OHIO ELDER LAW BLAWG

Some Signs of Dementia may be B-12 Deficiency Instead

The NY Times today had a piece which described a woman's cognitive declines.  Her daughter noticed her becoming more and more confused.  When Aricept (a common Alzheimers' disease treatment) was prescribed, the woman became more confused. 

When blood work was done her B-12 level was well below normal.  When she recieved B-12 injections, she recovered. Now 87, the woman still lives alone in Manhattan and feels well enough to refuse outside assistance.

The link to the article is below.  It discusses not only the story, but information about B-12. 

http://www.nytimes.com/2011/11/29/health/vitamin-b12-deficiency-can-cause-symptoms-that-mimic-aging.html?src=me&ref=general

Health Benefits of Walking May Include Protection of Brain Size and Memory

The benefits of walking are probably more than just helping to remain fit and healthy. We know walking results in a reduced risk of disability in the elderly population, as well as it lowers chances of developing cancer in men. According to a recent study, walking at least six miles per week protects brain size and preserves memory in old age.

The study was initiated on 299 individuals who showed no signs of dementia. During the study, participants had to record the number of blocks walked each week. Nine years later brain scans were taken in order to measure brain size of the subjects. Having completed four more years, authors conducted a test for ascertaining the presence of cognitive impairment or dementia. People walking at least 72 blocks a week, (six to nine miles) may have greater gray matter volume than people who didn’t walk that much. The results were measured at the nine-year time point after recording activity.

Kirk I. Erickson, PhD, with the University of Pittsburgh in Pittsburgh and the study author explained, “Brain size shrinks in late adulthood, which can cause memory problems. Our results should encourage well-designed trials of physical exercise in older adults as a promising approach for preventing dementia and Alzheimer’s disease.”

       Gray matter volume did not seem to boost any further in those walking more than 72 blocks. After four years, 116 volunteers comprising 40 percent were apparently diagnosed with either cognitive impairment or dementia. Walking possibly lowers chances of developing memory problems. Experts presume that while regular exercose enhances brain health in midlife, thinking and memory is improved in later life.

The study was published in the October 13, 2010, online issue of Neurology, the medical journal of the American Academy of Neurology.  Excerpts of this article were taken from healthjockey.com.

Those Who Know, Know Longer?

A recent study in the Journal of the International Neuropsychological Society seems to indicate that people who are aware they are developing mild memory problems as they age develop Alzheimer’s disease at a slower rate than those who do are not aware that their memory is failing.

The study compared a group of people with Mild Cognitive Impairment (MCI) to a group of healthy older adults.  All were given neuropsychological tests and were required to perform tasks during functional magnetic resonance imaging (fMRI) testing.  The results indicated that the cortical midline area of the brain showed activity during self-assessment exercises and that MCI participants with less insight into their impairment had considerably less brain activity than those who were aware of their mental difficulties. 

While MCI is always a precursor to Alzheimer’s disease, people with MCI don’t always develop Alzheimer’s. "[U]nawareness of function loss is beginning to be recognized as an important clinical symptom of MCI, and with studies like this one, we are starting to understand how these symptoms develop,” says Michele Ries, a neuropsychologist and researcher at the the University of Wisconsin Alzheimer’s Disease Research Center.

According to the Alzheimer’s Association, 5.3 million Americans live with the disease.  There will be half a million new cases this year alone.

To me this raises the question of whether honestly and openly discussing memory loss with our friends and family who may have MCI would be of benefit to them, or whether some individuals (or some disease processes) simply cannot have (or allow) insight into their own cognitive limitations.

Maybe further study will reveal the answer to that question.

Clocks Falling Back? Don't cause a Heart Attack... (But watch out for daylight savings time)

So, how much sleep do you need?  What are the effects of not quite getting enough?

An interesting finding in a study that having just one extra hour of sleep may make a difference in your cardiovascular health, and may even prevent heart attacks.

The study found that when clocks are set forward, and we lose an hour's sleep, the rate of heart attacks goes UP 5%.  When clocks are set back, and we get an extra hour, the heart attack rate drops. 

More and more evidence that sleep can drastically help health and mental clarity seems to be discovered every week.  

So, getting to bed an hour early now might be a good idea, especially with the clocks moving forward Sunday, March 14, 2010 at 2 a.m. for daylight savings time. 

Click for news Video

Those Extra Pounds: Bad for the Aging Brain?

According to research in the latest issue of The Journals of Gerontology Series A: Biological and Medical Sciences (Volume 65A, Number 1), the affects of being overweight are not only physical, but also affect neurological function.

The publication presents a collection of ten articles highlighting new findings related to obesity in older persons.

Anna Dahl, MS, of Sweden's Jönköping University, led a study which found that individuals with a midlife body mass index (BMI) score which was higher than thinner people's had lower general cognitive ability. These statistics were drawn from a 39 year study of twins in Sweeden, from 1963 to 2002. There was no difference in the results based on the participant's sex. 

Of course, more study is necessary. "One of the unanticipated consequences of improved medical management of cardiovascular disease is that many obese individuals reach old age," said Editor Luigi Ferrucci, MD, PhD, of the National Institute on Aging. "We need a better understanding of the causes and consequences of obesity in older individuals - especially when obesity is associated with sarcopenia."  (Sarcopenia is the loss of muscle mass and sometimes the replacement of muscle with fat). 

My Other Guilty Pleasure...The Wii

So, two Christmases ago, I bought the kids (ok, who am I kidding, I bought the kids and myself) a Nintendo Wii.  Its been fun to play, both with the kids, and with others around the world. (In a technologically savvy moment I got it hooked up to the internet so I can play other people I know as well as complete strangers).

Oh yeah...drop me a mail if you want to try to beat me in Super Mario Brothers or Super Smash Brothers.  If you want to play me in Guitar Hero, please know that I will likely use my son as a ringer, and he is pretty darned good.  I stink at it.

But I digress.  I really have fun playing my Wii and like it.  Apparently other people like it too. In a recent California study elderly people who exhibit depression and then play Wii Sports three times a week are likely to see their depression deminish.

In a pilot study, researchers found use of Wii Sports significantly improved mood and mental health-related quality of life in older adults with sub-syndromal depression. "The study suggests encouraging results from the use of the exergames," Dilip V.Jeste, M.D. said. "More than one-third of the participants had a 50-percent or greater reduction of depressive symptoms. any had a significant improvement in their mental health-related quality of life and increased cognitive stimulation."  Jeste is a Professor of psychiatry and neurosciences at University of California, San Diego, School of Medicine.

So, with all this snow, maybe we need a little wii time.

Full article here.  

P.S.  Oh, in case you were wondering, my original guilty pleasure was coffee.

Love as Pain Management

Ever hear the term "you only hurt the ones you love?"   While not saying that isn't true, it appears that the opposite may be true also, that the ones you love take pain away.

A new study indicates that simply thinking of a person we love may reduce the effects of pain.  "Typically, we think that in order for social support to make us feel good, it has to be the kind of support that is very responsive to our emotional needs. Here, however, we are seeing that just a photo of one's significant other can have the same effect," said study co-author Naomi Eisenberger.

Article Here.

Telomeres and Omega-3's: What are they and why should we care?

Omega 3's have been in the news lately, because a new study shows that having sufficient Omega 3's has anti-aging properties. These anti aging properties are on a cellular level. 

You may remember this blog's reference to an article that discussed Telomeres.  Telomeres are structures at the end of chromosomes. They are involved in the stability and replication of the chromosomes and are being recognized as markers of biological aging.  Various things will shorten Telomeres.  Genetics, exposure to certain chemicals and environmental stressors can shorten the length of telomeres. 

While the article I referenced discussed exercise's effect on Telomeres, more recently the Journal of the American Medical Association (JAMA) published an article that indicates omega-3s slow down the shortening of telomeres -- also indicating that omega-3 fatty acids may protect against aging on a cellular level.

The sources of Omega-3 fatty acids are varied.  Most people look to fish to supply Omega-3's, but over-consumption of fish may have other negative health effects, including exposure to mercury. 

Many of you who know me know I am a vegetarian, so I began to look for non-animal sources of Omega-3 and there are plenty.  Non-animal sources of Omega-3's include:

Walnuts; flaxseeds; flaxseed oil; hemp seeds (hulled); rapeseed oil; macadamia nuts; brazil nuts; hickory nuts; almonds; spinach; spirulina; wheat germ; peanuts; pumpkin seeds,soybeans, and olive oil.  Generally oils should not be heated if you desire the benefits of Omega-3, because heating can break it down. 

So, whether through fish or other sources, and in addition to exercise, having a good source of Omega-3 essential fatty acids in your diet may lead to a healthier life.

~Todd W. Bartimole

Sex Lives of Older Adults Studied

A report based on 2005-2006 data indicates that the sex lives of those from 57-64 are quite active, with 84% of men and 62% of women reporting they had engaged in sex in the last year.  This dipped to 38 percent of men and 17 percent of women in the oldest group surveyed, ages 75 to 85. 

The decrease may be due to health and age, as well as an increase in problems such as erectile dysfunction. The study results, which relied on self reporting by participants, may also reflect a bit of shyness in the 75-85 age group, where sex was more taboo than the younger age group, who lived through the 1960's at a younger age.   This phenomenon may also have affected respondent's answers to the question of whether they had engaged in self-stimulation during the last year, where 31 percent of women ages 57 to 64 reported that they had masturbated in the previous year but only about half of women ages 75 to 85 reported they had.

The researchers collected data on several key areas of older-adult sexuality, and asked over 3,000 participants about sexual relationships during the five years preceding the study.  The findings were published as 14 individual articles in The Journals of Gerontology.   

With regard to a link between human sexuality and aging, Linda J. Waite of the University of Chicago wrote that "[i]ndividuals with strong, functioning sexual and intimate relationships will have better trajectories of health and well-being than those whose relationships function less well or who lack such relationships."  Waite is the Director of The Center on the Demography and Economics of Aging at the University of Chicago.

~Todd W. Bartimole

Two Studies: Exercise's Positive Effect on Cognition

Glad I joined a gym recently.

In the e-magazine Endocrine Today, there is a story about the positive effects of exercise on cognition.  One study by the Mayo Clinic showed that "midlife moderate exercise was associated with a 39% reduction in the odds of developing the condition (P=.008), and moderate exercise in late life was associated with a 32% reduction (P=.02). The findings were consistent among men and women"  This was not true of light exercise such as bowling and slow dancing.

In a second study, participants were divided into two groups, one that engaged in stretching, the other in aerobic exercise. After six months, the aerobic exercise group were observed to have improved executive control processes of multitasking, cognitive flexibility, information processing efficiency and selective attention when  compared with the group that did only stretching exercises. 

The full article is here.