Mild cognitive impairment (MCI) is a condition in which people have more memory or thinking problems than other people their age. The symptoms of MCI are not as severe as those of Alzheimer’s disease or a related dementia. People with MCI can usually take care of themselves and carry out their normal daily activities.
People with MCI are at a greater risk of developing Alzheimer’s disease or a related dementia. Estimates vary as to how many people who have MCI will develop dementia. Roughly one to two out of 10 people age 65 or older with MCI are estimated to develop dementia over a one-year period. However, in many cases, the symptoms of MCI stay the same or even improve.
DELIRIUM is a rapidly-developing TEMPORARY DEMENTIA in response to almost any trauma, infection or stress, usually in a hospital setting, with its restrictive, isolating and disorienting environment.
I had little appreciation of the frequency or economic hazard of Delirium before I encountered this infographic. I knew little about the causative mechanisms, and after reading about it, I still don’t know what is going on. But I do know one thing; I don’t want to become delirious and risk its ominous outcome. To improve my odds, I want to keep myself as healthy as possible.
To prevent loss of focus, cognition and memory, challenge the Brain as much as possible. To prevent or restrain infection, support the immune system with a healthy diet. To combat sleep disturbances, practice Sleep Hygiene. To maintain adequate oxygen and nutrient delivery to the Brain, support a healthy cardiovascular-pulmonary system with regular aerobic exercise.
These preventative steps will also postpone the FRAILTY on which delirium feeds. This fuzziness, which afflicts most conditions with PSYCHIATRIC OVERTONES, should not be surprising, since the human Brain, the location of Delirium, is the most complex entity in the known universe.
Medical Knowledge of Delirium is still at the descriptive stage, even though it has been a feature of human life since Ancient times. Causation? Excess or Deficiency of most neurotransmitters have been described. To paraphrase “cytokine storm”, which can incidentally cause Delirium, one could call the condition a “neurotransmitter storm”.
Treatment? If the Delirious Patient is on a Psychotropic medication, try stopping it. If not taking such medication, try starting it. The only universal green light is Good general supportive care with IV fluids, oxygen, nutrition, and psychological support, with gentle, regular attention. Please read the accompanying Mayo Clinic article for a more conventional discussion.
We tested the hypothesis that apathy, but not depression, is associated with dementia in patients with SVD. We found that higher baseline apathy, as well as increasing apathy over time, were associated with an increased dementia risk. In contrast, neither baseline depression or change in depression was associated with dementia. The relationship between apathy and dementia remained after controlling for other well-established risk factors including age, education and cognition. Finally, adding apathy to models predicting dementia improved model fit. These results suggest that apathy may be a prodromal symptom of dementia in patients with SVD.
Cerebral small vessel disease (SVD) is the leading vascular cause of dementia and plays a major role in cognitive decline and mortality.1 2 SVD affects the small vessels of the brain, leading to damage in the subcortical grey and white matter.1 The resulting clinical presentation includes cognitive and neuropsychiatric symptoms.1
Apathy is a reduction in goal-directed behaviour, which is a common neuropsychiatric symptom in SVD.3 Importantly, apathy is dissociable from depression,3 4 another symptom in SVD for which low mood is a predominant manifestation.5 Although there is some symptomatic overlap between the two,6 research using diffusion imaging reported that apathy, but not depression, was associated with white matter network damage in SVD.3 Many of the white matter pathways underlying apathy overlap with those related to cognitive impairment, and accordingly apathy, rather than depression, has been associated with cognitive deficits in SVD.7 These results suggest that apathy and cognitive impairment are symptomatic of prodromal dementia in SVD.
Even limited hearing loss might be associated with cognitive decline. If true, early intervention with hearing aids might help people have better cognitive performance.
Michael Johns III, MD, online editor for JAMA Otolaryngology, speaks with Justin Golub, MD, MS, assistant professor of otolaryngology at Columbia University, whose research has shown that very mild hearing loss can be associated with cognitive disability.
Hearing loss and cognitive ability decline together as we age, starting earlier in some people than others.
LIVING A HEALTHY LIFE STYLE-with good SLEEP, DIET, EXERCISE and COGNITIVE STIMULATION -seems to help benefit almost everything, including hearing, while a poor life style, neglecting the 4 Pillars, smoking, and drinking alcohol to excess seems to hasten our aging.
Certain medications, often taken to treat the results of a poor life style, can also harm our hearing.
LOUD SOUNDS (such as AMPLIFIED MUSIC), especially if prolonged, are particularly bad. SOUND POLLUTION contaminates the modern world as much as industries‘ excesses. I would often wear ear plugs to Football games (108 dB on my meter) and even in row 4 of the Symphony.
Once damaged, the delicate HAIR CELLS of our inner ear don’t grow back, although medical science once again is working feverishly to save us from ourselves.
Hearing aids can now be programmed to compensate for our particular pattern of frequency loss.
The premise made in the above article and podcast, that decreased HEARING is accompanied by (and Causes?)decreased COGNITION could be supported by a study demonstrating that Improved hearing restores the cognition. I understand that early results may suggest a cognitive benefit of hearing aids.
But PRESERVING BOTH with healthy living would of course be better- at least in my opinion.
Prevention, unfortunately, is a very hard sell in a world of costly medical treatments, where we are protected from directly confronting those costs by ever-expanding insurance. How about Medical savings accounts?
Health journalist Judy Foreman talks about her new book Exercise Is Medicine: How Physical Activity Boosts Health and Slows Aging
This is Scientific American’s Science Talk, posted on April 24th, 2020. I’m Steve Mirsky. And under our current, often locked-down situation, it’s still really important to try to get some exercise. Judy Foreman is the author of the new book Exercise is Medicine: How Physical Activity Boosts Health and Slows Aging. She’s a former nationally syndicated health columnist for the Boston Globe, LA times, Baltimore Sun and other places, and an author for the Oxford University Press. We spoke by phone.
This Podcast is worth listening to in full. It will introduce some of the upcoming themes of DWWR.
Exercise is one of the 4 pillars of health, thriving and longevity, along with Diet, Sleep, and Intellectual Stimulation. We look forward to highlighting and reveling in these subjects.
Judy Foreman’s thesis “ exercise is medicine” is true in many dimensions, including industries desire to capture the many beneficial biological effects of exercise in a pill; it requires effort to get off your duff, and you need to budget the time to work out.
My preference is WALKING and WATER EXERCISE. I make passing the time PLEASANT by listening to BBC “in our time”, recorded on a water-proof mp-3 player. EXERCISE is both VALUABLE and ENJOYABLE!
Empowering Patients Through Education And Telemedicine