‘Brain training’ app found to improve memory in people with mild cognitive impairment

A ‘brain training’ game could help improve the memory of patients in the very earliest stages of dementia, suggests a new study. |  International Journal of Neuropsychopharmacology. | via ScienceDaily

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Researchers from the University of Cambridge have developed a memory game app, ‘Game Show’,  and have tested its effects on cognition and motivation in patients with amnestic mild cognitive impairment (aMCI).

The researchers randomly assigned forty-two patients with amnestic MCI to either the cognitive training or control group. Participants in the cognitive training group played the memory game for a total of eight one-hour sessions over a four-week period; participants in the control group continued their clinic visits as usual.

The results showed that patients who played the game made around a third fewer errors, needed fewer trials and improved their memory score by around 40%, showing that they had correctly remembered the locations of more information at the first attempt on a test of episodic memory.

In addition, participants in the cognitive training group indicated that they enjoyed playing the game and were motivated to continue playing across the eight hours of cognitive training. Their confidence and subjective memory also increased with gameplay. The researchers say that this demonstrates that games can help maximise engagement with cognitive training.

The findings of the study were published this month in The International Journal of Neuropsychopharmacology suggests

Read more on this story via ScienceDaily and at NHS Choices

Full reference:
Savulich, G et al. Cognitive Training Using a Novel Memory Game on an iPad in Patients with Amnestic Mild Cognitive Impairment (aMCI). International Journal of Neuropsychopharmacology, published online July 2nd 2017

The use of vitamin E in the treatment of mild cognitive impairment and dementia

Cochrane review finds no evidence that Vitamin E supplementation given to people with mild cognitive impairment (MCI) would help to prevent or delay the progression to dementia. Similarly, there is no evidence that Vitamin E supplementation improves cognitive function in people with MCI or dementia due to Alzheimer’s Disease. | Cochrane Database of Systematic Reviews

Vitamin E is found in a variety of foods, including vegetable oils and fats, nuts and seeds. Some animal and non-interventional studies have suggested it might have a role in the prevention or treatment of Alzheimer’s disease (AD). However, evidence has linked vitamiE with potentially serious side effects and even an increased risk of death. This review looked for evidence about the effect of vitamin E on people who had either dementia due to Alzheimer’s Disease or milder problems with memory or thinking (mild cognitive impairment).

The review concluded that from limited evidence, there was nothing to suggest that there are either benefits or harms from vitamin E supplements. As the quality of evidence was only moderate, the authors suggest further trials are needed to confirm the findings.

 Full reference: Farina, N et al. Vitamin E for Alzheimer’s dementia and mild cognitive impairment. Cochrane Database of Systematic Reviews. 2017 Apr 18;4

Hearing Loss and Risk of Mild Cognitive Impairment and Dementia

Heywood R. et al. (2017) Dementia & Geriatric Cognitive Disorders. 43(5-6) pp. 259-268

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Image source: mike krzeszak – Flickr // CC BY-ND 2.0

Aim: To investigate the associations between hearing loss and prevalent and incident mild cognitive impairment (MCI), dementia and MCI or dementia (all cases).

Conclusions: Hearing loss is independently associated with prevalent dementia and incident MCI or dementia

Read the full abstract here

Is the Mediterranean diet a feasible approach to preserving cognitive function and reducing risk of dementia for older adults in Western countries? New insights and future directions.

Knight, A. et al. Ageing Research & Reviews. 2016 Jan;25:85-101

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Image source: USDA

Abstract:

The rise in the ageing population has resulted in increased incident rates of cognitive impairment and dementia. The subsequent financial and societal burden placed on an already strained public health care system is of increasing concern.

Evidence from recent studies has revealed modification of lifestyle and dietary behaviours is, at present, the best means of prevention. Some of the most important findings, in relation to the Mediterranean diet (MedDiet) and the contemporary Western diet, and potential molecular mechanisms underlying the effects of these two diets on age-related cognitive function, are discussed in this review.

A major aim of this review was to discuss whether or not a MedDiet intervention would be a feasible preventative approach against cognitive decline for older adults living in Western countries. Critical appraisal of the literature does somewhat support this idea. Demonstrated evidence highlights the MedDiet as a potential strategy to reduce cognitive decline in older age, and suggests the Western diet may play a role in the aetiology of cognitive decline. However, strong intrinsic Western socio-cultural values, traditions and norms may impede on the feasibility of this notion.

Read the abstract here

Greater weight loss during aging associated with increased risk of mild cognitive impairment

An overview of the original research article and commentaries

1. Alhurani, R. et al. Decline in Weight and Incident Mild Cognitive Impairment. JAMA Neurology. Published online: February 01 2016.

Importance: Unintentional weight loss has been associated with risk of dementia. Because mild cognitive impairment (MCI) is a prodromal stage for dementia, we sought to evaluate whether changes in weight and body mass index (BMI) may predict incident MCI.

Objective: To investigate the association of change in weight and BMI with risk of MCI.

Design, Setting, and Participants: A population-based, prospective study of participants 70 years of age or older from the Mayo Clinic Study of Aging, which was initiated on October 1, 2004. Maximum weight and height in midlife (40-65 years of age) were retrospectively ascertained from the medical records of participants using a medical records–linkage system. The statistical analyses were performed between January and November 2015.

Main Outcomes and Measures: Participants were evaluated for cognitive outcomes of normal cognition, MCI, or dementia at baseline and prospectively assessed for incident events at each 15-month evaluation. The association of rate of change in weight and BMI with risk of MCI was investigated using proportional hazards models.

Results: Over a mean follow-up of 4.4 years, 524 of 1895 cognitively normal participants developed incident MCI (50.3% were men; mean age, 78.5 years). The mean (SD) rate of weight change per decade from midlife to study entry was greater for participants who developed incident MCI vs those who remained cognitively normal (−2.0 [5.1] vs −1.2 [4.9] kg; P = .006). A greater decline in weight per decade was associated with an increased risk of incident MCI (hazard ratio [HR], 1.04 [95% CI, 1.02-1.06]; P < .001) after adjusting for sex, education, and apolipoprotein E (APOE) ε4 allele. A weight loss of 5 kg per decade corresponds to a 24% increase in risk of MCI (HR, 1.24). A higher decrease in BMI per decade was also associated with incident MCI (HR, 1.08 [95% CI, 1.03-1.13]; P = .003).

Conclusions and Relevance  These findings suggest that increasing weight loss per decade from midlife to late life is a marker for MCI and may help identify persons at increased risk for MCI.

Read the original research abstract here

2. Alzheimer’s Society. Greater weight loss during aging associated with increased risk of mild cognitive impairment, study suggests. Published 1 February 2016.

Increasing weight loss per decade as people aged from midlife to later life has been associated with an increased risk of mild cognitive impairment (MCI).

Researchers identified 524 of 1,895 cognitively normal participants who developed MCI. Others factors may have played a role, as those who developed MCI were older, more likely to be carriers of a specific gene, and more likely to have diabetes, hypertension, stroke or coronary artery disease compared with study participants who remained cognitively normal.

Participants who developed MCI had a greater average weight change per decade from midlife than those who remained cognitively normal (-4.4 lbs vs. -2.6 lbs).
People with MCI are at an increased risk of developing dementia.

Read the full commentary here

3. Greater weight loss during aging associated with increased risk for mild cognitive impairment. ScienceDaily. Published 1 February 2016.

MCI is a prodromal (early) stage of dementia with about 5 percent to 15 percent of people with MCI progressing to dementia per year. Changes in body mass index (BMI) and weight are associated with increased risk of dementia but overall study findings have been inconclusive. An association of declining weight and BMI with MCI could have implications for preventive strategies for MCI.

Rosebud O. Roberts, M.B., Ch.B., of the Mayo Clinic, Rochester, Minn., and coauthors studied participants 70 or older from the Mayo Clinic Study of Aging, which started in 2004. Height and weight in midlife (40 to 65 years old) were collected from medical records.

During an average of 4.4 years of follow-up, the authors identified 524 of 1,895 cognitively normal participants who developed MCI (about 50 percent were men and their average age was 78.5 years). Those who developed MCI were older, more likely to be carriers of the APOE*E4 allele and more likely to have diabetes, hypertension, stroke or coronary artery disease compared with study participants who remained cognitively normal.

Read the full commentary here

 

 

Marked gender differences in progression of mild cognitive impairment over 8 years

Alzheimer’s & Dementia: September 2015 Volume 1, Issue 2, Pages 103–110

Abstract
Introduction
This study examined whether, among subjects with mild cognitive impairment (MCI), women progressed at faster rates than men.

Methods
We examine longitudinal rates of change from baseline in 398 MCI subjects (141 females and 257 males) in the Alzheimer’s Disease Neuroimaging Initiative-1, followed for up to 8 years (mean, 4.1 ± 2.5 years) using mixed-effects models incorporating all follow-ups (mean, 8 ± 4 visits).

Results
Women progressed at faster rates than men on the Alzheimer’s disease assessment scale-cognitive subscale (ADAS-Cog; P = .001) and clinical dementia rating-sum of boxes (CDR-SB; P = .003). Quadratic fit for change over time was significant for both ADAS-Cog (P = .001) and CDR-SB (P = .004), and the additional acceleration in women was 100% for ADAS-Cog and 143% for CDR-SB. The variability of change was greater in women. The gender effect was greater in apolipoprotein E (APOE) ε4 carriers.

Discussion
Women with MCI have greater longitudinal rates of cognitive and functional progression than men. Studies to confirm and uncover potential mechanisms appear to be warranted.

Marked gender differences in progression of mild cognitive impairment over 8 years

Available online 21 July 2015

Introduction

This study examined whether, among subjects with mild cognitive impairment (MCI), women progressed at faster rates than men.

Methods

We examine longitudinal rates of change from baseline in 398 MCI subjects (141 females and 257 males) in the Alzheimer’s Disease Neuroimaging Initiative-1, followed for up to 8 years (mean, 4.1 ± 2.5 years) using mixed-effects models incorporating all follow-ups (mean, 8 ± 4 visits).

Results

Women progressed at faster rates than men on the Alzheimer’s disease assessment scale-cognitive subscale (ADAS-Cog; P = .001) and clinical dementia rating-sum of boxes (CDR-SB; P = .003). Quadratic fit for change over time was significant for both ADAS-Cog (P = .001) and CDR-SB (P = .004), and the additional acceleration in women was 100% for ADAS-Cog and 143% for CDR-SB. The variability of change was greater in women. The gender effect was greater in ApoE4 carriers.

Discussion

Women with MCI have greater longitudinal rates of cognitive and functional progression than men. Studies to confirm and uncover potential mechanisms appear to be warranted.

via Marked gender differences in progression of mild cognitive impairment over 8 years.

Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment

Alzheimer’s & Dementia – Published Online: June 18, 2015

Abstract:

Neuropsychiatric symptoms (NPS) are common in dementia and in predementia syndromes such as mild cognitive impairment (MCI). NPS in MCI confer a greater risk for conversion to dementia in comparison to MCI patients without NPS.

NPS in older adults with normal cognition also confers a greater risk of cognitive decline in comparison to older adults without NPS. Mild behavioral impairment (MBI) has been proposed as a diagnostic construct aimed to identify patients with an increased risk of developing dementia, but who may or may not have cognitive symptoms.

We propose criteria that include MCI in the MBI framework, in contrast to prior definitions of MBI. Although MBI and MCI can co-occur, we suggest that they are different and that both portend a higher risk of dementia. These MBI criteria extend the previous literature in this area and will serve as a template for validation of the MBI construct from epidemiologic, neurobiological, treatment, and prevention perspectives.

via Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment – Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.