4 MEMORY SYSTEMS OF THE BRAIN AND DEMENTIA

Normal aging leads to changes in the brain, especially in areas involved in learning and memory.

Over time, changes in the brain can make it more difficult for an older person to learn new tasks or to retrieve information from memory, such as someone's name.

With Alzheimer's disease or a related dementia, the damage is more severe and ultimately affects larger regions of the brain.

The human brain contains an estimated 100 billion nerve cells (neurons). Chemical and electrical activity allows these neurons to perform their tasks and to communicate with one another. This elaborate communication system controls vital body functions and enables us to think, see, move, talk, remember, and experience emotions.

There are four different memory systems of the brain -- episodic, semantic, procedural, and working.

Memory Systems

Episodic Memory

The temporal lobe, which contains the hippocampus, and the prefrontal cortex are important to episodic memory, which enables us to learn new information and remember recent events. The hippocampus is one of the first brain structures damaged in Alzheimer's disease and accounts for one hallmark of early Alzheimer's: difficulty remembering recent events, without any trouble remembering events from long ago.

Semantic Memory

Semantic memory governs general knowledge and facts, including the ability to recognize, name, and categorize objects. This system also involves the temporal lobes and, researchers suspect, multiple areas within the cortex. People with Alzheimer's disease may be unable to name a common object or to list objects in a category, such as farm animals or types of birds.

Procedural Memory

The cerebellum is one of the structures involved in procedural memory. Procedural memory is what enables people to learn skills that will then become automatic (unconscious), such as typing or skiing. This memory system typically is not damaged in Alzheimer's disease or is one of the last cognitive domains to deteriorate.

Working Memory

Working memory involves primarily the prefrontal cortex. This memory system governs attention, concentration, and the short-term retention of needed information, such as a street address or phone number. Problems with working memory can impair a person's ability to pay attention or to accomplish multi-step tasks. Numerous cognitive disorders, such as Alzheimer's, Parkinson's, and Huntington's disease as well as dementia with Lewy bodies, can affect working memory.

In a nutshell, persons living with Alzheimer's or dementia cannot remember to remember. As a result, they can no longer either recall or use new memories in the future.

Nevertheless, persons living with dementia continue to surprise us with their stories and memories of the past.

This should be the focus of our compassionate caregiver efforts.

(Sources of information: John Hopkins +Alzheimer's Reading Room)

A New Tool To Diagnose Alzheimer’s Disease

For nearly a century, Alzheimer's destructive path in the brain could be seen only by directly examining the tissue during an autopsy after the patient died. Consequently, a diagnosis of Alzheimer's disease has been, and continues to be, based on results from a comprehensive evaluation that typically includes a medical history, a mental status evaluation, a clinical examination and laboratory tests.

Last year, the U.S. Food and Drug Administration (FDA) approved a new radioactive dye (Florbetapir F 18 Injection, Amyvid) that, when used during positron emission tomography (PET), enables doctors to spot telltale signs of Alzheimer's while the patient is still alive. But spotting signs of Alzheimer's disease and making an accurate diagnosis are two different things. And while the Amyvid scan is a major step forward, researchers have yet to find the Holy Grail. In the meantime, here are answers to questions you may have about this important tool.

How is the test performed and what does it reveal?

Amyvid is a radioactive dye that is injected into a vein prior to a PET scan. From there, the dye travels through the bloodstream and into the brain, where it binds to amyloid plaques. These plaques are abnormal clumps of brain cells mixed with beta-amyloid protein - a type of protein that forms in some people, including individuals with Alzheimer's disease. The PET scanner produces three-dimensional images of the brain that show how much plaque is present and where it is located. The results of the scan are graded as positive or negative.

Should everyone suspected of having Alzheimer's have a scan?

No. While Amyvid is approved for use in adults who are being evaluated for Alzheimer's disease and other causes of cognitive decline, most of the time, the doctor can make an accurate diagnosis without the additional information provided by the scan. The test is likely to be most useful in difficult cases, such as in younger patients with dementia or in patients with dementia that is rapidly progressing.

A word of caution

A number of Alzheimer's disease experts have expressed concern that disreputable companies may begin offering Amyvid scans (or scans using other agents that may gain FDA approval in the future). Be wary of any providers claiming that they can diagnose Alzheimer's or predict one's risk of developing it or determine a person's prognosis based on scan results. Also, be sure that the radiologist who interprets the findings has successfully completed the Amyvid reader training program developed by the product's manufacturer, Avid Radiopharmaceuticals.

(Source:  John Hopkins Health Alerts, 27 May 2013)

Brain Gym Exercises Can Help Keep Dementia At Bay

Sharing with you the article published in today’s Star (27 March 2013) written by Majorie Chiew of The Star who attended the “Brain Gym Vs Dementia” Talk & Exercise Session conducted at  ADFM PJ Daycare Centre on 9 March 2013.

Gymnastics for the Brain

Instructor Goh Siew Siew gets the crowd swinging and clapping their way through a series of exercises at a recent Brain Gym vs Dementia talk and exercise session. 

If our body needs exercise to stay in shape, so does the brain. EXERCISE can pack in a lot of fun, besides being good for the body and brain. At a recent Brain Gym vs Dementia talk and exercise session, the enthusiastic crowd swayed, clapped and sang in sync with Brain Gym songs such as Tony Chestnut, Apple Pie and Blueberry Pie.

“We’re going to make the best apple pie ... knee, shoulder, clap hands,” coaxed Goh Siew Siew, an international certified instructor of Brain Gym. The exercise involves touching the knees with your hands, then touching your shoulders and bringing your hands together in a clap.

“The left brain person needs instructions to do the exercise, while the right brain person knows how to do it, just by looking (at a demonstration),” said Goh.

She encouraged participants to “see it once and do it together!”

“Apple pie, apple pie, apple, apple, apple, apple pie. Anyone miss your pie?”

Before each workout, the participants are encouraged to drink water.

Goh said: “Time to drink water. Your brain needs ‘moisture’ to process (information).”

After the session, she asked: “Are you ready for Blueberry Pie (the exercise)?”

She was greeted with a resounding yes!

The talk and exercise session which was held at the Alzheimer’s Disease Foundation Malaysia (ADFM) PJ Daycare Centre, was open to care- givers and members of the public.

Brain Gym is a series of simple yet effective movements which are claimed to help stimulate neurological connections in the brain, reduces the stress of information processing, and rekindles the joy of learning.

It integrates the left and right hemispheric functions of the brain. As such, the exercises are claimed to enhance concentration, comprehension, reading and memory.

The movements also assist in balancing the body’s energy or meridian system and stress management.

The Brain Gym programme was the result of more than 30 years of clinical research by Dr Paul Dennison, an educational therapist, in the United States.  It has been taught worldwide and is used in corporate, institutional and atheletic training programme.

Brain Gym consists of 26 simple activities to improve learning skills through the use of both brain hemispheres. The exercises are said to be helpful for students with dyslexia or hyperactivity.

“Whether it is the body or the brain, the benefits of exercising and keeping fit have been proven for people of all ages, whatever their conditions. It is especially critical for dementia patients,” said Goh, who believes Brain Gym exercises can help keep dementia at bay.

Goh explained to the participants that the left side of the brain governs logic, thinking and language. However, dementia patients have problems with language and communication. “They cannot remember words to express themselves or sometimes they forget that they have eaten and want to eat again.”

The left side of the brain processes information in a linear manner and in sequence, while the right side is often called the creative side of the brain.

“Brain gym is for everyone – young and old. It emphasises on exercises which balance both the right and left brain functions.

“To sing a simple nursery rhyme like Baa Baa Black Sheep, you need both sides of the brain,” Goh explained.

BRAIN GYM EXERCISES

Other Brain Gym exercises which Goh taught the participants included Brain Buttons, Cross Crawl, Hook-ups, Arm Activations, Lazy Eight and Double Doodle.

And if I yawned at the end of the session, Goh will understand. For mine is not the “bored” yawn. In Brain Gym, it is the “energe-tic” yawn for scientific research has shown that yawning is an exercise which brings oxygen to the brain and as such, enhances learning.

The talk and exercise session was well received by the participants.

Retired microbiologist and biochemist, Clement Wong, 65, had no regrets signing up for the session as he had enjoyed himself tremendously.

A wellness consultant for 30 years, he said: “I am open to anything to do with wellness.”

His wife, Lucille Lee, 63, a retired school supervisor, liked The Owl exercise the most. “I have neck pain and this exercise is good for the shoulders and neck.”

The movements in The Owl are said to improve visual and auditory skills, head rotation, and lessen neck tension.

Another participant, project manager Kit Yuen, 55, said: “The exercises are very useful and I have started variations of them with my 79-year-old mother who has Alzheimer’s and has been diagnosed as a moderately severe case a few years ago.

“She has problems with memory, coordination, xenophobia and sensitivity. She does not remember what she said or is said to her within 5 minutes. She can still manage routines like eating, sleeping, reading the papers (albeit with fleeting concentration) and watching TV.”

Kit Yuen and her sister share the caregiving of their elderly mother and father. Her mother is currently “very unsociable” and will not even visit friends, let alone attend an event with a room full of strangers.

“I vary the moves (for the exercises) because my mother is diabetic; her exercise regime incorporates strengthening the leg muscles as well as coordination. I like the coordination exercises – the ones that involve arm and leg movements together– as they are very challenging,” said Kit Yuen.

And so it was a group of very happy participants who went home that day, with a new spring in their steps, and armed with tips to improve their memory.

(Source:  The Star, 27 March 2013, http://thestar.com.my)

BERRIES ARE GOOD FOR THE BRAIN

Older women who regularly ate blueberries and strawberries had slower rates of cognitive decline than those who ate berries infrequently, a new study found. The findings, part of the large and on- going Nurses’ Health Study, were published in the Annals of Neurology.

The study analysed results from some 16,000 women who had completed extensive questionnaires about the foods they ate, beginning in middle age and then every four years thereafter. They also underwent tests of memory and thinking skills every two years, starting at age 70.

Over the next four years, the researchers found, those women who ate the most strawberries and blueberries had the lowest rates of memory decline. The greatest benefit occurred in women who ate at least one serving of blueberries or at least two servings of strawberries per week. Including berries in your regular diet, the researchers estimated, was associated with a delay in cognitive aging of up to two-and-a-half years.

"Among women who consumed two or more servings of strawberries and blueberries each week, we saw a modest reduction in memory decline,” said study author Dr Elizabeth Devore, a researcher at Harvard Medical School. “This effect appears to be attainable with relatively simple dietary modifications."

Berries are rich in health-promoting flavonoids, the pigments that give them their colour. Flavonoids are also found in other fruits and vegetables, as well as herbs, grains, legumes and nuts at well. In the study, total flavonoid intake was also associated with less declining in brain function.

The authors noted that there is "substantial biologic evidence" to support a diet rich in berries and other foods rich in flavonoids in protecting the brain. Several flavonoids have been to reduce levels of inflammation, which scientists increasingly link to Alzheimer’s and other forms of dementia. Flavonoids are also potent antioxidants, which prevent cell damage from the reactive forms of oxygen known as free radicals, and have been shown to have other protective effects on brain cells as well.

Dietary studies can be unreliable, experts caution that, since people may not fill our food surveys accurately, and it can be difficult to tease out the cause-and-effect relationship between what we eat and the many factors that contribute to sound health. But "what makes our study unique is the amount of data we analysed over such a long period of time,” said Dr. Devore. “No other berry study has been conducted on such a large scale."

By ALZinfo.org, The Alzheimer's Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer's Research Foundation at The Rockefeller University.

Source: Elizabeth E. Devore ScD, Jae Hee Kang ScD, Monique M. B. Breteler MD, PhD, Francine Grodstein ScD: “Dietary intakes of berries and flavonoids in relation to cognitive decline.” Annals of Neurology Online, 25 April 2012.