Dementia

...ba href=/dementia/a/b, are associated with falls.

Cognitive tests could help doctors assess risk for falls; conversely, slow gait could alert them to check for cognitive impairment.

The findings are in the March issue of Neuropsychology, which is published by the American Psychological Association (APA).

Roee Holtzer, PhD, and his colleagues conducted a cross-sectional study of 186 cognitively normal, community-dwelling adults aged 70 and older at New York City’s Albert Einstein College of Medicine.

Gait speed was tested with and without interference.

In the interference conditions, participants had to walk while reciting alternate letters of the alphabet.Performance on cognitive tests of executive control and memory, and to a lesser extent of verbal ability, predicted “gait velocity” (walking speed) tested without interference.

For gait velocity tested with interference, only executive control and memory were predictive.

Adding interference to the tests of gait allowed the researchers to better simulate the real world, in which walkers continually deal with distractions.

The authors conclude that executive control and memory function are important when the individual has to walk in a busy environment.The findings suggest that in old age, walking involves higher-order executive-control processes.

That is, the intersecting cognitive and motor processes involved in walking may both rely on a common brain substrate, or set of structures.

As a result, changes in that substrate...

...ba href=/dementia/a/b, and compared against 99 similar patients who were given a placebo, a harmless lookalike tablet.

The patients were assessed, both before and after the test, on a range of cognitive skills and basic coping skills.

Those on the donepezil showed good improvements in memory, orientation, language and spatial awareness, and their decline in coping skills such as bathing, grooming, bowel and bladder function either slowed or stabilised.

The drug was well tolerated.

The study, published online by The Lancet, is led by Bengt Winblad, a professor of geriatrics at Sweden's Karolinska Institutet.

Several theories compete as to the cause of Alzheimer's.

One of them suggests the disease is caused by a deficiency in chemicals called neurotransmitters that are used by brain cells to communicate with each other.

Donepezil and other drugs in its class inhibit acetylcholinesterase, an enzyme responsible for the destruction of an important neurotransmitter, acetylcholine.

As a result, levels of acetylcholine in the brain are increased, which apparently causes the improvement in symptoms.

These drugs improve symptoms but do not halt them, nor do they stop the underlying progression to ba href=/dementia/a/b and eventually death.

The two other hypothesis say the cause lies with tangles of protein called tau or with deposits of a plaque protein called beta amyloid that also are the hallmarks of Alzheimer's.

Global population growth, greater longevity and changing lifestyles in developing countries poin...

...ba href=/dementia/a/b live better, safer and more comfortable lives staying in their homes.

"Unfortunately, the home environment is not well suited for many people to remain in as they age," said Olsen.

"Safety problems abound, especially when it comes to exterior maintenance." However, Olsen and Hutchings believe that vigilant attention to detail and common sense can keep many a loved one in their familiar surroundings.

The pair is in the vanguard of a growing national movement to enable the aging population and individuals with disabilities to remain at home.

The researchers recently co-authored A Home for Life, NJIT Press, 2005.

The text is a soft cover, easy-to-read and follow, 78-page guide for creating, safe, comfortable homes.

A grant from the U.S.

Department of Health and Human Service supported their work.

"Research shows that living at home for many people is better than being sent to an institution," said Olsen.

Fifteen states, to date, have arrangements so that Medicare money can pay for daily visits from home health aides to people in their homes.

Similar legislation is now pending in New Jersey as well as a pilot program for Ocean County.

"The thing to keep in mind when assessing a home is to remain flexible and honest when assessing the capabilities of the individual," said Olsen.

"Not everything works for everyone.

There is no silver bullet.

What we suggest are some ideas to try that we have seen often work for some people." "We also remind everyone to assess the situation...