Cognitive dysfunction

Posted on Cognitive dysfunction, Diet

Can the MIND diet lower the risk of memory problems later in life?

People whose diet more closely resembles the MIND diet may have a lower risk of cognitive impairment
People whose diet more closely resembles the MIND diet may have a lower risk of cognitive impairment.

The MIND diet is a blend of the Mediterranean and DASH diets. It incorporates green leafy vegetables such as spinach, kale, and collard greens, as well as other vegetables. It emphasizes whole grains, olive oil, poultry, fish, beans, and nuts. The diet favours berries over other fruits and suggests consuming one or more servings of fish per week.

“Given the rising number of people with dementia due to the ageing population, it’s crucial to identify changes that can help delay or slow down the onset of cognitive issues,” stated Russell P. Sawyer, MD, a study author from the University of Cincinnati in Ohio and a member of the American Academy of Neurology. “We were particularly interested in determining whether diet influences the risk of cognitive impairment in both Black and white study participants.”

The study involved 14,145 people with an average age of 64. Of the participants, 70% were white, and 30% were Black. They were followed for an average of 10 years.

Participants filled out a questionnaire on their diet over the past year. Researchers looked at how closely the foods people ate matched the MIND diet.

Remember the following dietary guidelines:

– Consume three or more daily servings of whole grains

– Eat six or more weekly servings of green leafy vegetables

– Have one or more daily servings of other vegetables

– Include two or more weekly servings of berries in your diet

– Consume one or more weekly servings of fish

– Include two or more weekly servings of poultry

– Aim for three weekly servings of beans

– Consume five daily servings of nuts

– Limit red meat to four or fewer weekly servings

– Limit fast or fried foods to one or fewer weekly servings

Aim for one or more weekly servings of olive oil

– Limit butter or margarine to one or fewer tablespoons daily

– Keep pastries and sweets to five or fewer weekly servings

– Limit wine to one glass per day

The total number of points possible is 12.

Researchers then divided participants into three groups. The low group had an average diet score of five, the middle group had an average score of seven, and the high group had an average score of nine.

Thinking and memory skills were measured at the beginning and end of the study.

During the study, cognitive impairment developed in 532 people, or 12% of 4,456 people in the low diet group; in 617 people, or 11% of 5,602 people in the middle group; and in 402 people, or 10% of the 4,086 people in the high group.

After adjusting for factors such as age, high blood pressure and diabetes, researchers found people in the high group had a 4% decreased risk of cognitive impairment compared to those in the low group.

Researchers found a 6% decreased risk of cognitive impairment for female participants who closely followed the diet, but no decreased risk for male participants.

Researchers also looked at how quickly people’s thinking skills declined as they developed problems. They found that people who more closely followed the MIND diet declined more slowly than those who did not, and that association was stronger in Black participants than in white participants.

“These findings warrant further study, especially to examine these varying impacts among men and women and Black and white people, but it’s exciting to consider that people could make some simple changes to their diet and potentially reduce or delay their risk of cognitive issues,” said Sawyer.

Posted on Cognitive dysfunction, Rheumatoid arthritis

Inflammatory activity of rheumatoid arthritis linked to specific cognitive impairments

Poorer visuospatial ability, recall, abstract thinking, working memory, concentration, inhibition
Poorer visuospatial ability, recall, abstract thinking, working memory, concentration, inhibition

e inflammatory activity in the body caused by rheumatoid arthritis is linked to specific cognitive impairments, finds a small comparative study, published in the open access journal RMD Open. 

These are diminished visuospatial abilities, recall, abstract thinking, and the executive functions of working memory, concentration, and inhibition.

Inflammatory activity in rheumatoid arthritis has been associated with various systemic effects, including on the brain, but it’s not clear which specific cognitive domains might be affected.

To try and find out, the researchers compared the cognitive function of 70 adults with rheumatoid arthritis (80% women, average age 56) under the care of one hospital and 70  volunteers without rheumatoid arthritis, and matched for age, sex, and educational attainment.

Nearly 3 out of 4 of the patients (49; 72%) had ongoing moderate to high levels of systemic inflammatory activity caused by their disease, as measured by levels of indicative proteins and the degree of joint inflammation, despite conventional drug treatment. They had had their disease for an average of 10.5 years. 

All 140 participants underwent comprehensive neurological and psychological assessment, plus various validated cognitive tests, and assessments of mood and quality of life between June 2022 and June 2023. 

Specific cognitive abilities tested were: ability to process and order visuospatial information; naming; attention; language; abstract thinking; delayed recall; and orientation, plus executive functions of working memory, concentration, and inhibition. 

Cognitive impairment was defined as a Montreal Cognitive Assessment (MoCA) score of less than 26 out of a maximum of 30.

Information was collected on other influential risk factors. These included age; sex; smoking; alcohol intake; high blood pressure; obesity; blood fat levels; diabetes; and a history of heart disease/stroke.

In general, those who were cognitively impaired tended to be older, have lower educational attainment, and more coexisting conditions, such as obesity, unhealthy blood fat levels, and high blood pressure than those with intact cognition. 

But patients with rheumatoid arthritis achieved lower average scores in the Montreal Cognitive Assessment than the volunteers (23 vs 25), and lower scores for executive function. Cognitive impairment was recorded in 60% of them compared with 40% of the volunteers. 

Significantly more of the patients also scored more highly for anxiety and depression and had lower quality of life scores than the volunteers.

Cognitively impaired patients had more substantial and persistent inflammatory activity than those patients who maintained their cognitive function. And they were more likely to have symptoms of depression and poorer physical capacity.

The factors associated with the greatest risk of cognitive impairment among the patients were obesity (almost 6 times the risk) and inflammatory activity throughout the course of the disease (around double the risk).  As in the general population, older age and lower educational attainment were also risk factors.

By way of an explanation for their findings, the researchers point to previous suggestions  that the chronic inflammation, autoimmune processes, and persistent symptoms of pain and fatigue associated with rheumatoid arthritis could underpin the diminution of cognitive function. 

This is an observational study, so no definitive conclusions about causal factors can be drawn. And the researchers acknowledge various limitations to their findings, including the lack of imaging tests to detect vascular damage associated with cognitive impairment.

But they conclude: “These results support the hypothesis that [rheumatoid arthritis] is a chronic systemic inflammatory disease that affects multiple systems, including neural tissue.

“[And the] results underline the importance of earlier and more stringent control of the activity of arthritis and the need for new therapeutic strategies aimed at associated factors, with the aim of mitigating the risk of cognitive impairment in patients with rheumatoid arthritis.”

Posted on Cognitive dysfunction, Multiple Sclerosis

Research shows promise for cognitive rehabilitation for multiple sclerosis

Improvements in memory performance, perceived memory ability in daily life, and functional performance, warrant more extensive clinical trials using TELE-self-GEN in MS therapy
Improvements in memory performance, perceived memory ability, and functional performance warrant more extensive clinical trials using TELE-self-GEN in MS therapy.

A preliminary study demonstrates the potential for a new treatment for memory problems in people with multiple sclerosis.

The pilot study involved ten participants with memory impairments related to multiple sclerosis (MS). It aimed to determine the feasibility and impact of six online sessions of TELE-Self-GEN, delivered via Zoom. Lead author Yael Goverover, PhD, OTR/L, a professor in New York University’s Department of Occupational Therapy and a visiting scientist at Kessler Foundation, explained that TELE-Self-GEN integrates memory strategies within a metacognitive framework to help individuals manage their cognitive challenges.

Participants reported high satisfaction levels, citing the convenience and accessibility of the virtual format. Most notably, they experienced improvements in memory tasks and their ability to perform daily activities.

“Our findings are promising, demonstrating that remote interventions can be both effective and satisfying for participants. Delivering therapy to individuals at home is not only convenient,” Dr. Goverover noted, “it expands access to cognitive rehabilitation designed to improve how individuals function in their daily lives.”

The intervention focuses on ‘self-generated learning,‘ a technique that encourages patients to create personal connections with everyday tasks, enhancing memory retention and recall. This method of association has proven effective in fostering greater independence and confidence among users, ultimately contributing to improved quality of life.

Posted on Cognitive dysfunction, Eye health, Multiple Sclerosis

A new study reveals a breakthrough in the treatment of visual and cognitive impairments in multiple sclerosis.

A pilot study conducted by researchers at the Kessler Foundation showed promising results in using methylphenidate to improve oculomotor function in individuals with multiple sclerosis (MS). The findings could have significant implications for the treatment of visual and cognitive impairments associated with multiple sclerosis (MS).

Silvana Costa, PhD

Dr. Costa is a research scientist at the Centers for Neuropsychology, Neuroscience, and Multiple Sclerosis Research at the Kessler Foundation. CREDIT Kessler Foundation

In a pilot randomized placebo-controlled trial, 11 participants with MS were randomly assigned to receive either methylphenidate or a placebo for four weeks. After a seven-day washout period, they underwent a crossover treatment for four more weeks. Assessments of oculomotor speed using the King-Devick test and information processing speed were conducted before and after each treatment phase.

“We noticed a significant increase in the participants’ eye movement speed when they were given methylphenidate compared to when they were given the placebo,” said Timothy J. Rich, PhD, OTR/L, research scientist at the Center for Stroke Rehabilitation Research at Kessler Foundation. “This improvement in eye movement speed was directly linked to better performance on tasks that involve hand-eye coordination, which is important for everyday activities.”

Dr. Silvana L Costa, who works as a research scientist at the Centers for Neuropsychology, Neuroscience, and Multiple Sclerosis Research at Kessler Foundation, and is also a co-author of the study, stated, “Our results indicate that methylphenidate might offer valuable benefits as a treatment for individuals with MS, particularly for those who are dealing with oculomotor deficits impacting their visual processing speed and, consequently, their overall quality of life.”

“These results are promising,” noted Dr. Costa, “offering a potential pathway to mitigate some of the cognitive and visual symptoms that are prevalent in MS.”

Posted on Alzheimer's, Cognitive dysfunction

Protecting Your Brain Health – How Science Is Revolutionizing Cognitive Health

We’re living in a neuroscience revolution, with more ways to detect and treat brain disorders than was imaginable just a few decades ago. Hear from Dr Longo, a leading expert in the research and treatment of neurological conditions, about the work being done at Stanford to transform the field and offer hope to the millions of people suffering from cognitive impairment due to Alzheimer’s and other neurodegenerative conditions. From novel blood tests and brain imaging approaches to emerging treatments, Dr Longo will explain how he and his fellow scientists work to detect problems earlier, create strategies to delay the onset of cognitive loss, reverse impairment once it begins, and increase brain resiliency for all people. He’ll also offer information you can use, starting now, to help protect your own brain health far into the future.