The Alzheimer's Solution

7 days ago

#braintraining #neuroplasticity #dementiaprevention

Brain Training in the improvement of cognitive function and modifying the cognitive decline associated with dementia has been the subject of several studies with mixed outcomes.

In a report linked to here, the case is made for what constitutes a "brain training" intervention (BrainHQ) that is based on sound and proven model that delivers on significant improvements in cognitive performance.

For example, "the IMPACT study" published in 2009, utilized a "Cognitive Training Program"—BrainHQ— in 487 adults aged 65 and older individuals that included a control group that did not receive any specialized brain training intervention.

The group that underwent an 8 week computerized cognitive training program "showed significant improvements on multiple secondary measures of attention and memory."

Prior to the IMPACT study , the ACTIVE study (2002) which recruited 2832 older individuals, aged 65 to 94 years, analyzed the effects of 3 "different cognitive training programs on cognitive function and time to dementia."

1. In-person training on verbal memory skills
2. In-person training on reasoning and problem-solving*
3. Computer-based speed-of-processing training on visual attention

A 10 session training intervention and each session was conducted over a 5- to 6-week period with booster trainings at 11 and 35 months.

Follow-up cognitive evaluations were at 1, 2, 3, 5, and 10 years.

Overall, the study "demonstrated that cognitive interventions helped normal elderly individuals to perform better on multiple measures of the specific cognitive ability for which they were trained".

Plus, the "speed-of-processing training"* (now part of BrainHQ) showed a 29% lower risk for dementia over the individuals that did not receive the training, and the training was superior to the other two training programs which showed "no net effect" gains in measures of cognitive ability.

More recently, the SYNERGIC study (2023), which included vitamin D and exercise (aerobic-resistance ) along with cognitive training program (Neuropeak), showed that "older adults with mild cognitive impairment receiving aerobic-resistance exercises with sequential computerized cognitive training significantly improved cognition, although some results were inconsistent."

Vitamin D supplementation had no effect.

The article review linked to here also included commentary from a host of experienced professional such as:

- Yuko Hara, PhD, director of Aging and Alzheimer's Prevention at the Alzheimer's Drug Discovery

- Michael Merzenich, PhD, professor emeritus at University of California San Francisco

- Montero-Odasso, one of the Synergic study authors and team leader at the Canadian Consortium on Neurodegeneration in Aging, and team co-leader at the Ontario Neurodegenerative Research Initiative

and,

- Henry Mahncke, PhD, CEO of the brain training company Posit Science/BrainHQ.

Not surprisingly, in a strong consensus agreement, the above named leaders of their respective fields of study, opined that engagement in mentally stimulating such as number and word puzzles, such as crosswords, cards, or board games may result in improvements in cognition and reduction in dementia risk.

Ditto for regular internet users and socially engaging activities such as dancing, and other exercise activities and such as yoga and swimming.

The point being that apart from more formal brain training programs there is a wealth of strong evidence that links mental and social activities to building a cognitive reserve of new brain connections (synapses) and neural pathways (neuroplasticity)* that significantly improves quality of life measures, and builds a better brain (neurogenesis) as you age and one that is more resilient against cognitive decline in later years.

Think ahead!

*Neuroplasticity, also known as brain plasticity, refers to the brain’s capacity for adaptive change.

Brain plasticity is reflected in the brain’s ability to integrate change
associated with learning, organize that experience, and form new neural connections and pathways that supports and enables that process.

BrainDefend®

... See MoreSee Less

Does 'Brain Training' Really Improve Cognition?

www.medscape.com

Some companies claimed that engaging in "brain games" can improve cognition or stave off cognitive decline. What's the evidence and do crosswords and Sudoku count?

The Alzheimer's Solution

4 weeks ago

#hormonereplacementtherapy #dementiarisk

An elevated risk for dementia with hormone replacement therapy in menopause?

"At the International Conference on Nutrition in Medicine, held in Washington, DC, on August 15, 2024, ... Amani Meaidi, MD, PhD, of the Danish Cancer Institute, Copenhagen, sounded a warning bell regarding possible elevated risks for dementia associated with HT [hormone therapy]."

However, there is much to unravel with regard to that "warning bell" for an increased risk of dementia with HT.

First, "The Menopause Society (formerly the North American Menopause Society) issued a position statement on HT in 2017, with a 2022 update ... the most suitable type of HT, including dose, formulation, route of administration, and duration of use. HT is recommended preferably for women < 60 years of age or within 10 years of menopause onset."

Note, the Menopause Society's position statement points to a personalized prescription of HT as early ( < 60 years of age) in menopause.

Second, Dr. Meaidi cited several past studies that found conflicting evidence with regard to HT and the risk for dementia.

In those studies, estrogen alone or estrogen and synthetic progestogen (e.g., progestin) combination, either was associated with an increased risk for dementia, or did not increase the risk of developing dementia.

The report linked to here has the summaries of those studies and findings, however, note that many of studies cited included women over and under 60 years of age.

In many past studies, the "critical window hypothesis" has been proposed, and the conclusions suggest that hormone therapy initiated soon after menopause, rather than later in life (after age 65), determines the success of estrogen replacement therapy (ERT).

Significant caveats have been noted in past hormone replacement studies with regard to the increased risk for dementia and Alzheimer's disease if therapy is started after the age of 60.

Nevertheless, Dr. Meaidi and colleagues conducted a study in which "median age at initiation of HT was 52 years for case patients as well as controls, and the median duration of use was just over 3.5 years"

And, "Compared with never-users, women who had received HT had a 24% higher risk of developing all-cause dementia,"

But wait!

Quote: "Progestin-only or vaginal estrogen–only HT regimens were not associated with an increased risk for dementia."

Confused?

Well if you are, rightfully so as there is much reported here and there that points to yea or nay for HT in the hopeful prevention of dementia and Alzheimer's disease.

Plus, there are so many other risk factors that should be taken not account when personalizing an Alzheimer's and dementia risk assessment and a prevention strategy and protocol.

In my book, The Diabetic Brain in Alzheimer's Disease", I stress the critical importance of such risk biomarker guided assessments and prevention interventions that should be instituted by MIDLIFE.

Lastly, please note the section toward the bottom of the report "Interpret With Caution".

For example, "Srilatha Raghuram, PhD, Alzheimer’s Association director of journal operations and special projects, expressed concern about concluding that HT increases dementia risk."

And, “Brain health is not determined by any one single factor in isolation.”.

"Also commenting for Medscape Medical News, Stephanie S. Faubion, MD, MBA, professor and chair of the Department of Medicine and the Penny and Bill George of the Mayo Clinic Center for Women’s Health, noted that there are a great deal of data on women who undergo premature menopause. “It’s clear that if those women don’t get estrogen, they have an increased risk of dementia,” she said."

For a comprehensive review of estrogens in the risk for vascular dementia and Alzheimer's disease, please listen to my podcasts in which I detail:

"Estrogen(s) in the Risk for Alzheimer’s—The Kind You Make, The Kind You Take, and The Kind You Eat." @
podcasts.apple.com/us/podcast/estrogen-s-in-the-risk-for-alzheimers-the-kind-you/id1614865183

and,

"Estrogen Deficiency and Cardiometabolic Disease at Midlife Underlies a Woman’s Greater Risk for Alzheimer’s Disease"
podcasts.apple.com/us/podcast/estrogen-deficiency-and-cardiometabolic-disease-at/id1614865183

Think ahead!

BrainDefend® ... See MoreSee Less

Hormone Therapy and Dementia: What Do We Know?

www.medscape.com

A recent study suggested the hormone therapy may increase the risk for dementia, but other data suggest that there may be a critical window of time in early menopause where it could lower risk.