Blue Light Exposure Can Have Lasting Effect on Cognitive Function

MedicalResearch.com Interview with:

Dr. Anna Alkozei

Dr. Anna Alkozei

Anna Alkozei, Ph.D.
Postdoctoral Research Fellow
SCAN Lab, Psychiatry Department
University of Arizona
Tucson, AZ 85724-5002

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Alkozei: We know that exposure to blue wavelength light, which is similar to the kind of light that we get on a bright sunny day, can improve attention and alertness during the day as well as at night. We wanted to extend previous findings by investigating whether blue light exposure can affect cognitive functioning after the blue light exposure period had already ended. We found that thirty minutes of exposure to blue wavelength light during the day, in comparison to an amber light exposure led to subsequently faster reaction times on a cognitive task forty minutes after the light exposure had already ended. Participants who were exposed to blue light also showed more efficient responding, which means they answered more items correctly per second, than individuals who were exposed to amber placebo light. Finally, we also found that individuals who were exposed to blue light showed greater activation within the prefrontal cortex when performing the task, an area necessary for optimal cognitive performance, than individuals who were exposed to amber light.

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Multiple Brain Microbleeds Linked To Cognitive Decline and Risk of Dementia

MedicalResearch.com Interview with:

Meike Vernooij, MD PhD Associate professor Radiology and Epidemiology Neuroradiologist and head & neck radiologist Rotterdam, The Netherlands

Dr. Meike Vernooij

Meike Vernooij, MD PhD
Associate professor
Radiology and Epidemiology
Neuroradiologist and head & neck radiologist
Rotterdam, The Netherlands

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Vernooij: Background of this study was the fact that small brain bleeds, so-called cerebral microbleeds, are recognized increasingly as markers on brain scans of disease of the brain’s small vessels. In earlier years, microbleeds were demonstrated to be very frequent in patients with stroke, and also in persons with Alzheimer’s disease. Yet, our previous work indicated that microbleeds are not only common in patients, but are also frequently seen (in up to 1 in 5 individuals over age 45) in presumably healthy persons. Our main research question was therefore whether the presence of microbleeds on brain scans of asymptomatic, stroke-free and dementia-free individuals, was related to risk of cognitive decline and risk of dementia. We studied this in a population of > 4,800 persons whom we followed for nearly 6 years.

Our main findings are that presence of microbleeds, especially when multiple (esp > 4), relates to cognitive decline and risk of dementia, in particular Alzheimer’s disease.

MedicalResearch.com: What should readers take away from your report?

Dr. Vernooij:  Our results indicate that microbleeds mark the presence of diffuse vascular and neurodegenerative brain damage.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Vernooij:  Future research should focus on exact mechanisms how microbleeds lead to dementia and cognitive decline, to identify possible preventive pathways.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Akoudad S, Wolters FJ, Viswanathan A, et al. Association of Cerebral Microbleeds With Cognitive Decline and Dementia. JAMA Neurol. Published online June 06, 2016. doi:10.1001/jamaneurol.2016.1017.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Limited Anesthesia in Young Children Not Link To Later Cognitive Impairment

MedicalResearch.com Interview with:

Lena S. Sun, MD E. M. Papper Professor of Pediatric Anesthesiology Professor of Anesthesiology and Pediatrics Executive Vice Chairman, Department of Anesthesiology Chief, Division of Pediatric Anesthesiology Columbia University Medical Center New York, New York 10032

Dr. Lena S. Sun

Lena S. Sun, MD
E. M. Papper Professor of Pediatric Anesthesiology
Professor of Anesthesiology and Pediatrics
Executive Vice Chairman, Department of Anesthesiology
Chief, Division of Pediatric Anesthesiology
Columbia University Medical Center
New York, New York 10032

MedicalResearch.com: What is the background for this study?

Dr. Sun: The background for the study is as follow: There is robust evidence in both rodent and non-human primate studies that exposure of the developing brain leads to impairment in cognitive function and behavior later in life. The evidence from human studies derives mostly from retrospective studies and the results have been mixed. Some have demonstrated anesthesia in early childhood was associated with impaired neurocognitive function, while others have found no such association. Our study is the first to specifically designed to address the question of effects of general anesthesia exposure on cognitive function, comparing exposure with no exposure.

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Study Addresses Why Blacks Are At Higher Risk of Cognitive Impairment in Later Life

MedicalResearch.com Interview with:

Zhenmei Zhang, Ph.D. Associate Professor Department of Sociology Michigan State University East Lansing, MI48824

Dr. Zhenmei Zhang

Zhenmei Zhang, Ph.D.
Associate Professor
Department of Sociology
Michigan State University
East Lansing, MI48824

MedicalResearch.com: What is the background for this study?

Dr. Zhang: Blacks are especially hard hit by cognitive impairment and dementia. Recent estimates of dementia prevalence and incidence were substantially higher for blacks than whites. Reducing racial/ethnic disparities in dementia has been identified as a national priority by the National Alzheimer’s Project Act, which was signed into law by President Obama in 2011. So I really want to contribute to the ongoing discussion of the origins and pathways through which racial disparities in cognitive impairment is produced. If we have a better understanding of the factors contributing to racial disparities in cognitive impairment in later life, more effective interventions can be conducted to reduce the racial disparities.
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Higher Blood Pressure Variability Predicts Faster Cognitive Decline

MedicalResearch.com Interview with:

Bo (Bonnie) Qin, Ph.D. Postdoctoral Scholar Rutgers Cancer Institute of New Jersey New Brunswick, NJ 08903

Dr. Bo Qin

Bo (Bonnie) Qin, Ph.D.
Postdoctoral Scholar
Rutgers Cancer Institute of New Jersey
New Brunswick, NJ 08903

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Qin: Preventing or delaying the age-related cognitive decline that typically precedes the onset of dementia is particularly important considering that no effective strategies for dementia treatment have been identified. Vascular conditions such as hypertension are thought to be risk factors for cognitive decline, but important gaps in the literature on this topic remain.

Randomized clinical trials of blood pressure-lowering treatments for reducing the risk of cognitive decline or dementia have largely failed to achieve beneficial effects. However, over the past 6 years, scientific evidence has accumulated that blood pressure variability over monthly or yearly visits may lead to greater risk of stroke and small and larger vessel cerebrovascular diseases. They could lead to subsequent changes related to cognitive dysfunction among older adults. We, therefore, hypothesized that blood pressure variability between visits is associated with a faster rate of cognitive function among older adults.

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Elevated Blood Pressure Is Risk Factor For Vascular Dementia

MedicalResearch.com Interview with:

Kazem Rahimi, DM, MSc Oxford Martin School University of Oxford United Kingdom

Dr. Kazem Rahimi

Kazem Rahimi, DM, MSc
Oxford Martin School
University of Oxford
United Kingdom

MedicalResearch.com: What is the background for this study?

Dr. Rahimi: Vascular dementia is the second most common cause of dementia and is increasing in prevalence worldwide. Vascular dementia often occurs after stroke and can cause apathy, depression, and a decline in cognitive function, and can eventually result in death. High blood pressure (BP) has been identified as a potential risk factor for the development of vascular dementia. However, previous studies, which have been small in size, have reported conflicting results on the relationship between blood pressure and vascular dementia.

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Shift Work Linked To Cognitive Impairment in Middle Aged and Older Adults

MedicalResearch.com Interview with:

Christian Benedict Ph.D Dept. of Neuroscience Uppsala University, Swedenphotographer: Magnus Bergström

Dr. Christian Benedict

Christian Benedict Ph.D
Dept. of Neuroscience
Uppsala University, Sweden

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Benedict: A considerably large proportion of today’s workforce performs shift work. Both epidemiological and experimental studies have demonstrated that shift workers are at an increased risk for multiple diseases, such as cardiovascular diseases. However, knowledge regarding short- and long-term effects of shift work on parameters of brain health is still fragmentary.

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Low Vitamin B12 Associated With Accelerated Brain Aging

MedicalResearch.com Interview with:

Babak Hooshmand, MD, PhD, MPH Center for Alzheimer Research–Aging Research Center Karolinska Institutet Stockholm University, Stockholm, Sweden  Department of Neurology, Klinikum Augsburg Augsburg, Germany

Dr. Babak Hooshmand

Babak Hooshmand, MD, PhD, MPH
Center for Alzheimer Research–Aging Research Center
Karolinska Institutet
Stockholm University, Stockholm, Sweden
Department of Neurology, Klinikum Augsburg
Augsburg, Germany

MedicalResearch.com: What is the background for this study? What are the main findings?

 Dr. Hooshmand: Low and subnormal levels of vitamin B12 as well as high levels of homocysteine (a vascular risk factor and neurotoxic amino-acid associated with B12 deficiency) are common conditions in the elderly and are associated with a variety of disorders, including cardiovascular and cerebrovascular

conditions. Our study showed that over 6-year of follow-up, both low vitamin B12 status and high homocysteine levels are associated with accelerated brain atrophy in older adults, which precedes clinical dementia.

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Cognitive Impairment Linked to Readmissions For Heart Failure

MedicalResearch.com Interview with:

Thomas H. Marwick, MBBS, PhD, MPH Baker IDI Heart and Diabetes Institute Melbourne, Australia

Dr. Thomas Marwick

Thomas H. Marwick, MBBS, PhD, MPH
Baker IDI Heart and Diabetes Institute
Melbourne, Australia

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Marwick: Readmission for heart failure (HF) remains common and the risk of this remains hard to predict. It’s possible that existing risk scores don’t cover all important patient features. We confirmed that cognitive impairment was an unmeasured contributor and incorporated this measurement in a prediction model. The resulting model was the most reliable reported to date and could be used to identify patients who need the closest follow up to avoid readmission.

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Fewer Teeth Linked To Greater Cognitive Decline

MedicalResearch.com Interview with:

Elham Emami, DDS, MSc, PhD Professeure agrégée Faculté de médecine dentaire École de santé publique, Département de médecine sociale et préventive Université de Montréal Montréal (Québec) Canada

Dr. Elham Emami

Elham Emami, DDS, MSc, PhD
Director , Oral Health and Rehabilitation Research Unit & Associate Professor
Faculty of Dental Medicine & School of Public Health
Université de Montréal
Adjunct Professor McGill University

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Emami: Over the past 20 years, scientific evidence has shown that oral and general health are closely linked. Recently, studies have shown that there is also a link between the number of teeth an older person has and his/her cognitive status.

We carried out a meta-analysis using the data from these latter studies. Our results indicate that, taking into account socioeconomic differences and other potential confounding variables, a person with less than 20 teeth has a 20% greater risk of having cognitive decline (HR= 1.26, 95% CI = 1.14 to 1.40) and dementia (HR = 1.22, 95% CI = 1.04 to 1.43) than someone who has 20 or more teeth.

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Better Cardiovascular Health Associated With Better Cognitive Functioning

MedicalResearch.com Interview with:
Hannah Gardener, ScD
Department of Neurology, Miller School of Medicine
University of Miami
Miami, FL

MedicalResearch.com: What is the background for this study?

Response: At the beginning of the study, 1,033 participants in the Northern Manhattan Study (average age 72; 65 percent Hispanic, 19 percent black and 16 percent white), were categorized using the American Heart Association’s “Life’s Simple Seven®” definition of cardiovascular health, which includes tobacco avoidance, ideal levels of weight, physical activity, healthy diet, blood pressure, cholesterol and glucose. The participants were tested for memory, thinking and brain processing speed. Brain processing speed measures how quickly a person is able to perform tasks that require focused attention. Approximately six years later, 722 participants repeated the cognitive testing, which allowed us to measure performance over time. The cardiovascular health factors, which have been shown to predict risk of stroke and myocardial infarction, were then examined in relation to cognitive performance and impairment over time.

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Study of Cognitive Functioning after Surgery Has Reassuring Findings

MedicalResearch.com Interview with:

Unni Dokkedal, M.P.H. Unit of Epidemiology, Biostatistics, and Biodemography University of Southern Denmark

Unni Dokkedal

Unni Dokkedal, M.P.H.
Unit of Epidemiology, Biostatistics, and Biodemography
University of Southern Denmark

MedicalResearch: What is the background for this study? 

Response: Early (seven days) postoperative cognitive impairment is common in adult surgical patients of all ages, but elderly patients are at higher risk for this complication. Previous studies have shown that these impairments are detectable up to three months after surgery in patients older than 60 years. Furthermore, the condition may persist for longer than six months in some patients with potential long-term implications of the surgery leading to impaired quality of life and increased mortality risk. We wanted to investigate the contribution of surgery, anesthesia, preexisting conditions and other factors on the postoperative cognitive functioning of elderly patients.

MedicalResearch:  What are the main findings?

Response: For a sample of 4,299 middle-aged twins younger than 70 years and 4,204 elderly twins over 70 years, all of whom were residents of Denmark, medical records were reviewed from 1977 and until the accomplishment of cognitive tests in the period from 1995 to 2001. Results from five cognitive tests were compared in twins exposed to surgery, classified as major, minor, hip and knee replacement, or other, with those of a reference group without surgery. A statistically significant lower composite cognitive score was found in twins with at least one major surgery compared with the reference group (mean difference, −0.27; 95% CI, −0.48 to −0.06), which is a negligible effect size. None of the other groups differed from the reference group except the knee and hip replacement group that tended to have higher cognitive scores (mean difference, 0.35; 95% CI, −0.18 to 0.87).To consider genetic and shared environmental confounding and to take preoperative cognition into account, intrapair analyses were performed in same-sexed pairs in whom one had a history of major surgery and the other no surgery. No difference was found in the intra-pair analysis. The results suggest that preoperative cognitive functioning and underlying diseases were more important for cognitive functioning in mid- and late life than surgery and anesthesia.
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Poor Sleep Linked to Cognitive Issues in Fetal Alcohol Syndrome

MedicalResearch.com Interview with:

Donald A. Wilson, Ph.D. Professor, Departments of Child & Adolescent Psychiatry and Neuroscience & Physiology NYU Langone Medical Center Senior Research Scientist Nathan Kline Institute for Psychiatric Research

Dr. Donald Wilson

Donald A. Wilson, Ph.D.
Professor, Departments of Child & Adolescent Psychiatry and Neuroscience & Physiology
NYU Langone Medical Center
Senior Research Scientist
Nathan Kline Institute for Psychiatric Research

Medical Research: What is the background for this study? What are the main findings?

Dr. Wilson: Fetal alcohol spectrum disorder (FASD) is characterized by cognitive, emotional and behavioral problems that are life-long.  Generally, it is assumed that the initial trauma of alcohol exposure at a critical time in life is the cause of these problems.  In this study using an animal model of FASD, we find that developmental alcohol causes a life-long disturbance in sleep.  Given that sleep is important for memory and emotion, among other things, this suggests that developmental alcohol can produce a daily insult to the brain, far outlasting that initial exposure.  Each night, the brain is unable to store memories, adjust emotional circuits, remove waste products, in the way that it should, because FASD has disrupted sleep.

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Intellectual Activity May Delay Onset of Alzheimer’s Dementia

MedicalResearch.com Interview with:

Prashanthi Vemuri, PhD Mayo Clinic Rochester, Minnesota

Dr. Prashanthi Vemuri

Prashanthi Vemuri, PhD
Mayo Clinic
Rochester, Minnesota 

Medical Research: What is the background for this study? What are the main findings?

Dr. Vemuri: Lifetime Intellectual enrichment has been found to delay the symptoms of dementia but the impact on brain changes due to Alzheimer’s disease has been poorly understood. In this study we studied the impact of lifetime intellectual enrichment (education, occupation, and midlife cognitive activities) on the brain changes related to Alzheimer’s disease. We obtained serial imaging on 393 individuals from a population based sample. We found that in majority of the individuals, there were minimal effects of intellectual enrichment on brain changes due to Alzheimer’s disease. However in those with higher genetic risk of Alzheimer’s, lifetime intellectual enrichment had a protective effect on the brain.

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Dementia Incidence Dropping In Those With At Least High School Education

MedicalResearch.com Interview with:

Claudia L. Satizabal, PhD Instructor in Neurology Boston University School of Medicine The Framingham Heart Study Boston, MA 02118-2526

Dr. Claudia Satizabal

Claudia L. Satizabal, PhD
Instructor in Neurology
Boston University School of Medicine
The Framingham Heart Study
Boston, MA 02118-2526

MedicalResearch: What is the background for this study? What are the main findings?

 

Dr. Satizabal: Our societies are expected to face an increasing burden of dementia in the next decades due to increasing life expectancies and the aging of a big proportion of the population, the so called “baby boomers”. However, some studies conducted in high-income countries have suggested a decline in the total number of cases (prevalence) as well as new cases (incidence) of dementia at any given age. Yet the findings of these studies were not seen as definitive, either because results were of borderline significance or because they were based on survey data, and stronger evidence was lacking.

We used information collected since 1975 in the Framingham Heart Study to estimate the trends in dementia incidence. One of the strengths of this study is that investigators have been careful to use the same diagnostic criteria for over the past 30 decades, which allows us to provide more robust evidence of dementia trends over time.

We found that there has been a progressive decline in the incidence of dementia at any given age over the past 30 decades. Compared to the late 1970s, we observed a decline of 22% in the late 1980s, 38% in the 1990s and 44% in the 2000s. This beneficial trend was only seen among persons with at least a high school diploma. We also explored trends in vascular risk factors such as blood pressure, smoking, diabetes, and others; however, these trends did not completely explain the decline in dementia incidence. One interesting finding was that the risk of dementia associated with cardiovascular diseases, such as stroke or atrial fibrillation, decreased dramatically over the course of time from the late 1970s to the 2000s.

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Midlife Weight Loss Linked to Mild Cognitive Impairment

Rosebud O. Roberts, M.B., Ch.B. Mayo Clinic Rochester, Minn.

Dr. Rosebud Roberts

MedicalResearch.com Interview with:
Rosebud O. Roberts, M.B., Ch.B.
Mayo Clinic
Rochester, Minn. 

Medical Research: What is the background for this study?

Dr. Roberts: Decline in weight has been observed 10-20 years prior to onset of dementia. We wanted to study whether this decline also occurs for mild cognitive impairment (an intermediate stage in the progression from normal cognition to dementia).

Medical Research: What are the main findings?

Dr. Roberts: The main finding was that there was indeed a decline in weight (from the maximum weight in midlife to weight assessed in late life) was associated with a increased risk of mild cognitive impairment.

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Unrecognized Cognitive Impairment in Heart Failure Patients Increases Costs and Readmissions

MedicalResearch.com Interview with:

Mark W Ketterer PhD, ABPP Health Psychology Henry Ford Hospital Detroit Michigan

Dr. Mark Ketterer

Mark W Ketterer PhD, ABPP
Health Psychology
Henry Ford Hospital
Detroit Michigan

MedicalResearch.com: What is the background for this study? What are the main findings? 

Dr. Ketterer:  Reducing wasteful healthcare costs is a high priority For Medicare/Medicaid, Obamacare and all third party payors.  Cognitive impairment (CI) is highly prevalent in patients  with chronic illnesses identified as having high readmission rates by the Center for Medicare and Medicaid Services (1,2,3), such as Congestive Heart Failure (4,5), End Stage Renal Disease (6,7) and Chronic Obstructive Pulmonary Disease (8-14). CI  is also a known prospective predictor of longer term admissions and deaths (15-18). Poor adherence is a frequent consequence of cognitive impairment (19,20), particularly when the family and/or patient have not yet recognized and intervened for the evolving problem, or the patient is not in a setting (e.g., Nursing Homes) that supervises medication administration

MedicalResearch.com: What should clinicians and patients take away from your report? 

Dr. Ketterer:  

  • Aggressive evaluation of heart failure patients for cognitive impairment.
  • Involvement of family in maximizing adherence is better care, and more efficient care.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Ketterer:  A randomly-assigned, controlled clinical trial of this intervention is warranted, needed and should be a high priority in healthcare research.

MedicalResearch.com: Is there anything else you would like to add? 

Dr. Ketterer:  As currently constructed, our healthcare system neglects common behavioral causes of waste, misdiagnosis and treatment failure.  Nonrecognition of cognitive impairment in heart failure patients is about 90%.  This can be a catastrophic failure for a given patient, resulting in a preventable death.

Citation:

Cognitive Impairment and Reduced Early Readmissions in Congestive Heart Failure? –

Mark W. Ketterer, PhD; Jennifer Peltzer, PsyD; Usamah Mossallam, MD; Cathy Draus, RN; John Schairer, DO; Bobak Rabbani, MD; Khaled Nour, MD; Gayathri Iyer, MD; Michael Hudson, MD; and James McCord, MD –

American Journal Managed Care Published Online: January 25, 2016

Mark W Ketterer PhD, ABPP (2016). Unrecognized Cognitive Impairment in Heart Failure Patients Increases Costs and Readmissions 

Reading Difficulties May Complicate Identification of Early Alzheimer’s Disease

Brian K. Lebowitz

Dr. Lebowitz

MedicalResearch.com Interview with:
Dr. Brian K. Lebowitz, PhD ABPP-CN
DIRECTOR OF NEUROPSYCHOLOGY TRAINING
Clinical Neuropsychologist
Clinical Assistant Professor, Neurology
Stony Brook University Medical Center

Medical Research: What is the background for this study? What are the main findings?

Dr. Lebowitz: As a lifespan neuropsychologist, my clinical work involves evaluating cognitive concerns in both children and adults.  We know that children with learning disorders, such as dyslexia, often demonstrate difficulties on neuropsychological tests that are seemingly unrelated to reading.  For example, children with dyslexia may have difficulty with auditory processing and short-term memory.  We also know that, for many individuals, learning disorders remain present throughout the lifespan.  Despite awareness of the relationship between reading disorder and other areas of cognitive weakness, many clinicians who work with older adults do not routinely ask about academic/neurodevelopmental history.  Further, little research has assessed the potential impact of lifelong learning disorder on later life neuropsychological test performance. Our study attempted to assess whether or not a history of possible reading disorder increased the likelihood that an individual’s performance would fall at a level suggestive of possible Mild Cognitive Impairment MCI), a diagnosis associated with increased risk for Alzheimer’s disease.  Individuals with MCI continue to function normally in everyday life but experience subjective memory problems and identified weaknesses on neuropsychological tests.  Our study found a strong relationship between poor reading ability and low memory test scores on two tests commonly used to evaluate memory complaints in older adults.  Depending on the test, individuals with a suspected reading disorder were two to three-and-one-half times more likely than their peers to score at a level indicative of Mild Cognitive Impairment.

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Obesity in Pre-School Years Linked To Some Cognitive Deficits

Dr Anne Martin PhD Research Associate/Research Fellow Physical Activity for Health Research Centre (PAHRC) Institute for Sport, PE & Health Sciences University of Edinburgh TeleScot Research Group Usher Institute for Population Health Sciences and Informatics Edinburgh

Dr. Martin

MedicalResearch.com Interview with:
Dr Anne Martin PhD

Research Associate/Research Fellow
Physical Activity for Health Research Centre (PAHRC)
Institute for Sport, PE & Health Sciences
University of Edinburgh
TeleScot Research Group
Usher Institute for Population Health Sciences and Informatics
Edinburgh

Medical Research: What is the background for this study? What are the main findings?

Dr. Martin: Impairments in cognitive development during childhood can have detrimental effects on health behaviour, educational attainment, and socio-economic status later in life. Epidemiological evidence indicates an association between childhood obesity and cognition and educational attainment. Knowledge of when obesity related deficits in cognition and attainment emerge, and how large the deficits are at various ages, may be useful to support arguments for school-based obesity prevention initiatives and in translating evidence on this topic into policy aimed at preventing obesity.

In this study we explored whether the adverse association between obesity and cognition emerges in early childhood. Measures of cognitive abilities included visuo-spatial skills, expressive language skills and reasoning skills. Our findings indicated that obesity in the pre-school years may be weakly associated with some poorer cognitive outcomes at age 5 years in boys, independently of socioeconomic status.

Stronger relationships between obesity and cognition or educational attainment may emerge later in childhood. Evidence from an English cohort study suggested an adverse association between obesity in teenage girls and lower academic attainment in Mathmatics, Science and English.

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Physical Activity Important For Brain Health At Any Age

MedicalResearch.com Interview with:
Tina Hoang MSPH
Staff Research Associate
Northern California Institute for Research and Education,
Veterans Affairs Medical Center
Dr. Kristine Yaffe MD
Professor of Psychiatry, Neurology, and Epidemiology
University of California
San Francisco, CA  94121

Medical Research: What is the background for this study? What are the main findings?

Response: We assessed physical activity and TV watching in young adults over 25 years to see if there was an association with cognitive function in middle age.  Most previous studies have only considered this association in older adults. We found that both low physical activity and high TV watching over time were associated with worse cognitive function.

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Visual Processing Speed Predicts Executive Functioning

Catherine Mewborn, B.A. Neuropsychology and Memory Assessment Laboratory Department of Psychology University of Georgia

Ms. Mewborn

MedicalResearch.com Interview with:
Catherine Mewborn, B.A.
Neuropsychology and Memory Assessment Laboratory
Department of Psychology
University of Georgia

Medical Research: What is the background for this study?

Response: Vision and cognitive functioning both tend to decline as individuals age. Processing speed, or the speed at which an individual can process information, is particularly vulnerable to age-related declines. In previous studies, cognition has typically been measured using traditional paper-and-pencil tests; however, these tests can be quite complex and recruit many different abilities. We wanted to use a simpler test to assess processing speed in the hopes of tapping into the more basic abilities that underlie performance on more complex cognitive tasks. For this study, we chose a measure of visual processing speed called critical flicker fusion, or CFF. We tested how well CFF could predict cognition in both younger and older adults.

Medical Research: What are the main findings?

Response: As expected, younger adults had better visual processing speed than older adults. Interestingly, in both age groups, CFF significantly predicted performance on a test of executive functioning, which assess abilities such as problem-solving and shifting attention between different tasks.

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Bilingual Patients More Likely To Recover From Stroke

MedicalResearch.com Interview with:
Dr. Thomas Bak

Centre for Cognitive Aging and Cognitive Epidemiology and Centre for Clinical Brain Sciences, University of Edinburgh and
Dr. Suvarna Alladi
Nizam’s Institute of Medical Sciences, Hyderabad, India

Medical Research: What is the background for this study? What are the main findings?

Response: In a previous study published in 2013 (attached) we have reported that bilingual patients develop dementia around 4 years later than monolingual ones – a phenomenon, which we tried to explain in a commentary in 2014 (also attached); the mechanism we have postulated as a possible explanation is so called “cognitive reserve”: the ability of the brain, boosted by a range of different mental activities, to cope better with potential damage. One manifestation of it has been now described in several studies: bilingual patients seem to develop dementia later than monolingual ones. But if the cognitive reserve helps in coping with brain damage, it should also help with the recovery after stroke. This was exactly what we set out to examine and exactly what we found. Bilingual patients showed a complete recovery of cognitive functions after stroke over twice as often as monolingual ones (40/5% vs. 19.6%).

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Patients with Colon Cancer May Have Memory and Cognitive Impairments

Dr Janette Vardy  BMed (Hons), PhD, FRACP A.Prof of Cancer Medicine University of Sydney Medical Oncologist ,Concord Cancer Centre Concord Repatriation & General Hospital Concord, Australia

Dr. Vardy

MedicalResearch.com Interview with:
Dr Janette Vardy  BMed (Hons), PhD, FRACP

A.Prof of Cancer Medicine
University of Sydney
Medical Oncologist ,Concord Cancer Centre
Concord Repatriation & General Hospital
Concord, Australia 

Medical Research: What is the background for this study?

Dr. Vardy: Many patients complain that their memory and concentration is not as good after chemotherapy.  Most of the studies have been in younger women with breast cancer, and are often limited by small sample sizes and short term follow up.    This is the largest longitudinal cohort study assessing impacts of cancer and its treatment on cognitive function.

We evaluated changes in cognitive function in 289 men and women with localized colorectal cancer (CRC), comparing those who received chemotherapy to those who did not require chemotherapy, 73 with metastatic disease, and a group of 72 healthy controls.?The localized CRC patients were assessed at baseline (soon after diagnosis and prior to any chemotherapy), 6, 12 and 24 months.  The healthy controls and metastatic group were assessed at baseline, 6 and 12 months.  We also examined underlying mechanisms.

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Chemotherapy-induced Peripheral Neuropathy Linked To Cognitive Dysfunction In Breast Cancer Patients

MedicalResearch.com Interview with:
Kelly N. H. Nudelman, Ph.D.
Department of Radiology and Imaging Sciences
Indiana University-Purdue University Indianapolis (IUPUI)
Indianapolis, IN 46202

Medical Research: What is the background for this study?

Dr. Nudelman: Varying levels of cognitive problems and related changes in brain structure and function have been reported in breast cancer patients treated with chemotherapy. Pain has also been associated with altered brain structure and function. However, the association of chemotherapy-induced peripheral neuropathy (CIPN), a side-effect of chemotherapy treatment characterized by nerve damage primarily in the extremities, has not been specifically investigated for association with cognitive symptoms in breast cancer. We used data from a prospective, longitudinal breast cancer cohort to investigate the relationship of CIPN and neuroimaging measures of cognitive dysfunction. 

Medical Research: What are the main findings?

Dr. Nudelman: We found that increased chemotherapy-induced peripheral neuropathy symptoms were associated with resting brain blood flow increase in regions known to be involved in pain processing. We also found that decreased frontal lobe gray matter density was correlated with these changes, suggesting a link between chemotherapy-induced peripheral neuropathy and cognitive dysfunction.

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Out-of-Pocket Expenses Greatest For Families Caring For Dementia Patient

Amy S. Kelley, MD, MSHS Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai New York, NY

Dr. Kelley

MedicalResearch.com Interview with:
Amy S. Kelley, MD, MSHS
Department of Geriatrics and Palliative Medicine
Icahn School of Medicine at Mount Sinai
New York, NY

Medical Research: Why is it so important to understand the financial burdens families may face in providing end-of-life care for a loved one and why do you think the burdens may be greater for dementia than for other medical conditions?

Dr. Kelley: Understanding the financial risks that older adults face in the last years of life is important for individuals and families, in order to plan and save, if possible. It is also important for our policy makers, in particular, to know about these costs so that this information can help shape health and social policy that will best serve our society. Households of those with dementia face the greatest burden of costs, on average, particularly with regard to out-of-pocket expenses and the costs of caregiving.  Many costs related to daily care for patients with dementia are not covered by health insurance, and these care needs, including everything from supervision, to bathing and feeding, may span several years.

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Breastfeeding May Not Be Important For Children’s IQ

Sophie von Stumm BSc MSc PhD Department of Psychology Goldsmiths University of London London, United KingdomMedicalResearch.com Interview with:
Sophie von Stumm BSc MSc PhD
Department of Psychology
Goldsmiths University of London
London, United Kingdom

Medical Research: What is the background for this study?

Dr. von Stumm: At the Hungry Mind Lab (www.hungrymindlab.com), which I direct, we study individual differences in lifespan cognitive development. In particular, I am interested in factors that influence change in cognitive ability and knowledge. One such factor is breastfeeding, which some previous studies suggested to be associated children’s intelligence and IQ gains while others failed to find a relationship.

Medical Research: What are the main findings?

Dr. von Stumm: For this study, which was published last week in PloS One (link:http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0138676), data were analyzed from more than 11,000 children born in the UK between 1994 and 1996. The children had been repeatedly assessed on IQ: the first time they were tested on intelligence at age 2, and then again repeatedly throughout childhood, overall 9 times, until the age of 16 years. We found that having been breastfed versus not having been breastfed was not meaningfully associated with children’s IQ differences at age 2 and also not with differences in children’s IQ gains until age 16. That is not to say that breastfeeding may not have other benefits for children’s development but our study strongly suggests that breastfeeding is not important for children’s IQ.   Continue reading

Beetroot Juice Enabled Better Sprint and Decision Making Times

Beetroot juice WikipediaMedicalResearch.com Interview with:
Chris Thompson BSc MSc ANutr AFHEA

University of Exeter
St. Luke’s Campus
Exeter Devon

Medical Research: What is the background for this study?

Response: Dietary nitrate has been shown to favourably alter the contractility of type II muscle fibres and enhance blood flow to working muscles that are predominantly type II. Dietary nitrate may also improve perfusion to areas of the brain responsible for cognitive function. It is therefore possible that through these mechanisms, nitrate-rich beetroot juice supplementation may improve both physical and cognitive performance during exercise which reflects the high intensity intermittent nature of team sport play.

Medical Research: What are the main findings?

Response: Participants were able to complete greater total work during an intermittent sprint test following nitrate-rich beetroot juice supplementation. We also found that dietary nitrate enabled a reduction in response time to decision making during the cognitive tasks performed throughout the exercise test.

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Brain Damage From Chronic Hypertension Studied

Daniela Carnevale, PhD, Researcher Laboratory of Giuseppe Lembo, MD, PhD Dept. of Molecular Medicine "Sapienza" University of Rome & Dept. of Angiocardioneurology and Translational Medicine IRCCS Neuromed - Technology Park Località CamerelleMedicalResearch.com Interview with:
Daniela Carnevale, PhD, Researcher
Laboratory of Giuseppe Lembo, MD, PhD
Dept. of Molecular Medicine
“Sapienza” University of Rome
& Dept. of Angiocardioneurology and Translational Medicine
IRCCS Neuromed – Technology Park
Località Camerelle

Medical Research: What is the background for this study?

Dr. Carnevale: Nowadays, one of the most demanding challenge in medicine is preserving cognitive functions during aging. It is well known that cardiovascular risk factors have a profound impact on the possibility of developing dementia with aging. However, we have no means to investigate this aspect in patients with cardiovascular diseases. Indeed, although we have clear clinical paradigms to explore target organ damage of vascular diseases like hypertension, we are less prepared to afford the brain damage that may result from chronic vascular diseases and impact on cognitive functions. Thus, we aimed at finding a diagnostic paradigm to assess brain damage that could predict for future development of dementia. Since it is becoming increasingly clear that hypertension may determine cognitive decline, even before manifest neurodegeneration, we elaborated a paradigm of analysis that are essentially focused on brain imaging and cognitive assessment. In particular, we used diffusion tensor imaging (DTI) on magnetic resonance that allows to reconstruct white matter connections that correlate with selective cognitive functions, and specifics tests for the evaluation of subtle alterations of cognitive functions.

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Low Vitamin D Associated With Accelerated Cognitive Decline

Joshua W. Miller, PhD Professor and Chair Dept. of Nutritional Sciences Rutgers The State University of New Jersey New Brunswick, NJ 08901

MedicalResearch.com Interview with:
Joshua W. Miller, PhD

Professor and Chair Dept. of Nutritional Sciences Rutgers
The State University of New Jersey
New Brunswick, NJ 08901 

Medical Research: What is the background for this study? What are the main findings?

Response: In recent years, there has been a growing scientific literature on the associations between low vitamin D status in older adults and risk of Alzheimer’s disease/dementia, cognitive impairment and decline, and brain atrophy.  The vast majority of these studies have been conducted in predominantly white populations.  The relatively unique aspect of our study was that over half of the cohort consisted of African Americans and Hispanics.  What we found in our cohort (mean age ~75y, n=382 at baseline) was that participants with vitamin D deficiency (serum 25-hydroxyvitamin D <12 ng/ml) or vitamin D insufficiency (serum 25-hydroxyvitamin D between 12 ng/ml and <20 ng/ml) on average experienced faster rates of cognitive decline in episodic memory and executive function than participants with adequate vitamin D status.  Importantly, the association between vitamin D status and the rate of decline in cognitive function was independent of race/ethnicity.  However, the prevalence of low vitamin D status in the study participants was significantly higher in the African American and Hispanic participants compared with the White participants.  This is most likely due to the fact that darker skin pigmentation reduces the ability of sunlight to induce vitamin D synthesis in the skin.  It may also reflect differences in dietary intake of vitamin D and supplement use between the different race/ethnicity groups, though we did not assess this in our study.  Thus, though the rate of cognitive decline in African Americans and Hispanics does not seem to be more or less affected by low vitamin D status than in Whites, because African Americans and Hispanics have a higher prevalence of low vitamin D status, as subpopulations they may be more prone to rapid cognitive decline in old age.  Further studies addressing this possibility are needed.

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Orthostatic Hypotension and Blood Pressure Variability Linked to Cognitive Decline

Christine McGarrigle PhD Research Director The Irish Longitudinal Study on Ageing (TILDA) Lincoln Gate Trinity College Dublin Dublin

MedicalResearch.com Interview with:
Christine McGarrigle PhD
Research Director
The Irish Longitudinal Study on Ageing (TILDA)
Lincoln Gate
Trinity College Dublin Dublin

 

Medical Research: What is the background for this study? What are the main findings?
Dr. McGarrigle: Mild cognitive impairment (MCI) is the intermediate state between healthy ageing and dementia and is a stage at which intervention could be effective in reducing conversion to dementia.

Neurocardiovascular instability is an age-related dysregulation of the blood pressure systems manifesting as exaggerated blood pressure variability and orthostatic hypotension (OH). Previous evidence has shown that autonomic dysfunction, blood pressure variation and hypotension are associated with mild cognitive impairment.

Our study found that systolic blood pressure variation was associated with cognitive decline. Mild cognitive impairment participants were more likely to have had OH and more prolonged OH compared to cognitively normal controls. Mild cognitive impairment participants with impaired orthostatic blood pressure responses were twice more likely to convert to dementia than mild cognitive impairment participants without the impaired response over a three year follow-up period.

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