The Tangled Neuron

Paul Whitby's "Memory Book"

Paul Whitby

I’ve written before about cognitive rehabilitation for people with memory loss.  Researchers at the University of Miami are conducting clinical trials in this area, and people like Morris Friedell are conducting their own informal programs.  Paul Whitby, a clinical psychologist working in the National Health Service in England, has been teaching a memory rehabilitation class for professionals for several years now.

“I reckon that a lot of our nurses still think that if somebody has dementia then there is no point telling them anything because they won't remember it,” he says.  “I try to work on the notion that if you have dementia (or any other memory problem), then there is all the more need to put a bit more effort into telling you things carefully and in a way that will stick (Spaced Retrieval) and making important information obvious, ready to hand and easy to use (calendars, notebooks).”

Paul has put together a Memory Book of practical ideas to encourage people with memory loss and their care partners to try rehabilitation.  The booklet also has tips on coping mechanisms. 

New Cognitive Fitness Center

The Alzheimer Research Forum has an interesting article on a new "cognitive fitness" center run by University of California Santa Barbara researchers.  Among other things, the center will test whether a personalized program of multiple lifestyle changes can prevent or delay memory loss.

According to the article, one of the priorities for the center is to find funding for the center's services by showing that the services decrease medical costs.  If the annual membership fee of $4000 is representative of the cost of programs per person, this could theoretically be offset if the person could avoid prescription medicine, doctor's visits and care costing $333 per month or more. 

Does Loss of Vision Contribute to Memory Loss?

Summary:  People who give up activities because of age-related macular degeneration may be more likely to have memory loss than those who find ways to stay active despite their loss of vision.

In the last few years, several studies have shown poor eyesight (macular degeneration in particular) is associated with memory loss.  In a large study by the Age-Related Eye Disease Study Group, the worse participants’ vision was, the more likely they were to do poorly on memory tests.

It’s unclear why there is a link between macular degeneration or poor vision and memory loss, however. Scientists have put forth different theories:

1.    in macular degeneration, abnormal forms of the protein called beta amyloid are deposited on the retina.  In Alzheimer’s, abnormal forms of the same protein are deposited in the brain.  This could mean the two diseases have the same origin.
2.    a lack of visual sensory input could cause changes in the brain
3.    low vision could cause people to stop participating in stimulating activities thought to reduce the risk of memory loss.

Robin Casten, Ph.D.

Dr. Robin Casten and her colleagues at Jefferson Medical College in Philadelphia decided to test the third hypothesis in a study of 206 people with no apparent memory loss who had age-related macular degeneration.  The researchers tracked participation in six types of activities:  reading, exercise or sports, hobbies, spectator activities, social activities and cards or games.  They found that each activity dropped due to vision loss seemed to increase the risk of memory loss over the three year study period. 

Poor Balance Linked to Memory Loss

A few months ago, I wrote about the possible connection between balance problems and memory loss.  Results of a study by French researchers published in this month’s Journal of Alzheimer’s Disease seem to confirm this connection.  The researchers found that poor performance on a balance test (standing on one leg) is associated with dementia and may predict more rapid cognitive decline.

Are You at Risk for Drug Interactions?

Summary:  A recent study suggests that some older adults are at risk for potentially dangerous drug interactions.  Make sure your doctor and your pharmacist are aware of all the supplements, prescription and over-the-counter medicines you take, and ask them to check for potential interactions.

In online forums and at meetings, I hear people with memory loss talk about the medicines and supplements they take.  It’s not unusual for them to reel off a list of several prescription drugs and twenty or more supplements.  Could the combination of some of these medicines be dangerous?

Dima Qato, PharmD, MPH

Potential drug interactions are a concern for everyone, not just for people with memory loss.  Late last year, the Journal of the American Medical Association published an article by Dr. Dima Qato and her colleagues at the University of Chicago on the medicines older Americans take.  The researchers catalogued the drug use of over 2200 people across the U.S., ages 57 through 85.