Oophorectomy and hysterectomy may increase dementia risk but only when performed prematurely

Oophorectomy and hysterectomy may increase dementia risk but only when performed prematurel

Healthy lifestyles to prevent dementia and reduce dementia symptoms

© Emerald Publishing Limited. Purpose - Dementia is a growing problem worldwide, due to an ageing population. It has significant human and economic costs. There is no effective medical treatment. The paper aims to discuss these issues. Design/methodology/approach - Using earlier reviews, the author discussed the difference between dementia and cognitive ageing and the different types of dementia, in terms of manifestation and pathology. The author reviewed non-modifiable risk factors for dementia, such as age, gender, genetics and education. Education can possibly have lifelong protective effects, as it may promote cognitive reserve. This paper focussed on lifestyle interventions to further increase brain reserve capacity. Findings from earlier reviews were summarised to provide guidelines for policymakers and practioners. Findings - The reviews suggested that most nutritional approaches may have limited effectiveness, and should be implemented in midlife, before dementia symptoms are present and probably only in people who are actually nutritionally deficient. The author found a reasonable positive evidence base of engagement in cognitive and physical activities to prevent dementia, which may also help reduce symptoms of dementia. Practical implications - From the studies reviewed, it was suggested that keeping physically and mentally active may help in all stages of life to prevent, but also reduce dementia symptoms. A focus on nutrition and treating heart disease risk factors is possibly limited to midlife, or before dementia symptoms are present. Originality/value - The author used an evidence based approach to review which lifestyle interventions could help prevent dementia or reduce dementia symptoms. The main outcome of this paper was that stage of life and ability (dementia present or not) may interact with success of the intervention

Validation of two short dementia screening tests in Indonesia

Validation of two short dementia screening tests in Indonesi

Research with and for Older People at Loughborough University

Our Dementia research is part of Loughborough University Health and Wellbeing (HWB) Global Challenge http://www.lboro.ac.uk/research/excellence/challenges/health-wellbeing/). This strategic approach supports multi-disciplinary research in bringing complex real world solutions to promote health and wellbeing across the life course. Other research priorities within HWB include Planetary Health and Anti-Microbial Resistance. Research with and for older people in Loughborough University is carried out by a number of multi-disciplinary research units/groups with different specialist interests for example: - Dementia research for design, diagnostics and interventions http://www.lboro.ac.uk/research/dementia/ - Centre for Research in Social Policy (http://www.lboro.ac.uk/research/crsp/) - Healthcare Ergonomics & Patient Safety (http://www.lboro.ac.uk/departments/design-school/research/environmentalergonomics/) - Life Long determinants of health and wellbeing (http://www.lboro.ac.uk/departments/ssehs/research/lifestyle-healthwellbeing/life-course-determinants-health-wellbeing/) We describe our research in these five overlapping and closely-related topic areas: (1) New Dynamics of Ageing; (2) Dementia: Diagnosis, Design and Interventions; (3) Getting out and about (Transport ); (4) Working Later; (5) Health, Wellbeing and Safety for Older Peopl

Meta-analyses of the effect of hormone treatment on cognitive function in postmenopausal women

As we age, most of us experience a certain degree of cognitive decline. In most cases, this decline is gradual. However, in some cases, cognitive impairment is so severe it can be classified as dementia and this impacts greatly on activities of daily living. Alzheimer’s disease (AD), the most common form of dementia, has been linked to a reduction in estrogen (E) levels that come with aging. More specifically, many researchers have hypothesized that E, and hence E replacement via Hormone Therapy (HT), could protect against cognitive decline in women. However, recent randomised controlled trials (RCTs) did not reflect this. In fact, some reports showed that HT could be detrimental on cognition in older postmenopausal women. The most publicised of these has been the Women’s Health Initiative Memory Study (WHIMS). However, studies have yielded conflicting results and conclusions. The reasons for this may be due to a number of factors, such as the age of participants, the time of HT onset (‘window of opportunity’ theory), type of treatment, type of menopause (surgical or natural) and, possibly, genetic risk factors. We performed quantitative and qualitative meta-analyses and reviewed each of these factors in detail. The future may lie in combining these factors in order to fully understand the potential mechanisms behind E and its effect on cognition

Stress, depression, and anxiety: psychological complaints across menopausal stages

IntroductionWith the number of menopausal women projected estimated to reach 1.2 billion by 2030 worldwide, it is critically important to understand how menopause may affect women’s emotional well-being and how many women are affected by this. This study aimed to explore (i) the relationship between psychological complaints (depression, anxiety, poor memory) across different menopausal stages and (ii) investigate the correlation between resilience, self-efficacy, and perceived stress levels, with psychological complaints and whether this was associated with menopausal stage and/or age.Methods287 respondents completed the Menopausal Quality of Life (MenQoL), Perceived Stress Scale (PSS-10), Brief Resilience Scale (BRS), and General Self-efficacy (GSE) scales. Parametric and non-parametric analysis were used to analyse how bothered women were by self-reported poor memory and feelings of depression and anxiety, alongside perceived stress, resilience, and self-efficacy between women in different menopausal stages using STRAW criteria. The association between protective factors (self-efficacy and resilience) and psychological complaints was analysed with partial correlation analysis controlling for menopausal stages and/or age.ResultsA significant difference was found between the levels of perceived stress, and how bothered women were by feelings of depression and anxiety between early-perimenopausal and post-menopausal women. However, with the inclusion of age as a covariate, menopausal stage no longer predicted the level of self-reported stress and anxiety in menopausal women. There was also no difference between poor self-reported memory, or of self-efficacy or resilience between women in different menopausal stages. However, self-efficacy and resilience were associated with how bothered women were by feelings of depression and anxiety, and the experience of stress. Stress was the only variable to be associated with poor self-reported memory independent of age and/or menopausal status.DiscussionEarly perimenopausal women experienced the highest level of stress and were more severely bothered by feelings of depression and anxiety, with the poorest overall self-reported psychosocial quality of life. Post-menopausal women, however, reported to have similar experiences as premenopausal women. Age explained the associations between menopausal stage, stress and anxiety, but not between depression and different menopausal stages. Resilience and self-efficacy were associated with psychological complaints independent of menopausal stage and age, suggesting that therapies focusing on increasing resilience and self-efficacy may be beneficial to help target these psychological complaints at any time

Loneliness, social integration, and incident dementia over 6 years: prospective findings from the English longitudinal study of ageing

Objectives: Social relationships are important for the maintenance of cognitive function at older ages, with both objective features of social networks and perceived social connections (loneliness) being relevant. There is limited evidence about how different aspects of social experience predict diagnosed dementia. Methods: The sample comprised 6,677 dementia-free individuals at baseline (2004) from the English Longitudinal Study of Ageing. Baseline information on loneliness, number of close relationships, marital status, and social isolation (contact with family and friends and participation in organizations) was analyzed in relation to incident dementia over an average 6.25 years using Cox regression, controlling for potential confounding factors. Results: Two hundred twenty participants developed dementia during follow-up. In multivariable analyses, dementia risk was positively related to greater loneliness (hazard ratio 1.40, 95% confidence interval 1.09-1.80, p = .008), and inversely associated with number of close relationships (p < .001) and being married (p = .018). Sensitivity analyses testing for reverse causality and different criteria for diagnosing dementia confirmed the robustness of these findings. There was no association with social isolation. Discussion: Dementia risk is associated with loneliness and having fewer close relationships in later life. The underlying mechanisms remain to be elucidated, but efforts to enhance older peoples' relationship quality may be relevant to dementia risk

Are optimal levels of testosterone associated with better cognitive function in healthy older women and men?

Background Sex steroids can positively affect the brain and from this it would follow that high levels of sex steroids could be associated with better cognitive function in older men and women. Methods This Healthy Ageing Study sample comprised of 521 older participants (51% women) without dementia at baseline, with an age range from 64 to 94 years. Testosterone and sex hormone binding globulin were measured using the automated Immulite 2000 and analyzed in association with baseline memory, global cognitive function and decline (assessed using the Mini-Mental Status Examination or MMSE) and controlling for potential confounds such as age, education, vascular disease, smoking, diabetes, thyroid function, and body mass index. Results In healthy older men and women, optimal levels of testosterone were associated with better MMSE scores at baseline. Follow-up analyses indicated that in men, low testosterone levels (OR = .94, 95% CI = .88 to 1.00) were a risk factor for a sharp cognitive decline after 2 years, perhaps indicative of dementia. Associations were independent of covariates and baseline MMSE. Conversely, women at risk for a sharp drop in cognitive function showed some evidence for higher calculated free testosterone levels at baseline. Conclusions Results replicate earlier cross-sectional findings that high levels of sex steroids are not associated with better cognitive function in older people. In men, age accelerated endocrinological change could be associated with dementia pathology. General significance These data do not support increasing testosterone levels to prevent cognitive decline in men and women over 65 years of age

The Hopkins verbal learning test: an in-depth analysis of recall patterns

© 2017 Informa UK Limited, trading as Taylor & Francis Group One of the earliest signs of dementia is memory issues and verbal word lists, such as the Hopkins Verbal Learning Test (HVLT), are successfully used for screening. To gain insight in how memory is affected in dementia, and to further improve the efficacy of the HVLT, in-depth analysis of the recall patterns of dementia cases and controls was conducted. Dementia cases and controls were matched for factors that can affect performance, such as age, gender and education level. Word frequency, syllable length, and orthographic neighbourhood size did not differ in the Indonesian version of the HVLT, nor did these characteristics affect recall. However dementia cases showed consistent and poor recall across the three trials; with the worst recall for the “human shelter” category and best recall for the “animals” category. Dementia cases also showed impaired accessibility of all categories with reduced subsequent recall from accessed categories and reduced primacy and recency levels. Finally, dementia cases exhibited lower levels of re-remembering and recalling new words, and higher levels of immediate forgetting and never recalling words. It was concluded that utilising the extra information provided by the in-depth analyses of the recall patterns could be beneficial to improve dementia screening