Mental Health Startup Uses Voice ‘Biomarkers’ To Detect Signs Of Depression And Anxiety

Young female character having a panic attack, an imaginary monster shadow silhouette, mental health issues, psychology

The quick brown fox jumps over the lazy dog,” Rima Seiilova-Olson says slowly and emphatically over Zoom.

The simple sentence holds enormous value for mental health care, she explains, smiling as if to acknowledge that it might be less than obvious how a silly phrase could be so meaningful to a computer programmer and leader of an artificial intelligence startup.

The short saying contains every letter of the alphabet and phoneme in the English language, says Seiilova-Olson, an immigrant from Kazakhstan who is cofounder and chief scientist of Kintsugi Mindful Wellness. Kintsugi believes these sounds offer invaluable insight that can help mental health providers better support people with depression and anxiety.

The Bay Area-based company is building AI software that analyzes short clips of speech to detect depression and anxiety. This so-called voice biomarker software is being integrated into clinical call centers, telehealth services and remote monitoring apps to screen and triage patients reaching out for support, helping providers more quickly and easily assess their needs and respond.

“There’s just not a lot of visibility as to who is severely depressed or anxious.”

Kintsugi CEO and co-founder Grace Chang

Seiilova-Olson, 36, first met co-founder and CEO Grace Chang, 40, a Taiwanese immigrant now based in Berkeley, in 2019 at an open AI hackathon in San Francisco. Surprised to cross paths at a male-dominated event, the women began comparing notes about their respective personal challenges trying to access mental health care:

Seiilova-Olson had struggled to secure a therapist during postpartum depression with her first child, and when Chang had needed her own support, she said it had taken months for anyone from Kaiser to call her back.

“Living in the Bay Area, you can push a button and a car can come to you or food can come to you,” Chang says. “But this was really a challenge.” As engineers, they viewed the dilemma differently than clinicians might.

“We saw this as an infrastructure problem, where you have so many people trying to jam through that front door,” Chang explains. “But there’s just not a lot of visibility as to who is severely depressed or anxious, who is low-to-moderate. And if we could provide this information to those frontline practitioners, then we’d maybe have an opportunity to greatly alleviate that bottleneck.”

Kintsugi was born out of that idea in 2019. It sits in a competitive space of health tech startups like Ellipsis Health and Winter Light Labs that are using voice biomarkers to detect mental health or cognitive issues, built on research showing that certain linguistic patterns and characteristics of a person’s voice can be correlated with psychiatric or neurological conditions.

Kintsugi last year raised $8 million in seed funding led by Acrew Capital, and in February, announced it had closed a $20 million Series A round led by Insight Partners, which valued the company at nearly $85 million, according to PitchBook.

In-person mental health facilities typically use questionnaires to gauge the severity of patients’ anxiety or depression, measures known as PHQ-9 and GAD-7 scores. But during telehealth visits or phone consults — where face-to-face interaction is lost, making it harder to pick up on symptoms — Kintsugi’s technology helps to fill that gap.

Nicha Cumberbatch, assistant director of public health at Spora Health, a provider focused on health equity and people of color, uses Kintsugi’s software to assess women in its all-virtual, doula-led maternal health program, Spora Mommas.

The voice analysis tool, which Spora began using for patient consultations a few weeks ago, has helped Cumberbatch identify women who are, or may be at risk of, experiencing anxiety and depression before, during or after their pregnancies. When a patient starts speaking to a Spora clinician or doula on Zoom, Kintsugi’s AI begins listening to and analyzing her voice.

After processing 20 seconds of speech, the AI will then spit out the patient’s PHQ-9 and GAD-7. The employee can then use that mental health score to decide what additional testing may be needed and how best to advise or direct the patient to resources — like a psychiatrist, cognitive behavioral therapist or obstetrician.

Cumberbatch says Kintsugi’s technology is allowing her to “​​keep a more watchful eye” on her patients “and then move forward with proactive recommendations around mitigating their symptoms.” And while it’s not meant to replace clinicians or formal medical evaluations, she adds, it can be used as a screening tool to “allow us to have a more well-rounded, 360-view of the patient when we don’t have them in front of our face.”

“That technology… [allows] us to have a more well-rounded, 360-view of the patient when we don’t have them in front of our face.”

Nicha Cumberbatch, assistant director of public health at Spora Health

Dr. ​​Jaskanwal Deep Singh Sara, a Mayo Clinic cardiologist who has collaborated with Ellipsis and led research on potential uses of voice biomarkers for cardiology, cautions that while the technology is promising for health care, the field has a long way to go to ensure that it’s accurate, safe and beneficial for patients and clinicians alike.

“It’s not ready for primetime by any stretch of the imagination yet,” Dr. Sara says. Studies in psychiatry, neurology, cardiology and other areas have shown an association between voice biomarkers and various conditions or diseases, but they haven’t shown how this relationship can be used to improve clinical outcomes, he says.

Such research is “not the same as saying, ‘How can we instrumentalize it in clinical practice, and how feasible is it? How effective is it in gauging an individual’s medical trajectory?’” he explains. “If it doesn’t provide any benefits in terms of how we manage them, then the question is: why would you do it?”

He says addressing those questions is “one of many next steps that we have to undertake on this” and that larger clinical trials are needed to answer them. “If it makes health care delivery cheaper or more efficient, or if it improves outcomes for patients, then that’s great,” he adds. “But I think we need to demonstrate that first with clinical trials, and that hasn’t been done.”

To address these issues and validate its software, Kintsugi is conducting clinical studies, including with the University of Arkansas for Medical Sciences, and the National Science Foundation has awarded Kintsugi multiple grants to ramp up its research. The company is also pursuing FDA “de novo” clearance and continuing to build its own dataset to improve its machine learning models.

(Data and insights from Kintsugi’s voice journaling app, as well as conversations with call centers or telehealth providers and clinical collaborations with various hospitals, all become part of an enormous dataset that feeds Kintsugi’s AI.) Seiilova-Olson says this self-generated, unfettered proprietary dataset is what sets Kintsugi apart in the AI health care space — where many technologies are reliant on outside data from electronic health records.

That collection of troves of data on individuals’ speech can be concerning — particularly in the mental health and wellness space, which is widely considered a regulatory Wild West. (These products and services are often not subject to the same laws and stringent standards that govern how licensed clinicians provide formal medical care to patients.)

But Kintsugi’s founders say that patient privacy is protected because what matters for its technology is not what people are saying, but how they are saying it. Patients are also asked for their consent to be recorded and care is not affected by their decision to opt in or opt out, according to the founders.

Kintsugi says it has served an estimated 34,000 patients. The company is currently working with a large health system with 90 hospitals and clinics across 22 states, and they are active in a care management call center that services roughly 20 million calls per year. It is also partnering with Pegasystems, which offers customer service tools for health care and other industries, to help payers and providers handle inbound calls.

Chang says other customers include Fortune 10 enterprise payers, pharmaceutical organizations and digital health applications focused on remote patient monitoring, but that she could not yet share their names. Kintsugi’s clinical partners include Children’s Hospital Colorado, Joe DiMaggio Children’s Hospital in Florida, Chelsea and Westminster Hospital in London and SJD Barcelona Children’s Hospital in Spain, Chang said.

Prentice Tom, Kintsugi’s chief medical officer, adds that it’s working with the University of Arkansas to explore how the tool can be used to possibly identify patients with suicidal ideation, or increased or severe suicide risk, as well as with Loma Linda University, to look at how the technology can be used to spot burnout amongst clinicians.

The team is also looking for ways to expand availability and uses for younger and elderly patients, as well as for maternal and postpartum populations. And beyond patients themselves, it’s perhaps nurses who are benefiting most from Kintsugi’s work, according to the founding team: having a triage tool that helps reduce administrative work or the time spent asking generic questions enables nurses to more seamlessly move patients in their journey.

But Tom, a Harvard-trained emergency medicine physician and former faculty member at Stanford University’s Department of Emergency Medicine, says Kintsugi is now doing far more than addressing infrastructure issues alone. It’s democratizing access to mental health care, Tom said, moving away from a physician-centric paradigm that caters more to people with significant enough depression that they require medical evaluation.

“This tool actually creates a view of mental health in terms of mental wellness,” Tom said, “where everyone has the opportunity to understand where they sit on the spectrum and that actually stratifies treatment options well beyond the current infrastructure.”

I’m a Senior Writer at Forbes covering the intersection of technology and society. Before joining Forbes, I spent three years as a tech reporter at Politico, where I covered

Source: Mental Health Startup Uses Voice ‘Biomarkers’ To Detect Signs Of Depression And Anxiety

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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.

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

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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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How Vision Loss Can Affect the Brain

A growing body of evidence suggests that when older people’s brains have to work harder to see, declines in language, memory, attention and more could follow.

Medical practice tends to divide its clients — you and me — into specialties defined by body parts: ophthalmology, neurology, gastroenterology, psychiatry and the like. But in fact, the human body doesn’t function in silos. Rather, it works as an integrated whole, and what goes awry in one part of the body can affect several others.

I’ve written about the potential harm of hearing loss to brain health, as well as to the health of our bones, hearts and emotional well-being. Untreated hearing loss can increase the risk of dementia. Even those with slightly less than perfect hearing can have measurable cognitive deficits.

Now, a growing body of research is demonstrating that vision loss can affect the brain’s function, too. As with hearing, if the brain has to work extra hard to make sense of what our eyes see, it can take a toll on cognitive function.

The latest study, published in JAMA Network Open in July, followed 1,202 men and women aged 60 to 94 for an average of nearly seven years. All were part of the Baltimore Longitudinal Study of Aging, and had vision and cognition tests every one to four years between 2003 and 2019.

The researchers found that those who scored poorly on initial tests of visual acuity — how well, for example, they could see the letters on an eye chart from a given distance — were more likely to have cognitive decline over time, including deficits in language, memory, attention and the ability to identify and locate objects in space.

Other vision issues, like with depth perception and the ability to see contrasts, also had deleterious effects on cognitive ability. The lead researcher, Bonnielin Swenor, an epidemiologist at the Johns Hopkins Wilmer Eye Institute, said that the new study “adds to mounting longitudinal data showing that vision impairment can lead to cognitive decline in older adults.”

Lest you think that the relationship is reversed — that cognitive decline impairs vision — another study that Dr. Swenor participated in showed that when both functions were considered, vision impairment was two times more likely to affect cognitive decline than the other way around.

This study, published in 2018 in JAMA Ophthalmology and led by Diane Zheng from the University of Miami Miller School of Medicine, included 2,520 community-dwelling adults ages 65 to 84, whose vision and cognitive function were periodically tested. She and her co-authors concluded that maintaining good vision as one ages may be an effective way to minimize the decline in cognitive function in older adults.

“When people have vision loss, they change the way they live their lives. They decrease their physical activity and they decrease their social activity, both of which are so important for maintaining a healthy brain,” Dr. Swenor said. “It puts them on a fast tack to cognitive decline.”

But identifying and correcting vision loss early on can help, Dr. Zheng said. She suggested regular eye checkups — at least once every two years, and more often if you have diabetes, glaucoma or other conditions that may damage vision. “Make sure you can see well through your glasses,” she urged.

There are “vision impairments that glasses won’t fix,” Dr. Swenor said, like age-related macular degeneration and glaucoma. Retinal disease began to compromise Dr. Swenor’s vision in her mid-20s. Those with problems like hers can benefit from something called low vision rehabilitation, a sort of physical therapy for the eyes that helps visually impaired people adapt to common situations and help them function better in society.

Dr. Swenor, for instance, can see objects in a high-contrast situation, like a black cat against a white fence, but has trouble seeing the difference between similar colors. She can’t pour white milk into a white mug without spilling it, for example. Her solution: Use a dark-colored mug. Finding such accommodations is an ongoing task, but it enables her to continue to function well professionally and socially.

Society, too, needs to help people with visual impairment function safely outside the home. Most things in hospitals are white, for example, which creates safety hazards for people with diminished contrast sensitivity. As a driver of 50 years, I’ve noticed that road barriers that used to be the same color as the road surface are now more often rendered in high contrast colors like orange or yellow, which undoubtedly reduces crashes even for people who can see perfectly.

“We need to create a more inclusive society that accommodates people with vision impairment,” Dr. Swenor said.

People who have trouble with depth perception can also incorporate helpful design features into the home. Placing colored strips on stair risers, varying textures of furniture and color-coding objects can all improve the ability to navigate safely. People who can no longer read books may also listen to audiobooks, podcasts or music instead, Dr. Swenor said.

The link between visual impairment and cognitive impairment “is not a doomsday message,” she added. “There are many ways to foster brain health for people with vision loss.”

Step one may be getting a Medicare extension bill through congress, which in turn might prompt private insurers to also cover vision care and rehabilitation. The Democrats’ current proposal to extend Medicare benefits to cover vision care would more than pay for itself in the long run by diminishing already-covered medical costs for cognitive and physical decline.

Case in point: The cost of a single hip replacement resulting from a vision-impaired fall would exceed the cost of many hundreds of eye exams and needed vision corrections.

Portrait of Jane E. Brody

Source: How Vision Loss Can Affect the Brain – The New York Times

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Related Contents:

Facts About Retinal Detachment – Facts About Glaucoma

Fast Facts: Ophthalmology

Facts About Age-Related Macular Degeneration

Eye Strokes: CRAO, BRVO And Other Retinal Artery And Vein Occlusions

Vitreous Hemorrhage: Diagnosis and Treatment

Branch retinal vein occlusion

Giant-Cell Arteritis and Polymyalgia Rheumatica

A review of central retinal artery occlusion: clinical presentation and management

Branch retinal vein occlusion

Pediatric, Adult Glaucoma Differ in Management: Patient Populations Not Same

Childhood blindness in the context of VISION 2020–the right to sight

Approach to the diagnosis of the uveitides

American Optometric Association web site

Neural correlates of natural human echolocation in early and late blind echolocation experts

The prevalence of low vision and blindness in Canada

Visual impairment and blindness Fact Sheet

Causes of blindness and visual impairment”. Archived

National Dissemination Center for Children with Disabilities

Free and Appropriate Public Education and the Personnel Crisis for Students with Visual Impairments and Blindness

High Eye Pressure and Glaucoma

Eye Trauma Epidemiology and Prevention

Circadian Rhythm Sleep Disorder

A comparison of the causes of blindness certifications in England and Wales in working age adults

Optical reading aids for children and young people with low vision

Headaches: Three Tips From a Neuroscientist On How To Get Rid Of Them

Woman sitting at desk clutches her neck and back in pain.

Everyone experiences headaches. From dull throbbing dehydration headaches to incapacitating migraines, a sore head is an extremely common complaint. This is perhaps especially true at the moment. COVID-19 can cause them, as can sitting at desks for too long and not getting out of the house enough.

When headaches strike, many people’s reaction is to reach for a painkiller. And these can do the job. But a better solution is often to probe the reasons behind the pain – especially if you get similar types of headaches a lot.

Even though they all entail pain, where the pain is can clue us into what type of headache we are experiencing. Pain in the face and forehead are markers of sinus-related headache whilst the sensation of a pneumatic drill somewhere in our cranium is often migraine.

But ultimately, all headaches are caused by vasodilation in the head – the widening of blood vessels near the brain. This stretches sensory receptors in the vessel wall and we feel that sensation as pain.

To understand why we need to think about the constraints the contents of our head are working under. Blood is toxic to brain tissue and so is kept separate through the blood-brain barrier. If a blood vessel leaks or breaks, this results in a haemorrhage and the death of the brain tissue the blood seeps into. So, if our blood vessels dilate beyond comfortable limits, the sensory receptors will fire off signals to the brain, which we interpret as pain.

Headaches are an early warning system. The best way to counteract them is to work out what they are warning us about.

1. Think beyond your head

 

This means thinking beyond your head. Yes, headache pain is generated somewhere in our head and we feel it in our head and that is why it is called headache. But headache is so much more than that – which is why I’m fascinated by them, have studied them for the past 20 years and recently published a book on the subject.

It’s a two-way street. The cause of our headache can sometimes come from our body or our behaviour. And of course headaches affect both our body and our behaviour. If we see headache as something isolated to our cranium then we will never truly understand its cause, our experience of it, or how we can best mitigate it.

Frequent migraine sufferers intimately understand this and often religiously track their food intake and their activities as well as the weather in order to work out what triggers them. But the normal headache sufferer is often less in tune with the causes of their pain.

Tension headache is a really good example of how this works. It feels like a tight band squeezing around your head with a tonne weight sitting on top for good measure. We are all aware of their occurrence at times of great emotional stress (lockdown homeschooling anyone?) but they can equally be caused by the stress we put on our body, with bad posture for example, or recovery from injury.

Both entail over-activity of the musculature around the head and neck, which sets up an inflammatory response involving prostaglandins and nitric oxide, both of which are chemicals that act to widen blood vessels. Inflammatory chemicals also directly activate the trigeminal nerve – the most complex of the cranial nerves and the one responsible for sensation and movement in the face.

Taking too many things on, rushing around trying to get things done in negative time, and trying to be all things to all people are common behavioural markers that will predict a tension headache. That and the actions we take when the pain begins.

2. Listen to the pain

If you have a pain in your leg, it might stop you from playing in that tennis match or turning up for five-a-side football. You know that if you play on it, you might do more damage and your recovery will take longer. But we don’t tend to do that with headache. We take a painkiller or an anti-inflammatory and carry on as normal even though our pain receptors are screaming at us that there is something wrong.

Taking paracetamol or ibuprofen will act to avert the danger, reducing the inflammation, the dilation and the perception of pain, but the headache will reoccur unless we can address the cause. Sometimes it’s obvious – if you have a sinus headache you’re just going to have to wait for your sinuses to clear, so taking a painkiller or a decongestant may be a good approach – but sometimes our coping strategy can make things worse.

We may decide a bottle of wine and a takeaway is just the kind of treat we need to relax and de-stress. But both lead to dehydration, another ubiquitous cause of headache. With your brain made of more than 70% water, if your kidneys need borrow some to dilute alcohol or salts and spices, it usually comes from this oasis. The brain loses water such that it literally shrinks in volume, tugging on the membranes covering the brain and triggering pain.

3. Use the brain’s natural painkillers

So what else can we do? One way is to lean into the brain’s natural painkiller system and to boost neurochemicals associated with happiness (such as serotonin and oxytocin) and reward (dopamine). Having a laugh at a comedy, enjoying a good friend’s company or indulging in some intimacy with a partner will all boost these hormones to various degrees.

Each block pain signals coming from the body, not only helping you get a handle on your headache but also redressing the balance of neurochemicals that were the mechanism of your upset emotional state.

The knowledge that we can leverage our behaviour and our body to keep our brain’s neurochemicals in balance gives us a way to break the headache cycle. So next time you have a headache for which the causes aren’t glaringly obvious – you’re not otherwise sick and you’ve been keeping hydrated – take a look at your life and see what you can change there. The pain, after all, is trying to tell you something.

 

By: Professor of Neuroscience, Durham University

 

Source: Headaches: three tips from a neuroscientist on how to get rid of them

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“Famous” Physical Therapists Bob Schrupp and Brad Heineck discuss an approach to stopping your headaches using a new neuroscience approach. Adriaan Louw Headache Book available at https://bobandbrad.com/favorite-books and on our Amazon list. Make sure to like Bob and Brad on FaceBook https://www.facebook.com/BobandBrad/
Check out the Products Bob and Brad LOVE on their Amazon Preferred Page : https://www.amazon.com/shop/physicalt… Follow us on Twitter https://twitter.com/PtFamous Our Website: https://www.bobandbrad.com/ Our book “Three Simple Steps To Treat Back Pain” is available on Kindle http://www.amazon.com/Three-Simple-St… Brad’s Book “Martial Arts Manual: For Stretching, Strengthening, Prevention, and Treatment of Common Injuries” is also available on Kindle. https://www.amazon.com/Martial-Arts-M…
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