Mindfulness Meditation May Benefit Older Adults with Mild Cognitive Impairment

Mindfulness meditation may benefit older adults with mild cognitive impairment (MCI), according to a small pilot study published in the Journal of Alzheimer’s Disease.

There’s currently no known way to prevent older adults with MCI from developing Alzheimer’s disease, but mindfulness meditation may be a safe and feasible non-pharmacological treatment that can help.

Mindfulness means maintaining a moment-by-moment, non-judgmental awareness of thoughts, feelings, bodily sensations, and surrounding environment.

“Our study showed promising evidence that adults with MCI can learn to practice mindfulness meditation, and by doing so may boost their cognitive reserve,” said Rebecca Erwin Wells, MD, MPH, associate professor of neurology at Wake Forest School of Medicine, a practicing neurologist at Wake Forest Baptist Medical Center and associate director of clinical research for its Center for Integrative Medicine.

Cognitive reserve is a person’s capacity to maintain normal cognitive function in the presence of deteriorating brain function.

“While the concept of mindfulness meditation is simple, the practice itself requires complex cognitive processes, discipline and commitment,” Wells explained. “This study suggests that the cognitive impairment in MCI is not prohibitive of what is required to learn this new skill.”

Previous research has shown that high levels of chronic stress negatively impact the hippocampus, a part of the brain involved in memory and learning, and are associated with increased incidence of MCI and Alzheimer’s. Other studies have indicated that non-drug interventions such as aerobic exercise can have positive effects on cognition, stress levels and the brain.

To determine whether a mindfulness-based stress-reduction (MBSR) program could benefit adults with MCI, the study team recruited 14 men and women between the ages of 55 and 90 with clinically diagnosed MCI and randomized them to either an eight-week course involving mindfulness meditation and yoga or a “waiting list” control group.

The researchers previously reported that the nine participants who completed the MBSR program showed trends toward improvements on measures of cognition and well-being and indications of positive impacts on the hippocampus as well as other areas of the brain associated with cognitive decline.

The new study adds context to those findings with an analysis of the MBSR participants’ responses in interviews conducted at the end of the eight-week course.

“While the MBSR course was not developed or structured to directly address MCI, the qualitative interviews revealed new and important findings specific to MCI,” Wells said. “The participants’ comments and ratings showed that most of them were able to learn the key tenets of mindfulness, demonstrating that the memory impairment of MCI does not preclude learning such skills.”

Participants who practiced at least 20 minutes a day were most likely to have understood the underlying concepts of mindfulness, Wells noted.

“Until treatment options that can prevent the progression to Alzheimer’s are found, mindfulness meditation may help patients living with MCI,” said Well.

The limitations of the study include the small sample size and that the results may not generalize to all patients with MCI, as two-thirds of the participants in this study had a college education or more. Additional research is needed to further test the preliminary hypotheses contained in this study.

Source: Wake Forest Baptist Medical Center

Adults With Family History of Alzheimer’s Show Reduced Scores in Memory Test

In a new study of more than 59,000 people who completed an online memory test, researchers found that adults with a first-degree relative with Alzheimer’s disease performed worse than participants without a family history of the disease.

The findings, published in the journal eLife, also show that this impairment appears to be worsened by having diabetes or a variation in the Alzheimer’s-linked gene called apolipoprotein E (APOE), while being female or having a higher education were seen as protective factors.

Although having a family history of Alzheimer’s is a well-known risk factor for developing the condition, the effects on learning and memory throughout an individual’s life are less clear.

“Identifying factors that reduce or eliminate the effect of a family history of Alzheimer’s disease is particularly crucial since there is currently no cure or effective disease-slowing treatments,” says lead author Joshua Talboom, Ph.D., a Postdoctoral Fellow at the Translational Genomics Research Institute in Arizona.

And while some studies have tackled this subject, most have been too small to draw any significant conclusions. So in order to recruit a large pool of participants, the research team created an easy-to-use website (http://www.mindcrowd.org) where individuals could log on and complete a memory test.

A total of 59,571 participants were asked to learn 12-word pairs and were then tested on their ability to complete the missing half of the pair when presented with one of the words.

The volunteers were also asked to answer questions about their sex, education, age, language, country and health, including a question about whether one of their parents or siblings had been diagnosed with Alzheimer’s disease.

The results show that participants with a family history of Alzheimer’s were able to match about two and one-half fewer word pairs than those without a family history. Having diabetes appeared to compound the learning impairments seen in individuals with a family history.

In addition, a subset of 742 participants who had a close relative with Alzheimer’s submitted a sample of dried blood or saliva that the researchers tested for a genetic variation in the APOE gene linked to the disease.

“The APOE genotype is an important genetic factor that influences memory, and we found that those with the variation performed worse on the memory test than those without the variation,” Talboom said.

Certain characteristics, however, appeared to protect against memory and learning impairments in people with a family history of Alzheimer’s disease: Those with higher levels of education showed less of a decline in scores on the learning and memory test than people with lower levels of education, even when they have a family history of the disease. Women also appear to fair better despite having Alzheimer’s disease risk factors.

“Our study supports the importance of living a healthy lifestyle, properly treating diseases such as diabetes, and building learning and memory reserve through education to reduce the cognitive decline associated with Alzheimer’s disease risk factors,” said senior author Matthew Huentelman, Professor of Neurogenomics at the Translational Genomics Research Institute, Arizona.

Source: eLife

Study: Midlife Sleep Problems May Up Risk of Alzheimer’s

A new study suggests that people who report a declining quality of sleep as they age from their 50s to their 60s have a higher risk of developing Alzheimer’s disease later in life. The study appears online in the Journal of Neuroscience.

Psychologists at the University of California, Berkeley discovered a link between insufficient sleep and the presence of beta-amyloid protein in their brains — a biomarker associated with the development of Alzheimer’s.

Experts believe the new finding highlights the importance of sleep at every age to maintain a healthy brain into old age.

“Insufficient sleep across the lifespan is significantly predictive of your development of Alzheimer’s disease pathology in the brain,” said the study’s senior author, Matthew Walker, a sleep researcher and professor of psychology.

“Unfortunately, there is no decade of life that we were able to measure during which you can get away with less sleep. There is no Goldilocks decade during which you can say, ‘This is when I get my chance to short sleep.’”

Walker and his colleagues, including graduate student and first author Joseph Winer, found that adults reporting a decline in sleep quality in their 40s and 50s had more beta-amyloid protein in their brains later in life, as measured by positron emission tomography, or PET.

Those reporting a sleep decline in their 50s and 60s had more tau protein tangles. Both beta-amyloid and tau clusters are associated with a higher risk of developing dementia, though not everyone with protein tangles goes on to develop symptoms of dementia.

Based on the findings, the authors recommend that doctors ask older patients about changes in sleep patterns and intervene when necessary to improve sleep to help delay symptoms of dementia.

Proactive measures to improve sleep could include treatment for apnea, which leads to snoring and frequent halts in breathing that interrupt sleep, and cognitive behavioral therapy for insomnia (CBT-I).

CBT is a highly effective way to develop healthy sleep habits. Individuals may benefit from simple sleep counseling to convince patients to set aside time for a full eight hours of sleep and simple sleep hygiene tricks to accomplish that.

“The idea that there are distinct sleep windows across the lifespan is really exciting. It means that there might be high-opportunity periods when we could intervene with a treatment to improve people’s sleep, such as using cognitive behavioral therapy for insomnia,” Winer said.

“Beyond the scientific advance, our hope is that this study draws attention to the importance of getting more sleep and points us to the decades in life when intervention might be most effective.”

The 95 subjects in the study were part of the Berkeley Aging Cohort Study (BACS), a group of healthy older adults — some as old as 100 years of age — who have had their brains scanned with PET, the only technique capable of detecting both beta-amyloid tangles and, very recently, tau tangles, in the brain.

The team also made a second discovery. They found that people with high levels of tau protein in the brain were more likely to lack the synchronized brain waves associated with a good night’s sleep. The synchronization of slow brain waves throughout the cortex of the sleeping brain, in lockstep with bursts of fast brain waves called sleep spindles, takes place during deep or non-rapid eye movement (NREM) sleep.

The investigators discovered that the more tau protein older adults had, the less synchronized these brain waves were. This impaired electrical sleep signature may therefore act as a novel biomarker of tau protein in the human brain.

“There is something special about that synchrony,” given the consequences of this tau protein disruption of sleep, Walker said.

“We believe that the synchronization of these NREM brain waves provides a file-transfer mechanism that shifts memories from a short-term vulnerable reservoir to a more permanent long-term storage site within the brain, protecting those memories and making them safe.

But when you lose that synchrony, that file-transfer mechanism becomes corrupt. Those memory packets don’t get transferred, as well, so you wake up the next morning with forgetting rather than remembering.”

Indeed, last year, Walker and his team demonstrated that synchronization of these brain oscillations helps consolidate memory, that is, hits the “save” button on new memories.

Several years ago, Walker and his colleagues initially showed that a dip in the amplitude of slow wave activity during deep NREM sleep was associated with higher amounts of beta-amyloid in the brain and memory impairment. Combined with these new findings, the results help identify possible biomarkers for later risk of dementia.

“It is increasingly clear that sleep disruption is an under-appreciated factor contributing to Alzheimer’s disease risk and the decline in memory associated with Alzheimer’s,” Walker said. “Certainly, there are other contributing factors: genetics, inflammation, blood pressure. All of these appear to increase your risk for Alzheimer’s disease. But we are now starting to see a new player in this space, and that new player is called insufficient sleep.”

The brain rhythms were recorded over a single eight-hour night in Walker’s UC Berkeley sleep lab, during which most of the 31 subjects wore a cap studded with 19 electrodes that recorded a continual electroencephalogram (EEG). All had previously had brain scans to assess their burdens of tau and beta-amyloid that were done using a PET scanner, operated by study co-author William Jagust, professor of public health and a member of Berkeley’s Helen Wills Neuroscience Institute.

Experts are investigating if sleep is a biomarker for dementia. Physicians have been searching for early markers of dementia for years, in hopes of intervening to stop the deterioration of the brain. Beta-amyloid and tau proteins are predictive markers, but only recently have they become detectable with expensive PET scans that are not widely accessible.

Yet, while both proteins escalate in the brain in old age and perhaps to a greater extent in those with dementia, it is still unknown why some people with large burdens of amyloid and tau do not develop symptoms of dementia.

“The leading hypothesis, the amyloid cascade hypothesis, is that amyloid is what happens first on the path to Alzheimer’s disease. Then, in the presence of amyloid, tau begins to spread throughout the cortex, and if you have too much of that spread of tau, that can lead to impairment and dementia,” Winer said.

Walker added that, “A lack of sleep across the lifespan may be one of the first fingers that flicks the domino cascade and contributes to the acceleration of amyloid and tau protein in the brain.”

The hypothesis is supported in part by Jagust’s PET studies, which have shown that higher levels of beta-amyloid and tau protein tangles in the brain are correlated with memory decline, tau more so than amyloid. Tau occurs naturally inside the brain’s neurons, helping to stabilize their internal skeleton.

With age, tau proteins seem to accumulate inside cells of the medial temporal lobe, including the hippocampus, the seat of short-term memory. Only later do they spread more widely throughout the cortex.

While Jagust has run PET scans on the brains of many healthy people, as well as those with dementia, many more subjects are needed to confirm the relationship between protein tangles and dementias like Alzheimer’s disease. Because PET scanners are currently expensive and rare, and because they require injection of radioactive tracers, other biomarkers are needed, Walker said.

The new study suggests that sleep changes detectable in a simple overnight sleep study may be less intrusive biomarkers than a PET scan.

“As wearable technology improves, this need not be something you have to come to a sleep laboratory for,” said Walker.

“Our hope is that, in the future, a small head device could be worn by people at home and provide all the necessary sleep information we’d need to assess these Alzheimer’s disease proteins. We may even be able to track the effectiveness of new drugs aimed at combating these brain proteins by assessing sleep.”

“I think the message is very clear,” Walker added. “If you are starting to struggle with sleep, then you should go and see your doctor and find ways, such as CBT-I, that can help you improve your sleep. The goal here is to decrease your chances of Alzheimer’s disease.”

Source: University of California Berkeley/EurekAlert
 
Photo: Greater levels of pathological tau protein, primarily in the brain’s medial temporal lobe (orange and yellow at bottom in cross section of the brain), were associated with weaker synchrony of slow waves (red) and sleep spindles (orange), two brain waves important for storing memories while we sleep. Credit: UC Berkeley image by Matthew Walker and Joseph Winer.

Mobile Game Can Detect Risk of Alzheimer’s

UK researchers have announced the development of a mobile phone game that can detect people at risk of Alzheimer’s. The app is designed to help researchers better understand dementia by seeing how the brain works in relation to spatial navigation.

University of East Anglia researchers report that more than 4.3 million people worldwide have downloaded and played the Sea Heron Quest app. The game was created by Deutsche Telekom in partnership with Alzheimer’s Research UK, University College London (UCL), the University of East Anglia and game developers, Glitchers.

Investigators studied the gaming data comparing how people who are genetically pre-disposed to Alzheimer’s disease play the game compared to people who are not.

During the game, players make their way through mazes of islands and icebergs. Researchers then translate every 0.5 seconds of gameplay into scientific data.

The results, published in the journal PNAS, show that people who are genetically at risk of developing Alzheimer’s disease can be distinguished from those who are not on specific levels of the Sea Hero Quest game.

The findings are particularly important because a standard memory and thinking test could not distinguish between the risk and non-risk groups.

Lead researcher, Professor Michael Hornberger, from UEA’s Norwich Medical School, said: “Dementia will affect 135 million people worldwide by 2050. We need to identify people earlier to reduce their risk of developing dementia in the future.

“Current diagnosis of dementia is strongly based on memory symptoms, which we know now are occurring when the disease is quite advanced. Instead, emerging evidence shows that subtle spatial navigation and awareness deficits can precede memory symptoms by many years.

“Our current findings show that we can reliably detect such subtle navigation changes in at-genetic-risk of Alzheimer’s disease healthy people without any problem symptoms or complaints. Our findings will inform future diagnostic recommendations and disease treatments to address this devastating disease.”

Investigators explain that the data collected by the Sea Hero Quest app is vital for their on-going research because every two minutes spent playing the game is equal to five hours of lab-based research. And having three million players globally equates to more than 1,700 years’ worth of lab-based research.

The team studied gaming data taken from 27,108 UK players aged between 50-75 — the most vulnerable age group to develop Alzheimer’s in the next decade.

They compared this benchmark data with a smaller lab-based group of 60 people who underwent genetic testing.
In the smaller lab group, 31 volunteers carried the APOE4 gene, which is known to be linked with Alzheimer’s disease, and 29 people did not. Both lab groups were matched for age, gender, education and nationality with the benchmark cohort.

Genetic risk for Alzheimer’s is complicated. People (around one in every four) who have one copy of the APOE4 gene are around three times more likely to be affected by Alzheimer’s and develop the disease at a younger age.

Professor Hornberger said, “We found that people with a high genetic risk, the APOE4 carriers, performed worse on spatial navigation tasks. They took less efficient routes to checkpoint goals.

“This is really important because these are people with no memory problems.

“Meanwhile, those without the APOE4 gene travelled roughly the same distance as the 27,000 people forming the baseline score. This difference in performance was particularly pronounced where the space to navigate was large and open.

“It means that we can detect people who are at genetic risk of Alzheimer’s based on how they play the game.”

Intriguingly, researchers have found that people in different countries and populations navigate through the Sea Hero Quest differently.

This research shows that data collected from people who downloaded and played Sea Hero Quest can be used as a benchmark to help identify those at a genetically higher risk of developing Alzheimer’s in smaller groups of people,” reports Gillian Coughlan, also from UEA’s Norwich Medical School.

“Sea Hero Quest succeeded where a conventional memory and thinking test failed. It demonstrates the power of harnessing large-scale citizen science projects and applying big data technologies to help improve the early detection of diseases like Alzheimer’s.

“This global Sea Hero Quest project provides an unprecedented chance to study how many thousands of people from different countries and cultures navigate space. It is helping to shed light on how we use our brain to navigate and also to aid the development of more personalized measures for future diagnostics and drug treatment programs in dementia research.

“This is the tip of the iceberg and there is still a lot more work to do to extract and capitalize on the wealth of data collected through the Deutsche Telekom’s Sea Hero Quest project.”

Professor Hugo Spiers, from UCL, explained, “Our discovery highlights the value of bringing together big data with precise data to aid the development of digital tools for medical diagnoses.”

Hilary Evans, Chief Executive at Alzheimer’s Research UK, added, “We often hear heart-breaking stories about people with dementia who get lost and can’t find their way home, and we know spatial navigation difficulties like these are some of the earliest warning signs for the condition.

“Research shows us that the brain changes associated with diseases like Alzheimer’s begin decades before symptoms like memory loss start, and for future Alzheimer’s treatments to be effective, it’s likely they must be given at the earliest stages of disease, before there’s too much damage to the brain.

“Using big data to help improve the early and accurate detection of the diseases that cause dementia can help revolutionize how we research and treat the condition. Sea Hero Quest is an amazing example of how pioneering research can help scientists get one step closer to a life-changing breakthrough.”

Hans-Christian Schwingen, Chief Brand Officer at Deutsche Telekom, said, “What Sea Hero Quest has demonstrated is the unique power of innovative cross sector partnerships in advancing research. We are very proud to have been a part of facilitating such a revolutionary project and are excited to see the future insights generated through analysis of the data set collected.”

Source: University of East Anglia

Brain Stimulation Improves Memory of Older Adults

A new study finds that stimulating the brain’s memory center with electromagnetic pulses improves the memory of older adults to the level of young adults. Specifically, Northwestern medical school researchers discovered precise stimulation to the hippocampus dramatically improved the memory of older adults with age-related memory loss.

“Older people’s memory got better up to the level that we could no longer tell them apart from younger people,” said lead investigator Joel Voss, associate professor at Northwestern University Feinberg School of Medicine. “They got substantially better.”

The study used Transcranial Magnetic Stimulation (TMS) to target the hippocampus — the brain region that atrophies as people grow older, which is responsible for memory decline.

“It’s the part of the brain that links two unrelated things together into a memory, like the place you left your keys or your new neighbor’s name,” Voss said. “Older adults often complain about having trouble with this.”

Researchers explain that this type of memory worsens as we age. Nearly all people experience a decline in their memory ability as they age.

The new study of 16 people, aged 64 to 80 years old with normal age-related memory problems, shows it’s possible to alter memory ability in older adults using this type of brain stimulation, Voss said.

“There is no previous evidence that the specific memory impairments and brain dysfunction seen in older adults can be rescued using brain stimulation or any other method.”

Study finds appear in the journal Neurology.

In the study, the hippocampus — which is smaller in older adults — was identified in each individual with an fMRI. This imaging tool (functional MRI) measures how active a part of the brain is at a given time.

Researchers then located an area of the parietal lobe that communicates with the hippocampus for stimulation delivery. This spot was behind and slightly above a person’s left ear, but everyone had a slightly different spot.

It isn’t possible to directly stimulate the hippocampus with TMS, which is noninvasive, because it’s too deep in the brain for the magnetic fields to penetrate. As an alternative, Voss and colleagues identified a superficial brain region close to the surface of the skull with high connectivity to the hippocampus.

“We stimulated where brain activity is synchronized to the hippocampus, suggesting that these regions talk to each other,” said first author Aneesha Nilakantan.

At baseline, younger and older adults were given memory tasks in which they learned arbitrary relations between paired things, such as this object goes on this spot on the computer screen. Younger adults scored about 55 percent correct and older adults less than 40 percent correct.

The research team then applied high-frequency repetitive magnetic stimulation to the spot for five consecutive days for 20 minutes a day. Stimulating this area improved the function of regions important for memory that are disrupted by aging, evident by more neural activity visible on an fMRI.

Then, 24 hours after the final stimulation, the subjects were given a new memory test in which they had to learn new arbitrary relations between paired things. After the brain stimulation, older adults scored at the level of young adults on the memory tasks.

The amazing results were also validated by the use of a fake placebo stimulation condition, which did not improve memory.

Voss and colleagues will next test this approach on participants with mild cognitive impairment, the early stage of Alzheimer’s disease. They will be stimulating the brain for longer periods of time.

Voss isn’t certain how long the effects could last. He suggests the enhanced memory effects could last longer with more stimulation. For instance, when depression is treated with TMS for five weeks, those patients get an antidepressant effect that lasts for many months, he noted.

In a future study, Voss will be stimulating the brain in persons with age-related memory loss for a longer period to test this hypothesis.

Source: Northwestern University

Orange Juice, Leafy Greens May Be Tied to Reduced Memory Loss in Men

Drinking orange juice and eating leafy greens may be linked to a reduction in memory loss over time in men, according to a new study published online in the journal Neurology.

“One of the most important factors in this study is that we were able to research and track such a large group of men over a 20-year period of time, allowing for very telling results,” said study author Changzheng Yuan, ScD, of Harvard T.H. Chan School of Public Health in Boston. “Our studies provide further evidence dietary choices can be important to maintain your brain health.”

The study involved 27,842 men (average age of 51) who were all health professionals, such as dentists, optometrists, and veterinarians. Participants filled out questionnaires about how many servings of fruits, vegetables and other foods they had each day at the beginning of the study and then every four years for 20 years.

A serving of fruit is considered one cup of fruit or a half cup of fruit juice. A serving of vegetables is considered one cup of raw vegetables or two cups of leafy greens.

Volunteers completed a subjective test of cognition at least four years before the end of the study, when they were an average age of 73. The test was designed to identify any noticeable changes in memory before those changes would be detected by objective cognitive tests. Changes in memory reported by the participants would be considered precursors to mild cognitive impairment.

The six questions include “Do you have more trouble than usual remembering a short list of items, such as a shopping list?” and “Do you have more trouble than usual following a group conversation or a plot in a TV program due to your memory?”

A total of 55 percent of the participants had good thinking and memory skills, 38 percent had moderate skills, and 7 percent had poor thinking and memory skills.

The participants were split into five groups based on their fruit and vegetable consumption. For vegetables, the highest group ate about six servings per day, compared to about two servings for the lowest group. For fruits, the top group ate about three servings per day, compared to half a serving for the bottom group.

Participants who ate the most vegetables were 34 percent less likely to develop poor thinking skills than the men who ate the least amount of vegetables. A total of 6.6 percent of men in the top group developed poor cognitive function, compared to 7.9 percent of men in the bottom group.

Men who drank orange juice every day were 47 percent less likely to develop poor thinking skills than those who drank less than one serving per month. This link was mainly observed for regular consumption of orange juice among the oldest men.

A total of 6.9 percent of men who drank orange juice every day developed poor cognitive function, compared to 8.4 percent of men who drank orange juice less than once a month. This difference in risk was adjusted for age but not adjusted for other factors related to reported changes in memory.

Men who ate the most fruit each day were less likely to develop poor thinking skills, but that association was weakened after researchers adjusted for other dietary factors that could affect the results, such as consumption of vegetables, fruit juice, refined grains, legumes and dairy products.

The findings also show that men who ate larger amounts of fruits and vegetables 20 years earlier were less likely to develop thinking and memory problems, whether or not they kept eating larger amounts of fruits and vegetables about six years before the memory test.

The study does not show a direct cause and effect relationship between eating fruits and vegetables and a reduction in memory loss; it only shows a link between them.

A limitation of the research was that participants’ memory and thinking skills were not measured at the onset of the study to see how they changed over the course of the study. However, because all participants completed professional training, they can be assumed to have started with relatively high cognitive function in early adult life.

Further, the participants were all male health professionals; thus, the results may not apply to women and other groups of men.

Source: American Academy of Neurology