Author Interviews, Cognitive Issues, Geriatrics, JAMA, Surgical Research / 17.10.2018

MedicalResearch.com Interview with Mark Oldham, M.D. Assistant Professor of Psychiatry Medical Director, PRIME Medicine Proactive Integration of Mental Health Care in Medicine University of Rochester Medical Center MedicalResearch.com: What is the background for this study? Response: Patients who have undergone coronary artery bypass graft (CABG) surgery and, specifically, those who have been placed on cardiopulmonary bypass (CPB) have received attention for the potential effects of such procedures on brain health. Heart valve surgery patients have received far less attention, which often leaves clinicians to extrapolate the data from CABG cohorts to their patients preparing to undergo valve surgery. However, there are many reasons why this is far less than ideal, especially as the CABG literature increasingly points to person- and procedure-specific factors as the determinants of postoperative cognitive outcomes. (more…)
Author Interviews, Cannabis, Cognitive Issues, Memory / 18.08.2018

MedicalResearch.com Interview with: Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC Ana Maria Sebastião, PhD Professor of Pharmacology and Neurosciences Director Institute of Pharmacology and Neurosciences, Faculty of Medicine and Francisco Mouro, PhD Unit of Neurosciences, Institute of Molecular Medicine University of Lisbon, Portugal MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is pressing need to comprehend how cannabinoid exposure impacts brain functioning. While cannabinoid-related research has increased exponentially in the last decade, the mechanisms through which cannabinoids affect brain functioning are still elusive. Specifically, we need to know how prolonged cannabinoid exposure affects important cognitive processes, such as memory, and also find the roots of those effects. This is particularly relevant considering that several countries have already approved cannabis-based medicines. In this sense, our work sheds new light into the mechanisms underlaying the memory-deficits provoked by a continuous exposure to a cannabinoid drug. More precisely, using brain imaging techniques, we found that long-term exposure to a synthetic cannabinoid drug impairs the ability of key brain regions involved in learning and memory to communicate with each other. Our data points to the necessity of considering cannabinoid actions in a broader perspective, including brain circuitry and communication.  (more…)
Author Interviews, Cognitive Issues, Memory / 05.08.2018

MedicalResearch.com Interview with: Dr Antonina Pereira - CPsychol, PhD, FHEA, AFBPsS Head of Department of Psychology & Counselling University of Chichester Chichester, West Sussex UK MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Prospective memory (PM) is the ability to remember to perform future activities, such as remembering to take medication or remembering to attend an appointment. Prospective memory tasks pervade our daily lives, and PM failures, although sometimes merely annoying (e.g., forgetting an umbrella at home on a rainy day), can have serious and even life-threatening consequences (e.g., forgetting to turn off the stove). The fulfilment of such delayed intended actions can indeed be an early indicator of Alzheimer’s disease, with prospective memory failures representing one of the most prominent memory concerns in older adulthood and a fundamental requirement for independent living across the lifespan. We aimed to address this issue by exploring the potential benefits of a purposefully designed technique, encoded enactment, where participants were encouraged to act through the activity they must remember to do. This particular study was the fruit of an international research collaboration led by the University of Chichester and including members from Radboud University Nijmegen, Sussex Partnership NHS Foundation Trust and the Faculty of Medicine of the University of Lisbon. Our team has explored the potential benefits of this specific encoding strategy for healthy younger adults, healthy older adults as well as for patients with mild cognitive impairment. Results were very encouraging: All age groups reported improvement in prospective memory, but this was particularly evident in older patients with mild cognitive impairment, that is, potentially in the early stages of Alzheimer’s disease. The study suggests that encouraging people in this category to adopt enactment as a means to enhance prospective memory could result in them leading independent, autonomous lives for longer. (more…)
Author Interviews, Cognitive Issues, JAMA, Social Issues / 18.05.2018

MedicalResearch.com Interview with: Dr Dorina Cadar Research Associate in Dementia Psychobiology Group Department of Behavioural Science and Health University College London London MedicalResearch.com: What is the background for this study? Response: Dementia is one of the most feared medical conditions, which represents a significant global challenge to health and social care. Education may serve different roles in the development of dementia: it is a proxy for early life experiences and (parental) socioeconomic status, it is related to future employment prospects, income and wealth, determines occupational exposures and characteristics of adult life (e.g., job complexity, work stress, environmental exposures) and it provides lifelong skills for optimal mental abilities and mastery. However, given that education is typically completed many decades before dementia onset, other individual and area-based components of socioeconomic status, such as wealth, income and area deprivation may provide a more accurate indication of current socioeconomic resources.  Also, at older ages, accumulated wealth represents a more robust measure of socioeconomic resources than income or occupation alone. (more…)
Author Interviews, Cognitive Issues, Mental Health Research / 16.05.2018

MedicalResearch.com Interview with: Dr. Eero Vuoksimaa PhD Institute for Molecular Medicine University of Helsinski Finland MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are many previous reports indicating a positive association between height and cognitive ability but the underlying mechanisms behind this correlation are not well known. We used a mediation model to test if this association is explained by brain size as measured with cortical grey matter size. We found that total cortical surface mediated the relationship between height and cognitive ability. (more…)
Author Interviews, Cognitive Issues, OBGYNE, Sugar / 02.05.2018

MedicalResearch.com Interview with: “Soda” by Jannes Pockele is licensed under CC BY 2.0Juliana F. W. Cohen, ScM, ScD Department of Health Sciences Merrimack College North Andover MA 01845. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sugar consumption among Americans is above recommended limits and this excess intake may have important health implications. This study examined the associations of pregnancy and offspring sugar consumption, as well as sugar-sweetened beverages, other beverages (diet soda, juice), and fruit consumption with child cognition. This study found that when pregnant women or their children consumed greater quantities of sugar, as well as when women consumed diet soda during pregnancy, this was associated with poorer childhood cognition.  However, children’s fruit consumption was associated with higher cognitive scores. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Epilepsy / 12.04.2018

MedicalResearch.com Interview with: Britta Haenisch, PhD Pharmacoepidemiology in Neurodegenerative Disorders German Center for Neurodegenerative Diseases, DZNE  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Antiepileptic drugs (AEDs) have been shown to affect cognition by suppressing neuronal excitability and increasing inhibitory neurotransmission. Previous studies suggested that AEDs may be associated with cognitive adverse effects. Therefore, we evaluated the association between AED use and incident dementia and Alzheimer’s disease (AD). We utilized large longitudinal datasets from Finnish health registers and from German health insurance data. The case-control analyses was adjusted for several potential confounders like comorbidities and polypharmacy. The inclusion of a lag time between . Antiepileptic drugs use and dementia diagnosis allowed minimization of protopathic bias. Our study provides an association between regular prescription of  antiepileptic drugs with known cognitive adverse effects and the occurrence of dementia and AD in patients aged 65 years and older.  (more…)
Author Interviews, Cognitive Issues, JAMA, Pediatrics / 26.02.2018

MedicalResearch.com Interview with: Sabrina Twilhaar, MS, PhD candidate Child Study Group, sectie Klinische Neuropsychologie Vrije Universiteit Amsterdam MedicalResearch.com: What is the background for this study? What are the main findings?  Response: It is well-known that preterm birth has negative consequences for cognitive development. During the early 1990s important progress in neonatal health care resulted in a considerable increase in the survival of preterm infants. Earlier meta-analyses showed large differences in intelligence between very preterm and full-term born children. However, these meta-analyses included mostly studies on children born before 1990. Because of the advances in neonatal health care since that time, it was important to update our knowledge on the outcomes of more recently born preterm infants. We combined the results of 71 studies, together including 7752 very preterm and 5155 full-term born children, and found a difference in intelligence between very preterm and full-term children that was still large. Interestingly, despite advancing neonatal health care, we also found no indication of improvement in the cognitive outcomes of very preterm born children during the period from 1990 to 2008. In addition, we searched for factors that increase the risk for poor cognitive outcomes in these children and we found that children with a chronic lung disease that is amongst others caused by mechanical ventilation of the immature lungs are even more at risk for poor cognitive outcomes. (more…)
Alcohol, Author Interviews, Cognitive Issues, Lancet / 21.02.2018

MedicalResearch.com Interview with: “undefined” by Iñaki Queralt is licensed under CC BY 2.0Michaël Schwarzinger, MD, PhD Translational Health Economics Network (THEN) Paris MedicalResearch.com: What is the background for this study? What are the main findings? Response: The association of heavy drinking with dementia has been known for decades. For instance, there is about no Wernicke–Korsakoff syndrome without heavy drinking and the syndrome was described in 1890. But this type of dementia is very rare. Also, heavy drinking is knowingly associated with multiple risk factors for dementia onset such as hypertension or diabetes. But heavy drinkers generally refuse to participate to cohort studies and declaration of alcohol use among participants is generally biased downward... So the study rationale is very strong, but supporting empirical evidence is quite scarce. This nationwide study included all 31+ million adults discharged from hospitals over 6 years, i.e., 50% of the French population before 65 years old and 80% above that age. Of 1.1+ million adults diagnosed with dementia, one in twenty had an early-onset (before 65 years old). Heavy drinking was recorded in most (56%) early-onset dementia cases: two-third in men; one-third in women. In addition, the association of heavy drinking with dementia goes far beyond 65 years old, both directly (>3 times higher risk for dementia onset after controlling for more than 30 known risk factors for dementia) and indirectly as heavy drinking was associated with all other independent risk factors for dementia onset. Accordingly, heavy drinking had the largest effect on dementia risk of all independent modifiable risk factors such as hypertension or diabetes. The effects were found whatever dementia case definition or population studies. (more…)
Author Interviews, Cognitive Issues, Geriatrics, Kidney Disease, Salt-Sodium / 11.02.2018

MedicalResearch.com Interview with: Dr. Kristen L. Nowak PhD Division of Renal Diseases and Hypertension University of Colorado Anschutz Medical Campus Aurora, CO 80045 MedicalResearch.com: What is the background for this study?   Response: Subtle impairments in cognition are common with aging, even in the absence of clinically apparent dementia. Mild hyponatremia is a common finding in older adults; however, the association of lower serum sodium with cognition in older adults is currently uncertain. We hypothesized that lower normal serum sodium would be associated with prevalent cognitive impairment and the risk of cognitive decline over time in asymptomatic, community-dwelling older men. (more…)
Author Interviews, Cognitive Issues, Environmental Risks / 07.02.2018

MedicalResearch.com Interview with: Dr. Lily Yan MD PhD Department of Psychology & Neuroscience Program Michigan State University East Lansing, MI 48824  MedicalResearch.com: What is the background for this study? What are the main findings?
  • The effects of light on cognitive function have been well-documented in human studies, with brighter illumination associated with better cognitive performance. However, the underlying neural mechanisms are not well understood.
  • In this study, we explored the mechanisms of how light modulates spatial learning and memory, using diurnal Nile grass rats. In contrast to most laboratory animals that are active at night and fall asleep following light exposure, these animals are active during the day, thus an ideal model for understanding the effects of light on humans.
  • When the animals were housed in dim light during the day, mimicking the cloudy days or typical indoor lighting, the animals had a ~30% reduction in the dendritic spines, which make the connection between brain cells, within the hippocampus, a brain region critical for learning and memory. Animals housed in dim light also performed poorly in a water maze, compared to those housed in bright light.
  • When the animals that had been in dim light were then housed in bright light for 4 weeks, the connections in their hippocampus and performance in the water maze recovered fully. 
(more…)
Author Interviews, Cognitive Issues, Geriatrics, Mayo Clinic / 25.01.2018

MedicalResearch.com Interview with: Richard J. Caselli MD Department of Neurology Mayo Clinic Arizona Scottsdale, AZ   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Personality changes are common in patients with a variety of dementing illnesses, and underlie the behavioral disturbances that complicate the course of dementia patients.  We have a been conducting a large longitudinal study of cognitive aging in individuals at genetically defined risk for Alzheimer’s disease (AD) based on their APOE genotype, and have been administering a large battery of neuropsychological tests as well as the gold standard personality questionnaire (the NEO-PI-R) in order to determine whether personality changes during the transition from normal cognition/preclinical AD to mild cognitive impairment.   (more…)
Author Interviews, Cognitive Issues, Genetic Research, JAMA, Medical Imaging, Mental Health Research / 25.01.2018

MedicalResearch.com Interview with: “The Fourth Sex: Adolescent Extremes” by Victor Soto is licensed under CC BY 2.0Dag Alnaes, PhD Norwegian Centre for Mental Disorders Research KG Jebsen Centre for Psychosis Research Division of Mental Health and Addiction, Oslo University Hospital Oslo, Norway  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The transition from childhood to adulthood is characterized by swift and dramatic changes, both in our environment and in our brains. This period of life also coincides with the onset of many mental disorders. To gain a better understanding of why, the clinical neurosciences must attempt to disentangle the complex and dynamic interactions between genes and the environment and how they shape our brains. The ultimate goal is to be able to predict which individuals are at risk before clinical symptoms appear. Advanced brain imaging has been proposed to represent one promising approach for such early detection, but there is currently no robust imaging marker that allows us to identify individuals at risk with any clinically relevant degree of certainty. Our study shows that self-reported early signs of mental illness are associated with specific patterns of brain fiber pathways in young people, even if they may not fulfill criteria for a formal diagnosis or are currently in need of treatment.  (more…)
Annals Internal Medicine, Author Interviews, Cognitive Issues, Lifestyle & Health / 20.12.2017

MedicalResearch.com Interview with: “Exercise” by Diabetes Education Events is licensed under CC BY 2.0Michelle Brasure, MSPH, PhD, MLIS Evidence-based Practice Center School of Public Health University of Minnesota  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We conducted a large systematic review to assess the evidence relating to interventions to prevent cognitive decline and dementia. We included experimental studies with follow up times of at least six months. This paper analyzes the physical activity interventions; other papers in this issue address other types of interventions. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Geriatrics, Hearing Loss, JAMA / 11.12.2017

MedicalResearch.com Interview with: “Hear” by Jaya Ramchandani is licensed under CC BY 2.0David G. Loughrey, BA(Hons) NEIL (Neuro Enhancement for Independent Lives) Programme Trinity College Institute of Neuroscience, School of Medicine Trinity College Dublin, Dublin, Ireland MedicalResearch.com: What is the background for this study? Response: Age-related hearing loss, a common chronic condition among older adults, has emerged in the literature as a potential modifiable risk factor for dementia. This is of interest as current pharmacological therapies for dementias such as Alzheimer’s disease only offer symptom-modifying effects. Treatment of risk factors such as hearing loss may help delay the onset of dementia and may provide an alternate therapeutic strategy. However, there is variance in the research on hearing loss and cognition with some studies reporting a small or non-significant association. In this meta-analysis, we investigated this association and we only included observational studies that used standard assessments of cognitive function and pure-tone audiometry (the clinical standard). (more…)
Author Interviews, Cognitive Issues, Dermatology, Infections, Mental Health Research, Neurological Disorders, NIH / 23.11.2017

MedicalResearch.com Interview with:   Byron Caughey, Ph.D. Senior Investigator Chief, TSE/prion Biochemistry Section Laboratory of Persistent Viral Diseases NIH/NIAID Rocky Mountain Laboratories Hamilton, MT      MedicalResearch.com: Would you briefly explain what is meant by Creutzfeldt-Jakob disease? Response: Creutzfeldt-Jakob disease (CJD) is an incurable—and ultimately fatal—transmissible, neurodegenerative disorder in the family of prion diseases. Prion diseases can be found in many mammalian species and are due to the conversion of normally harmless prion protein molecules into abnormally folded, aggregated and self-propagating clusters and filaments in the brain. The accumulation of these clusters has been associated with tissue damage that often leaves dying neurons and microscopic sponge-like holes in the brain. In the sporadic and genetic forms of CJD this pathogenic process appears to arise spontaneously in the patient. However, the transfer of the prion protein aggregates from a Creutzfeldt-Jakob disease patient into another human or experimental animal can initiate the pathogenic process in the recipient. These infectious forms of prion protein are called prions. Human prion diseases include fatal insomnia; kuru; Gerstmann-Straussler-Scheinker syndrome; and variant, familial and sporadic CJD. Sporadic CJD is the most common human prion disease, affecting about one in one million people annually worldwide. Other prion diseases include scrapie in sheep; chronic wasting disease in deer, elk and moose; and bovine spongiform encephalopathy (BSE), or mad cow disease, in cattle. (more…)
Author Interviews, Cognitive Issues, Compliance, HIV, JAMA / 16.11.2017

MedicalResearch.com Interview with: Ryan Sanford, MEng Department of Neurology and Neurosurgery Montreal Neurological Institute McGill University, Montréal, Québec, Canada   MedicalResearch.com: What is the background for this study? What are the main findings? Response: With the introduction of combination antiretroviral therapy (cART) the outlook for HIV+ individuals has dramatically shifted from a fatal disease to a chronic manageable condition. However, HIV-associated neurocognitive disorders are still prevalent. The etiology of this dysfunction remains unknown. Previous work has reported progressive brain atrophy in HIV+ individuals with advanced disease and poor viral suppression, but it is unclear whether stable treatment and effective viral suppression can mitigate the progression of brain atrophy. To examine this issue, we followed well-treated HIV+ individuals with good viral suppression and well-matched controls, and assessed whether ongoing brain atrophy occurs over time. The main finding in this study was the HIV+ participants had reduced brain volumes and poorer cognitive performance compared to the control group, but the changes in brain volumes and cognitive performance were similar between the groups. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Genetic Research, Nature / 07.11.2017

MedicalResearch.com Interview with: Dr Miguel Chillon PhD Department of Biochemistry and Molecular Biology Universitat Autonoma Barcelona Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: Klotho is a protein with an anti-aging and neuroprotective role. Recent studies show it prevents the development of cognitive problems associated with aging and Alzheimer's disease. Klotho works mainly by inhibiting the insulin / IGF-1 signaling pathway and decreasing the damage caused by oxidative stress in the brain. One of the latest results revealed that the concentration of Klotho in cerebrospinal fluid is significantly lower in Alzheimer's patients than in human controls of the same age; and it is lower in the elderly with respect to young adults. Our study used a gene therapy strategy to introduce the Klotho gene into the Central Nervous System of adult animals. With just a single injection of the Klotho gene, young adult animals were protected over time from the cognitive decline associated with aging in old animals. These exciting results pave the way to further advances in research and the development of a neuroprotective therapy based on Klotho. (more…)
Author Interviews, Cannabis, Cognitive Issues, HIV / 03.11.2017

MedicalResearch.com Interview with: Richard Saitz, MD, MPH, FACP, DFASAM Department of Community Health Sciences Boston University School of Public Health Clinical Addiction Research and Education (CARE) Unit Section of General Internal Medicine, Department of Medicin Boston University School of Medicine and Boston Medical Center Boston , Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many people living with HIV infection use alcohol and other drugs including marijuana. People with HIV infection are also susceptible to cognitive dysfunction from many causes from HIV infection itself to aging. The main findings were that among people with HIV and substance use disorder, lifetime marijuana and alcohol use were not associated with cognitive dysfunction, likely due to competing risks.  But current marijuana use was associated with cognitive dysfunction. (more…)
Author Interviews, Cognitive Issues, Heart Disease / 26.10.2017

MedicalResearch.com Interview with: Dr. Leif Friberg MD, PhD Associate professor in cardiology Karolinska Institute Friberg Resarch Stockholm, Sweden  MedicalResearch.com: What is the background for this study? What are the main findings? Response: I have been doing research on atrial fibrillation and stroke risk for many years and knew that the very common heart arrhythmia is associated with a 40% increased risk of dementia. Considering that that 12-15% of 75 years olds have this arrhythmia, and even more at higher ages, the problem is significant to say the least. The mechanism behind stroke in atrial fibrillation is that blood clots are formed in the heart. When these are dislodged they travel with the blood stream and may get stuck in the narrow vessels of the brain where they stop blood flow causing brain infarction or stroke. Oral anticoagulant drugs like warfarin or the newer so called NOAC (new oral anticoagulant) drugs are highly efficient in preventing formation of these large blood clots and offer at least 70% risk reduction. Now, blood clots come in different sizes. There are also microscopic clots that do not cause symptoms of stroke but all the same eat away at the brain at a slow but steady pace. Imaging studies shows this after only a few months or even weeks of atrial fibrillation. Our hypothesis was therefore: If anticoagulants are so effective in protecting against large clots, will they not help against the small ones too? (more…)
AACR, Alzheimer's - Dementia, Author Interviews, Cancer Research, Cognitive Issues, Colon Cancer, UCSF / 24.10.2017

MedicalResearch.com Interview with: Yingjia Chen, M.Sc, MPH, Ph.D. Postdoctoral Fellow University of California, San Francisco  MedicalResearch.com: What is the background for this study? Response: Both colon cancer and dementia are prevalent among the elderly and have a high risk of co-occurrence. Previous studies found that patients with dementia were treated less aggressively. In this study, we hypothesized that presence of pre-existing dementia was associated with worse survival for stage III colon cancer patients, and that post-operative chemotherapy was on the causal pathway. (more…)
Author Interviews, Cognitive Issues, Mental Health Research / 20.09.2017

MedicalResearch.com Interview with: Amitai Abramovitch, PhD Assistant Professor Department of Psychology Texas State University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obsessive-Compulsive Disorder (OCD) is associated with moderate degree of underperformance on several cognitive tests such as processing speed, and some higher order functions such as planning and inhibition. While this does not constitute a clinically meaningful impairment on these functions, we set out to explore the prevailing myth that OCD is associated with above-average intelligence. This myth, that was propagated by Sigmund Freud 115 years ago and is still surprisingly all too prevalent -  was never tested empirically. The notion of above average intelligence in OCD didn’t make sense to us given that IQ tests are comprised of subtests that assess cognitive function. To test this, we collected all the available data ever published in the scientific literature regarding IQ in OCD versus control samples, and conducted a meta-analysis. Our results show that OCD is not associated with higher IQ than average. In fact we found a slightly lowered IQ in OCD compared to controls, although IQ scores for OCD samples were in the average range. The total IQ score (Full Scale IQ) is comprised of two subscales, namely Verbal IQ, and Performance IQ. Our results show that reduced Full Scale IQ stems primarily from lowered Performance IQ, a scale that is comprised of a number of timed tests. In other words, as opposed to Verbal IQ tests, test scores on Performance IQ subtests rely heavily on performance within a specific time frame, and not only on performance accuracy. Thus, our findings suggest that reduced processing speed found in OCD could lead to reduced Performance IQ, and subsequently lead to lowered Full Scale IQ, and may not be indicative of specific cognitive deficits. This finding suggests that IQ tests administered to individuals diagnosed with OCD may result in a biased Full Scale IQ scores that does not accurately reflect their full intellectual potential. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, JAMA / 05.09.2017

MedicalResearch.com Interview with: Carol A. Derby, Ph.D. Research Professor, The Saul R. Korey Department of Neurology Research Professor, Department of Epidemiology & Population Health Louis and Gertrude Feil Faculty Scholar in Neurology Albert Einstein College of Medicine Bronx, NY 10461 MedicalResearch.com: What is the background for this study? Response: The population over the age of 85 is expected to triple in the coming decades, and with the aging of the population, the number of individuals living with dementia is projected to increase dramatically. While dementia prevalence rates are driven by demographic shift to older ages, changes in dementia incidence- the rate at which new cases are diagnosed, would also impact the proportion of the population affected in the coming decades. Recently, studies have suggested that dementia incidence rates may be declining in some populations, although the results have not been consistent. Better understanding trends in dementia rates is important for public health planning. Our objective was to determine whether there has been a change in the incidence of dementia diagnosis within a community residing group of over older adults followed by the Einstein Aging Study, at the Albert Einstein College of Medicine, in the Bronx, NY between the years 1993 and 2015. To accurately characterize trends over time in disease rates requires separating the effects of age and the effects of calendar time. Therefore, we conducted a birth cohort analysis in which we examined age specific dementia incidence rates by birth year, for individuals born between 1910 and 1940. The analysis included over 1300 individuals over the age of 70, who were free of dementia when they enrolled in the study. Dementia was diagnosed using identical criteria over the entire study period, and study recruitment was also consistent over the period. We also examined trends in cardiovascular co-morbidities that have been related to dementia risk, as well as trends in education.  (more…)
Author Interviews, Cognitive Issues, JAMA, Sleep Disorders / 30.08.2017

MedicalResearch.com Interview with: Yue Leng, M.Phil, MD, PhD Postdoctoral Research Fellow Department of Psychiatry, University of California, San Francisco SFVAMC  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sleep-disordered breathing (SDB) is a very common but treatable condition in older adults. Recent evidence has suggested a link between SDB and cognitive decline in the elderly, but previous studies have been conflicting and have used different methods to examine SDB or cognition. Therefore, it is difficult to draw conclusion on the consistency of this association based on each individual study. Moreover, because each study has reported on specific domains using different scales, it is unclear if Sleep-disordered breathing has differential effects on cognitive domains. The current study is the first to quantitively synthesize all published population-based studies, which covers a total of over 4 million adults, and concluded that people with Sleep-disordered breathing were 26% more likely to develop cognitive impairment than those without SDB. They also had slightly worse performance in executive function but not in global cognition or memory.  (more…)
Author Interviews, Brain Injury, Cleveland Clinic, Cognitive Issues, MRI, Occupational Health / 29.07.2017

MedicalResearch.com Interview with: Virendra Mishra, Ph.D. Department of Imaging Research Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas MedicalResearch.com: What is the background for this study? What are the main findings? Response: Repetitive head trauma has been shown to be a risk factor for various neurodegenerative disorders, mood swings, depression and chronic traumatic encephalopathy. There has been a significant amount of research into identifying an imaging biomarker of mild traumatic brain injury (mTBI) due to repetitive head trauma. Unfortunately, most of the biomarkers have not been able to find a successful translation to clinics. Additionally, the quest for the mTBI imaging biomarker especially using Magnetic Resonance Imaging (MRI) techniques has been done by looking at either the gray matter (T1-weighted) or the white matter (Diffusion Tensor Imaging) independently; and both have shown changes that are associated with repetitive head trauma. Hence in this study, we wanted to investigate if combining gray matter and white matter information enables us to better predict the fighters who are more vulnerable to cognitive decline due to repetitive head trauma. Our method found seven imaging biomarkers that when combined together in a multivariate sense were able to predict with greater than 73% accuracy those fighters who are vulnerable to cognitive decline both at baseline and follow-up. The imaging biomarkers were indeed a combination of gray and white matter measures of regions reported previously in the literature. A key point in our study was we found the regions predicting cognitive decline without enforcing any assumptions on the regions previously reported. (more…)
Author Interviews, Cognitive Issues, General Medicine, JAMA / 26.07.2017

MedicalResearch.com Interview with: Jochen René Thyrian, PhD German Center for Neurodegenerative Diseases (DZNE) Greifswald, Germany MedicalResearch.com: What is the background for this study? What are the main findings? Response: Dementia presents a challenge to the health care systems worldwide. People with dementia (PWD) need comprehensive medical, nursing, psychological and social support to delay the progression of disease and sustain autonomy and social inclusion. Evidence-based interventions alleviate the burden of disease for PwD and their caregivers, as no curative treatment is currently available. Involving caregivers is important because they provide the largest proportion of care for PwD. General physicians in residency have been identified as the first point of contact for PwD and is thus a promising setting for identification, comprehensive needs assessment and initiating dementia-specific treatment and care. In this study we tested the effectiveness and safety of a model of collaborative care, Dementia Care Management (DCM) on patient-oriented outcomes in n=634 people screened positive for dementia in primary care. DCM is provided by specifically trained nurses, supported by a computerized intervention management system, in close cooperation with the treating physician at the people´s homes. Recommendations for improving treatment and care were based on a comprehensive needs assessment, discussed interprofessionally and their implementation monitored/ adjusted over the course of 6-12 months (more…)
Author Interviews, Cognitive Issues, PLoS / 26.07.2017

MedicalResearch.com Interview with: Carla Aimé PhD Institute of Evolutionary Sciences of Montpellier France MedicalResearch.com: What is the background for this study? What are the main findings? Response:  In all human populations, regardless of environmental and socioeconomic conditions, menopause occurs in women well before the end of their expected lifespan. Conversely, extensive post-reproductive life-span is rare in other species; except in some cetaceans. Evolutionary theory predicts that menopause and extensive post-reproductive lifespan should emerge and persist in populations only if it is advantageous for gene transmission. Identifying this advantage is a long-standing issue, and some hypotheses has already been suggested by other researchers. However, testing these hypotheses about the emergence of menopause is difficult, in particular because menopause exists today in all human populations. It is thus not possible to measure in real life the evolutionary advantage related to menopause by comparing gene transmission of women who stop reproduction and women who don't stop reproduction. Here, we used computer simulations to overcome this difficulty by modeling the emergence of menopause in simulated human populations. The main finding were the following : - Physiological constraints are not required for menopause to emerge. - The increasing cost of reproduction with age cannot explain menopause. - Grandmothering is part of the process leading to menopause : stopping reproduction allow reallocating resources to existing children and grand-children, thus leading to increase gene transmission via increased fertility of children and survival of grand children - Cognitive resources are also important. Indeed, cognitive abilities allow accumulation of skills and experience over the lifespan, thus providing an advantage for resource acquisition. These surplus resources can then be used to increase the number of offspring or be transmitted to existing offspring and grandoffspring. Stopping reproduction during aging allows allocating more resources to assist offspring and grandoffspring, thus increasing children’s fertility and grandchildren’s survival. (more…)
Author Interviews, Cognitive Issues, JAMA, Schizophrenia / 26.07.2017

MedicalResearch.com Interview with: Olav B. Smeland MD PhD Postdoctoral researcher SFF NORMENT, KG Jepsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine University of Oslo Oslo, Norway MedicalResearch.com: What is the background for this study? What are the main findings? Response: Schizophrenia is a severe mental disorder associated with widespread cognitive impairments. The cognitive deficits are associated with disabilities in social, economic and occupational functioning and lower quality of life among individuals with schizophrenia. Despite this, current treatment strategies largely fail to ameliorate these cognitive impairments. To develop more efficient treatment strategies in schizophrenia, a better understanding of the disease mechanisms underlying cognitive deficits is needed. For a long time we have known that schizophrenia is heritable, and in recent years many schizophrenia risk genes have been identified. Moreover, several studies have indicated that genetic risk of schizophrenia may contribute to cognitive dysfunction. In this study, we aimed to identify schizophrenia risk genes that also influence cognitive function. In a large international collaboration of researchers, we combined genome-wide association studies on schizophrenia and the cognitive traits of verbal-numerical reasoning, reaction time and general cognitive function. In total, we analyzed genetic data from more than 250.000 participants. We were able to identify 21 genetic variants shared between schizophrenia and cognitive traits. For 18 of these genetic variants, schizophrenia risk was associated with poorer cognitive performance. (more…)