with the associated cognitive stimulation that offers.

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Benefits of childhood music lessons may extend into old age

June, 2011

A new study finds length of musical training in childhood is associated with less cognitive decline in old age.

A study involving 70 older adults (60-83) has found that those with at least ten years of musical training performed the best on cognitive tests, followed by those with one to nine years of musical study, with those with no musical training trailing the field.

All the musicians were amateurs who began playing an instrument at about 10 years of age. Half of the high-level musicians still played an instrument at the time of the study, but they didn't perform better on the cognitive tests than the other advanced musicians who had stopped playing years earlier. Previous research suggests that both years of musical participation and age of acquisition are critical.

All the participants had similar levels of education and fitness. The cognitive tests related to visuospatial memory, naming objects and executive function.

Reference: 

Hanna-Pladdy, B. & MacKay, A. 2011. The relation between instrumental musical activity and cognitive aging. Neuropsychology, 25 (3), 378-86. doi: 10.1037/a0021895

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Higher levels of social activity decrease the risk of cognitive decline

May, 2011
  • More evidence indicating that a lack of engagement in social activities increases the rate of cognitive decline in older adults.

Adding to the growing evidence that social activity helps prevent age-related cognitive decline, a longitudinal study involving 1,138 older adults (mean age 80) has found that those who had the highest levels of social activity (top 10%) experienced only a quarter of the rate of cognitive decline experienced by the least socially active individuals (bottom 10%). The participants were followed for up to 12 years (mean of 5 years).

Social activity was measured using a questionnaire that asked participants whether, and how often, in the previous year they had engaged in activities that involve social interaction—for example, whether they went to restaurants, sporting events or the teletract (off-track betting) or played bingo; went on day trips or overnight trips; did volunteer work; visited relatives or friends; participated in groups such as the Knights of Columbus; or attended religious services.

Analysis adjusted for age, sex, education, race, social network size, depression, chronic conditions, disability, neuroticism, extraversion, cognitive activity, and physical activity.

There has been debate over whether the association between social activity and cognitive decline is because inactivity leads to impairment, or because impairment leads to inactivity. This study attempted to solve this riddle. Participants were evaluated yearly, and analysis indicates that the inactivity precedes decline, rather than the other way around. Of course, it’s still possible that there are factors common to both that affect social engagement before showing up in a cognitive test. But even in such a case, it seems likely that social inactivity increases the rate of cognitive decline.

Reference: 

[2228] James, B. D., Wilson R. S., Barnes L. L., & Bennett D. A.
(2011).  Late-Life Social Activity and Cognitive Decline in Old Age.
Journal of the International Neuropsychological Society. FirstView, 1 - 8.

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More evidence linking heart disease risk factors and cognitive decline

May, 2011

Another study confirms that cardiovascular risk factors are also risk factors for cognitive decline.

A study involved 117 older adults (mean age 78) found those at greater risk of coronary artery disease had substantially greater risk for decline in verbal fluency and the ability to ignore irrelevant information. Verbal memory was not affected.

The findings add to a growing body of research linking cardiovascular risk factors and age-related cognitive decline, leading to the mantra: What’s good for the heart is good for the brain.

The study also found that the common classification into high and low risk groups was less useful in predicting cognitive decline than treating risk as a continuous factor. This is consistent with a growing view that no cognitive decline is ‘normal’, but is always underpinned by some preventable damage.

Risk for coronary artery disease was measured with the Framingham Coronary Risk Score, which uses age, cholesterol levels, blood pressure, presence of diabetes, and smoking status to generate a person's risk of stroke within 10 years. 37 (31%) had high scores. Age, education, gender, and stroke history were controlled for in the analysis.

Reference: 

Gooblar, J., Mack, W.J., Chui, H.C., DeCarli, C., Mungas, D., Reed, B.R. & Kramer, J.H. 2011. Framingham Coronary Risk Profile Predicts Poorer Executive Functioning in Older Nondemented Adults. Presented at the American Academy of Neurology annual meeting on Tuesday, April 12, 2011.

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Temporary cognitive impairment for many hospitalized seniors

May, 2011

Hospitalization can temporarily impair seniors’ cognitive function, and more support is needed. Discharge instructions should be given with this in mind.

A study involving 200 older adults (70+) experiencing a stay in hospital has found that at discharge nearly a third (31.5%) had previously unrecognized low cognitive function (scoring below 25 on the MMSE if high-school-educated, or below 18 if not). This impairment had disappeared a month later for more than half (58%).The findings are consistent with previous research showing a lack of comprehension of discharge instructions, often resulting in rehospitalization.

The findings demonstrate the effects of hospitalization on seniors, and point to the need for healthcare professionals and family to offer additional support. It’s suggested that patient self-management may be better taught as an outpatient following discharge rather than at the time of hospital discharge.

Sleep disruption and stress are presumed to be significant factors in why this occurs.

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Adverse changes in sleep duration associated with cognitive decline in middle-aged adults

May, 2011

A large long-running study has found that middle-aged adults whose night’s sleep had decreased from 6-8 hours or increased from 7-8 hours performed worse on some cognitive tests.

From the Whitehall II study, data involving 5431 older participants (45-69 at baseline) has revealed a significant effect of midlife sleep changes on later cognitive function. Sleep duration was assessed at one point between 1997 and 1999, and again between 2002 and 2004. A decrease in average night’s sleep from 6, 7, or 8 hours was significantly associated with poorer scores on tests of reasoning, vocabulary, and the MMSE. An increase from 7 or 8 hours (but not from 6 hours) was associated with lower scores on these, as well as on tests of phonemic and semantic fluency. Short-term verbal memory was not significantly affected. The magnitude of these effects was equivalent to a 4–7 year increase in age.

Around 8% of participants showed an increase from 7-8 hours of sleep over the five-year period (7.4% of women; 8.6% of men), while around a quarter of women and 18% of men decreased their sleep amount from 6-8 hours. About 58% of men and 50% of women reported no change in sleep duration during the study period. Some 27% of the participants were women.

The optimal amount of sleep (in terms of highest cognitive performance) was 7 hours for women, closely followed by 6 hours. For men, results were similar at 6, 7 and 8 hours.

Analysis took into account age, sex, education and occupational status. The Whitehall II study is a large, long-running study involving British civil servants. Sleep duration was assessed simply by responses to the question "How many hours of sleep do you have on an average week night?"

A very large Chinese study, involving 28,670 older adults (50-85), of whom some 72% were women, also supports an inverted U-shaped association between sleep duration and cognitive function, with 7-8 hours sleep associated with the highest scores on a delayed word recall test.

I would speculate that this finding of an effect of short-term verbal memory (in contrast to that of the Whitehall study) may reflect a group distinction in terms of education and occupation. The Whitehall study is the more homogenous (mostly white-collar), with participants probably averaging greater cognitive reserve than the community-based Chinese study. The findings suggest that memory is slower to be affected, rather than not affected.

Reference: 

Ferrie JE; Shipley MJ; Akbaraly TN; Marmot MG; Kivimäki M; Singh-Manoux A. Change in sleep duration and cognitive function: findings from the Whitehall II study. SLEEP 2011;34(5):565-573.

Xu L; Jiang CQ; Lam TH; Liu B; Jin YL; Zhu T; Zhang WS; Cheng KK; Thomas GN. Short or long sleep duration is associated with memory impairment in older Chinese: the Guangzhou Biobank Cohort Study. SLEEP 2011;34(5):575-580.

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More evidence moderate alcohol consumption helps stave off dementia

April, 2011

More evidence that a moderate amount of alcohol helps protect against Alzheimer’s —but not vascular dementia or age-related cognitive decline.

A review of 23 longitudinal studies of older adults (65+) has found that small amounts of alcohol were associated with lower incidence rates of overall dementia and Alzheimer dementia, but not of vascular dementia or age-related cognitive decline. A three-year German study involving 3,327 adults aged 75+ extends the evidence to the older-old.

The study found alcohol consumption was significantly associated with 3 other factors that helped protect against dementia: better education, not living alone, and absence of depression. Nevertheless, the lower risk remained after accounting for these factors.

The ‘magic’ amount of alcohol was between 20-29g, roughly 2-3 drinks a day. As in other studies, a U-shaped effect was found, with higher risk found among both those who consumed less than this amount of alcohol, and those who consumed more.

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Long term exposure to pesticides linked to cognitive decline

April, 2011

A French study of vineyard workers points to lower cognitive performance and cognitive decline in those chronically exposed to pesticides.

A study involving 614 middle-aged vineyard workers has found that those who were exposed to pesticides were five times as likely to perform more poorly on cognitive tests compared to those not exposed, and twice as likely to show cognitive decline over a two-year period.

Participants were in their 40s and 50s and had worked for at least 20 years in the agricultural sector. One in five had never been exposed to pesticides as part of their job; over half had been directly exposed, and the remainder had been possibly or certainly indirectly exposed. Educational level, age, sex, alcohol consumption, smoking, psychotropic drug use and depressive symptoms were taken into account.

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Individual differences in learning motor skills reflect brain chemical

April, 2011

An imaging study demonstrates that people who are quicker at learning a sequence of finger movements have lower levels of the inhibitory chemical GABA.

What makes one person so much better than another in picking up a new motor skill, like playing the piano or driving or typing? Brain imaging research has now revealed that one of the reasons appears to lie in the production of a brain chemical called GABA, which inhibits neurons from responding.

The responsiveness of some brains to a procedure that decreases GABA levels (tDCS) correlated both with greater brain activity in the motor cortex and with faster learning of a sequence of finger movements. Additionally, those with higher GABA concentrations at the beginning tended to have slower reaction times and less brain activation during learning.

It’s simplistic to say that low GABA is good, however! GABA is a vital chemical. Interestingly, though, low GABA has been associated with stress — and of course, stress is associated with faster reaction times and relaxation with slower ones. The point is, we need it in just the right levels, and what’s ‘right’ depends on context. Which brings us back to ‘responsiveness’ — more important than actual level, is the ability of your brain to alter how much GABA it produces, in particular places, at particular times.

However, baseline levels are important, especially where something has gone wrong. GABA levels can change after brain injury, and also may decline with age. The findings support the idea that treatments designed to influence GABA levels might improve learning. Indeed, tDCS is already in use as a tool for motor rehabilitation in stroke patients — now we have an idea why it works.

Reference: 

[2202] Stagg, C J., Bachtiar V., & Johansen-Berg H.
(2011).  The Role of GABA in Human Motor Learning.
Current Biology. 21(6), 480 - 484.

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Why multitasking is more difficult with age

April, 2011

A new study reveals that older adults’ greater problems with multitasking stem from their impaired ability to disengage from an interrupting task and restore the original task.

Comparison of young adults (mean age 24.5) and older adults (mean age 69.1) in a visual memory test involving multitasking has pinpointed the greater problems older adults have with multitasking. The study involved participants viewing a natural scene and maintaining it in mind for 14.4 seconds. In the middle of the maintenance period, an image of a face popped up and participants were asked to determine its sex and age. They were then asked to recall the original scene.

As expected, older people had more difficulty with this. Brain scans revealed that, for both groups, the interruption caused their brains to disengage from the network maintaining the memory and reallocate resources to processing the face. But the younger adults had no trouble disengaging from that task as soon as it was completed and re-establishing connection with the memory maintenance network, while the older adults failed both to disengage from the interruption and to reestablish the network associated with the disrupted memory.

This finding adds to the evidence that an important (perhaps the most important) reason for cognitive decline in older adults is a growing inability to inhibit processing, and extends the processes to which that applies.

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