Fighting off dementia

DementiaAlzheimer’s – already afflicting well over 5 million Americans – is expected to claim more than 16 million of us by 2050 if a cure isn’t found. Today it is at the top of the Bad News list of potential diagnoses for almost anyone over 50. Justifiably so, since the Centers for Disease Control and Prevention reports than one in three seniors now die with Alzheimer’s or other dementia.

That’s the bad news.

The good news, explained recently by Patricia Spilman, M.S. at a sold-out Commonwealth Club event in San Francisco, is that there are things one can to do lower the risk, and perhaps slow the progress of the disease. Spilman, who is Staff Scientist at the Buck Institute’s Bredesen Lab, should know. She has spent more than two decades researching neurodegenerative disease, and has written and spoken extensively on Alzheimer’s and related diseases.

“Forgetting,” Spilman says, by way of reassurance, “is normal. You don’t need to remember where you put the car keys last week, or a doctor’s appointment last month.” And studies – including one by Buck Institute founding President and CEO Dale Bredesen M.D. that is fascinating even for a lay reader – suggest that cognitive decline can be slowed, or in some cases reversed.

Spilman’s prepared remarks consisted largely of useful, realistic advice about how to delay the cognitive decline most of us will experience at some point. The audience, ranging from 20-somethings to more than a few senior citizens, was furiously note-taking throughout (or furiously jotting down questions for the Q&A session to follow.)

Exercise – particularly activities that combine movement and navigation such as tennis or golf – is at the top of the list. “It’s easier if you have a partner,” Spilman suggests, “because this adds the important element of socialization. Walking, plus climbing, is particularly good if you try new routes.” More than a few audience members nodded knowingly when Spilman noted the increasing, widespread dependence on mindless GPS. “Take the opportunity to look at a map,” she said.

Cognitive decline can also be offset by paying attention to the critical need for plenty of sleep. To help with a good night’s sleep, Spilman advises allowing at least several hours between eating and going to bed, and having a dark room. Chronic stress is relieved by a combination of exercise and sleep, along with those other preservatives of gray matter, yoga and mindfulness meditation.

Also good for the brain: almost any sensory stimulation. Music, smells, touch. Spilman cites Oliver Sacks’ Musicophilia: Tales of Music and the Brain, and Norman Cousins’ Anatomy of an Illness, in which Cousins treated himself with comedy as useful reading.

“Do something new every week,” Spilman suggests; “every day. Have goals in later life. Take classes, volunteer, build intergenerational relationships, pursue spirituality, encourage others to change and to grow.”

Computer games can improve cognition also. Spilman did not mention any specific sites, but this writer has enjoyed BrainHQ, and other brainy items from Posit Science’s Karen Merzenich, as well as introductory games on the Lumosity site. Most fascinating of all is the University of California San Francisco (UCSF)’s Brain Health Registry, in which anyone can participate; it’s free, and your brain might wind up helping someone else’s brain one day.

The Q&A segment following Spilman’s talk was fast and full of both personal stories and pertinent questions: “What’s normal decline?” (The difference between not remembering the movie star’s name and not being able to do a job well. You might keep a diary of cognitive function.) “What about genetics – the father-daughter-son factors?” (Yet unproven.) “How about overexposure to electromagnetic fields? (Don’t have unnecessary radiation.) And enough other issues raised for two or three more hours.

No one’s brain, in any event, was idle. Which indicates that everyone in Spilman’s audience was lowering his or her risk of Alzheimer’s.

Saving One Small Piece of the Planet

Every now and then you can go home again… at least, home to a better planet. Here’s another story (OK, we admit to too many stories about the ducks…) from Mountain Lake in San Francisco’s Presidio National Park.

whirlpool
Mysterious whirlpool

Recently a few Mountain Lake Park regulars began to notice a strange and mysterious phenomenon: whirlpools in the lake! Mineral springs? Fresh water from the bowels of the earth bubbling up into this water-starved state? A submerged hot tub? As the King of Siam would have said, “It’s a puzzlement.”

Enter Jason Lisenby, Biological Science Technician with the Presidio Trust and a particular friend of Mountain Lake Park. It was Lisenby who intervened when this writer wanted to mount a campaign to find a mate for lonely Musco the Duck. “Wait, wait,” he said. “You will wind up with a lake full of – non-native – Muscovy ducks and nothing else.” Musco apparently got bored with being behind the giant dark fence while the non-native fish were being removed anyway, and has relocated to other waters. Where we hope he has found a family more appropriate if less devoted than the human admirers he had at Mountain Lake.

The whirls and bubbles, Lisenby explains, “are from a newly installed aeration and water-mixing system” recently turned on. “We are using a compressor to pump air through hoses to twelve locations around the bottom of the lake. The added oxygen and movement will help keep algae blooms at bay while we get the lake’s aquatic plant communities restarted.

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More whirlpools, and a spot that’s lovely even on a foggy day

“Limiting algae will keep the water more clear, and clear water is good for our newly reestablishing aquatic plants. In the long run, the aquatic plants will do the work the aeration system is currently doing, but this is a solution until then.”

Who knew? Biological science knew. Already the lake is so clear it’s possible to see eight feet down (don’t try this yourself; the lake is not for swimming and diving), and this is a body of water so polluted by highway runoff, abandoned pets and assorted human detritus that only a few years ago you couldn’t see your hand six inches below the surface. You wouldn’t have wanted to get too near the water anyway.

aquatic plants
Aquatic plants coming soon (or their relatives will be coming soon) to Mountain Lake

All this, a little good news amidst the abundant smoldering global bad news, right here in the Presidio National Park. Your tax dollars, and biological science, at work.

Halleluia.

Want to put your brain to good use?

child Head

(Part Two of Data Today – Better Tomorrow)

Could this be you? Creating a better tomorrow through brain research??

It turns out one does not have to be a pro football linebacker to have a brain worth studying. One does not even need to have a brain like Albert Einstein’s, Steven Hawking’s or any of those scientists/exceptionalists/geniuses whose brains would seem worth figuring out.

One only needs to be 18 or over and willing to be studied, and then to go sign up on the Brain Health Registry. This entitles you to sit back and wait for your brain to help discover a cure for Alzheimer’s or ADHD or depression, or perhaps help find better ways to treat traumatic brain injury. Not bad, for just having a brain and investing a little time (no money.)

This writer got off to a sluggish start as a Brain Health Registry member. Signed up early on because it sounds like such a great endeavor, but then I ran into a few off-putting instructions like “This will take about 20 minutes. It is best done in a quiet room where there will be no distractions or interruptions.” Twenty minutes, quiet rooms and absence of distractions are three things hard to come by around my house.

Eventually, however, the requisite conditions were found, and I was off to create a better tomorrow – well, in partnership with a few thousand other participants and some very smart neuroscientists – by finding out stuff about the human brain. And this is one fascinating journey. The neuroscientists find it fascinating because they really are going to figure stuff out. But for participants, the fascination is in the process.

Participants enter a little basic, very general data about medical/family history etc. Then the fun begins. We have two sets of ‘Cognition’ tests aimed at assessing our memory, attention and other cognitive characteristics. “These tests give us a sense of how your brain is currently functioning,” the screen says. This participant can only wonder what the Brain Health assessment people think about how her brain is functioning. The ‘Cognition’ tests are computer games on steroids. For a while you try to remember and replicate the pattern of dots, and then you go to the card games. The card games require Yes or No answers about what the cards are doing, press D for Yes and K for No. My brain kept trying to tell me what the cards were doing, while my fingers tried to remember that K was not for Yes.

It is, all in all, a lot more fun that the computer games the rest of the world is playing.

In another three to six months, the BHR people will be reminding me to go back and do it again, or do something else, to see how the brain is getting along. Perhaps they will flag my entry and advise me to check myself into an institution. But more likely they will just combine my data with the data of a zillion more or less anonymous others – and find a cure for Alzheimer’s! Or depression! Or improvements in treatment of traumatic brain injuries! All with the help of my weary, aging brain. Plus, when the survey was completed I got an email from UCSF professor Michael Weiner, MD telling me I am a medical hero. “You’re helping to make brain research faster, better and less expensive – and ultimately that gets us closer to a cure for Alzheimer’s, Parkinson’s, and other brain disorders that strike tens of millions of Americans every year.” Who could resist?

You may want to go straight over to the Brain Health Registry and join the fun.

Data Today, Better Tomorrow, yay!

Women's Health Initiative

Some of us are suckers for studies: clinical trials, focus groups, surveys – whatever promises to shed a little light on the human condition, or possibly make that condition a little better.

This writer is a hopeless volunteer.

I have had my knees examined by MRIs, perhaps studying why I still have the originals despite a long history of abuse. I have had blood drawn for a study of celiac disease by someone who came to the house as part of the deal but unfortunately was not trained to find veins without causing excruciating pain. I have filled out lengthy surveys about addictive behavior – which may include addiction to study-participation (though that was not among the category choices.)

Currently, I am proudest of being an original part of the Women’s Health Initiative, which launched in 1993 with more than 160,000 postmenopausal women including this writer. In 1993 this was a Very Big Deal: studies had been made for all sorts of things with all sorts of participants, but finally there was a study of WOMEN. It sought to discover links between cancer (imagine! Studying women and cancer!) medical protocols, diet and other factors. Being a congenital wimp, and knowing I wouldn’t change my diet or stick to other proscribed regimens, I just signed up for the control group… but still. Even we control groupies are useful.

Over the years, WHI has developed a huge amount of useful data, probably the most beneficial being the finding that (imagine! Studying women!) hormone replacement therapy was not the be-all and end-all we had originally thought, but actually not such a good idea. (Read all about it.)

WHI has published over a thousand articles, approved well over 300 ancillary studies, and twice conducted extension studies. Findings have been about links between age, daily activities, diet etc and things like body fat, omega oils, heart disease, endometrial cancer – there is a list of useful discoveries resulting from this one large and ever-growing study project that boggles the mind.

Some – though surely not all – of this data is collected through regular survey forms received every year by WHI participants in addition to the annual birthday cards that by now this writer accepts as a “Congratulations! Are you’re still alive?” greeting. They seek data about lifestyles and life changes along with the traditional general health issues – and sometimes make one wonder what the next findings may be. My personal favorite question was, “When you enter a room full of people, do you often imagine they are talking about you?”

Paranoia after mastectomy? Who knows.

It is fascinating to be on the questioning end of tomorrow’s answers. Next blog: The Brain Health Registry. Assuming my closely-watched brain is still functioning.

WHI: Strengthening Women’s Health

WHICould the health and wellbeing of a few million women be improved, and a few billion dollars saved in the process? A very big dream.

When the Women’s Health Initiative was established more than 20 years ago, no one was talking in grandiose terms and few would have anticipated the wide-ranging health benefits (and huge cost savings) that would result in the decades ahead. Many of us were simply saying, “Imagine this. At last we’re studying women to find answers about women’s health issues.”

This writer was proud and happy to enlist in the first WHI study. I joined more than 100,000 other postmenopausal women volunteering to fill out forms, have blood drawn and answer questions over the next 15 years. That initial focus was on tracking the effects of hormone therapy, dietary patterns and/or calcium/vitamin D supplements on prevention of heart disease, cancer and osteoporotic fractures. I had not yet had breast cancer – that would come about 10 years into the study; a family history of osteoporosis added to my personal interest in WHI. Over the years I volunteered to participate in some of the wide-ranging ancillary studies looking at other health-related things like physical activities, lifestyle, tobacco and dozens of peripheral issues. (My personal favorite question appeared on one of the multi-page annual update forms. It read – Yes or No – “When you enter a room full of other people, do you have the feeling they are talking about you?” There may someday be a report on women and paranoia.)

Mysterious questions aside, WHI is serious business. Here, excerpted from the latest Extension Study newsletter are a few facts about what has been learned from the historic initiative, and a little of what is still ahead.

Those hormones millions of postmenopausal women were taking, widely thought to be miracle answers? Studies showed the risks far outweighed the benefits, and millions stopped taking them. Hormones in different combinations had been commonly taken to minimize chances of cardiovascular disease, cancers, fractures, diabetes, gall bladder disease and a variety of quality-of-life measures; quitting the hormones proved a better choice. Health benefits can’t be precisely measured, but the reduction in hormone use has led to a decrease in rates of breast cancer and cardiovascular disease.

And in dollars and cents? Some $37.1 billion, (in 2012 when all costs and quality-adjusted years of life are considered, has been the total economic return of the WHI trial.

By June, 2014, over 1000 papers based on WHI data had been published in scientific journals. What’s ahead? Researchers are looking at pet ownership and risk of cardiovascular disease; physical activity during childhood and risk of Alzheimer’s disease; breast cancer distribution by rural/urban areas and geographic differences in cognitive decline/dementia.

Every year on their birthday, WHI study participants receive a card – some of us call it the “Hooray, you’re still alive” card. For women everywhere, it represents something worth more than gold.

Good genetic news for geezers

http://upload.wikimedia.org/wikipedia/commons/1/1a/The_Triumph_of_Death%2C_or_The_Three_Fates.jpg

The Three Fates, Flemish tapestry (probably Brussels ca 1510-1520) Victoria and Albert Musem, London. (WikiMedia)

 

Live longer, get smarter? We wish.

And this wish could some day come true, thanks to the gene variant KL-VS, whose friendlier name is the klotho gene. The klotho gene was already known to be associated with longer life. But a team of scientists at UCSF and the Gladstone Institutes, found that it also seems to make people smarter.

One in five of us has the klotho gene. As this writer is definitely older I had hoped to get in on the smarter, although I never cancelled the dementia provision of my advance directives. But in an interview with San Francisco Chronicle health writer Erin Allday Dr. Lennart Mucke, director of neurological research at Gladstone, said, “Klotho increases cognition but doesn’t replace aging-related decline. You’re just coming down from a higher level.” So much for immediate — or personal — optimism.

UCSF Assistant Professor of Neurology Dena Dubal was lead author of the study, findings of which were published recently in the journal Cell Reports. Dubal and Mucke say more studies are needed, but the  hope is that eventually klotho could help old brains — old human brains; so far we’re talking about mouse brains — function better.

This writer, having an old brain far too right-brained to follow neurological research very far, did at least complete several years of Greek at Randolph-Macon Woman’s College some years before Dena Dubal was born. But as my class notes are not handy I turned to Theoi.com, an online encyclopedia of Greek mythology, to find more about Klotho. (For the record, her name is more commonly spelled Clotho in classical texts, but most of all this pre-dates Spellcheck.)

Klotho and her sisters Lakhesis and Atropos where the daughters of Zeus and Themis, and in Greek mythology one couldn’t ask for better parentage. They were known as “The Fates,” or “The Moirai,” the goddesses who determined everyone’s destiny. According to Theoi, “They assigned to every person his or her fate or share in the scheme of things.” Clotho (on the right in the tapestry above) was “the Spinner,” who spun the thread of life. Lakhesis (in the center)  measured the thread of life and Atropos (on the left) cut the thread. Presumably they are arising from Themis; birthing in mythology was somewhat less complicated than today.

(It’s tempting to speculate on what it would mean to have too many Atropos gene variants, but that is going too far with all this.)

No amount of Googling turns up the scientist who named the KL-VS gene variant after Klotho, but he or she had an appropriate understanding of Greek mythology. If Klotho can indeed eventually lead to reactivating old brains, she will have spun us all a golden thread.

 

Your brain at 100+

Since about 1900, when the average lifespan for U.S. citizens was somewhere around 50, we’ve been pushing that boundary ever upward. Today, depending on exactly where you live and other factors like cigarettes and French fries, you can expect to hang on into your eighties and beyond. That’s fine with most of us, especially if our brains stay functional too – and therein lies the problem.

There is reason to believe, if neurological studies on worms prove out, that humans could live to be 300 with a little genetic tinkering. If you sign up for this, a possibility predicted by University of California San Francisco neuroscientist Dena Dubal, you might want to have Dr. Dubal and her colleagues nearby for your brain care.

At a recent luncheon in San Francisco, Dr. Dubal and fellow UCSF research scientist Wade Smith talked of the work going on in their labs as if it were simply what they do for a living. To a spellbound audience, however, it sounded more like miracle-making. “Just a little genetic tinkering.” Altering the aging process, staving off dementia… it’s all in a day’s work. A little extra Clotho (so designated for the anti-aging Greek goddess of the same name) blocked memory loss in mice, Dr. Dubal said; it’s reasonable to project that similar treatment might some day be made available to mammals.

This reporter came home, followed a few of those links and was quickly lost, which is attributable — in part, at least, we hope — not to short-term memory loss but to my degrees in Art and Short Fiction vs the very long list of degrees plus other academic and scientific credentials of Drs. Dubal and Wade.

For those of us already worried about the relentless increase in dementia among the 65+ population, the possibility of living to be 300 is not altogether good news. But fortunately our brains are the concern of the brains at UCSF.

You and your brain are in the crosshairs of neuromarketing

Why does this not seem altogether good news? Details have recently been revealed about new insights into the human brain — and how marketers can make use of them to sell more stuff.

Just in from Daily News & Analysis — which reportedly “has fast entrenched itself in the lives of a young and dynamic readership in India’s commercial capital Mumbai” and from that position offers its readers “a composite picture of India and the world” — is a story about new discoveries in neuroscience that are expected to revolutionize the marketing world. How? By using tests to measure, with a high degree of accuracy, your brain’s responses to whatever catches your eye. Well, maybe not your brain, but focus groups of brains enough like yours that sellers will be homing in on you as never before. It’s called EEG-based neuromarketing.

It’s all covered in a new book titled The Buying Brain: secrets for selling to the subconscious mind, by A.K. Pradeep, founder and CEO of NeuroFocus Inc and a Silicon Valley entrepreneur whose MySpace page says that his brain research company is going to change the world as we know it forever.

“Companies around the world, including the largest and most successful global giants”, reports DN&A, “are increasingly turning to EEG-based neuromarketing that measures the whole brain because it offers far more accuracy, reliability, and actionable results than conventional market research methods.” That “actionable results” business refers to you and me, Mr. & Ms. Target Market.

But to move from the Daily News & Analysis over to Amazon.com, here are a couple of tips from its Product Description segment which says “The Buying Brain is your guide to the ultimate business frontier – the human brain.”

1) Your brain gets scared in some stores. Your conscious mind doesn’t know it, of course, but your subconscious mind views sharp corners as a threat. Who knew?

2) Too much of one thing can make your brain go blind. “Repetition blindness” sets in when we see too many of the same objects. (The TV department of Best Buy either has not figured this out yet, or has found that TV buyers like to buy blindly.)

3) Men and women are hard-wired to shop differently. Men shop by looking for targets; women shop by looking for landmarks. Women explore their territory; men make maps.

There are fewer and fewer secrets. You may indeed be able to improve your memory or strengthen brain function, but marketers are probably going to be one step ahead of you. That caveat emptor phrase has morphed from “buyer beware” to Be Very Afraid.