Alzheimer’s Association International Conference (AAIC 2017)

1. Healthy eating habits may preserve cognitive function and reduce the risk of dementia – Alzheimer’s Society comment

Results from four large population-based studies support a link between good dietary practices and better cognition in old age. Study results were reported today (Monday 17 July 2017) at the 2017 Alzheimer’s Association International Conference (AAIC 2017) in London.

A group of US scientists found that, among nearly 6,000 older adults in the Health and Retirement Study, who consistently followed diets long known to contribute to cardiovascular health were also more likely to maintain strong cognitive function in old age.

They found that sticking to the specially designed MIND diet and Mediterranean diet was associated with 30-35% lower risk of cognitive impairment in healthy older adults. In fact, the investigators discovered that those with healthier diets exhibited meaningful preservation of cognitive function.

Dr Doug Brown, Director of Research & Development at Alzheimer’s Society said:

'These studies continue to build on the increasing evidence that suggests a Mediterranean style diet that’s rich in oily fish, fresh vegetables and nuts can help to maintain your memory as you get older, as well as maintaining your heart’s health.

'We’re starting to see evidence that this diet can not only help maintain memory, but also reduce the risk of dementia. And although the biggest risk factor for dementia is age, there are things we can all do now that help to lower our chances of developing the condition, including healthy eating, regular exercise and avoiding smoking.'

2. Verbal fluency could be predict cognitive health – Alzheimer’s Society comment

Research results reported today (Monday 17 July 2017) at the Alzheimer’s Association International Conference (AAIC) 2017 have provided clues about associations between cognitive status in older people and several behaviour and lifestyle factors, including verbal skill.

Researchers at Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, investigated whether people with very early memory declines also showed changes in their everyday speech.

The researchers found that subtle changes in everyday speech, such as the use of short sentences, more pronouns, and pauses like “um” and “ah,” correlated with early Mild Cognitive Impairment (eMCI), which can be a precursor to Alzheimer’s disease.

In the study, researchers analysed two speech samples, taken two years apart, from 264 participants. Of these participants, 64 were identified as having eMCI based on cognitive testing over 8-10 years. The speech samples, averaging one minute long, were collected by asking the participants to describe a simple picture.

Study participants with eMCI declined faster on two measures of speech: content and fluency. The content of their speech was less specific, with a higher proportion of pronouns to nouns (e.g., “she,” “it,” “them”). Their fluency was more disrupted (more hesitations, word repetitions, and filled pauses (“um,” “uh”)). Also, those with eMCI used less complex syntax and shorter sentences, and took more time to express the same amount of content as the cognitively healthy group.

Detection of dementia at the earliest stages has become a worldwide health priority because drug treatments, prevention strategies and other interventions will likely be more effective very early in the disease process, before extensive brain damage has occurred.

Dr James Pickett, Head of Research at Alzheimer’s Society said:

'Diagnosing dementia is challenging, as we don’t yet have a definitive test that can tell a doctor if someone has dementia, and symptoms often present differently in each individual.

'This study suggests that subtle changes in speech could be an early indicator of memory and thinking decline, but it didn’t look at whether people who experience these changes go on to be diagnosed with dementia.

'This early-stage research was conducted in a small number of people, but in future innovative tests like this could help to detect the early signs of dementia, which could lead to a more accurate and timely diagnosis.

'We all have difficulty finding the right word at times, but if you are concerned that you or someone you know is having increasing problems with speech, contact your GP for more advice.'

3. Emergency and urgent hospitalisations are related to accelerated cognitive decline in older people – Alzheimer’s Society comment

In research reported today (Monday 17 July 2017) at AAIC 2017, it was found older adults are at higher risk of memory and other cognitive problems after being hospitalised, including transient delirium and long-term changes in cognition.  Until now, it was unknown whether elective hospitalisations, such as scheduled surgery, put older individuals at the same risk of faster cognitive decline as emergency or urgent admissions.

Data came from 930 older adults (75% female, mean age of 81 years old) enrolled in the Rush Memory and Ageing Project (MAP) in Chicago. The study involved annual cognitive assessments, as well as clinical evaluations. Information on hospitalisations was found by linking 1999-2010 Medicare claims records for these participants to their MAP data. All hospital admissions were designated as elective, emergency, or urgent (the latter two combined as non-elective for analysis).

Of the 930 participants, 613 were hospitalised at least once over an average of almost five years of observation. Of those who were hospitalised, 260 (28%) had at least one elective hospital admission, and 553 (60%) had at least one non-elective hospital admission; 200 participants (22%) had both types of hospitalisations. In a model adjusted for age, sex, education, self-reported chronic medical conditions, length of stay, surgeries, intensive care unit stays, and comorbidities, non-elective hospitalisations were associated with acceleration in the rate of cognitive decline from before hospitalisation, while elective hospitalisations were not. Non-elective hospitalisations were associated with an approximately 60% acceleration in the rate of decline.

Dr Doug Brown, Director of Research and Development at Alzheimer’s Society said:

'It’s common for people with dementia to notice a decline in memory and thinking skills after surgery, but it’s not known exactly why this is.

'This study sheds light on the issue, finding that emergency or urgent hospitalisations are associated with faster decline in thinking skills, but that planned hospitalisations, like scheduled surgery, are not.

'The good news is that the risks of planned surgery may be lower than previously thought, but we still can’t be sure if emergency surgery has an effect on thinking skills, or whether other aspects of the procedure cause this.

'It’s important to talk to your doctor about any possible risk or benefits of surgery.'