Learning another language 'could protect against dementia'

Learning another language 'rewires' the brain and could help delay the onset of dementia by years, research suggests.

By Stephen Adams, Medical Correspondent

5:00PM BST 29 Mar 2012

 

Having to grapple with two languages makes the brain work harder, making it more resilient in later life, say academics. 

One study found that, among people who did eventually get dementia, those who were bilingual throughout their lives developed the disease three to four years later. 

Dr Ellen Bialystok, of York University in Toronto, Canada, and two colleagues examined hospital records of patients diagnosed with a variety of different types of dementia. 

They found: "In spite of being equivalent on a variety of cognitive and other factors, the bilinguals experienced onset and symptoms and were diagnosed approximately three to four years later than the monolinguals.

"Specifically, monolingual patients were diagnosed on average at age 75.4 years and bilinguals at age 78.6 years.

Several other studies found similar results, they noted in the journal Trends in Cognitive Sciences.
While lifelong bilingualism appeared to have the strongest protective effect, any attempt at learning another language was likely to be beneficial, they wrote.
"If bilingualism is protective against some forms of dementia, then middle-aged people will want to know whether it is too late to learn another language, or whether their high-school French will count towards coginitive reserve," they said.
"A related question concerns the age of acquisition of a second language: is earlier better?" The best answer at present is that early age of acquisition, overall fluency, frequency of use, levels of literacy and grammatical accuracy all contribute to the bilingual advantage, with no single factor being decisive. "Increasing bilingualism" led to "increasing modification" of the brain, they said.
Brain imaging scans have found that having to switch between two languages helps exercise parts of the brain that carry out taxing intellectual tasks, like multi-tasking and concentrating intensely on a subject for a sustained period of time. These "executive control" functions tend to be among the first to wane in old age, a process known as "cognitive decline".
Dr Bialystok commented: "Our conclusion is that lifelong experience in managing attention to two languages reorganises specific brain networks, creating a more effective basis for executive control and sustaining better cognitive performance throughout our lifespan."
Dr Marie Janson, of Alzheimer's Research UK, said:"We know there are several lifestyle factors - such as healthy eating, exercise and mental activity - that could help to reduce our risk of dementia.
"This review discusses the evidence that keeping our brains active by switching between different languages could help to resist some of the damage caused by dementia, delaying the onset of symptoms.
"More research is needed to tease apart the most beneficial aspects of bilingualism - whether it is the age we starting learning, how fluent we are or how much we use the language in everyday life. 
"With 820,000 people in the UK living with dementia and this number expected to rise, it is vital to invest in research to understand more about how to prevent or delay the onset of this devastating condition." Original article from the Telegraph

Dementia, From the Inside

March 28, 2012, 8:19 am

By JANE GROSS, Founding Blogger

 

Lee Gorewitz in a scene from the film “You’re Looking at Me Like I Live Here and I Don’t.”

 

Scott Kirschenbaum’s new film, “You’re Looking at Me Like I Live Here and I Don’t,” was supposed to be scripted and cast — a coherent story with a beginning, a middle and an end. Then he found his unlikely star: Lee Gorewitz, 78, who lives in dementia unit at Reutlinger Community for Jewish Living in Danville, Calif.
They met one day in 2009 as Mr. Kirschenbaum arrived at the facility, which was to be his setting, on a scouting mission. Fit, well-coiffed and made-up, in earrings that matched her baby blue jogging suit, Mrs. Gorewitz greeted him at the door and was eager to show him around.

But as she walked through the facility, he recalled in an interview, her tour made less and less sense.

“Windows,” she said.

“Purses.”

“Gardeners.”

And eventually: “I hear the song in my ears, and I think they don’t love me anymore.’’

Mrs. Gorewitz was vivacious, energetic, charming and “trying her darndest to communicate with me,” Mr. Kirschenbaum said, but the “gap between her thinking and speech’’ was cavernous. The head of the unit called Mrs. Gorewitz’s way of communicating “word salad.”

But the 31-year-old filmmaker knew that telling the story he wanted to tell, of living with Alzheimer’s from the inside out, meant “working with an unreliable narrator.” It meant giving up on the idea of a linear plot. It meant entering a fragmented reality where “emotional coherence had replaced intellectual coherence.’’ And so Mrs. Gorewitz, with her family’s wholehearted support, became his muse.


The result is a strange and transfixing television experience, shot over the course of two weeks in April 2009. It will air on PBS stations on March 29 in Chicago, Denver and San Francisco; on April 1 in New York and Los Angeles; and on April 6 in Washington. (Viewers should check their local PBS listings.)

Until now, screen depictions of dementia mostly have been told from the perspective of the caregiver. Mr. Kirschenbaum, never seen in the film, is heard only a few times, in barely a whisper, asking Mrs. Gorewitz questions about her late husband, children, favorite color, the identities of people in the photographs in her room, the recipient of a birthday card she had saved, what she wore to her wedding, the meaning of love.
Mostly, the camera follows her wanderings through the unit, her interactions with other residents and staff, her sudden swings from conviviality to despair to anger. We hear the background noise and conversation, if you can call it that, of residents and aides. Family members are never in the frame. We are there only to the extent Mrs. Gorewitz is. What she cannot tell us, we don’t know.

She rails at her grown children, who visit with some regularity; her grandchildren have decorated her room with photos and mementos. That birthday card was meant for her, it turns out, but she can’t figure it out.
Displaying her “wedding dress,” she holds up a lavender blazer of recent vintage. Of her late husband she says, “How do I even say it? The air’’ – she pauses – “was very good.’’

And the meaning of love? She is silent for a long time, licking her lips. “That’s a darn good thing to work with,’’ she says.

In the corridors and lounges of the unit, Mrs. Gorewitz dances and snaps her fingers when the tape deck plays “Billy Boy’’ or Frank Sinatra sings “Somewhere, Beyond the Sea.’’ She soothes an old woman curled in a wheelchair cradling a doll in her arms. She kicks an old man, also in a wheelchair, and blurts out at him, “You’re going to die.’’ He responds with a jaunty wave.

In one scene, she lies curled in a fetal position on her bed, with its blue flowered comforter, keening, “I don’t know why. I don’t why I do what I do.’’

At the end of each day’s shooting, Mr. Kirschenbaum recalled, Mrs. Gorewitz kissed him goodbye, tearing up at their parting. He had become family. “There is no such thing as enough when you are that sociable, confused and lonely,” he said. “The fundamental struggle is how to make do with the social dynamic available to her.’’

Mr. Kirschenbaum has some background in the subject matter. His grandfather, 100, lives in a Rochester nursing home; his 93-year-old grandmother is three miles away, in assisted living, and visits her husband a few times a week. At Yale, he made a documentary about the role of Jewish humor in the lives of 15 nursing home residents. He wrote profiles of the elderly for the Yale Journal for Humanities in Medicine. Later, living in New York, he answered an online ad for a companion for a screenwriter with Alzheimer’s disease. The pair spent every Wednesday over muffins and coffee.

The title of the film is simply something Mrs. Gorewitz said one day, sitting at the edge of her bed, not far from tears and playing with a bunch of small stuffed animals. He didn’t ask what she meant.

Original article from the NY times

Watchie GPS Locator Helps Keep Alzheimer’s and Dementia Patients Safe

Posted by K. T. Bradford | 03/20/2012 | 0 Comments

Every week I’m guaranteed to see a Gray Alert on my Twitter feed or a flyer in my neighborhood here in New York concerning an elderly person who’s gone missing. Usually it’s a person with Alzheimer’s or dementia who accidentally wandered from home and didn’t come back.
Taking care of someone with either of these conditions is difficult, especially when you’re trying to balance their desire for dignity with your need to keep them safe. A new device called Watchie seeks to help with this issue and offers caregivers some peace of mind.
Watchie looks and is worn just like a watch and includes GPS technology and a SIM card for accurate tracking both indoors and out. Caregivers can set up specific safe zones and get alerts when the wearer leaves those zones or the wearer can press a panic button if they find themselves lost with no idea how to get home.

Caregivers can see where the Watchie is via a website or an app for their iPhone or iPad. There doesn’t appear to be an Android version yet.
The built-in accelerometer can also alert caregivers to sudden falls just in case the wearer isn’t able to press the panic button.
Despite the constant connection to cell towers and GPS satellites, the company behind Watchie claims that the device can go several days or weeks without needing a charge.
Watchie works in over 140 countries and is set to launch soon.

Original Article 3/20/12

Exercising an Aging Brain

By DENISE GRADY

MORE and more retired people are heading back to the nearest classroom — as students and, in some cases, teachers — and they are finding out that school can be lovelier the second time around. Some may be thinking of second careers, but most just want to keep their minds stimulated, learn something new or catch up with a subject they were always curious about but never had time for. 

 

For many, at least part of the motivation is based on widespread reports that exercising the brain may preserve it, forestalling mental decline and maybe even Alzheimer’s disease and other types of dementia.

Is there any truth to it? And if there is, what type of learning is best suited to the older brain?

Many studies do find that being mentally active is associated with a lower risk of Alzheimer’s disease. But the standard caveat applies: association does not prove cause and effect, and there is always the chance that the mentally active people who never got Alzheimer’s simply had healthier brains to begin with.

Even, so, researchers say, there is no harm in telling people to try to stay engaged. 

“When you and I are having this conversation, you’re taking notes, thinking, remembering pieces of it, trying to relate it to other things,” said Arthur Toga, a professor of neurology and director of the laboratory of neuroimaging at the University of California, Los Angeles. “You’re changing the circuitry in your brain. That is because you have changed something in your brain to retain that memory.” 

Dr. Toga elaborated: “The conversation requires nerve cells in the brain to fire, and when they fire they are using energy. More oxygen and sugar must be delivered, by increased blood flow to those regions.

“Why would that be good? If you are vasodilating, delivering more blood to certain regions of the brain, that is important. It increases the longevity and the health of those circuits. In adults, if I ask you to perform tasks you’ve never done before, the amount of brain it takes for you to try and do it is far greater than the amount of brain it takes for you to do something you’re already good at. So yes, exercising the brain is good.” Playing video games probably qualifies as a type of brain exercise, he said, though older people might not sharpen their skills as fast as younger ones do. 

But Dr. Toga warned that while using the brain might help avert some of the mental slowing that normally comes with aging, it had its limits. “I do not believe that it forestalls degenerative disease, however,” he said. “That’s a different process.” There is a “little bit of snake oil,” he added, in the various products and programs that are being marketed with the implied promise that they will ward off Alzheimer’s disease.

But research continues. Dr. William Jagust, a professor of public health and neuroscience at the University of California, Berkeley, said there were two main theories that tried to explain why exercising the brain might make it more resistant to disease. 

One is the “cognitive reserve” theory, which says that if the brain is in the best possible shape with extensive neuronal connections from being used a lot, it may be able to withstand the onset of Alzheimer’s disease for a while and symptoms may take longer to develop. 

A hallmark of Alzheimer’s is deposits in the brain of an abnormal form of a protein called amyloid.

“A paper we published showed that people who were more cognitively active over their whole life span had less amyloid,” Dr. Jagust said. 

Animal research, he said, shows that neural activity actually releases amyloid into the brain. How, then, could mentally active people have less amyloid? 

“My interpretation is that people who are more cognitively active have more efficient brains,” Dr. Jagust said. “What seems to happen in aging is that older people seem to have less efficient brains.” A scan of brain activity on a 20-year-old being asked to remember something will show less activity needed than in an 80-year-old asked to perform the same task. 

“Older people seem to activate or bring on line brain areas that young people don’t use,” Dr. Jagust said. “They have to work their brains harder. So people who stay cognitively active may use their brains more efficiently.” 

That way, they may generate fewer amyloid deposits. But he emphasized that being mentally active throughout life — not just in old age — was what mattered. 

“It has to do with lifelong patterns of behavior,” Dr. Jagust said. “We tend to focus on what people do at 75 in terms of dementia. But there is more evidence that what you do in your life, at 40 or 50, is probably more important.” 

Nonetheless, Dr. Jagust acknowledged, “this is all theoretical.” 

As to what kinds of things older people tend to be best at learning, the researchers said there were no hard and fast rules. Memory usually does diminish, even in people who do not have dementia, and reaction time slows. 

“You’re not going to learn to hit a fastball,” Dr. Jagust said. 

Over time, he said, the best-preserved abilities seem to involve vocabulary and knowledge about the world, what researchers call “crystallized intelligence.” Problem-solving and math ability, part of “fluid intelligence,” do not seem to stick as well. 

The slippage in memory may make it tough to learn a new language. But people who already know more than one language may be more adept than others, because the process of learning different rules of syntax and grammar, especially early in life, seems to program extra skills into the brain, ones that people appear to retain. 

Dr. Toga said that the sensorimotor parts of the brain that control the senses and muscle movement did not tend to shrink later in life the way the cognitive centers did. So in theory, learning physical skills like dancing ought to come easily. But nature can be cruel: where the brain is strong, the flesh may be weak. Failing eyesight and hearing, weakened muscles and stiff joints may all sabotage the signals the brain needs to choreograph smooth moves on the dance floor. 

“Everything is sliding downward, unfortunately,” he said, laughing. 

But it is still a good idea to try something new. 

 

“A variety of things is important,” Dr. Toga said. “We try to encourage people to do certain things because it couldn’t hurt and may be good. Retaining lots of social interaction is really important. It involves so much of the brain. You have to interpret facial expressions and understand new concepts. If you want to learn to ride a monocycle or do acrobatics at 75, it’s probably not a good idea. But exercising more geography in the brain, I think that’s important.” 

Columbia University has had a program for “lifelong learners” since 1986. About 200 participants take regular Columbia courses. They are expected to keep up with the reading, but there are no term papers, homework, exams or grades. 

The older students tend toward history courses, renowned professors and language classes that they hope will help in their travels. 

“A lot of the time, when seniors are in history classes, specially if it’s relevant to the topic, they are often used by professors as sort of experts to give testimony to events that actually occurred during a certain period,” said Kristine Billmyer, the dean and a professor at Columbia’s school of continuing education. “That’s pretty cool, and I think it’s something that’s highly valued by the students as well as the faculty.” 

Programs geared to older people also exist at many other colleges and universities. An organization based in California, the Bernard Osher Foundation, supports lifelong learning programs at 117 colleges and universities, at least one in every state, based on the idea that many older students go back to school for the joy of learning. 

One of the largest programs for retirees is at the University of Wisconsin, Green Bay (it is not associated with Osher). Called Learning in Retirement, it is sponsored by the university, with more than 1,000 members and more than 240 courses a year. Classes — mostly short, a few two-hour sessions — include painting, jazz, travel, eBay, osteoarthritis, Zumba, the periodic table, the history of the earth, building with straw bales and “motorcycling and aging awareness.” Most require no outside reading, homework or exams. Some are taught by college faculty, some by members of the group or others in the community. 

Michael W. Murphy, who spent more than 30 years as an English professor, said this program had brought him some of the greatest joy he had experienced in the classroom. Since 2001, when he stepped down from his post as acting dean at the university, he has been teaching poetry and other subjects to Learning in Retirement members. It is an unpaid position. 

“I’ve always enjoyed teaching, and the idea of teaching without having to read papers, correct tests and worst of all, give out grades, was really appealing,” Dr. Murphy said. 

To his delight, the students actually want to be there. They take the time to tell him how much they appreciate him and sometimes even break into applause after his lectures. One of his courses filled a hall with seats for 120 and had 130 more people on the waiting list. The students include doctors, lawyers, professors and high-school dropouts, who have all been around the block a few times, and every so often someone challenges him — a kind of mental jousting he enjoys. 

“The biggest problem I had teaching 18-year-olds was a kind of general apathy,” Dr. Murphy said. “They were looking forward to a career in high finance and I was trying to teach them to appreciate Tennyson. The fact that these people show up, and toddle in or waddle in, some with their walkers or wheelchairs, it’s heartwarming.”
Original article from the NY times
Published March 7, 2012