MedicalResearch.com Interview with: Joe Verghese, MBBS, MS
Professor of Neurology and Medicine,
Chief, Integrated Divisions of Cognitive & Motor Aging (Neurology) and Geriatrics (Medicine), Director, Resnick Gerontology Center,
Murray D Gross Memorial Faculty Scholar in Gerontology,
Albert Einstein College of Medicine, Bronx, NY 10461
Medical Research: What are the main findings of the study?Answer:Motoric Cognitive Risk Syndrome (MCR) is a newly described pre-dementia syndrome that is characterized by presence of slow gait and cognitive complaints in older adults without dementia or mobility disability. In this study, we report that the prevalence of Motoric Cognitive Risk Syndrome was 9.7% in 26,802 adults aged 60 and older from 22 cohort studies based in 17 countries. Presence of Motoric Cognitive Risk Syndrome was also associated with an almost two-fold risk of developing dementia.
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MedicalResearch.com Interview with: Florien Boel MSc
VU University Medical Center
Department of Medical Psychology
Amsterdam, The Netherlands
Medical Research: What are the main findings of the study?Answer: In postmenopausal breast cancer patients, endocrine therapy is widely used, and often for many years on end. Endocrine therapy is thought to have an effect on cognitive functioning, but previous studies have not yet accounted for the possible influence of the diagnosis of cancer and subsequent anxiety, depression or fatigue on cognitive performance. In addition, the cognitive effects of endocrine therapy after long-term use are still mostly unknown.
Therefore, we compared cognitive functioning of postmenopausal breast cancer patients who underwent surgery and/or radiotherapy (N=43) with the cognitive performance of women who also received adjuvant endocrine therapy (tamoxifen) (N=20) and a group of healthy matched individuals (N=44). In accordance with the literature, we found that especially cognitive domains that rely heavily on verbal abilities (verbal memory and fluency) seem to be at risk for deterioration during long-term treatment (~2.5 years) with tamoxifen.
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MedicalResearch.com Interview with: Prashanthi Vemur, Ph.D.
Mayo Clinic
Rochester, Minnesota
MedicalResearch: What are the main findings of the study?Dr. Vemuri: Lifetime intellectual enrichment might delay the onset of cognitive impairment and be used as a successful preventive intervention to reduce the impending dementia epidemic. We studied two non-overlapping components of lifetime intellectual enrichment: education/occupation-score and mid/late-life cognitive activity measure based on self-report questionnaires. Both were helpful in delaying the onset of cognitive impairment but the contribution of higher education/occupation was larger.
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MedicalResearch.com Interview with: Regina Shih PhD
Senior Behavioral Scientist at the RAND Corporation.
MedicalResearch: What are the main findings of the study?Dr. Shih: RAND identified 25 high-impact policy options to improve the delivery, workforce, and financing of long term care, with a specific eye toward those with dementia and their caregivers. Undertaking these 25 policy options would achieve five goals: increasing public awareness of dementia and its signs and symptoms; improving access to long-term care; promoting high-quality, person-centered care like that offered at Lakeside Manor; providing better support for family caregivers; and reducing the burden of dementia costs on individuals and their families.
Of these 25 policy options, we identified four unique options that have never been identified in any national plan on dementia or long-term care. This is likely because we focused on the intersection between dementia and long-term care, rather than just one or the other. And, rather than only focusing on actions that federal agencies can take, we identified policy options by interviewing 30 different stakeholders in the public and private sectors at the local, state, and national levels. These unique, high-impact policy options have to do with
Linking private health insurance with private long-term care insurance;
Including home and community-based services in state Medicaid plans;
Establishing cross-setting teams focused on returning the person with dementia to the community;
Expanding financial compensation to family caregivers.
MedicalResearch.com Interview with: Evan Thacker PhD
Brigham Young University
Provo, Utah
MedicalResearch: What are the main findings of the study?Dr. Thacker:In this study of over 17,000 American adults aged 45 and above, we first measured people’s cardiovascular health based on their smoking habits, diet, physical activity, body weight, blood pressure, blood cholesterol, and blood sugar. We then tracked these people for several years with cognitive function tests which measure memory and thinking abilities. The main finding of our study was that people who had the lowest levels of cardiovascular health at the beginning of the study were more likely to experience cognitive impairment – poor performance on the cognitive function tests – at the end of the study. People who had medium to high levels of cardiovascular health were less likely to experience cognitive impairment.
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MedicalResearch.com Interview with:Dr. Anna-Maija Tolppanen PhD
Department of Neurology
University of Eastern Finland, Kuopio
MedicalResearch: What are the main findings of the study?Dr. Tolppanen: Persons who had higher levels of cynical distrust were about three times more likely to develop dementia over eight-year follow-up.
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MedicalResearch.com Interview with: William Kronenberger, Ph.D., HSPP
Professor and Director, Section of Psychology
Acting Vice Chair of Administration
Department of Psychiatry
Indiana University School of Medicine
Riley Child and Adolescent Psychiatry Clinic
MedicalResearch: What are the main findings of the study?Dr. Kronenberger: The main findings of the study are that children with cochlear implants had two to five times the risk of delays in executive functioning compared to children with normal hearing. Executive functioning is the ability to regulate and control thinking and behavior in order to focus and achieve goals; it is important for everything from learning to social skills. The areas of executive functioning that were most affected in children with cochlear implants were working memory, controlled attention, planning, and concept formation. Approximately one-third to one-half of the sample of children with cochlear implants had at least mild delays in these areas, compared to one-sixth or fewer of the normal-hearing sample. We think that reduced hearing experience and language delays cause delays in executive functioning to occur at higher rates in children with cochlear implants.
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MedicalResearch.com Interview withT. Jared Bunch, MD
Medical director for Heart Rhythm Services
Director of Heart Rhythm research
Intermountain Medical Center, Utah
MedicalResearch: What are the main findings of the study?Dr. Bunch: The main findings of the study are:
1) Atrial fibrillation patients treated with warfarin anticoagulation that have lower percentages of time in therapeutic range have significantly higher risks of all forms of dementia.
2) The dementia relative risk related to lower percentages of time in therapeutic range was higher than all other variables associated with stroke or risk of bleeding.
3) The risk of dementia related to lower percentages of time in therapeutic range was highest in younger patients in the study (<80 years).
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MedicalResearch.com Interview with: Elizabeth Devore, ScD
Associate Epidemiologist
Brigham and Women’s Hospital
Instructor in Medicine, Harvard Medical School
MedicalResearch.com: What are the main findings of the study?Dr. Devore: In this study, we examined sleep duration and memory performance in a group of ~15,000 women participating in the Nurses’ Health Study. We found that women with sleep durations of 5 or fewer hours/day or 9 or more hours/day, either in midlife or later life, had worse memory at older ages than those sleeping 7 hours/day. In addition, women with sleep durations that changed by two or more hours/day from midlife to later life performed worse on memory tests compared to those whose sleep duration did not change during that time period.The magnitude of these memory differences was approximately equivalent to being 1-2 years older in age.
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MedicalResearch.com Interview with:Tara Lagu MD PhD
Assistant Professor of Medicine
Tufts University School of Medicine
MedicalResearch.com: What are the main findings of the study?Dr. Lagu:We found that use of mechanical ventilation in patients 65 and older is increasing rapidly. If current rates of increase continue, we expect that by 2020 there will be more than 600,000 hospitalizations per year that involve mechanical ventilation. This is a doubling in 20 years (2001-2020), and represents demand that could easily exceed the capacity of the US critical care system. We also found that increase in use among patients with dementia is 4 times faster than those without dementia. This is important because dementia is a terminal illness, and use of mechanical ventilation in patients with end-stage dementia is associated with poor 30-day and 1-year outcomes.
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MedicalResearch.com Interview with:
Julian Benito-Leon
University Hospital “12 de Octubre”,
Madrid, Spain
MedicalResearch.com: What are the main findings of the study?
Dr. Benito-León: It...
MedicalResearch.com Interview with: Ioannis Tarnanas M.Sc
Senior Researcher
Gerontechnology and Rehabilitation Research Group,
ARTORG Centre for Biomedical Engineering,
University of Bern, 3010 Bern, Switzerland
MedicalResearch.com: What are the main findings of the study?Answer: We examined 75 healthy older people and 134 patients with mild cognitive impairment. Our aim was to collect neuropsychological, neurophysiological, neuroimaging and behavioural data by means of a virtual reality serious game, in order to model the profile of the patients who will progress to dementia within the next 2-4 years. We found that the prediction based on the performance at the virtual reality based computerized assessment instrument is comparable to that of more established and widely accepted biomarkers, such as ERP and MRI. This can be explained by the cognitive fidelity and richness of behavioural data collected with virtual reality based measures, which directly reflect neurocognitive processes affected at a very early stage.
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MedicalResearch.com Interview with:
Teresa Liu-Ambrose, PhD, PT
Associate Professor, Canada Research Chair
Department of Physical Therapy
Aging, Mobility, and Cognitive Neuroscience Laboratory
Vancouver Coastal...
MedicalResearch.com Interview with:Alex Leow, MD PhD
Psychiatric Institute
Chicago, IL 60612 and
Tony J. Simon, PhD
University of California,
Davis MIND Institute Sacramento,
CA 95817
MedicalResearch.com: What are the main findings of the study?Answer: Fragile X syndrome (FXS) is the most common inherited cause of intellectual disabilities and the most prevalent known single-gene cause of autism in males. The fragile X mental retardation 1 gene (FMR1) can be mutated with expanded numbers of CGG trinucleotide repeats in the 5’ untranslated region on the Xq27.3 site of the X chromosome. Normally, unaffected individuals have fewer than 45 CGG repeats in FMR1. When the size of the CGG repeat exceeds 200 FMR1 is silenced and the mutation is categorized as full, generating the FXS phenotype. If the expansion is between 55–200 repeats, then the individual is generally classified as a fragile X premutation carrier (fXPC). An estimated 40% of male and 8-16% of female premutation carriers later develop Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS), which is a late-onset (usually 50-70 years old) neurodegenerative disorder.
We recruited 46 neurologically symptomless young to middle aged carriers of the FMR1 gene mutation. They were age and gender matched with 42 unaffected control individuals without the gene mutation. Both groups were evaluated by cognitive testing as well as novel neuroimaging techniques termed “brain connectomics,” based on diffusion tensor imaging (DTI) whole-brain tractography. A connectome is a comprehensive map, like a wiring diagram, of neural connections in the brain. Our study is the first-ever connectome study to compare fXPCs and controls.
In short, brain connectomics enable scientists for the first time to study the global organizational properties of the human brain by applying cutting edge computational techniques, based on graph theory, to these comprehensive maps of neural connections (i.e., the brain graphs). Our main finding was that, in neurologically symptomless male carriers we detected a correlation between brain graphs’ efficiency in processing information and the number of CGG repeats in the mutated region of FMR1 (we estimated that each additional CGG repeat that in these males represents an effective increase of ~1.5 years of “brain aging”). The correlation may prove to be an effective marker of early brain aging in otherwise neurologically symptomless premutation carriers. The study also further confirmed previous findings of smaller brain stem volumes in male fXPCS than in male controls.
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MedicalResearch.com Interview with: David R. Jacobs Jr, PhD
Divisions of Epidemiology
School of Public Health
University of Minnesota, Minneapolis
MedicalResearch.com: What are the main findings of this study?Dr. Jacobs: Vigorous activity is what is well understood to improve cardiorespiratory fitness. People with high fitness are likely (based on this study) to
a) Lose fitness more slowly as they age and
b) To maintain sharper "thinking skills" into late middle age.
I think the message of this study is primarily for the people in the low to mid range of fitness in young adulthood. Thus, of more importance to the general population, if the people with low to moderate fitness simply do things, be engaged in family, job, community, move around, they would be able to do better on a treadmill test such as we used. Because those who lost less fitness over average age 25 to average age 45 had higher thinking skills at age 50, people who start moving around are likely to reap the benefit of less loss of thinking skills by average age 50.
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MedicalResearch.com Interview with:Osvaldo P. Almeida, MD, PhD, FRANZCP, FFPOA
Professor & Winthrop Chair of Geriatric Psychiatry | School of Psychiatry & Clinical Neurosciences | University of Western Australia.
Consultant | Department of Psychiatry | Royal Perth Hospital.
MedicalResearch.com: What are the main findings of this study?Prof. Almeida: This study used the principles of Mendelian randomisation to clarify whether alcohol use is a direct cause of cognitive impairment in later life. The rationale behind this approach is that the genetic variation associated with lower risk of alcohol abuse or dependence should also be associated with lower risk of cognitive impairment if alcohol misuse is a direct cause cognitive impairment. We found no evidence for such an association.
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MedicalResearch.com Interview with: Michelle M. Mielke, Ph.D.
Associate Professor
Department of Health Sciences Research, Division of Epidemiology
Department of Neurology
Mayo Clinic Rochester, MN 55905
MedicalResearch.com: What are the main findings of the study?Dr. Mielke: Using a population-based sample of cognitively normal individuals, aged 70-89 at baseline, we found that a medical-record confirmed diagnosis of COPD was associated with an increased risk of mild cognitive impairment, specifically non-amnestic mild cognitive impairment. The risk of mild cognitive impairment increased with a longer duration of COPD such that individuals who had COPD for more than 5 years had a 2.5-fold increased risk of developing non-amnestic mild cognitive impairment.
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MedicalResearch.com Interview with:Dr Tobias Teichert
Assistant Professor of Psychiatry
University of Pittsburgh
Pittsburgh, PA 15261
MedicalResearch.com: What are the main findings of the study?Dr. Teichert: "Our study provided three main findings:First, we measured how long it takes subjects to allocate attention to a relevant target and how effectively they can block out the distractors. We found that after 120 msec selective attention is fully engaged and completely blocks out the distractor. Based on this finding, we predicted that subjects should be able to improve decision accuracy by delaying decision onset, and that this should be more effective than simply prolonging the whole decision process.
Most importantly, we found that subjects indeed use this more effective way of improving decision onset: On average, subjects delayed decision onset by about 50 msec when we asked them be as accurate as possible. The good news is that people seem to use this more optimal mechanism automatically, without being told to do so and without being aware of what they do. The bad news is that we don’t seem to be using this skill quite as effectively as we could. In our case, subjects could have improved accuracy even further by delaying decision onset by an additional 50 ms. However, taken together, our findings show that decision onset is to some degree under cognitive control, and that we might be able to devise training strategies to harness its full potential”
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MedicalResearch.com Interview with:Ajay K Parsaik, MD, MS
Department of Psychiatry and Behavior Sciences
The University of Texas Medical School, Houston
Department of Neurology and Mayo Alzheimer’s Disease Research Center, Mayo Clinic, Rochester, Minnesota
MedicalResearch.com: What are the main findings of the study?Dr. Parsaik:Main findings of our study are that clinical and subclinical hypothyroidism is not associated with mild cognitive impairment in an elderly population after accounting for possible confounding factors and interactions.
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MedicalResearch.com Interview with:Dr. Alan B. Zonderman PhD
Cognition Section
Laboratory of Personality and Cognition, NIA
Gerontology Research Center
Baltimore, MD 21224-6825
MedicalResearch.com: What are the main findings of the study?
Dr. Zonderman: In a prospective population-based 5-year follow-up study the authors examined the rate at which participants converted from mild cognitive impairment to dementia or reverted from mild cognitive impairment to normal cognitive performance. As has been common, they found elevated risk for dementia associated with mild cognitive impairment, but also found elevated risk for dementia among those who reverted (temporarily) to normal cognitive performance.
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MedicalResearch.com Interview with: Dr. Ronald C. Petersen M.D., Ph.D.
Division of Epidemiology
Department of Health Sciences Research; Department of Neurology
Mayo Clinic, Rochester, MN
MedicalResearch.com: What are the main findings of the study?
Dr. Petersen: The diagnosis of mild cognitive impairment increases the likelihood of developing dementia.
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MedicalResearch.com Interview with:Prof Ype Elgersma PhD
Professor, Neuroscience
Neuroscience Institute, Erasmus University Rotterdam
Rotterdam, Netherlands
MedicalResearch.com: What are the main findings of the study?Answer: Research in genetic mouse models suggested that inhibition of HMG-CoA-reductase by statins might ameliorate the cognitive and behavioral phenotype of children with Neurofibromatosis type 1 (NF1), an autosomal dominant disorder. In a 12-month randomized placebo-controlled study including 84 children with NF1, we found that simvastatin, an inhibitor of the HMG-CoA-reductase pathway had no effect on full-scale intelligence, attention problems or internalizing behavioral problems, or on any of the secondary outcome measures.
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MedicalResearch.com Interview with:Dr. Soo Borson, M.D.
Professor Department of Psychiatry and Behavioral Sciences,
University of Washington School of Medicine
MedicalResearch.com: What are the main findings of the study?Dr. Borson: We developed a new short screen to help clinicians and health care systems identify dementia patients and their caregivers who have unmet needs for dementia care services - extra help from primary care providers or clinical specialists skilled in understanding and managing problems related to dementia, working with caregivers to alleviate stress and burden, and locating community-based support services.
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MedicalResearch.com: Samantha Gardener PhD Student
Senior Research Assistant for DIAN and AIBL Studies
McCusker Alzheimer's Research Foundation
2/142 Stirling Hwy NEDLANDS
6009 Western Australia
MedicalResearch.com: What are the main findings of your study?Answer: Our research indicates that consuming larger quantities of foods included in a western dietary pattern is associated with greater cognitive decline in visuospatial functioning after 36 months. Foods included in the western dietary pattern are red and processed meats, high fat dairy products, chips, refined grains, potatoes, sweets and condiments. Visuospatial functioning is an area which includes distance and depth perception, reproducing drawings and using components to construct objects or shapes.
In contrast, adherence to the Mediterranean diet, a healthy eating pattern is associated with less decline in executive function. Foods included in the Mediterranean diet are vegetables, fruits and fish. Examples of executive function include planning and organising, problem solving and time management.
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MedicalResearch.com Interview with:Prof David K Menon MD PhD FRCP FRCA FFICM FMedSci
Head, Division of Anaesthesia, University of Cambridge Consultant,
Neurosciences Critical Care Unit BOC Professor,
Royal College of Anaesthetists
Professorial Fellow, Queens' College, Cambridge
Senior Investigator, National Institute for Health Research
Box 93, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK
MedicalResearch.com: What is the background for your study?Dr. Menon:We have known for some time that a history of traumatic brain injury (TBI) results in a significant (between 2 and 10 fold) increase in the likelihood of getting dementia in later life. On possible mechanistic explanation for this comes from the finding that about a third of individuals who died of TBI, regardless of age, are found at autopsy to have deposits of β-amyloid in the brain, often Aβ42, which is the same variant of amyloid seen in the brain of patients who have Alzheimer’s Disease.
However, such detection after death has made it impossible to examine the linkage of such early amyloid deposition to late dementia. More recently, imaging with positron emission tomography (PET) and Pittsburgh compound B (PIB) has been used to image amyloid deposits in Alzheimer’s Disease. However, the technique had not been validated in traumatic brain injury.
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MedicalResearch.com Interview with:Dr. Rebecca Todd
Assistant Professor
University of British Columbia
Department of Psychology
Centre for Interactive Research on Sustainability
4342A-2260 West Mall
Vancouver, BC V6T 1Z4
MedicalResearch.com: What are the main findings of the study?Answer:What we found, in essence, is that some individuals are genetically predisposed to see the world more darkly than others. We find that a common gene variant is linked to perceiving emotional events --especially negative ones --¬ more vividly than others. This gene variant has been previously linked (by other researchers) to emotional memory and the likelihood of experiencing intrusive, or “flashback” memories following traumatic experience. Our findings suggest that in healthy young adults this enhanced emotional memory may be because individuals are more likely to perceive what’s emotionally relevant in the first place. We've all heard of rose colored glasses, but this is more like gene-colored glasses, tinted a bit darkly. (more…)
MedicalResearch.com Interview with:Dr. Seth S. Martin, MD
Division of Cardiology, Johns Hopkins Hospital
600 North Wolfe Street
Baltimore, Maryland 21287
Johns Hopkins Hospital
Baltimore, MD 21287.
MedicalResearch.com: What are the main findings of the study?Dr. Martin: Our systematic review identified 16 studies for qualitative synthesis and 11 for quantitative synthesis. In individuals without baseline cognitive dysfunction, statins did not adversely affect memory when used in the short-term (<1 year). Long-term cognition studies including 23,433 patients with a mean exposure duration of 3 to 24.9 years showed a 29% relative reduction in incident dementia related to statin use (hazard ratio, 0.71; 95% CI 0.61-0.82) and a 2% absolute risk reduction (number needed to treat for 6.2 years: 50). (more…)
MedicalResearch.com Interview with:Agnieszka Anna Tymula
Lecturer (Assistant Professor)
School of Economics
The University of Sydney
NSW 2006, Australia
MedicalResearch.com: What are the main findings of the study?
Answer: We found that individual risk preferences as well as consistency and rationality in choice change with age. Just like cognitive abilities, the ability to make consistent and rational decisions considerably declines in older adulthood. Tolerance to risk in the domain of gains follows an inverted U-shaped pattern along the life span, with older adults (65+ y. o.) and adolescents being more risk averse than young or midlife adults. Interestingly, in the domain of losses, older adults are willing to accept significantly more risks than adolescents, young and midlife adults.
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Neil V. Marrion, PhDProfessor of Neuroscience
Programme Director for BSc and MSci Pharmacology degrees
School of Physiology & Pharmacology
Medical and Veterinary Sciences University Walk
University of Bristol Bristol, BS8 1TD.
MedicalResearch.com: What are the main findings of the study?Dr. Marrion: We tested pravastatin and atorvostatin (two commonly prescribed statins) in rat learning and memory models. Rats were treated daily with pravastatin (brand name - Pravachol) or atorvostatin (brand name - Lipitor) for 18 days. The rodents were tested in a simple learning task before, during and after treatment, where they had to learn where to find a food reward. On the last day of treatment and following one week withdrawal, the rats were also tested in a task which measures their ability to recognise a previously encountered object (recognition memory).
The study’s findings showed that pravastatin tended to impair learning over the last few days of treatment although this effect was fully reversed once treatment ceased. However, in the novel object discrimination task, pravastatin impaired object recognition memory. While no effects were observed for atorvostatin in either task. (more…)
MedicalResearch.com: Teppo Särkämö PhD
Institute of Behavioural Sciences
PL 9 (Siltavuorenpenger 1A), 363
FI-00014, HELSINGIN YLIOPISTO Finland
MedicalResearch.com: What are the main findings of the study?Answer: We found that caregiver-implemented musical leisure activities, such
as singing and music listening, are beneficial for elderly persons
with mild-moderate dementia (PWD). Compared to standard care, regular
singing and music listening improved mood, orientation level, episodic
memory and to a lesser extent, also attention and executive function
and general cognition. Singing also enhanced verbal working memory and
caregiver well-being, whereas music listening had a positive effect on
quality of life.
(more…)
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