Will individuals with Alzheimer's disease benefit from cataract surgery?

June 25, 2009

CLEVELAND--A multi-institutional team of researchers, led by the Mandel School of Applied Social Sciences at Case Western Reserve University, will begin a five-year, $2.9 million National Institutes of Health-funded study. They will examine the lives of patients with both cataracts and Alzheimer's disease (AD) to document how restored vision improves everyday life for people with dementia.

"This project addresses a major social justice issue in the disparity in vision care of persons diagnosed with Alzheimer's disease," said Grover "Cleve" Gilmore, dean of the Case Western Reserve Mandel School and principal investigator of the study.

Gilmore will lead faculty from the departments of Ophthalmology and Visual Sciences and Neurology at the Case Western Reserve University School of Medicine and physicians from the Eye Institute and Neurological Institute at University Hospitals and the Division of Ophthalmology at MetroHealth Medical Center.

In 20 years of research, Gilmore has found people with dementia lose their ability to see objects in medium- and low-contrast environments, but boosting the contrast of objects improves their ability to move around their homes; eat better; read; and do other simple, everyday tasks.

Cataracts cloud and blur the vision in the eye causing AD patients additional problems. If untreated, the cataracts lead to blindness, but sight can be restored with surgery to remove the cataract.

Co-investigator Jonathan Lass, M.D., the Charles I Thomas Professor and chair of the department of ophthalmology and visual sciences at the Case Western Reserve School of Medicine and director of the Eye Institute at University Hospitals, says, surprisingly, a preliminary study has shown 10 percent of patients over 65 who have an eye exam have some memory impairment along with cataracts. Most people start to show signs of cataracts in their early 60s.

"This research is important because we are a visual world," said Thomas Steinemann, M.D., professor of ophthalmology at the School of Medicine and ophthalmologist in the ophthalmology division at Metrohealth Medical Center.

Steinemann said he has observed improvements in AD patients following cataract surgery. Some who were combative before surgery are more cooperative following it. And even though they still are cognitively impaired to some degree, Steinemann said improved vision may even help AD patients recognize family members.

"Ultimately, if you can't perceive something, it is hard to remember it," says Alan Lerner, associate professor of neurology at the Case Western Reserve School of Medicine and director of the Memory and Cognition Center in University Hospital's Neurological Institute. "If the vision is blurry, then your memory may be more faulty than necessary. The cataract removal may offer benefits of improved quality of life which is a major aim in AD therapeutics overall."

"This grant demonstrates that the NIH recognizes a major disparity in healthcare for individuals with Alzheimer's disease and cataracts," said Gilmore. "We hope to provide evidence that AD patients also benefit from cataract surgery."

In the randomized controlled NIH-funded study, half of the 210 patients will receive cataract surgery and the other half will have surgery delayed for six months. The researchers will follow the progress of the two groups. During this time, the primary caregivers associated with these patients also will supply information about the patient's quality of life and activity levels by answering surveys and other measures.

In addition to finding scientific evidence that cataract surgery helps AD patients, the researchers hope to identify a warning sign of AD. They will test changes in the thickness of the retina, a part of the eye that is an extension of the brain. Using a technology called optical coherence tomography (OCT), they will track changes in the retinal thickness of these patients over six months to determine if there is a connection with AD.

By using the technology, Gilmore says they hope to find an indicator of the onset of AD and prompt referrals to neurologist for early interventions and medicines to delay memory loss.
-end-
In addition to Gilmore, Lass, Lerner and Steinemann, Julie Belkin, M.D., assistant professor of ophthalmology at the Case Western Reserve School of Medicine and of the Eye Institute at University Hospitals, will work with the co-investigators.

Case Western Reserve University is among the nation's leading research institutions. Founded in 1826 and shaped by the unique merger of the Case Institute of Technology and Western Reserve University, Case Western Reserve is distinguished by its strengths in education, research, service, and experiential learning. Located in Cleveland, Case Western Reserve offers nationally recognized programs in the Arts and Sciences, Dental Medicine, Engineering, Law, Management, Medicine, Nursing, and Social Work. http://www.case.edu.

Case Western Reserve University

Related Memory Articles from Brightsurf:

Memory of the Venus flytrap
In a study to be published in Nature Plants, a graduate student Mr.

Memory protein
When UC Santa Barbara materials scientist Omar Saleh and graduate student Ian Morgan sought to understand the mechanical behaviors of disordered proteins in the lab, they expected that after being stretched, one particular model protein would snap back instantaneously, like a rubber band.

Previously claimed memory boosting font 'Sans Forgetica' does not actually boost memory
It was previously claimed that the font Sans Forgetica could enhance people's memory for information, however researchers from the University of Warwick and the University of Waikato, New Zealand, have found after carrying out numerous experiments that the font does not enhance memory.

Memory boost with just one look
HRL Laboratories, LLC, researchers have published results showing that targeted transcranial electrical stimulation during slow-wave sleep can improve metamemories of specific episodes by 20% after only one viewing of the episode, compared to controls.

VR is not suited to visual memory?!
Toyohashi university of technology researcher and a research team at Tokyo Denki University have found that virtual reality (VR) may interfere with visual memory.

The genetic signature of memory
Despite their importance in memory, the human cortex and subcortex display a distinct collection of 'gene signatures.' The work recently published in eNeuro increases our understanding of how the brain creates memories and identifies potential genes for further investigation.

How long does memory last? For shape memory alloys, the longer the better
Scientists captured live action details of the phase transitions of shape memory alloys, giving them a better idea how to improve their properties for applications.

A NEAT discovery about memory
UAB researchers say over expression of NEAT1, an noncoding RNA, appears to diminish the ability of older brains to form memories.

Molecular memory can be used to increase the memory capacity of hard disks
Researchers at the University of Jyväskylä have taken part in an international British-Finnish-Chinese collaboration where the first molecule capable of remembering the direction of a magnetic above liquid nitrogen temperatures has been prepared and characterized.

Memory transferred between snails
Memories can be transferred between organisms by extracting ribonucleic acid (RNA) from a trained animal and injecting it into an untrained animal, as demonstrated in a study of sea snails published in eNeuro.

Read More: Memory News and Memory Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.