Chair Yoga May Improve Quality of Life in Dementia Patients

Chair yoga may help improve quality of life in older adults with moderate-to-severe dementia, according to a new study by Florida Atlantic University (FAU).

Chair yoga provides a safe environment for stretching, strengthening and flexibility while decreasing the risk of falls by using a chair. It also provides important breathing and relaxation techniques through stationary poses and guided relaxation of various muscle groups.

“We think that the physical poses we used in the chair yoga and chair-based exercise groups were an important factor in improving quality of life for the participants in our study,” said Juyoung Park, Ph.D., lead author and an associate professor in the Phyllis and Harvey Sandler School of Social Work within FAU’s College for Design and Social Inquiry.

“It is fascinating that, although some participants showed mild levels of agitation or wandering in the intervention room prior to the yoga session, they became calm and attentive when the yoga interventionist started demonstrating yoga poses.”

“Although they did not understand the interventionist’s verbal instructions due to their cognitive impairment associated with advanced dementia, they followed the instructor’s poses.”

For the study, published in the American Journal of Alzheimer’s Disease & Other Dementias, researchers from FAU compared chair yoga with two other types of non-pharmacological interventions: chair-based exercise and music intervention.

The study involved older adults (mean average age was 84 years old) with moderate-to-severe dementia, including Alzheimer’s disease (the largest diagnostic group), Lewy Body dementia and Parkinson disease dementia. The patients were unable to participate in regular exercise or standing yoga due to cognitive impairment, problems with balance, or fear of falling.

Participants in each of the three groups attended 45-minute sessions twice a week for 12 weeks. Researchers collected data at baseline, after six weeks and after completing the 12-week intervention.

Results showed that participants with moderate-to-severe dementia could safely adhere to non-pharmacological interventions, and more than 97% of the participants fully engaged in each session.

The findings show that those in the chair yoga group improved significantly in quality-of-life scores compared to the music intervention group. Both the chair yoga and chair-exercise groups showed improvement over time, while the music intervention group declined.

In addition, both the chair yoga and chair-based exercise groups showed lower depression across all three time points when compared to the music intervention group.

The team did not find any differences in the three intervention groups on physical function, with the exception of handgrip strength, which was higher in the chair yoga group compared to the music intervention group. None of the three groups declined significantly in any of the investigated physical functional measures.

Researchers also did not find any significant between-group differences in anxiety at any time point. There were no significant between-group differences in change in depression and anxiety. The researchers also did not find significant differences among the three intervention groups for sleep quality at any of the three time points.

“We did see an increase in agitation in the chair yoga group even though this group reported a higher quality of life score, including physical condition, mood, functional abilities, interpersonal relationships, ability to participate in meaningful activities, and final situations,” said Park.

“It’s important to note that quality of life is a more comprehensive approach to biopsychosocial and behavioral function than a mere measure of agitation. Meditation and the mind-body connection component of the chair yoga program may have increased quality of life for participants in this study. This finding is consistent with our earlier studies that showed a targeted approach was successful in increasing quality of life in patients with dementia.”

Source: Florida Atlantic University

Walking Patterns Differ Between Alzheimer’s Disease, Lewy Body Dementia

A new U.K. study reveals distinct walking variations between people with Lewy body dementia and those with Alzheimer’s disease.

Researchers from Newcastle University in England found that people with Lewy body dementia change their walking steps more often — varying step time and length — and are asymmetric when they move, in comparison to those with Alzheimer’s disease.

The study, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, suggests gait could be used as a clinical biomarker for various subtypes of dementia and could lead to improved treatment plans for patients.

“The way we walk can reflect changes in thinking and memory that highlight problems in our brain, such as dementia,” said Dr. Ríona McArdle, post-doctoral researcher at Newcastle University’s Faculty of Medical Sciences and leader of the Alzheimer’s Society-funded study.

“Correctly identifying what type of dementia someone has is important for clinicians and researchers as it allows patients to be given the most appropriate treatment for their needs as soon as possible.”

“The results from this study are exciting as they suggest that walking could be a useful tool to add to the diagnostic toolbox for dementia.

“It is a key development as a more accurate diagnosis means that we know that people are getting the right treatment, care and management for the dementia they have.”

Currently, diagnosis of either type of dementia is made by identifying specific symptoms and, when required, referring to a brain scan.

For the study, researchers analyzed the walking patterns of 110 people, including 29 older adults whose cognition was intact, 36 with Alzheimer’s disease and 45 with Lewy body dementia.

The participants took part in a simple walking test at the Gait Lab of the Clinical Ageing Research Unit. Participants moved along a walkway — a mat with thousands of sensors — which captured their footsteps and gait patterns as they walked across it at their normal speed.

Participants with Lewy body dementia had a unique walking pattern in that they changed how long it took to take a step or the length of their steps more frequently than someone with Alzheimer’s disease, whose walking patterns rarely changed.

When a person has Lewy body dementia, their steps are more irregular, and this is associated with increased fall risk. Their walking is more asymmetric in step time and stride length, meaning their left and right footsteps are different.

Scientists found that analyzing both step length variability and step time asymmetry could accurately identify 60% of all dementia subtypes — which has never been shown before.

Further research will aim to identify how these characteristics enhance current diagnostic procedures and assess their effectiveness as a screening method. It is hoped that this tool will be available within five years.

“We know that research will beat dementia and provide invaluable support for the 850,000 people living with the condition in the UK today. It’s now vital that we continue to support promising research of this kind,” said Dr. James Pickett, head of research at the Alzheimer’s Society. “We look forward to seeing larger, longer studies to validate this approach and shed light on the relationship between a person’s gait and dementia diagnosis.”

Source: Newcastle University

Study: Spread of Abnormal Proteins Explain Gender Difference in Alzheimer’s

New research suggests the way in which abnormal proteins spread throughout the brain may help explain why the prevalence of Alzheimer’s is higher in women than in men. If the results are confirmed, a need for sex-specific approaches for the prevention of Alzheimer’s disease may be indicated.

Over the last twenty years, scientists have linked an abnormal accumulation of tau proteins to cognitive impairment and Alzheimer’s disease. In the new investigation, researchers from the Center for Cognitive Medicine (CCI) at Vanderbilt University Medical Center identified differences in the spread of tau protein between men and women, with women showing a larger brain-wide accumulation of tau than men due to an accelerated brain-wide spread.

The findings were presented at a recent Alzheimer’s Association International Conference in Los Angeles.

Accumulating evidence suggests that tau spreads through brain tissue like an infection, traveling from neuron to neuron and turning other proteins into abnormal tangles, subsequently killing brain cells.

In the study, researchers used data from positron emission tomography (PET) scans of healthy individuals and patients with mild cognitive impairment who were enrolled in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. The CCI researchers then constructed in vivo networks modeling tau spread using graph theory analysis.

“It’s kind of like reconstructing a crime scene after a crime. You weren’t there when it happened, but you can determine where an intruder entered a house and what room they entered next,” said Sepi Shokouhi, PhD, assistant professor of Psychiatry and Behavioral Sciences and lead investigator for the study.

“The graph analysis does something similar to show how tau spreads from one region to another.”

The results of the analysis showed the architecture of tau networks is different in men and women, with women having a larger number of “bridging regions” that connect various communities in the brain.

This difference may allow tau to spread more easily between regions, boosting the speed at which it accumulates and putting women at greater risk for developing Alzheimer’s disease.

An accelerated spread of tau in women may indicate a need for gender-specific approaches for the prevention of Alzheimer’s disease. This may include earlier therapies, lifestyle interventions and/or cognitive remediation. Scientists note, however, that more studies are needed to validate the accelerated tau spread model in women.

“Understanding how different biological processes influence our memory is a really important topic. Sex-specific differences in the brain’s pathological, neuroanatomical and functional organization may map into differences at a neurobehavioral and cognitive level, thus explaining differences in the prevalence of neurodegenerative disorders and helping us develop appropriate treatments,” said Shokouhi.

Source: Vanderbilt University Medical Center/EurekAlert

AI May Revolutionize Detection and Management of Alzheimer’s

Alzheimer’s disease is a healthcare albatross lurking in the background to prey upon our aging population. Despite considerable attention to detection and management of Alzheimer’s disease (AD), significant gaps remain.

While many traditional memory assessment tools are available, deficiencies in screening and detection accuracy and reliability remain prevalent. New research suggests use of technology in the form of artificial intelligence (AI) may present a solution for testing and managing the complex human health condition.

Worldwide, about 44 million people are living with AD or a related form of dementia. Although 82 percent of seniors in the United States say it’s important to have their thinking or memory checked, only 16 percent say they receive regular cognitive assessments.

And even with the development of new, simple online tests, numerous integrated and complex factors complicate the interpretation of memory evaluation test results. This presents a real challenge for clinicians and is a collective barrier for addressing the growing and widespread prevalence of AD.

As such, a team of researchers at Florida Atlantic University’s College of Engineering and Computer Science, SIVOTEC Analytics, HAPPYneuron, MemTrax, and Stanford University School of Medicine, believe AI can significantly help address these complex issues.

One challenge is determining the reliability and validity of new assessment instruments such as MemTrax — a very simple online memory test using image recognition. MemTrax is a supervised machine learning and predictive modeling tool that can serve as a clinical decision support screening tool for assessing cognitive impairment.

As published in the Journal of Alzheimer’s Disease, researchers determined MemTrax is an effective tool that can be administered as part of the online Continuous Recognition Tasks (M-CRT) test, in screening for variations in cognitive brain health.

Notably, a comparison of MemTrax to the recognized and widely utilized Montreal Cognitive Assessment Estimation of mild cognitive impairment underscores the power and potential of this new online tool. MemTrax improves the ability to evaluate short-term memory and aids in diagnostic support for cognitive screening and assessment for a variety of clinical conditions and impairments including dementia.

“Machine learning has an inherent capacity to reveal meaningful patterns and insights from a large, complex inter-dependent array of clinical determinants and the ability to continue to ‘learn’ from ongoing utility of practical predictive models,” said Taghi Khoshgoftaar, PhD, co-author and Motorola Professor in FAU’s Department of Computer and Electrical Engineering and Computer Science.

“Seamless use and real-time interpretation will enhance case management and patient care through innovative technology and practical and readily usable integrated clinical applications that could be developed into a hand-held device and app.”

For the study, the researchers used an existing dataset, which includes data from more than 18,000 individuals. They examined answers to general health screening questions (addressing memory, sleep quality, medications, and medical conditions affecting thinking) and demographic information. They also reviewed the test results from adults who took the MemTrax (M-CRT) test for episodic-memory screening.

“Findings from our study provide an important step in advancing the approach for clinically managing a very complex condition like Alzheimer’s disease,” said Michael F. Bergeron, PhD, senior author.

“By analyzing a wide array of attributes across multiple domains of the human system and functional behaviors of brain health, informed and strategically directed advanced data mining, supervised machine learning, and robust analytics can be integral, and in fact necessary, for health care providers to detect and anticipate further progression in this disease and myriad other aspects of cognitive impairment.”

AD is the sixth leading cause of death in the United States, affecting 5.8 million Americans. According to the Alzheimer’s Association, this number is projected to rise to 14 million by 2050. In 2019, AD and other dementias will cost the nation $290 billion. By 2050, these costs could rise as high as $1.1 trillion.

“With its widespread prevalence and escalating incidence and public health burden, it is imperative to ensure that the tools clinicians use for testing and managing Alzheimer’s disease and other related cognitive conditions are optimal,” said Stella Batalama, PhD, dean of FAU’s College of Engineering and Computer Science.

“Results from this important study provide new insights and discovery that has set the stage for future impactful and significant research.”

Source: Florida Atlantic University/EurekAlert
Photo: A team of researchers at Florida Atlantic University’s College of Engineering and Computer Science, SIVOTEC Analytics, HAPPYneuron, MemTrax, and Stanford University School of Medicine introduce supervised machine learning as a modern approach and new value-added complementary tool in cognitive brain health assessment and related patient care and management. Credit: Florida Atlantic University.

Older Adults Who Fall for Scams May Be at Greater Risk for Dementia

Older adults are often targeted by con-artists and are highly vulnerable to scams and fraud, particularly scams that are financial in nature. Now a new study finds that older adults who easily fall for these scams may be at greater risk of developing Alzheimer’s dementia or mild cognitive impairment.

The findings, published in the Annals of Internal Medicine, suggest that changes in social judgment may occur before any obvious changes in thinking or memory.

Researchers from Rush Alzheimer’s Disease Center in Chicago asked 935 dementia-free older adults to complete a “scam awareness questionnaire” to calculate a scam awareness score. For approximately 6 years, participants also completed traditional neuropsychological tests each year, and the 264 participants who died had an autopsy of the brain to look for the hallmarks of Alzheimer’s disease.

The research team found that low scam awareness was a predictor of poor cognitive outcomes. Low scam awareness was also linked to Alzheimer’s disease pathology in the brain. According to the researchers, the findings suggest that low scam awareness is an early sign of impending mild cognitive impairment and dementia.

The researchers conclude that screening for behaviors such as scam awareness may help to identify people at risk for dementia before cognitive symptoms begin to surface.

An older adult who is defrauded may end up unable to pay for medications, food, and long-term care, the author wrote. The author provides an example of a patient who was scammed out of the majority of his life savings by a con-artist who tricked him into thinking he had won the lottery.

Reduced financial capacity, financial abuse and exploitation are major economic and public health problems. As such, the new findings should be a call to action for health care systems, the financial services industry and their regulators to protect the health and wealth of our aging population.

Source: American College of Physicians

Mouse Study: Why Heart Failure Patients Often Struggle With Depression, Impaired Thinking

Heart failure patients often struggle with neurological issues, including depression and thinking problems, but the reasons for this have remained unclear. In a new paper published in the journal Scientific Reports, Canadian researchers from the University of Guelph (U of G) use a mouse model to explain how the circadian rhythm may play a role in this heart-brain connection.

“Neurosurgeons always look in the brain; cardiologists always look in the heart. This new study looked at both,” said Tami Martino, a professor in U of G’s department of biomedical sciences and director of the Centre for Cardiovascular Investigations.

Human patients with heart failure often have neurological problems such as cognitive impairment and depression, said Martino. She suspected the heart-brain connection may involve the circadian mechanism molecule, called “clock.”

Circadian rhythms in humans and other organisms follow Earth’s 24-hour cycle of light and darkness, signaling when to sleep and when to be awake. Martino’s previous research showed how disrupting circadian rhythms — as with shift workers, jet-lagged travelers and patients disturbed in intensive-care units — can trigger changes that worsen heart disease and impair overall health and well-being.

In the new study, the researchers compared normal mice with mice carrying a mutation in their circadian mechanism (called “clock mice”). They found that the mutation impacted the structure of neurons in brain areas important for cognition and mood. Working with University of Toronto colleagues, the team also found differences in clock regulation of blood vessels in the brains of the clock mice.

After inducing heart failure in mice to simulate human heart failure, they identified key genes in the brain that were altered in neural growth, stress and metabolism pathways. The results show that the circadian mechanism influences neural effects of heart failure, said Martino. Pointing out that no cure exists for the heart condition, she said understanding how the circadian mechanism works in the brain may lead to new strategies to improve patients’ quality of life.

For example, patients recovering from heart attacks often experience disturbed circadian rhythms from light, noise and interactions with hospital staff at night. “Maintaining circadian rhythms especially for patients with heart disease could lead to better health outcomes,” said Martino.

The study also points to potential health benefits for people in general. Avoiding shift work for individuals with underlying heart conditions or sleep disorders, reducing light at night or avoiding social jet lag (going to bed late and waking up later than usual on weekends) could all help reduce neurobiological impairments.

These problems — and potential solutions — involve not just hearts but brains, she said. “If we’re not yet able to cure heart failure, we should at least be focusing on how we can improve quality of life for patients.”

Source: University of Guelph