Now your competent? doctor has no reason not to give this to you to delay your risk of dementia post stroke. Is your doctor competent?
DOES YOUR INCOMPETENT? DOCTOR NOT HAVE THESE?
DOES YOUR DOCTOR HAVE EXACT DEMENTIA PREVENTION PROTOCOLS? NO? So, your doctor is incompetent?
1. A documented 33% dementia chance post-stroke from an Australian study? May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.`
3. A 20% chance in this research. July 2013.
4. Dementia Risk Doubled in Patients Following Stroke September 2018
The latest here:
Cognitive Intervention Does More Than Defend Against Dementia
Sleep, brain resilience, and blood flow improved with structured POINTER program
Three ancillary studies to the U.S. POINTER trial collectively demonstrated that a structured 2-year lifestyle intervention for older adults at increased risk of cognitive decline led to better overall health.
In main results from the U.S. POINTER trial released in July, two lifestyle interventions -- one structured, the other self-guided -- improved cognitive scores in over 2,000 older adults, said Rema Raman, PhD, of the University of Southern California in Los Angeles, who co-chaired a symposium at the Clinical Trials on Alzheimer's Disease (CTAD) annual meeting.
Both 2-year interventions in U.S. POINTER encouraged physical activity, cognitive activity, healthy diet, social engagement, and cardiovascular health monitoring, but they differed in structure, intensity, and accountability.
The mean annual increase in global cognitive scores was greater in the structured group compared with the self-guided group (P=0.008). "The structured intervention may, in our opinion, slow the cognitive aging clock by about 1 to 2 years compared to the self-guided intervention," Raman said.
At CTAD, the first results reported from the trial's ancillary studies -- POINTER-NV (neurovascular), POINTER-Neuroimaging, and POINTER-zzz (sleep) -- showed that blood pressure regulation, cognitive resilience, and sleep apnea were better with the structured intervention.
"I am very encouraged by these early findings from the U.S. POINTER ancillary studies, which offer valuable insights into the physiological mechanisms that may have contributed to the positive results of the U.S. POINTER trial," said Richard Hodes, MD, director of the NIH's National Institute on Aging, which supported the research.
"The forthcoming publications and continued analysis of this rich dataset will deepen our understanding of how multimodal interventions can support brain health," Hodes said in a statement.
POINTER-NV
The POINTER-NV study showed that the structured intervention significantly enhanced blood pressure regulation, cerebral autoregulation, and vascular elasticity while also improving functional properties of the aorta and major cerebral arteries, reported principal investigator Tina Brinkley, PhD, of the Wake Forest University School of Medicine in Winston-Salem, North Carolina.
Baroreflex sensitivity, which measures a mechanism that regulates blood pressure and ultimately drives cerebral blood flow, was a key outcome. In the structured intervention group, baroreflex sensitivity improved by 1.177 ms/mm Hg (95% CI 0.634-1.720) over 2 years, representing a 14% increase, Brinkley said. In the self-guided group, the change in baroreflex sensitivity was not significant.
The findings indicate that a structured multidomain lifestyle intervention can improve the body's ability to regulate blood pressure, which is crucial for proper brain blood flow to the brain, Brinkley said.
POINTER-Neuroimaging
In POINTER-Neuroimaging, participants with high-risk profiles -- those who had low baseline hippocampal volume or entorhinal tau accumulation in the brain -- had greater cognitive benefits from the structured versus the self-guided intervention (P=0.006).
Amyloid status did not appear to affect the cognitive benefit of the intervention. "This means that people with amyloid build-up experienced the same benefits from the intervention as those without amyloid," said Susan Landau, PhD, of the University of California Berkeley, who led the ancillary study.
The structured and self-guided groups did not differ overall on 2-year changes in amyloid, tau, hippocampal volume, or white matter hyperintensity volume, Landau noted. However, the structured intervention showed a protective effect on cognitive function, reducing the effect of entorhinal tau as it accumulated, she said. A 4-year extension study to follow these biomarkers is underway.
POINTER-zzz
In POINTER-zzz, participants had sleep assessments at baseline, 12 months, and 24 months. At baseline, 63% had least mild sleep apnea, reported Laura Baker, PhD, also of the Wake Forest University School of Medicine.
Home-based sleep testing revealed that, over 2 years, the structured intervention group had a reduction of one to two respiratory disturbance events per hour relative to the self-guided group. In the structured group, the mean 2-year reduction in the apnea-hypopnea index (AHI) from baseline was 1.759 (95% CI -2.554 to -0.965). In the self-guided group, the difference was not significant.
The structured intervention benefit on AHI was consistent across several key subgroups and tended to be stronger for people with more severe baseline sleep apnea, Baker noted. These improvements in sleep-disordered breathing are clinically meaningful and may confer additional neuroprotective benefits, she said.
Data about other metrics, including sleep fragmentation, are still being analyzed.
Overall, the ancillary study findings suggest that "the U.S. POINTER lifestyle intervention with structured support has substantial and significant health benefits beyond improving cognition, and the benefits are in areas known to lower risk of cognitive decline and dementia," observed Maria Carrillo, PhD, chief science officer of the Alzheimer's Association in Chicago, which supported the trial.
"Bottom line, we now have a more comprehensive picture of how the U.S. POINTER intervention affects brain health, and overall health, too," she added.
The U.S POINTER trial was supported by the Alzheimer's Association. The National Institute on Aging of the NIH supported the POINTER ancillary studies.
Brinkley had no disclosures.
Landau reported relationships with the NIH, Eisai, IMPACT-AD, Johnson & Johnson, ATRI, the Alzheimer's Association, and Shenzhen Bay Lab.
Baker had no disclosures.
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