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Non-drug treatments for dementia show promise, experts say
December 20, 2006WINSTON-SALEM, N.C. - Memory training and other non-drug treatments may one day help older adults ward off declines in mental function, according to researchers from Wake Forest University School of Medicine in an editorial in the current issue of the Journal of the American Medical Association.
"The latest research suggests that mental training and physical activity both have promise for preventing declines in cognition," said Sally A. Shumaker, Ph.D., lead author on the editorial. "It's possible to envision a future treatment approach that combines lifestyle and drug treatments to meet the specific needs of each individual."
Shumaker, a professor of public health sciences and associate dean for research at Wake Forest, said the findings suggest opportunities for studying other non-drug treatments, such as meditation, to prevent or slow declines in cognition, which includes concentration, language, memory and abstract reasoning.
"Cognitive decline is a rapidly growing problem because of our aging population," said Shumaker. "It is probably one of the biggest fears that older adults have - the loss of your mind and your competency and independence. It seriously threatens the ability of the aging population to live independently."
In the editorial, Shumaker and co-authors Claudine Legault, Ph.D., and Laura H. Coker, Ph.D., also from Wake Forest, discuss the results of a recent multicenter study involving cognitive training, as well as other advances in the field.
The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study involved almost 3,000 participants. Half received 10 sessions of cognitive training and half received no special training. Participants who had the training showed immediate improvements in memory, reasoning and speed of processing. When the participants were tested five years later, the improvements had been sustained.
Other recent research showing that sedentary older adults perform less well on measures of memory suggests that physical activity may also be able to improve memory, according to the editorial.
There are an estimated 24 million people in the world with dementia and 4.6 million new cases are diagnosed each year. Declines in certain mental functions, such as memory, predict future inability to perform activities of daily living, such as dressing and feeding themselves.
"These studies illustrate the promise of non-drug treatments," said Shumaker. "The medications available today produce only low to moderate improvements in mental function. And they can have adverse side effects. Showing that cognitive training can protect mental function means that individuals who cannot tolerate existing drugs would have additional treatment options."
"The ACTIVE study is an important step toward demonstrating the feasibility of enrolling older adults in a long-term study of a cognitive training intervention," according to the editorial.
The authors say that matching cognitive training with an individual's risk factor profile is an intriguing possibility. For example, training that focuses on memory may be best for those at risk for Alzheimer's disease.
"Once they are standardized and developed for mass markets, cognitive training programs might be available to seniors through churches, schools and senior centers," said Shumaker.
"Importantly, cognitive training programs may give individuals a greater sense of control over the disturbing prospect of cognitive decline and have a beneficial effect on their quality of life," says the editorial.
As a researcher, Shumaker served as national principal investigator for the Women's Health Initiative Memory Study, which showed that estrogen and progestin doubled the risk of dementia in older women.
Wake Forest University Baptist Medical Center
"Cognitive decline is a rapidly growing problem because of our aging population," said Shumaker. "It is probably one of the biggest fears that older adults have - the loss of your mind and your competency and independence. It seriously threatens the ability of the aging population to live independently."
In the editorial, Shumaker and co-authors Claudine Legault, Ph.D., and Laura H. Coker, Ph.D., also from Wake Forest, discuss the results of a recent multicenter study involving cognitive training, as well as other advances in the field.
The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study involved almost 3,000 participants. Half received 10 sessions of cognitive training and half received no special training. Participants who had the training showed immediate improvements in memory, reasoning and speed of processing. When the participants were tested five years later, the improvements had been sustained.
Other recent research showing that sedentary older adults perform less well on measures of memory suggests that physical activity may also be able to improve memory, according to the editorial.
There are an estimated 24 million people in the world with dementia and 4.6 million new cases are diagnosed each year. Declines in certain mental functions, such as memory, predict future inability to perform activities of daily living, such as dressing and feeding themselves.
"These studies illustrate the promise of non-drug treatments," said Shumaker. "The medications available today produce only low to moderate improvements in mental function. And they can have adverse side effects. Showing that cognitive training can protect mental function means that individuals who cannot tolerate existing drugs would have additional treatment options."
"The ACTIVE study is an important step toward demonstrating the feasibility of enrolling older adults in a long-term study of a cognitive training intervention," according to the editorial.
The authors say that matching cognitive training with an individual's risk factor profile is an intriguing possibility. For example, training that focuses on memory may be best for those at risk for Alzheimer's disease.
"Once they are standardized and developed for mass markets, cognitive training programs might be available to seniors through churches, schools and senior centers," said Shumaker.
"Importantly, cognitive training programs may give individuals a greater sense of control over the disturbing prospect of cognitive decline and have a beneficial effect on their quality of life," says the editorial.
As a researcher, Shumaker served as national principal investigator for the Women's Health Initiative Memory Study, which showed that estrogen and progestin doubled the risk of dementia in older women.
Wake Forest University Baptist Medical Center
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A study by neuroscientist William C. Mobley, MD, PhD, chair of the Department of Neurosciences at the University of California, San Diego School of Medicine, and colleagues at Stanford University Medical School has demonstrated a possible new approach to slowing the inevitable progression of cognitive decline found in Down's syndrome.
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Neuroimaging provides insights into new treatment options for Alzheimer's disease
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Reduced muscle strength associated with risk for Alzheimer's
Individuals with weaker muscles appear to have a higher risk for Alzheimer's disease and declines in cognitive function over time, according to a report in the November issue of Archives of Neurology, one of the JAMA/Archives journals.
Amyloid beta protein gets bum rap
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Blood test identifies women at risk from Alzheimer's
Middle-aged women with high levels of a specific amino acid in their blood are twice as likely to suffer from Alzheimer's many years later, reveals a thesis from the Sahlgrenska Academy at the University of Gothenburg, Sweden.
Estrogen therapy likely must be given soon after menopause to provide stroke protection
For estrogen replacement to provide stroke protection, it likely must be given soon after levels drop because of menopause or surgical removal of the ovaries, scientists report in the Journal of Neuroscience.
Biofield therapies: helpful or full of hype?
Biofield therapies, which claim to use subtle energy to stimulate the body's healing process, are promising complementary interventions for reducing the intensity of pain in a number of conditions, reducing anxiety for hospitalized patients and reducing agitated behaviors in dementia, over and above what standard treatments can achieve.
Benefit of memantine in the treatment of Alzheimer's disease not proven
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