Scientists are Studying Blood Tests For Dementia

As pharmaceutical companies spend hundreds of millions of dollars on a potential treatment for Alzheimer’s disease, other researchers are focusing on a more elemental question. How can you tell whether a family member or loved one has Alzheimer’s or another form of dementia?

These researchers say a new generation of blood tests could offer an easier and accurate way to detect signs of Alzheimer’s, a disease that afflicts an estimated 6.5 million Americans. New research found one blood test can detect hallmarks of the disease in older adults with memory problems. It is among more than a half dozen blood tests being developed and tested to detect early stages of Alzheimer’s disease.

Experts say the tests are important because they would be easier, cheaper and available to more people than brain scans or spinal taps now used to detect biological hallmarks of the disease.

Developers of blood tests say the immediate payoff would be testing older adults with signs of memory loss as well as quickly screening large numbers of people necessary to test new drugs that aim to slow or halt Alzheimer’s disease. Eventually, the tests might be useful in detecting the earliest signs of disease, informing individuals of their risk years before memory and thinking problems take root.

Blood tests represent “a very early start to a new era of diagnosis for Alzheimer’s disease,” said Stephen Salloway, a professor of neurology and psychiatry at Brown University who directs a memory and aging program at Butler Hospital in Providence, Rhode Island. “I see them as being transformative for Alzheimer’s, because once we validate them a little bit further, and hopefully get coverage for them, we can use them both to screen for clinical trials and to screen for treatment.”

Diagnosing the disease is time-consuming and inaccessible to those who live far away from memory clinics or other specialists. Doctors might quiz a patient or family members about habits, changes in behavior or personality. Specialists conduct memory and cognitive tests and rule out other potential causes such as depression. Brain scans and spinal taps confirm biological signs of the disease.

One blood test, called the PrecivityAD test, which uses a technology called mass spectrometry, measures amyloid proteins and genetic risk for the disease. In two studies published April 21 in Journal of the American Medical Association Open, the test accurately detected the protein amyloid in 81% of samples when compared with a brain scan.

Amyloid accumulates and forms clumps in the brains of Alzheimer’s disease patients. Researchers and drug companies have spent hundreds of million of dollars over the past two decades on the theory that drugs clearing amyloid from the brain could slow memory decline, but those drugs have not proven to halt Alzheimer’s disease.

Other drug studies are now underway to administer amyloid-targeting drugs even earlier, before memory and thinking problems emerge. C2N Diagnostics CEO Joel Braunstein said the peer-reviewed study is an important step for doctors who want to see more evidence before recommending his company’s test to patients with memory and cognitive problems.

“Clinicians like to see evidence that a test works,” Braunstein said. “This was an important step forward because of the transparency of the scientific findings.”

The test, which has been available since 2020, is now mostly used to accelerate research for new drugs being studied to slow cognitive decline and memory loss in people with Alzheimer’s disease or other forms of dementia. Braunstein believes more doctors will be willing to recommend the test as they grow comfortable from findings in the studies.

Blood tests promise quicker, cheaper diagnosis

Scans and spinal taps now used can be invasive and don’t work for all patients. For example, people who are on blood-thinning medication might not be able to get a spinal tap, Salloway said. In such cases, a validated blood test would be suitable replacement.

Blood tests also might be more affordable than positron emission tomography, or PET scans, which cost consumers $3,000 out of pocket, according to the Alzheimer’s Association. Hospitals charge for administering a PET scan, which includes special chemical tracers to reveal the amyloid. Consumers also can expect a bill from an imaging specialist who interprets the results to verify whether a patient has amyloid.

The PrecivityAD test, which is not yet covered by Medicare or private insurers, costs $1,250. The company offers financial assistance for eligible consumers, Braunstein said, while it is “making progress” in efforts to get Medicare and private insurers to pay for the test.

The company is allowed to market the test under Food and Drug Administration rules because it’s performed at the company’s lab, which is certified under the Clinical Laboratory Improvement Amendments, the federal laboratory law known as CLIA. Doctors or testing sites ship samples to the lab and the company completes the test within 10 days, Braunstein said.

Braunstein said the company’s lab has the capacity to handle tests performed within the United States and Canada. As the company seeks to offer the test overseas, it probably will partner with other labs that can perform the intricate measurements the test requires.

Another blood test developed by Eli Lilly detected signs of Alzheimer’s disease 20 years before cognitive problems were expected in a group of people who carry a rare genetic mutation, according to a study published in 2020 in JAMA. The p-tau217 test measured the tau protein on more than 1,400 people already enrolled in dementia studies in Sweden, Arizona and Colombia.

Eli Lilly used the test during a 257-patient Phase 2 study of its Alzheimer’s drug called donanemab. The drugmaker also will use the test to screen people for a prevention trial to test donanemab in at-risk patients who have not yet exhibited memory and thinking problems. Lilly plans to send mobile units to communities and use the test to screen people, which would expand the company’s efforts to recruit patients from diverse populations, a Lilly spokeswoman said.

Quest Diagnostics, a national lab company, launched a new blood test in March that measures two amyloid variants, a Quest spokeswoman said.

Advocacy organizations would like to see tests that are simple, inexpensive and accessible to doctors and their patients, said Heather Snyder, vice president of medical and scientific relations at the Alzheimer’s Association.

“We ultimately want to be at a place where we can identify an individual at the earliest possible point who may be at the greatest risk and may have initial changes associated with the disease,” Snyder said.

She said it’s important for the field to have “a toolbox of potential interventions” such as medications or lifestyle changes “that would allow us to stop or slow the progression of the underlying biology at that time.”

In 2021, the Food and Drug Administration approved Biogen’s Aduhelm, a $28,000-a-year drug that yielded mixed results in clinical trials, even though the agency’s own experts suggested the agency reject the application. The agency that oversees Medicare decided to pay for the drug only in clinical trials.

Aduhelm is part of class of Alzheimer’s drugs known as monoclonal antibodies, several of which could soon land before FDA decision-makers. Lilly expects to submit donanemab, a monoclonal antibody, for approval later this year. Roche’s Genentech has studied two Alzheimer’s drugs, gantenerumab and crenezumab, in late-stage clinical trials.

By:

Source: Scientists are studying blood tests for dementia: ‘A new era of diagnosis for Alzheimer’s disease’

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More contents:

Symptoms of Dementia and Early Warning Signs

From age 50 on, it’s not unusual to have occasional trouble finding the right word or remembering where you put things.

Dementia Symptoms at a Glance

  • Difficulty with everyday tasks
  • Repetition
  • Communication problems
  • Getting lost
  • Personality changes
  • Confusion about time and place
  • Troubling behavior

But persistent difficulty with memory, cognition and ability to perform everyday tasks might be signs that something more serious is happening to a loved one’s brain.

Dementia isn’t actually a disease, according to the Mayo Clinic. It’s a catch-all term for changes in the brain that cause a loss of functioning that interferes with daily life. Dementia can diminish focus, the ability to pay attention, language skills, problem-solving and visual perception. It also can make it difficult for a person to control his or her emotions and lead to personality changes.

Roughly 6.5 million Americans are living with Alzheimer’s dementia, according to the “2022 Alzheimer’s Disease Facts and Figures” report from the Alzheimer’s Association. Alzheimer’s disease is the leading cause of dementia, accounting for 60 percent to 70 percent of cases, but a range of brain illnesses can lead to the condition (see sidebar, “Diseases that cause dementia”).

Diseases that cause dementia

These conditions are the leading causes of dementia. Many patients have mixed dementia, a combination of two or more types, such as Alzheimer’s and vascular dementia.

Alzheimer’s disease. Alzheimer’s is characterized by amyloid plaques and tangled fibers in the brain and by a loss of connections between nerve cells. Damage initially appears in the hippocampus, an area of the brain involved in memory formation, and gradually spreads.

Vascular dementia. The second most common type of dementia results from damage to the vessels that supply blood to the brain. It tends to affect focus, organization, problem-solving and speed of thinking more noticeably than memory.

Lewy body dementia. Abnormal protein deposits in the brain, called Lewy bodies, affect brain chemistry and lead to problems with behavior, mood, movement and thinking.

Frontotemporal disorders. Degenerative damage to the brain’s frontal and temporal lobes is the most common cause of dementia in people age 65 and younger. Symptoms might include apathy; difficulty communicating, walking or working; emotional changes; and impulsive or inappropriate behaviors.

A loved one showing symptoms of dementia needs to see a medical expert who can conduct tests and come up with a diagnosis. If a loved one has dementia, you’ll want to plan how you will manage that care, especially as the condition progresses.

But it’s also important to rule out other medical conditions with dementia-like symptoms that may disappear with treatment such as infections and side effects of medications.

Dementia symptoms to watch for

Here are some of the warning signs identified by dementia experts and mental health organizations:

• Difficulty with everyday tasks. Everyone makes mistakes, but people with dementia may find it increasingly difficult to do things like keep track of monthly bills or follow a recipe while cooking, the Alzheimer’s Association says. They also may find it hard to concentrate on tasks, take much longer to do them or have trouble finishing them.

• Repetition. Asking a question over and over or telling the same story about a recent event multiple times are common indicators of mild or moderate Alzheimer’s, according to the Cleveland Clinic.

• Communication problems. Observe if a loved one has trouble joining in conversations or following along with them, stops abruptly in the middle of a thought or struggles to think of words or the name of objects.

• Getting lost. People with dementia may have difficulty with visual and spatial abilities. That can manifest itself in problems like getting lost while driving, according to the Mayo Clinic.

• Personality changes. A loved one who begins acting unusually anxious, confused, fearful or suspicious; becomes upset easily; or loses interest in activities and seems depressed is cause for concern.

• Confusion about time and place. Loved ones who forget where they are or can’t remember how they got there should raise alarms. Another worrisome sign is disorientation about time — for example, routinely forgetting what day of the week it is, says Jason Karlawish, M.D., a professor at the University of Pennsylvania’s Perelman School of Medicine and co-director of the Penn Memory Center.
• Troubling behavior. If your family member seems to have increasingly poor judgment when handling money or neglects grooming and cleanliness, pay attention.

Some people who experience memory loss or have difficulty with attention, decision-making language or reasoning may have a condition known as mild cognitive impairment. The condition causes a noticeable decline, but the changes are less severe than with dementia and a person can still perform normal daily activities, according to the Cleveland Clinic.

People with mild cognitive impairment are at an increased risk of developing dementia.

Signs of dementia? Where to find help

When your loved one is displaying troubling symptoms, a trip to a primary care physician is often the first step. But to get a definitive diagnosis, you’ll need to see a specialist such as a neurologist, geriatrician or geriatric psychiatrist.

If you can’t find one, the National Institute on Aging recommends contacting the neurology department of a nearby medical school. Some hospitals also have clinics that focus on dementia.

Ailments can mimic dementia

Any number of treatable conditions can cause dementia-like symptoms. Some of the most common:

• Alcohol abuse
• Anxiety, depression or stress
• Blood clots, brain infections or tumors
• Delirium
• Head injuries
• Kidney, liver or thyroid problems
• Side effects of medication
• Vitamin deficiencies

Source: National Institute on Aging

Specialists will want to know about the patient’s personal and family medical history. A close relative or relatives having had Alzheimer’s is a major risk factor.

Recent research suggests that a prevalence among even members of your extended family can increase your dementia risk. Doctors also will conduct physical and neurological exams to rule out other treatable causes for dementia symptoms.

Some of the methods that doctors use to diagnose dementia:

• Cognitive and neuropsychological tests assess language and math skills, memory, problem-solving and other types of mental functioning.

• Lab tests of blood and other fluids, including checking levels of various chemicals, hormones and vitamins, can help rule out nondementia causes for the symptoms.

• Brain scans such as CT, MRI or PET imaging can spot changes in brain structure and function. These tests also can identify strokes, tumors and other problems that can cause dementia.

• Psychiatric evaluation can determine whether a mental health condition is causing or affecting the symptoms.

• Genetic tests are important, especially if someone is showing symptoms before age 60. The early onset form of Alzheimer’s is strongly linked to a person’s genes, according to the Mayo Clinic. Talk with a genetic counselor before and after getting tested.

Editor’s note: This article was published on October 22, 2019. It has been updated with more recent information.

By: Patrick J. Kiger

Patrick J. Kiger is a contributing writer for AARP. He has written for a wide variety of publications, including the Los Angeles Times Magazine, GQ and Mother Jones, as well as the websites of the Discovery Channel and National Geographic.​​

Source: Symptoms of Dementia and Early Warning Signs

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Critics:

Having trouble with memory can be an early symptom of dementia. The changes are often subtle and tend to involve short-term memory. A person with dementia may be able to remember events that took place years ago, but not what they had for breakfast.

Another early symptom of dementia is difficulty with communicating thoughts. A person with dementia may have a hard time explaining something or finding the right words to express themselves. They may also stop in the middle of a sentence and not know how to continue.

Having a conversation with a person who has dementia can be challenging, and it may take longer than usual for them to express their thoughts or feelings.

A change in mood is also common with dementia. If you have dementia, it may not be easy to recognize this in yourself, but you may notice this change in someone else. Depression, for instance, is common in the early stages of dementia.

Someone who has dementia may also seem more fearful or anxious than they were before. They could get easily upset if their usual daily routine is changed, or if they find themselves in unfamiliar situations.

Apathy, or listlessness, is a common sign in early dementia. A person with dementia may lose interest in hobbies or activities that they used to enjoy doing. They may not want to go out anymore or have fun.They may also lose interest in spending time with friends and family, and they may seem emotionally flat.

Someone in the early stages of dementia may often become confused. They may have trouble remembering faces, knowing what day or month it is, or figuring out where they are. Confusion can occur for a number of reasons and apply to different situations. For example, they may misplace their car keys, forget what comes next in the day, or have difficulty remembering someone they recently met.

But dementia is not one single condition. It’s essentially an umbrella term that covers a wide range of cognitive disorders. This includes Alzheimer’s disease, which accounts for 60 to 80 percent of cases, according to the Alzheimer’s Association…

More contents:

Caregiving for dementia: Helping your loved one stay connected

Healthy lifestyle, not supplements, prevent dementia

Staying Sharp: Take control of your brain health

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Supporting a Friend or Family Member with a Mental Illness

It can be scary when someone you love is sick. It can be especially scary if they’re diagnosed with a mental illness. It’s hard to see someone you love in pain and it’s confusing when someone you know well is not acting like themselves. You know how you would take care of them if they had a cold or flu, but what do you do for a mental illness? Like any other health problem, someone with a mental illness needs extra love and support. You may not be able to see the illness, but it doesn’t mean that you’re powerless to help.

How can I help?

Research confirms that support from family and friends is a key part of helping someone who is going through a mental illness. This support provides a network of practical and emotional help. These networks can be made up of parents, children, siblings, spouses or partners, extended families, close friends and others who care about us like neighbours, coworkers, coaches and teachers. Some people have larger networks than others, but most of us have at least a few people who are there for us when we need them.

There are a number of major ways that family and friends can help in someone’s journey of recovery from a mental illness:

Knowing when something is wrong—or right: Getting help early is an important part of treating mental illness. Family and friends are often the first ones to notice that something is wrong. See “How do I know when to help?” on the next page for signs to watch for. Finding a treatment that works is often a process of trial and error, so family members may also be the first to see signs of improvement.

How do I do this?

  • TIP: Learn more about the signs and symptoms of different mental illnesses. Also learn more about how treatments work so that you know what side effects you may see, when to look for improvements and which ones to look for first. A recent review found that when the family is educated about the illness, the rates of relapse in their loved ones were reduced by half in the first year.

Seeking help: Families and friends can be important advocates to help loved ones get through those hard, early stages of having a mental illness. They can help their loved one find out what treatment is best for them. They can also be key in letting professionals know what’s going on, filling in parts of the picture that the person who’s ill may not be well enough to describe on their own.

How do I do this?

  • TIP: Offer to make those first appointments with a family doctor to find out what’s wrong or accompany your loved one to the doctor—these steps can be hard if your loved one doesn’t have much energy or experiences problems with concentration. If you do accompany the person, work with them to write down any notes or questions either of you have in advance so that you cover all the major points. If your loved one wants to do it on their own, show them your support and ask them if there’s anything you could do to help.
  • TIP: You can’t always prevent a mental health crisis from happening. If your loved one needs to go to hospital, try and encourage them to go on their own. If you’re concerned that your loved one is at risk of harm, they may receive treatment under BC’s Mental Health Act. It may be necessary in certain cases, but involuntary treatment can be complicated and traumatic for everyone. To learn more about the Mental Health Act, see the “Coping with Mental Health Crises and Emergencies” info sheet.

Helping with medications, appointments and treatments: If you spend a lot of time around your loved ones, you can help them remember to take their medications. You may also be able to help tell a doctor why medications aren’t being taken as they should be. Similarly, you may be involved in reminding your loved one to do their counselling homework or use their light therapy treatment each morning, or reminding your loved one to make or keep appointments for treatment.

How do I do this?

  • TIP: If you notice that your loved one is having trouble taking their medication, you can encourage them to talk to their doctor or pharmacist. They can suggest ways to make pill taking easier. If there are other problems with taking medicine, such as side effects, encourage your loved one to write down their concerns and questions and talk to their doctor. If they don’t have a good relationship with their doctor, help them find a new one. If cost is a barrier, learn about BC’s no-charge psychiatric medication coverage called Plan G.

Supporting a healthy lifestyle: Families can also help with day-to-day factors such as finances, problem solving, housing, nutrition, recreation and exercise, and proper sleeping habits.

How do I do this?

  • TIP: See our Wellness Modules at http://www.heretohelp.bc.ca for practical tips on how to have a healthy lifestyle for both you and your loved one. Case managers and peer support workers at mental health centres in your community may be able to help with life skills training as well as connections to income and housing.

Providing emotional support: You can play an important role in helping someone who’s not feeling well feel less alone and ashamed. They are not to blame for their illness, but they may feel that they are, or may be getting that message from others. You can help encourage hope.

How do I do this?

  • TIP: Try to be as supportive, understanding and patient as possible. See our “Where do I go from here?” section for resources on how to be a good communicator.
  • TIP: Taking care of an ill family member or friend can be stressful. Remember that you need emotional support, too. Consider joining a support group for family members of people with mental illness. There, you can connect with other people going through the same things and they can help you work through your own emotions. It’s very important to make sure you are taking care of your own mental health as well.

“Tom’s recovery has been an exercise in patience, love and understanding. We take one step forward and stumble two steps back; baby steps—small increments of success, tiny improvements of things we would ordinarily take for granted—are things we celebrate. When Tom smiles, cracks a joke or declares that he wants to go for a run, they are positive, encouraging signs: baby steps forward.”
—Family member from Family Toolkit

“The most important thing [families] have to do is accept you completely, with all your faults. Families can help by saying ‘You’re okay, we love you, and you’ll get better”
—Mariam, 31 in recovery from clinical depression 

If you need advice on how to get your loved one the help they need, there are a number of resources available to you.

Other helpful resources are:

BC Partners for Mental Health and Addictions Information
Visit www.heretohelp.bc.ca for info sheets and personal stories on supporting loved ones. You’ll also find more information, tips and self-tests to help you understand many different mental health problems.

Alzheimer Society of BC
Visit www.alzheimerbc.org or call 1-800-936-6033 (toll-free in BC) for information and community resources for individuals and families with dementia.

AnxietyBC
Visit www.anxietybc.com or call 604-525-7566 for information, tools, and community resources on anxiety.

British Columbia Schizophrenia Society
Visit www.bcss.org or call 1-888-888-0029 (toll-free in BC) or 604-270-7841 (in Greater Vancouver) for information and community resources on schizophrenia and other major mental illnesses and support for families.

Canadian Mental Health Association, BC Division
Visit www.cmha.bc.ca or call 1-800-555-8222 (toll-free in BC) or 604-688-3234 (in Greater Vancouver) for information and community resources on mental health and mental illnesses.

FORCE Society for Kids’ Mental Health
Visit.www.forcesociety.com or call 1-855-887-8004 (toll-free in BC) or 604-878-3400 (in the Lower Mainland) for information and resources that support parents of a young person with mental illness.

Jessie’s Legacy at Family Services of the North Shore
Visit www.familyservices.bc.ca or call 1-888-988-5281 ext. 204 (toll-free in BC)  or 604-988-5281 ext. 204 (in Greater Vancouver) for information and resources on body image and prevention of eating disorders.

Kelty Mental Health
Contact Kelty Mental Health at www.keltymentalhealth.ca or 1-800-665-1822 (toll-free in BC) or 604-875-2084 (in Greater Vancouver) for information, referrals and support for children, youth and their families in all areas of mental health and addictions.

Mood Disorders Association of BC
Visit www.mdabc.net or call 604-873-0103 (in the Lower Mainland) or 1-855-282-7979 (in the rest of BC) for resources and information on mood disorders. You’ll also find more information on support groups around the province.

Resources available in many languages:
*For each service below, if English is not your first language, say the name of your preferred language in English to be connected to an interpreter. More than 100 languages are available.

1-800-SUICIDE
If you are in distress or are worried about someone in distress who may hurt themselves, call 1-800-SUICIDE 24 hours a day to connect to a BC crisis line, without a wait or busy signal.

Source: Supporting a Friend or Family Member with a Mental Illness | Here to Help

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References

Brain Fog: How Trauma, Uncertainty and Isolation Have Affected Our Minds and Memory

After a year of lockdown, many of us are finding it hard to think clearly, or remember what happened when. Neuroscientists and behavioural experts explain why

Before the pandemic, psychoanalyst Josh Cohen’s patients might come into his consulting room, lie down on the couch and talk about the traffic or the weather, or the rude person on the tube. Now they appear on his computer screen and tell him about brain fog. They talk with urgency of feeling unable to concentrate in meetings, to read, to follow intricately plotted television programms.

“There’s this sense of debilitation, of losing ordinary facility with everyday life; a forgetfulness and a kind of deskilling,” says Cohen, author of the self-help book How to Live. What to Do. Although restrictions are now easing across the UK, with greater freedom to circulate and socialize, he says lockdown for many of us has been “a contraction of life, and an almost parallel contraction of mental capacity”.

This dulled, useless state of mind – epitomized by the act of going into a room and then forgetting why we are there – is so boring, so lifeless. But researchers believe it is far more interesting than it feels: even that this common experience can be explained by cutting-edge neuroscience theories, and that studying it could further scientific understanding of the brain and how it changes.

I ask Jon Simons, professor of cognitive neuroscience at the University of Cambridge, could it really be something “science”? “Yes, it’s definitely something science – and it’s helpful to understand that this feeling isn’t unusual or weird,” he says. “There isn’t something wrong with us. It’s a completely normal reaction to this quite traumatic experience we’ve collectively had over the last 12 months or so.”

What we call brain fog, Catherine Loveday, professor of cognitive neuroscience at the University of Westminster, calls poor “cognitive function”. That covers “everything from our memory, our attention and our ability to problem-solve to our capacity to be creative. Essentially, it’s thinking.” And recently, she’s heard a lot of complaints about it: “Because I’m a memory scientist, so many people are telling me their memory is really poor, and reporting this cognitive fog,” she says.

She knows of only two studies exploring the phenomenon as it relates to lockdown (as opposed to what some people report as a symptom of Covid-19, or long Covid): one from Italy, in which participants subjectively reported these sorts of problems with attention, time perception and organisation; another in Scotland which objectively measured participants’ cognitive function across a range of tasks at particular times during the first lockdown and into the summer. Results showed that people performed worse when lockdown started, but improved as restrictions loosened, with those who continued shielding improving more slowly than those who went out more.

Loveday and Simons are not surprised. Given the isolation and stasis we have had to endure until very recently, these complaints are exactly what they expected – and they provide the opportunity to test their theories as to why such brain fog might come about. There is no one explanation, no single source, Simons says: “There are bound to be a lot of different factors that are coming together, interacting with each other, to cause these memory impairments, attentional deficits and other processing difficulties.”

One powerful factor could be the fact that everything is so samey. Loveday explains that the brain is stimulated by the new, the different, and this is known as the orienting response: “From the minute we’re born – in fact, from before we’re born – when there is a new stimulus, a baby will turn its head towards it. And if as adults we are watching a boring lecture and someone walks into the room, it will stir our brain back into action.”

Most of us are likely to feel that nobody new has walked into our room for quite some time, which might help to explain this sluggish feeling neurologically: “We have effectively evolved to stop paying attention when nothing changes, but to pay particular attention when things do change,” she says.

Loveday suggests that if we can attend a work meeting by phone while walking in a park, we might find we are more awake and better able to concentrate, thanks to the changing scenery and the exercise; she is recording some lectures as podcasts, rather than videos, so students can walk while listening.

She also suggests spending time in different rooms at home – or if you only have one room, try “changing what the room looks like. I’m not saying redecorate – but you could change the pictures on the walls or move things around for variety, even in the smallest space.”

The blending of one day into the next with no commute, no change of scene, no change of cast, could also have an important impact on the way the brain processes memories, Simons explains. Experiences under lockdown lack “distinctiveness” – a crucial factor in “pattern separation”. This process, which takes place in the hippocampus, at the centre of the brain, allows individual memories to be successfully encoded, ensuring there are few overlapping features, so we can distinguish one memory from another and retrieve them efficiently.

The fuggy, confused sensation that many of us will recognize, of not being able to remember whether something happened last week or last month, may well be with us for a while, Simons says: “Our memories are going to be so difficult to differentiate. It’s highly likely that in a year or two, we’re still going to look back on some particular event from this last year and say, when on earth did that happen?”

Perhaps one of the most important features of this period for brain fog has been what Loveday calls the “degraded social interaction” we have endured. “It’s not the same as natural social interaction that we would have,” she says. “Our brains wake up in the presence of other people – being with others is stimulating.”

We each have our own optimum level of stimulation – some might feel better able to function in lockdown with less socialising; others are left feeling dozy, deadened. Loveday is investigating the science of how levels of social interaction, among other factors, have affected memory function in lockdown. She also wonders if our alternative to face-to-face communication – platforms such as Zoom – could have an impact on concentration and attention.

She theorises – and is conducting a study to explore this – that the lower audio-visual quality could “create a bigger cognitive load for the brain, which has to fill in the gaps, so you have to concentrate much harder.” If this is more cognitively demanding, as she thinks, we could be left feeling foggier, with “less brain space available to actually listen to what people are saying and process it, or to concentrate on anything else.”

Carmine Pariante, professor of biological psychiatry at King’s College London, is also intrigued by brain fog. “It’s a common experience, but it’s very complex,” he says. “I think it is the cognitive equivalent of feeling emotionally distressed; it’s almost the way the brain expresses sadness, beyond the emotion.” He takes a psycho-neuro-immuno-endocrinological approach to the phenomenon – which is even more fascinating than it is difficult to say. He believes we need to think about the mind, the brain, the immune and the hormonal systems to understand the various mental and physical processes that might underlie this lockdown haze, which he sees as a consequence of stress.

We might all agree that the uncertainty of the last year has been quite stressful – more so for some than for others. When our mind appraises a situation as stressful, Pariante explains, our brain immediately transmits the message to our immune and endocrine systems. These systems respond in exactly the same way they did in early humans two million years ago on the African savannah, when stress did not relate to home schooling, but to fear of being eaten by a large animal.

The heart beats faster so we can run away, inflammation is initiated by the immune system to protect against bacterial infection in case we are bitten, the hormone cortisol is released to focus our attention on the predator in front of us and nothing else. Studies have demonstrated that a dose of cortisol will lower a person’s attention, concentration and memory for their immediate environment. Pariante explains: “This fog that people feel is just one manifestation of this mechanism. We’ve lost the function of these mechanisms, but they are still there.” Useful for fighting a lion – not for remembering where we put our glasses.

When I have experienced brain fog, I have seen it as a distraction, a kind of laziness, and tried to push through, to force myself to concentrate. But listening to Loveday, Simons and Pariante, I’m starting to think about it differently; perhaps brain fog is a signal we should listen to. “Absolutely, I think it’s exactly that,” says Pariante. “It’s our body and our brain telling us that we’re pushing it too much at the moment. It’s definitely a signal – an alarm bell.” When we hear this alarm, he says, we should stop and ask ourselves, “Why is my brain fog worse today than yesterday?” – and take as much time off as we can, rather than pushing ourselves harder and risking further emotional suffering, and even burnout.

For Cohen, the phenomenon of brain fog is an experience of one of the most disturbing aspects of the unconscious. He talks of Freud’s theory of drives – the idea that we have one force inside us that propels us towards life; another that pulls us towards death. The life drive, Cohen explains, impels us to create, make connections with others, seek “the expansion of life”. The death drive, by contrast, urges “a kind of contraction. It’s a move away from life and into a kind of stasis or entropy”. Lockdown – which, paradoxically, has done so much to preserve life – is like the death drive made lifestyle.

With brain fog, he says, we are seeing “an atrophy of liveliness. People are finding themselves to be more sluggish, that their physical and mental weight is somehow heavier, it’s hard to carry around – to drag.” Freud has a word for this: trägheit – translated as a “sluggishness”, but which Cohen says literally translates as “draggyness”. We could understand brain fog as an encounter with our death drive – with the part of us which, in Cohen’s words, is “going in the opposite direction of awareness and sparkiness, and in the direction of inanimacy and shutting down”.

This brings to mind another psychoanalyst: Wilfred Bion. He theorised that we have – at some moments – a will to know something about ourselves and our lives, even when that knowledge is profoundly painful. This, he called being in “K”. But there is also a powerful will not to know, a wish to defend against this awareness so that we can continue to live cosseted by lies; this is to be in “–K” (spoken as “minus K”).

I wonder if the pandemic has been a reality some of us feel is too horrific to bear. The uncertainty, the deaths, the trauma, the precarity; perhaps we have unconsciously chosen to live in the misty, murky brain fog of –K rather than to face, to suffer, the true pain and horror of our situation. Perhaps we are having problems with our thinking because the truth of the experience, for many of us, is simply unthinkable.

I ask Simons if, after the pandemic, he thinks the structure of our brains will look different on a brain scan: “Probably not,” he says. For some of us, brain fog will be a temporary state, and will clear as we begin to live more varied lives. But, he says, “It’s possible for some people – and we are particularly concerned about older adults – that where there is natural neurological decline, it will be accelerated.”

Simons and a team of colleagues are running a study to investigate the impact of lockdown on memory in people aged over 65 – participants from a memory study that took place shortly before the pandemic, who have now agreed to sit the same tests a year on, and answer questions about life in the interim.

One aim of this study is to test the hypothesis of cognitive reserve – the idea that having a rich and varied social life, filled with intellectual stimulation, challenging, novel experiences and fulfilling relationships, might help to keep the brain stimulated and protect against age-related cognitive decline. Simons’ advice to us all is to get out into the world, to have as rich and varied experiences and interactions as we can, to maximize our cognitive reserve within the remaining restrictions.

The more we do, the more the brain fog should clear, he says: “We all experience grief, times in our lives where we feel like we can’t function at all,” he says. “These things are mercifully temporary, and we do recover.”

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Source: Brain fog: how trauma, uncertainty and isolation have affected our minds and memory | Health & wellbeing | The Guardian

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Sleep Deprivation Fuels Accumulation Of Two Alzheimer’s Proteins In The Brain

The brain of a sleep-deprived person is imbued with excess of two proteins that are substantially associated with Alzheimer’s disease.

According to the study published in the journal Science, a protein called tau is found in excess in the fluid that fills the brain and spinal cord of individuals with chronic sleep deprivation. The protein also drives neuron degeneration, and during Alzheimer’s, it scatters throughout the brain.

Similarly, sleep deprivation also induces accumulation of protein called amyloid-beta – a chunk of which dots the brains of Alzheimer’s patients.

In the study, researchers went over the samples of cerebrospinal fluid of eight adult participants who were sleep-deprived for nearly 36 hours. They found 51.5 percent increase in their tau levels. Similarly, mice that were rob of sleep were found to have twice the level of tau compared to well-rested ones.

Another study also reported that the lack of sleep to be the legitimate cause of increased level of A-beta in the cerebrospinal fluid, and if preceded by a week of poor sleep, the levels of tau also increased.

Since lack of sleep increases the levels of tau and A-beta in the brain, it appears that the only way to curtail the risk of developing Alzheimer’s symptom is to treat sleep disorders during mid-life and get good amount of sleep as much as possible. Proper sleep helps our brain get rid of excess proteins and other unnecessary stuffs, so getting less sleep means that wash cycle is disturbed.

References:

  • Lack of sleep is tied to increases in two Alzheimer’s proteins (Science News)
  • The sleep-wake cycle regulates brain interstitial fluid tau in mice and CSF tau in humans (Science)
  • Association of Excessive Daytime Sleepiness With Longitudinal β-Amyloid Accumulation in Elderly Persons Without Dementia (Jama Neurology)

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Source: Sleep Deprivation Fuels Accumulation Of Two Alzheimer’s Proteins In The Brain – Sparkonit

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This 4-minute video shows how Alzheimer’s disease changes the brain and looks at promising ideas to treat and prevent the disease. Alzheimer’s disease is the most basic form of dementia, and scientists are trying to understand how the affects the nervous system. This video illustrates how neurons communicate in a healthy brain compared to that of a person with Alzheimer’s disease. In a healthy brain, cells such as astrocytes and microglia help keep neurons healthy by clearing away debris that builds up over time. In a person with Alzheimer’s disease, toxic changes in the brain destroy the ability of these cells to maintain a healthy environment for the neurons in the brain, ultimately causing a loss of neurons. Researchers believe that the Alzheimer’s disease process involves two proteins: beta amyloid protein and tau protein. Within the brain of a person with Alzheimer’s disease, these proteins become compromised. Over time, abnormal tau accumulates and eventually forms tangles inside the neurons, and the beta amyloid clumps into plaques, which build up between the neurons. As the level of amyloid increases, tau rapidly spreads throughout the brain. Other changes that affect the brain may play a role in the disease, such as the inability of the vascular system to deliver enough blood and nutrients to the brain. These factors cause the brain to shrink in size, starting with the hippocampus. A person with Alzheimer’s gradually loses the ability to think, remember, make decisions, and function independently. Researchers are working on the key to understanding Alzheimer’s disease so that Alzheimer’s disease research can lead to the development of more effective therapies with the hope that we can delay or even prevent the devastation of dementia. This video was developed by the National Institute on Aging (https://www.nia.nih.gov/), part of the National Institutes of Health (https://www.nih.gov/). Want to learn more? Subscribe to the National Institute on Aging’s YouTube channel: https://www.youtube.com/user/NatlInst…. Find more information about Alzheimer’s disease from the National Institute on Aging: https://www.nia.nih.gov/health/alzhei…. Find more health information from the National
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