Public release date: 14-Feb-2012
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Contact: Jennifer Beal
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Wiley-Blackwell

Cognitive stimulation therapies have beneficial effects on memory and thinking in people with dementia, according to a systematic review by Cochrane researchers. Despite concerns that cognitive improvements may not be matched by improvements in quality of life, the review also found positive effects for well-being.

There is a general belief that activities that stimulate the mind help to slow its decline in people with dementia. Cognitive stimulation provides people with dementia with activities intended to stimulate thinking, memory and social interaction, in order to delay the worsening of dementia symptoms. In 2011, the World Alzheimer's Report recommended that cognitive stimulation should be routinely offered to people with early stage dementia. However, increased interest in its use in dementia in recent years has provoked concern about its effectiveness and potential negative effects on well-being.

The review, published in The Cochrane Library, included 15 randomised controlled trials involving 718 people with mild to moderate dementia, mainly in the form of Alzheimer's disease or vascular dementia. Participants were treated in small groups and involved in different activities, from discussions and word games to music and baking. All activities were designed to stimulate thinking and memory. Improvements were weighed against those seen without treatment, with "standard treatments", which could include medicine, day care or visits from community mental health workers, or in some cases alternative activities such as watching TV and physical therapy.

"The most striking findings in this review are those related to the positive effects of cognitive stimulation on performance in cognitive tests," said lead author, Bob Woods, of the Dementia Services Development Centre Wales, at Bangor University in Bangor, UK. "These findings are perhaps the most consistent yet for psychological interventions in people with dementia."

Those who received cognitive stimulation interventions scored significantly higher in cognitive function tests, which measure improvements in memory and thinking. These benefits were still being seen one to three months after treatment. In addition, positive effects on social interaction, communication and quality of life or well-being were observed in a smaller number of the trials, based on self-reported or carer-reported measures.

In one trial, family members were trained to deliver cognitive stimulation on a one-to-one basis, with no additional strain on burden on caregivers reported. "Involving family caregivers in the delivery of cognitive stimulation is an interesting development and deserving of further attention," said Woods.

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Cognitive stimulation beneficial in dementia

The speed at which someone walks may predict the development of dementia later in life, according to researchers in the U.S.

The study was conducted at the Boston Medical Centre. 2,410 people, who were 62 years old, participated in the study.

Their brain scans, walking speed and grip strength were recorded. The results that were presented at the Academy of Neurology's annual meeting said 11 years later, 34 people had developed dementia and 79 had had a stroke.

The researchers said that the slow speed walkers have a higher risk of dementia and stronger grip with a lower risk of stroke.

Dr Erica Camargo, who conducted the latest study at the Boston Medical Centre, told BBC: "While frailty and lower physical performance in elderly people have been associated with an increased risk of dementia, we weren't sure until now how it impacted people of middle age."

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 "These are basic office tests which can provide insight into risk of dementia and stroke and can be easily performed by a neurologist or general practitioner," Camargo said.

He added: "Further research is needed to understand why this is happening and whether preclinical disease could cause slow walking and decreased strength."

These findings have not yet been published in an academic journal.

Experts have raised important questions. "Before people take stock in the strength of a handshake or the speed you cross the road, more research is needed to understand why and what other factors are involved," quoted BBC as Dr Anne Corbett, research manager at the Alzheimer's Society saying.

"The good news is that there are many things you can do to reduce your risk of developing dementia," Corbett said.

"We recommend you eat a healthy balanced diet, don't smoke, maintain a healthy weight, take regular exercise; and get your blood pressure and cholesterol checked regularly," he added.

The Stroke Association's Dr Sharlin Ahmed also shared his view that says: "Around a third of those who have a stroke are left with some kind of physical disability, including hand weakness and difficulty walking. However, this is the first time we have seen research that looks at the presence of related symptoms before a stroke."

"This is an interesting study, but a lot more research is needed before we can conclude that strength of grip or walking speed can determine the risk of stroke," Ahmed added.

The rest is here:
Pace of Walking Linked to Dementia: Study

Woodhaugh Rest Home, in Dunedin, is seeking permission to develop a 16-bed dementia unit and a hospital facility.

Cressida Healthcare general manager Colleen Stairmand, of Auckland, said the rest-home was seeking permission from the Ministry of Health for the dementia unit and a 16 to 18-bed hospital facility.

A new manager, who started in January, was "making a real difference" at the home, Mrs Stairmand said. There were no major problems at the home.

Southern DHB carried out a site visit in November, after complaints the home was not carrying adequate basic supplies.

The DHB gave the home the all-clear, but has been monitoring more closely since.

Mrs Stairmand said the dementia unit and hospital facility would increase the profitability of the 70-bed rest-home.

"The rest-home has some empty beds, so we were looking at ways that we could make it profitable and offer more services."

Southern DHB funding and finance general manager Robert Mackway-Jones said capacity outstripped demand in the residential care sector in the South at present. Demand for dementia and hospital care was tipped to grow, he said.

Hospital-level care had risen in the past three years, while residential dementia care had been "reasonably flat" in recent years.

Hospital bed use grew 4.5% in 2009-10, 4.1% in 2010-11, and 2.8% so far in 2011-12.

Rest-home demand was "flat and declining" and this trend would be exacerbated by the board's plans to develop new services to keep people at home for longer.

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Originally posted here:
Dementia unit permission sought

By Jenny Hope

Last updated at 9:55 AM on 16th February 2012

Middle-aged people who walk slowly and have a poor grip could be at greater risk of dementia or stroke in later life, researchers have warned.

Simple tests of physical ability may give clues as to who is most likely to go on to develop disorders such as Alzheimer’s and, to a lesser extent, suffer a stroke, they say.

Their study involved monitoring more than 2,400 participants with an average age of 62 over 11 years.

Tight grip: Research has found that simple tests on things like how fast a person walks may help doctors determine how likely that person might suffer dementia or a stroke

Those with a slower walking speed were found to be one and a half times more likely to develop dementia over the age of 65 compared with those who were more speedy.

People with a stronger grip had a 42 per cent lower risk of stroke or a mini-stroke – known as a transient ischemic attack (TIA) – over the age of 65, although the risk was not cut at younger ages.

Lead researcher Dr Erica Camargo said this level of testing could be routinely carried out by primary care physicians and GPs. ‘These are basic office tests which can provide insight into risk of dementia and stroke and can be easily performed by a neurologist or general practitioner,’ she added.

Participants in the U.S. study were tested for walking speed, hand grip strength and cognitive function, and had brain scans.

During the follow-up period, 34 people developed dementia and 70 people had a stroke.

A scan showing a healthy brain (above) and one (below) revealing the warning signs of Alzheimer's in red. Researchers in Boston are looking at new tests to find out if a person is more likely to suffer from the disease (file picture)

Dr Camargo, of Boston Medical Centre, said: ‘While frailty and lower physical performance in elderly people have been associated with an increased risk of dementia, we weren’t sure how it impacted people of middle age.’

Researchers also found that slower  walking speed was associated with lower total cerebral brain volume – fewer ‘grey’ cells  and poorer performance on memory,  language and decision-making tests. Stronger grip strength was associated with larger  total cerebral brain volume as well as better performance on cognitive tests asking people to identify similarities among objects.

‘Further research is needed to understand why this is happening and whether preclinical disease could cause slow walking and decreased strength,’ added Dr Camargo.

Dr Anne Corbett, of the Alzheimer’s Society, said: ‘Before people take stock in the strength of a handshake or the speed you cross the road, more research is needed to understand why and what other factors are involved.

‘The good news is that there are many things to reduce your risk of developing dementia.

‘We recommend you eat a healthy balanced diet, don’t smoke, maintain a healthy  weight, take regular exercise, and get your blood pressure and cholesterol checked regularly.’

The research was presented yesterday at the American Academy of Neurology’s 64th annual meeting in New Orleans. Some 820,000 people are affected by dementia in the UK.

See the original post:
Dementia: Fast walking speed and a strong grip in middle age may help predict risk

WEDNESDAY, Feb. 15 (HealthDay News) -- How fast you walk or how strong your grip is in middle age might help predict your odds for dementia or stroke later in life, a new study suggests.

Tests assessing walking speed and grip can be easily performed in a doctor's office, noted study author Dr. Erica C. Camargo, of the Boston Medical Center.

She and her colleagues tested the walking speed, hand grip strength and cognitive function of more than 2,400 people, average age 62. The participants also underwent brain scans.

During a follow-up period of up to 11 years, 34 people went on to develop dementia (including Alzheimer's disease) and 70 had a stroke.

People who had a slower walking speed at the start of the study were 1.5 times more likely to develop dementia than those with a faster walking speed, according to the findings, which are slated to be presented at the annual meeting of the American Academy of Neurology (AAN) in New Orleans in April.

People aged 65 and older who had a stronger hand grip strength at the start of the study had a 42 percent lower risk of stroke or mini-stroke (transient ischemic attack) than those with weaker hand grip strength. This difference was not seen in people younger than 65.

"While frailty and lower physical performance in elderly people have been associated with an increased risk of dementia, we weren't sure until now how it impacted people of middle age," Camargo said in an AAN news release.

The researchers also found that slower walking speed was associated lower total cerebral brain volume and poorer performance on memory, language and decision-making tests. Stronger hand grip was associated with larger total cerebral brain volume and better results on tests of thinking and memory in which people had to identify similarities among objects.

"Further research is needed to understand why this is happening and whether preclinical disease could cause slow walking and decreased strength," Camargo said.

Experts said the findings might be valuable in assessing patient risk.

"It is unclear why there is such a correlation between walking speed and hand grip on these disease processes, yet they are two simple tests that can give us a pre-clinical clue as to what we might expect, and enable us to implement prevention," said Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City.

Dr. Marshall Keilson, director of neurology at Maimonides Medical Center, also in New York City, agreed. "At the very least," he noted, "this research suggests novel approaches to early identification of dementia and stroke risk. It would be interesting to test an even younger patient population with the same protocol."

Findings presented at medical meetings should be considered preliminary until published in a peer-revised journal.

More information

The American Academy of Family Physicians has more about dementia.

Read the original post:
Can Walking Speed, Hand Grip in Middle Age Predict Dementia Risk?

NEW YORK (Reuters Health) - A series of group activities designed to stimulate thought, conversation and memory appears to improve the mental functioning of people with mild or moderate dementia, according to a new review of the evidence.

"This is good news for the industry," said Robert Winningham, a professor at the University of Western Oregon, who was not involved in this study. "This is showing the people who work in memory care communities and nursing homes and assisted living facilities that they can improve cognitive function, and they need to be providing these kinds of interventions."

Cognitive stimulation, as the therapy is called, involves structured activities in a group setting, usually one or more times a week for at least a month.

The sessions might include a discussion of current events, a sort of show-and-tell with objects, baking, drawing or other activities that get the participants to engage their minds.

Bob Woods, a professor at Bangor University in the UK who led the study, said that researchers in this field had considered cognitive stimulation to be helpful for people with dementia, based on earlier work.

To get a better sense of just how much the therapy can do, he and his colleagues at University College London pulled together the findings from 15 studies comparing cognitive stimulation to no extra intervention for people with mild or moderate dementia.

In total, 718 people participated in the studies.

The stimulation sessions lasted from 30 to 90 minutes, and people met as frequently as five times a week. The studies continued for at least a month and up to two years.

"One of the difficulties in dementia is people do become a bit apathetic and withdrawn," Woods told Reuters Health. "So having this structured form of stimulation guarantees they are engaged and active for a period of time."

At the end of the studies people took a test to measure their mental functioning.

Those who were in the cognitive stimulation groups performed about one or two points better than those who didn't participate, on tests that had ranges of zero to 30 and zero to 70.

Woods said the effect is fairly small, but encouraging. He explained that people with dementia typically decline by a few points on these tests in six months or a year.

So a one or two point increase over people who didn't receive any treatment means their dementia, at least in terms of their mental skills, was essentially stabilized and didn't progress.

SOME RESULTS DISAPPOINTING

Other skills for daily living, however, did not show any improvements compared to the people who didn't receive cognitive stimulation.

"To be honest, that's disappointing," Winningham told Reuters Health. "Activities of daily living are your ability to take care of yourself, to do a check book, go grocery shopping. We need to find ways to improve these because that's what will allow people to stay independent and reduce health care costs."

Winningham said the mental gains are important, though, and training staff at assisted living or nursing care facilities to provide cognitive stimulation is a worthwhile investment.

"It's a very inexpensive way to improve cognitive function, relative to much more expensive drug therapies that have been, really, the only thing that we were sure worked before these studies came out," he said.

Woods said most of the studies have focused on interventions given in group sessions, and he'd like to see whether individual sessions, perhaps given by a family member, could deliver similar results.

"I'm quite hopeful some grandchildren would want to do this with their grandfather or grandmother who has dementia," he said.

In the report, published by the Cochrane Collaboration, the authors disclose that some of them have earned money by providing training and manuals for cognitive stimulation.

Cochrane is a large, international network of researchers that consolidates and reviews studies on a given medical treatment.

SOURCE: http://bit.ly/Af8nyY Cochrane Database of Systematic Reviews, February 2012.

Read the rest here:
Group mental activities help people with dementia, review shows

When Times staff photographer Rob Gauthier and I first visited the Bryant family last April to begin reporting a story, (“Little-known brain disease rips apart lives of victim, loved ones,”), about a rare type of dementia, known as frontotemporal dementia, we realized that we needed to explore the science behind the malady. FTD, as the disease is known, is similar to Alzheimer's but affects the front portions of the brain and leads to behavioral problems such as the Bryants experienced with Stu.

I knew about Phineas Gage, the railroad foreman who in 1848 lost the front portion of his brain in a terrible construction accident and who survived as a radically changed man. I had read the work of Hanna and Antonio Damasio, neuroscientists who almost 20 years ago pioneered our understanding of the biology of emotions, and I was eager to see how frontotemporal dementia was being studied to further this research. 

In the course of our reporting, Rob and I took a number of trips to UCLA and the West Los Angeles Veterans Affairs hospital to interview Mario Mendez, the physician and neuroscientists treating Stu. In our conversations, Mendez helped us understand what Oliver Sacks meant when he wrote, “Without the great development of the frontal lobes in the human brain, civilization could never have arisen.”

By studying the effects of frontotemporal dementia – and its slow diminishment of personality – Mendez is able to see more clearly the so-called social brain, a portion of our frontal and temporal lobes that plays a role in allowing us to successfully interact with each other and build relationships. Take away this portion of the cortex and we are no longer able to moderate our emotions. 

Moderation – the inhibition of emotional impulses – can take the form of empathy and embarrassment and is critical in helping us negotiate complex social environments. Without either, as Rob and I learned during the time we spent with Stu, humans grow untethered to the world, unable to read feelings or behave in an appropriate manner.

By steering the discussion about morality, normally the providence of ethicists and philosophers, away from the symposium and putting it inside the laboratory where thoughts are considered to be not so much conscious choices, but instead reflexes based on a neurological network, Mendez and other neuroscientists are furthering the inquiry into the nature of right and wrong. In this light, religion, family, even Freud's notions of superego, ego and id matter less than biology.

Mendez argues that specific behaviors – not harming another person, respecting hierarchy and authority, accepting communal goals, recognizing equity and fairness – evolved among humans.  Good manners, therefore, have as much to do with what we are born with as they do with how we were raised and what our parents taught us.

“Much of the social behavior that we take for granted and that we often consider to be learned or cultural or developmental is actually behavior that is deeply ingrained in the nervous system and in the frontal lobes,” Mendez says.

Consider that the next time you’re in a crowded restaurant and watching the kaleidoscope of interactions. Never mind the ability to speak and communicate. Never mind the opposable thumbs. The frontal lobes make humans human.

See the original post:
The science behind frontotemporal dementia

Latest Exercise & Fitness News

MONDAY, Feb. 13 (HealthDay News) -- Here's another reason to get into shape: Physical activity may reduce the risk of dementia-related death, according to a new study.

Researchers assessed the health of more than 45,000 men and nearly 15,000 women, ages 20 to 88 years, in the United States and grouped them into one of three fitness categories -- low, middle or high.

After an average follow-up of 17 years, about 4,050 participants died. Of those deaths, 164 were attributed to dementia (72 vascular dementia and 92 Alzheimer's disease). Of those 164 deaths, 123 of the people were in the low-fitness group, 23 were in the middle-fitness group, and 18 were in the high-fitness group.

People in the high- and medium-fitness groups had less than half the risk of dying as those in the low-fitness group, the researchers concluded.

The study appears in the February issue of the journal Medicine & Science in Sports & Exercise.

"These findings support physical-activity promotion campaigns by organizations such as the Alzheimer's Association and should encourage individuals to be physically active," study author Riu Liu said in a journal news release.

"Following the current physical-activity recommendations from the American College of Sports Medicine will keep most individuals out of the low-fit category and may reduce their risk of dying with dementia," Liu added.

Liu conducted the study as part of her dissertation at the University of South Carolina. She is now a postdoctoral fellow at the U.S. National Institute of Environmental Health Sciences.

While deaths in the United States associated with heart disease, breast cancer and stroke have declined in recent years, deaths related to dementia and Alzheimer's rose 46 percent between 2002 and 2006, according to the release.

The study doesn't prove that exercise will prevent dementia, however. Other factors may also come into play.

-- Robert Preidt

Copyright © 2012 HealthDay. All rights reserved.

SOURCE: Medicine & Science in Sports & Exercise, news release, Feb. 7, 2012

View original post here:
Exercise a Defense Against Dementia: Study

15 February 2012 Last updated at 21:52 ET

The speed someone walks may predict the likelihood of developing dementia later in life, according to researchers in the US.

They also told a conference that grip strength in middle-age was linked to the chance of a stroke.

The scientists said more studies were needed to understand what was happening.

Experts said the findings raised important questions, but more research was needed.

Suggestions of a link between slow walking speed and poor health have been made before.

A study, published in the British Medical Journal in 2009, said there was a "strong association" between slow walking speed and death from heart attacks and other heart problems. A Journal of the American Medical Association study suggested a link between walking faster over the age of 65 and a longer life.

Dr Erica Camargo, who conducted the latest study at the Boston Medical Centre, said: "While frailty and lower physical performance in elderly people have been associated with an increased risk of dementia, we weren't sure until now how it impacted people of middle age."

Brain scans, walking speed and grip strength were recorded for 2,410 people who were, on average, 62 years old.

Results presented at the Academy of Neurology's annual meeting said that 11 years later, 34 people had developed dementia and 79 had had a stroke.

The researchers said slower walking speeds were linked to a higher risk of dementia and stronger grip with a lower risk of stroke.

Continue reading the main story “Start Quote

"Before people take stock in the strength of a handshake or the speed you cross the road, more research is needed to understand why and what other factors are involved”

End Quote Dr Anne Corbett Alzheimer's Society

Dr Camargo said: "These are basic office tests which can provide insight into risk of dementia and stroke and can be easily performed by a neurologist or general practitioner.

"Further research is needed to understand why this is happening and whether preclinical disease could cause slow walking and decreased strength."

The findings have not yet, however, been published in a peer-reviewed academic journal.

Dr Marie Janson, director of development at Alzheimer's Research UK, said: "Although this study has yet to be published in full, it does raise some important questions about whether physical problems, such as difficulty walking, could precede other symptoms associated with dementia.

"Further study could shed new insight into how walking speed and dementia may be linked."

Dr Anne Corbett, research manager at the Alzheimer's Society, said: "Before people take stock in the strength of a handshake or the speed you cross the road, more research is needed to understand why and what other factors are involved.

"The good news is that there are many things you can do to reduce your risk of developing dementia.

"We recommend you eat a healthy balanced diet, don't smoke, maintain a healthy weight, take regular exercise; and get your blood pressure and cholesterol checked regularly."

The Stroke Association's Dr Sharlin Ahmed, said: "Around a third of those who have a stroke are left with some kind of physical disability, including hand weakness and difficulty walking. However, this is the first time we have seen research that looks at the presence of related symptoms before a stroke.

"This is an interesting study, but a lot more research is needed before we can conclude that strength of grip or walking speed can determine the risk of stroke."

Read the original here:
Slow walking 'predicts dementia'

15 February 2012 Last updated at 21:52 ET

The speed someone walks may predict the likelihood of developing dementia later in life, according to researchers in the US.

They also told a conference that grip strength in middle-age was linked to the chance of a stroke.

The scientists said more studies were needed to understand what was happening.

Experts said the findings raised important questions, but more research was needed.

Suggestions of a link between slow walking speed and poor health have been made before.

A study, published in the British Medical Journal in 2009, said there was a "strong association" between slow walking speed and death from heart attacks and other heart problems. A Journal of the American Medical Association study suggested a link between walking faster over the age of 65 and a longer life.

Dr Erica Camargo, who conducted the latest study at the Boston Medical Centre, said: "While frailty and lower physical performance in elderly people have been associated with an increased risk of dementia, we weren't sure until now how it impacted people of middle age."

Brain scans, walking speed and grip strength were recorded for 2,410 people who were, on average, 62 years old.

Results presented at the Academy of Neurology's annual meeting said that 11 years later, 34 people had developed dementia and 79 had had a stroke.

The researchers said slower walking speeds were linked to a higher risk of dementia and stronger grip with a lower risk of stroke.

Continue reading the main story “Start Quote

"Before people take stock in the strength of a handshake or the speed you cross the road, more research is needed to understand why and what other factors are involved”

End Quote Dr Anne Corbett Alzheimer's Society

Dr Camargo said: "These are basic office tests which can provide insight into risk of dementia and stroke and can be easily performed by a neurologist or general practitioner.

"Further research is needed to understand why this is happening and whether preclinical disease could cause slow walking and decreased strength."

The findings have not yet, however, been published in a peer-reviewed academic journal.

Dr Marie Janson, director of development at Alzheimer's Research UK, said: "Although this study has yet to be published in full, it does raise some important questions about whether physical problems, such as difficulty walking, could precede other symptoms associated with dementia.

"Further study could shed new insight into how walking speed and dementia may be linked."

Dr Anne Corbett, research manager at the Alzheimer's Society, said: "Before people take stock in the strength of a handshake or the speed you cross the road, more research is needed to understand why and what other factors are involved.

"The good news is that there are many things you can do to reduce your risk of developing dementia.

"We recommend you eat a healthy balanced diet, don't smoke, maintain a healthy weight, take regular exercise; and get your blood pressure and cholesterol checked regularly."

The Stroke Association's Dr Sharlin Ahmed, said: "Around a third of those who have a stroke are left with some kind of physical disability, including hand weakness and difficulty walking. However, this is the first time we have seen research that looks at the presence of related symptoms before a stroke.

"This is an interesting study, but a lot more research is needed before we can conclude that strength of grip or walking speed can determine the risk of stroke."

Read the original here:
Slow walking 'predicts dementia'

15 February 2012 Last updated at 05:10 ET

People with dementia and their carers are to be recruited for a trial looking at how word games and quizzes can benefit brain stimulation in sufferers.

Bangor University research suggests cognitive stimulation from playing dominoes or even baking a cake can also help boost memory.

There are now plans to trial the technique to see how it can be used by families and carers.

The trial in north Wales will be run jointly with University College London.

According to Bangor University, there is a general belief that activities that stimulate the mind - cognitive stimulation - help to slow its decline in people with dementia.

The review, led by Bangor University professor, Bob Woods, and published in The Cochrane Library, looked at trial results from around the world involving 718 people with mild to moderate dementia.

Prof Woods, of the university's dementia services development centre, told BBC Radio Wales: "This review involves people who have already developed dementia.

Continue reading the main story “Start Quote

It can range from music to dominoes, word games, quizzes, baking a cake, reminiscing - a whole range of things”

End Quote Prof Bob Woods Bangor University

"It suggests that in people with mild to moderate dementia this is very useful strategy, not only for improving memory, but for improving quality of life.

"These are very simple straightforward activities.

"It's not like brain training - repeating the same exercises over - these are meant to be enjoyable fun activities that people can do together.

"It can range from music to dominoes, word games, quizzes, baking a cake, reminiscing - a whole range of things."

The review says the benefits of cognitive stimulation were still being seen up to three months after starting.

He said such activities were carried out by staff in many care homes.

"We are also interested in whether this can be taught to family carers looking after a person with dementia and we've got a major trail starting here at Bangor to examine the effects of that approach," he added.

Here is the original post:
Dementia brain stimulation trial