Aging

Low vitamin D speeds age-related cognitive decline

  • On average, older adults with low levels of vitamin D showed much faster decline in episodic memory and executive function.
  • Older adults with dementia had significantly lower levels of vitamin D compared to those with MCI or normal cognition.
  • Low vitamin D was more common in African-Americans and Hispanics, compared to whites.

A study involving 382 older adults (average age 75) followed for around five years, has found that those who don’t get enough vitamin D may experience cognitive decline at a much faster rate than people who have adequate vitamin D.

Participants included 17.5% with dementia at the beginning of the study, 32.7% with MCI, and 49.5% cognitively healthy.

Those with dementia had lower levels of vitamin D than the other two groups.

While some people with low vitamin D didn’t show any cognitive decline and some with adequate vitamin D declined quickly, people with low vitamin D on average declined two to three times as fast as those with adequate vitamin D, in two crucial cognitive domains: episodic memory and executive function. Semantic memory and visuospatial ability were not significantly affected.

Factors such as age, gender, education, BMI, season of blood draw, vascular risk, and presence of the 'Alzheimer's gene', ApoE4, were controlled for.

Unlike previous studies of vitamin D and dementia, the participants were racially and ethnically diverse and included whites (41%), African Americans (30%), and Hispanics (25%). Nearly two-thirds (61%) had low vitamin D levels in their blood, including 54% of the whites and 70% of the African-Americans and Hispanics.

Vitamin D is primarily obtained through sun exposure. Accordingly, people with darker skin are more likely to have low levels of vitamin D because melanin blocks ultra-violet rays.

It remains to be seen whether Vitamin D supplements could slow cognitive decline.

http://www.futurity.org/vitamin-d-cognitive-decline-1003932/

 

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Movie study confirms older people are more distractible

Idiosyncratic brain activity among older people watching a thriller-type movie adds to evidence that:

  • age may affect the ability to perceive and remember the order of events (explaining why older adults may find it harder to follow complex plots)
  • age affects the ability to focus attention and not be distracted
  • age affects the brain's connectivity — how well connected regions work together.

A study involving 218 participants aged 18-88 has looked at the effects of age on the brain activity of participants viewing an edited version of a 1961 Hitchcock TV episode (given that participants viewed the movie while in a MRI machine, the 25 minute episode was condensed to 8 minutes).

While many studies have looked at how age changes brain function, the stimuli used have typically been quite simple. This thriller-type story provides more complex and naturalistic stimuli.

Younger adults' brains responded to the TV program in a very uniform way, while older adults showed much more idiosyncratic responses. The TV program (“Bang! You're dead”) has previously been shown to induce widespread synchronization of brain responses (such movies are, after all, designed to focus attention on specific people and objects; following along with the director is, in a manner of speaking, how we follow the plot). The synchronization seen here among younger adults may reflect the optimal response, attention focused on the most relevant stimulus. (There is much less synchronization when the stimuli are more everyday.)

The increasing asynchronization with age seen here has previously been linked to poorer comprehension and memory. In this study, there was a correlation between synchronization and measures of attentional control, such as fluid intelligence and reaction time variability. There was no correlation between synchronization and crystallized intelligence.

The greatest differences were seen in the brain regions controlling attention (the superior frontal lobe and the intraparietal sulcus) and language processing (the bilateral middle temporal gyrus and left inferior frontal gyrus).

The researchers accordingly suggested that the reason for the variability in brain patterns seen in older adults lies in their poorer attentional control — specifically, their top-down control (ability to focus) rather than bottom-up attentional capture. Attentional capture has previously been shown to be well preserved in old age.

Of course, it's not necessarily bad that a watcher doesn't rigidly follow the director's manipulation! The older adults may be showing more informed and cunning observation than the younger adults. However, previous studies have found that older adults watching a movie tend to vary more in where they draw an event boundary; those showing most variability in this regard were the least able to remember the sequence of events.

The current findings therefore support the idea that older adults may have increasing difficulty in understanding events — somthing which helps explain why some old people have increasing trouble following complex plots.

The findings also add to growing evidence that age affects functional connectivity (how well the brain works together).

It should be noted, however, that it is possible that there could also be cohort effects going on — that is, effects of education and life experience.

http://www.eurekalert.org/pub_releases/2015-08/uoc-ymt081415.php

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Physical activity linked to greater mental flexibility in older adults

  • A correlation has been found between physical activity in healthy older adults and more variable resting-state brain activity.
  • More variable resting-state activity in older adults has previously been linked to better cognition.
  • No such correlation was found between cardiorespiratory fitness and resting-state brain activity.
  • The finding supports previous evidence linking higher levels of physical activity in old age with better cognition and brain health.

A study involving 100 healthy older adults (aged 60-80) has found that those with higher levels of physical activity showed more variable spontaneous brain activity in certain brain regions (including the precuneus, hippocampus, medial and lateral prefrontal, and temporal cortices). Moreover, this relationship was positively associated with better white-matter structure.

Higher rates of activity when the brain is “at rest” have previously been shown to be associated with better cognitive performance in older adults, especially in IQ and memory.

The brain regions showing this relationship all play an important role in major resting-state networks, including the default mode network, the motor network, and networks associated with executive control and salience detection. They are all highly connected.

Participants' physical activity over a week was measured using accelerometers. Cardiorespiratory fitness was also assessed. Participants were generally not very active and not very fit.

The findings add to evidence linking higher fitness and physical activity with greater brain integrity and higher cognitive performance. They are also consistent with previous studies showing an increase in such brain signal fluctuations among older adults participating in physical exercise programs.

Interestingly, level of brain activity fluctuations was only correlated with physical activity, not with cardiorespiratory fitness. This indicates that CRF and physical exercise cannot be considered as functional equivalents — there must be some aspects of physical activity not captured by a measure of cardiorespiratory fitness.

It's also worth noting that there wasn't a significant correlation between sedentary time and resting-state brain activity fluctuations, although this may be because the participants all showed not-very-dissimilar levels of sedentary time.

http://www.eurekalert.org/pub_releases/2015-08/uoia-slp082415.php

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Burzynska AZ, Wong CN, Voss MW, Cooke GE, Gothe NP, Fanning J, et al. (2015) Physical Activity Is Linked to Greater Moment-To-Moment Variability in Spontaneous Brain Activity in Older Adults. PLoS ONE 10(8): e0134819. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0134819

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No benefit in omega-3 supplements for cognitive decline

  • A large study of older adults with age-related macular degeneration found no cognitive benefit from taking omega-3 supplements, or supplements of lutein and zeaxanthin.

A large, five-year study challenges the idea that omega-3 fatty acids can slow age-related cognitive decline. The study, involving 4,000 older adults, was part of the Age-Related Eye Disease Study (AREDS), which established that daily high doses of certain antioxidants and minerals can help slow the progression of age-related macular degeneration. However, a follow-up study found the addition of omega-3 fatty acids to the AREDS formula made no difference.

Omega-3 fatty acids are believed to be responsible for the health benefits associated with regularly eating fish, which is associated with lower rates of AMD, cardiovascular disease, and possibly dementia.

In this study, participants from the AREDS study, all of whom had early or intermediate AMD, were randomly assigned to either omega-3, or lutein and zeaxanthin (nutrients found in large amounts in green leafy vegetables), or both, or a placebo. As they all had AMD, participants also took the AREDS formula, which includes vitamins C, E, beta carotene, and zinc. Cognitive testing took place at the beginning, at 2 years, and at 4 years.

There was no benefit to these supplements: all groups showed a similar rate of cognitive decline over the study period.

The researchers speculate that the failure to find a benefit may lie in the age of the participants — it may be that supplements, to be of benefit, need to be started earlier. The other possibility (and the one I myself give greater weight to, although both factors may well be influential) is that these nutrients need to be taken in food to be effective.

It should be noted that the omega-3 fatty acids taken were those found in fish, not those found in plant foods such as flaxseed, walnuts, soy products, and canola and soybean oils.

http://www.eurekalert.org/pub_releases/2015-08/nei-nss082115.php

http://www.eurekalert.org/pub_releases/2015-08/tjnj-eop082115.php

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Limited benefit of physical activity for preventing cognitive decline

  • A large study of older adults (70+) found no cognitive benefit from a regular exercise program, compared to another social & mental intervention.
  • However, a subset of participants (those over 80, and those with poor physical function at the beginning of the study) did show improvement in executive function.
  • Participants in both programs showed no cognitive decline over the two-year period, suggesting both interventions were helpful.

A large, two-year study challenges the evidence that regular exercise helps prevent age-related cognitive decline.

The study involved 1,635 older adults (70-89) who were enrolled in the Lifestyle Interventions and Independence for Elders (LIFE) study. They were sedentary adults who were at risk for mobility disability but able to walk about a quarter mile. Participants had no significant cognitive impairment (as measured by the MMSE) at the beginning of the study. Around 90% (1476) made it to the end of the study, and were included in the analysis.

Half the participants were randomly assigned to a structured, moderate-intensity physical activity program that included walking, resistance training, and flexibility exercises, and the other half to a health education program of educational workshops and upper-extremity stretching.

In the physical activity condition, participants were expected to attend 2 center-based visits per week and perform home-based activity 3 to 4 times per week. The sessions progressed toward a goal of 30 minutes of walking at moderate intensity, 10 minutes of primarily lower-extremity strength training with ankle weights, and 10 minutes of balance training and large muscle group flexibility exercises.

The health education group attended weekly health education workshops during the first 26 weeks of the intervention and at least monthly sessions thereafter. Sessions lasted 60 to 90 minutes and consisted of interactive and didactic presentations, facilitator demonstrations, guest speakers, or field trips. Sessions included approximately 10 minutes of group discussion and interaction and 5 to 10 minutes of upper-extremity stretching and flexibility exercises.

Cognitive assessments were made at the beginning of the study and at 24 months, as well as a computerized assessment at either 18 or 30 months.

At the end of the study, there was no significant difference in cognitive score, or incidence of MCI or dementia, between the two groups. However, those in the exercise group who were 80 years or older ( 307) and those with poorer baseline physical performance ( 328) did show significantly better performance in executive function.

Executive function is not only a critical function in retaining the ability to live independently, research has also shown that it is the most sensitive cognitive domain to physical exercise.

Note also that there was no absolute control group — that is, people who received no intervention. Both groups showed remarkably stable cognitive scores over the two years, suggesting that both interventions were in fact effective in “holding the line”.

While this finding is disappointing and a little surprising, it is not entirely inconsistent with the research. Studies into the benefits of physical exercise for fighting age-related cognitive decline and dementia have produced mixed results. It does seem clear that the relationship is not a simple one, and what's needed is a better understanding of the complexities of the relationship. For example, elements of exercise that are critical, and the types of people (genes; health; previous social, physical, and cognitive attributes) that may benefit.

http://www.eurekalert.org/pub_releases/2015-08/tjnj-eop082115.php

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A diet to delay age-related cognitive decline

More evidence for the benefits of the Mediterranean diet for fighting age-related cognitive decline comes from a large 5-year study. The study involved 960 older adults, whose cognitive change was assessed over 4.7 years. Those who followed the MIND diet more rigorously showed an equivalent of being 7.5 years younger cognitively than those who followed the diet least.

The Mediterranean-DASH Diet Intervention for Neurodegenerative Delay is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. It requires at least:

  • three servings of whole grains every day
  • a green leafy vegetable and one other vegetable every day
  • a glass of wine
  • snack most days on nuts
  • beans every other day or so
  • poultry at least twice a week
  • fish at least once a week
  • berries at least twice a week (blueberries are particularly recommended)
  • very limited intake of designated unhealthy foods, especially:
    • butter
    • sweets and pastries
    • whole fat cheese
    • fried or fast food

http://www.eurekalert.org/pub_releases/2015-08/rumc-eaa080415.php

http://www.theguardian.com/society/2015/aug/05/diet-high-in-leafy-green-vegetables-may-slow-cognitive-decline-in-elderly-study

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Aerobic exercise improves cognition in healthy older adults

A six-month pilot study involving 101 healthy older adults (65+), who were randomly put into one of three exercise interventions or a no-change control, has found that the exercise groups all showed significant improvement in visual-spatial processing and attention, with more improvement in visual-spatial processing occurring in those with higher levels of exercise.

The benefits of increasing exercise for visual-spatial processing, however, were fully accounted for by improvements in cardiorespiratory fitness, suggesting that exercise intensity may be more important than exercise duration.

The researchers suggest that individualized exercise programs designed to maximize cardiorespiratory fitness will be of greatest benefit.

The three exercise levels were: 150 minutes per week (the recommended level); 75 minutes per week; 225 minutes per week. Exercise was supervised, and mainly consisted of treadmill walking of moderate intensity. Participants exercised 3-5 days a week. Performance in five cognitive domains were tested: Verbal Memory, Visuospatial Processing, Simple Attention, Set Maintenance and Shifting, and Reasoning.

Note that only 77 individuals made it through the trial, and also adhered to at least 80% of the alloted amount of exercise. Unsurprisingly, the 225-minute group had the most trouble meeting the allotment: 70% of the group managed it, compared to 82% of the 75-minute group, and 85% of the 150-minute group. It's worth noting that, of those who met the 80% requirement, almost all (>95%) fully adhered to the prescription, and this was true across all exercise prescriptions.

http://www.eurekalert.org/pub_releases/2015-07/uokm-eci071515.php

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Vidoni ED, Johnson DK, Morris JK, Van Sciver A, Greer CS, Billinger SA, et al. (2015) Dose-Response of Aerobic Exercise on Cognition: A Community-Based, Pilot Randomized Controlled Trial. PLoS ONE 10(7): e0131647. doi:10.1371/journal.pone.0131647

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Why older adults lose working memory capacity

The root of age-related cognitive decline may lie in a reduced ability to ignore distractors. A new study indicates that older adults put more effort into focusing during encoding, in order to compensate for a reduced ability to hold information in working memory. The finding suggests a multi-pronged approach to improving cognitive ability in older adults.

I've reported before on the idea that the drop in working memory capacity commonly seen in old age is related to the equally typical increase in distractability. Studies of brain activity have also indicated that lower WMC is correlated with greater storage of distractor information. So those with higher WMC, it's thought, are better at filtering out distraction and focusing only on the pertinent information. Older adults may show a reduced WMC, therefore, because their ability to ignore distraction and irrelevancies has declined.

Why does that happen?

A new, large-scale study using a smartphone game suggests that the root cause is a change in the way we hold items in working memory.

The study involved 29,631 people aged 18—69, who played a smartphone game in which they had to remember the positions of an increasing number of red circles. Yellow circles, which had to be ignored, could also appear — either at the same time as the red circles, or after them. Data from this game revealed both WMC (how many red circle locations the individual could remember), and distractability (how many red circle locations they could remember in the face of irrelevant yellow circles).

Now this game isn't simply a way of measuring WMC. It enables us to make an interesting distinction based on the timing of the distraction. If the yellow circles appeared at the same time as the red ones, they are providing distraction when you are trying to encode the information. If they appear afterward, the distraction occurs when you are trying to maintain the information in working memory.

Now it would seem commonsensical that distraction at the time of encoding must be the main problem, but the fascinating finding of this study is that it was distraction during the delay (while the information is being maintained in working memory) that was the greater problem. And it was this distraction that became more and more marked with increasing age.

The study is a follow-up to a smaller 2014 study that included two experiments: a lab experiment involving 21 young adults, and data from the same smartphone game involving only the younger cohort (18-29 years; 3247 participants).

This study demonstrated that distraction during encoding and distraction during delay were independent contributory factors to WMC, suggesting that separate mechanisms are involved in filtering out distraction at encoding and maintenance.

Interestingly, analysis of the data from the smartphone game did indicate some correlation between the two in that context. One reason may be that participants in the smartphone game were exposed to higher load trials (the lab study kept WM load constant); another might be that they were in more distracting environments.

While in general researchers have till now assumed that the two processes are not distinct, it has been theorized that distractor filtering at encoding may involve a 'selective gating mechanism', while filtering during WM maintenance may involve a shutting down of perception. The former has been linked to a gating mechanism in the striatum in the basal ganglia, while the latter has been linked to an increase in alpha waves in the frontal cortex, specifically, the left middle frontal gyrus. The dorsolateral prefrontal cortex may also be involved in distractor filtering at encoding.

To return to the more recent study:

  • there was a significant decrease in WMC with increasing age in all conditions (no distraction; encoding distraction; delay distraction)
  • for older adults, the decrease in WMC was greatest in the delay distraction condition
  • when 'distraction cost' was calculated (((ND score − (ED or DD score))/ND score) × 100), there was a significant correlation between delay distraction cost and age, but not between encoding distraction cost and age
  • for older adults, performance in the encoding distraction condition was better predicted by performance in the no distraction condition than it was among the younger groups
  • this correlation was significantly different between the 30-39 age group and the 40-49 age group, between the 40s and the 50s, and between the 50s and the 60s — showing that this is a progressive change
  • older adults with a higher delay distraction cost (ie, those more affected by distractors during delay) also showed a significantly greater correlation between their no-distraction performance and encoding-distraction performance.

All of this suggests that older adults are focusing more attention during attention even when there is no distraction, and they are doing so to compensate for their reduced ability to maintain information in working memory.

This suggests several approaches to improving older adults' ability to cope:

  • use perceptual discrimination training to help improve WMC
  • make working memory training more about learning to ignore certain types of distraction
  • reduce distraction — modify daily tasks to make them more "older adult friendly"
  • (my own speculation) use meditation training to improve frontal alpha rhythms.

You can participate in the game yourself, at http://thegreatbrainexperiment.com/

http://medicalxpress.com/news/2015-05-smartphone-reveals-older.html

Reference: 

[3921] McNab, F., Zeidman P., Rutledge R. B., Smittenaar P., Brown H. R., Adams R. A., et al.
(2015).  Age-related changes in working memory and the ability to ignore distraction.
Proceedings of the National Academy of Sciences. 112(20), 6515 - 6518.

McNab, F., & Dolan, R. J. (2014). Dissociating distractor-filtering at encoding and during maintenance. Journal of Experimental Psychology. Human Perception and Performance, 40(3), 960–7. doi:10.1037/a0036013

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Evidence for the benefits of meditation in fighting age-related cognitive decline

A review of meditation research reported in January last year concluded that there were insufficient good studies to allow us to say that meditation clearly improves attention and cognition. Studies from 2014 suggest three factors that might be part of the reason for inconsistent research findings:

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