Dementia Risk Reduced by 25% with Specific Type of Brain Exercise

Will your doctor GUARANTEE NOT GETTING DEMENTIA by doing this? You are at a high risk of dementia.

I bet your fuckingly incompetent stroke medical 'professionals' DID NOTHING WITH THIS: 9+ years of incompetence and still has a job. Boy, your board of directors is a shitworthy piece of world class incompetence!

This Type of Brain Training Can Keep You From Getting Dementia September 2016

One particular type of brain training exercise cut the long-term risk of dementia by 29% November 2017 

The latest here:

Dementia Risk Reduced by 25% with Specific Type of Brain Exercise

Summary: Results from the long-term ACTIVE study reveal that a specific type of cognitive exercise can significantly reduce the risk of dementia for up to two decades. The study, which followed nearly 3,000 older adults for 20 years, found that those who participated in “speed of processing” training—exercises designed to sharpen visual attention and reaction time—were 25% less likely to be diagnosed with dementia compared to a control group.

Remarkably, this benefit was only seen in participants who received “booster” sessions following their initial five-week program. While speed training showed lasting neuroprotective effects, traditional memory and reasoning exercises did not significantly reduce dementia incidence, highlighting the unique impact of training the brain’s processing speed.

Key Facts

• The Winning Method: “Speed of processing” training involves computer-based tasks that challenge the brain to identify and locate visual information quickly across a widening field of view.
• The “Booster” Necessity: The 25% reduction in risk was specific to those who completed initial training plus refresher sessions at 11 and 35 months. Without boosters, speed training showed no significant long-term benefit.
• Long-Term Durability: The study utilized 20 years of Medicare claims data to track diagnoses, proving that less than 24 hours of total training can have protective effects that last into a person’s 80s and 90s.
• Implicit vs. Explicit Learning: Researchers believe speed training works because it targets “implicit” learning (automatic skills), whereas memory and reasoning focus on “explicit” strategies (facts and logic) which may be less resistant to age-related decline.

Source: Johns Hopkins Medicine

Adults age 65 and older who completed five to six weeks of cognitive speed training — in this case, speed of processing training, which helps people quickly find visual information on a computer screen and handle increasingly complex tasks in a shorter time period — and who had follow-up sessions about one to three years later were less likely to be diagnosed with dementia, including Alzheimer’s disease, up to two decades later, according to new findings published today in Alzheimer’s & Dementia: Translational Research and Clinical Interventions.

This National Institutes of Health (NIH)-funded study is the first randomized clinical trial, and only study of its kind, to assess 20-year links with dementia, including Alzheimer’s disease, among adults who participated in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study.

Cognitive speed training builds “cognitive reserve” by strengthening the brain’s implicit learning pathways, offering protection against dementia for decades. Credit: Neuroscience News

Investigators enrolled 2,802 adults into this study in 1998–99 to assess long-term benefits of participants randomized to three different types of cognitive training — memory, reasoning and speed of processing — in comparison to a control group who received no training.

In the three training groups, participants received up to 10 sessions of 60–75 minutes of cognitive training that took place over five to six weeks.

Additionally, half of participants were randomized to receive up to four additional cognitive training sessions, or boosters, which took place 11 and 35 months after the initial training. 

In this 20-year follow-up study, investigators found that 105 out of 264 (40%) participants in the speed-training group with boosters were diagnosed with dementia, which was a 25% reduced incidence compared to 239 out of 491 (49%) adults in the control arm. This was the only intervention with a statistically significant, or meaningful, difference compared to the control group.

To reach these findings, investigators reviewed Medicare data from 2,021 participants (72% of the original study) between 1999 and 2019. Characteristics of participants in the follow-up study were similar to the original trial.

Three-fourths of participants were women, 70% were white, and the average age was 74 at the start of the study. During the follow-up period, about three-fourths of participants died (at an average age of 84). 

Dementia is characterized as declines in thinking that result in the inability of an individual to live independently or manage on their own on a daily basis. It’s estimated to affect 42% of adults older than age 55 at some point in their life, and costs the U.S. more than $600 billion each year.

Alzheimer’s disease, the most common type, accounts for about 60%–80% of dementia cases, while vascular dementia accounts for about 5%–10%. Other types of dementia include Lewy body, frontotemporal or combinations. 

“Seeing that boosted speed training was linked to lower dementia risk two decades later is remarkable because it suggests that a fairly modest nonpharmacological intervention can have long-term effects,” says Marilyn Albert, Ph.D., the corresponding study author and director of the Alzheimer’s Disease Research Center at Johns Hopkins Medicine.

“Even small delays in the onset of dementia may have a large impact on public health and help reduce rising health care costs.” 

Albert explained that additional studies are needed to understand underlying mechanisms that may help explain these associations and to understand why the reasoning and memory interventions didn’t have the same 20-year associations.

Findings from this 20-year study expand on prior research from the ACTIVE trial, which is the largest study in the U.S. to assess different types of cognitive training in adults. ACTIVE researchers previously found that cognitive training helped participants improve everyday tasks involved with thinking, remembering, reasoning and quickly making decisions for up to five years.

All three training arms were also linked to improved outcomes with everyday function 10 years later. Additionally, those who completed speed training had a 29% lower incidence of dementia 10 years later compared to the control group. Each booster session was linked to further risk reductions.

The authors explain that speed training may have been particularly effective because the program was adaptive – it adapted its level of challenge for each participant’s individual performance level that day.

People who were faster at the start moved to faster challenges quickly, and people who needed more time started at slower levels. The memory and reasoning programs were not adaptive — everyone in the group learned the same strategies.

Additionally, speed training drives implicit learning (more like an unconscious habit or a skill), while memory training and reasoning training drive explicit learning (more like learning facts and strategies).

Scientists already know that implicit learning works very differently in the brain than explicit learning, and this may contribute to the results seen with dementia in the current analysis. 

“Our findings provide support for the development and refinement of cognitive training interventions for older adults, particularly those that target visual processing and divided attention abilities,” says site principal investigator George Rebok, Ph.D., a lifespan developmental psychologist who creates community programs for healthy aging and is a professor emeritus of mental health at the Johns Hopkins Bloomberg School of Public Health.

“It is possible that adding this cognitive training to lifestyle change interventions may delay dementia onset, but that remains to be studied.”  

The authors also note that speed training may synergistically support other lifestyle interventions that strengthen neural connections, but more research is needed to understand these interactions and to confirm this.

Other activities that have been associated with reduced risk of cognitive decline include taking steps to support cardiovascular health, such as monitoring blood pressure, blood sugar, cholesterol and body weight, and engaging in regular physical activity. 

Additional study authors include Norma B. Coe, Chuxuan Sun and Elizabeth Taggert (University of Pennsylvania), Katherine E. M. Miller and Alden L. Gross (the Johns Hopkins Bloomberg School of Public Health), Richard N. Jones (Brown University), Cynthia Felix (University of Pittsburgh), Michael Marsiske (University of Florida), Karlene K. Ball (University of Alabama at Birmingham) and Sherry L. Willis (University of Washington). 

Funding:This study is funded by NIH grants from the National Institute on Aging (R01AG056486).

The original ACTIVE trial was supported by NIH grants to six field sites and the coordinating center. This includes Hebrew Senior-Life, Boston (NR04507), the Indiana University School of Medicine (NR04508), The Johns Hopkins University (AG014260), the New England Research Institutes (AG014282), the Pennsylvania State University (AG14263), the University of Alabama at Birmingham (AG14289) and Wayne State University/University of Florida (AG014276).

Key Questions Answered:

Q: Is this the same as doing a daily crossword or Sudoku?

A: No. This study found that memory and reasoning exercises (like those used in crosswords) did not lower dementia risk over 20 years. The benefit came specifically from speed training, which forces the brain to process visual information faster and manage divided attention.

Q: How much training do I actually need to see a benefit?

A: Surprisingly little. Participants completed just 10 sessions (about 10-12 hours) initially, with a few hours of “booster” sessions a year or two later. Total training time was under 24 hours spread over three years.

Q: Can I do this specific training at home?

A: Yes. The specific “speed of processing” exercises used in the study have been developed into commercial software (often found under the name “Double Decision”).

Editorial Notes:

• This article was edited by a Neuroscience News editor.
• Journal paper reviewed in full.
• Additional context added by our staff.

About this cognitive training and Alzheimer’s disease research news

Author: Jessica Frost
Source: Johns Hopkins Medicine
Contact: Jessica Frost – Johns Hopkins Medicine
Image: The image is credited to Neuroscience News

Original Research: Open access.
“Impact of cognitive training on claims-based diagnosed dementia over 20 years: evidence from the ACTIVE study” by Norma B. Coe, Katherine E. M. Miller, Chuxuan Sun, Elizabeth Taggert, Alden L. Gross, Richard N. Jones, Cynthia Felix, Marilyn S. Albert, George W. Rebok, Michael Marsiske, Karlene K. Ball, and Sherry L. Willis. Alzheimer’s & Dementia: Translational Research and Clinical Interventions
DOI:10.1002/trc2.70197

Can Brain Speed Training Delay Dementia? 20-Year Medicare Study Results

 

Will your doctor GUARANTEE NOT GETTING DEMENTIA by doing this? You are at a high risk of dementia.

I bet your fuckingly incompetent stroke medical 'professionals' DID NOTHING WITH THIS: 9+ years of incompetence and still has a job. Boy, your board of directors is a shitworthy piece of world class incompetence!

This Type of Brain Training Can Keep You From Getting Dementia September 2016

One particular type of brain training exercise cut the long-term risk of dementia by 29% November 2017 

The latest here:

Can Brain Speed Training Delay Dementia? 20-Year Medicare Study Results

Key Takeaways

• Speed-of-processing training with booster sessions was tied to a lower dementia risk over a 20-year period.
• Memory and reasoning training did not show significant associations with reduced dementia risk.
• The findings provide support for developing and refining cognitive training interventions for older adults.

A subset of people who had one of three interventions in the ACTIVE trial had a reduced risk of dementia over a 20-year follow-up period, an analysis of Medicare claims showed.

Older adults in the ACTIVE trial were randomized to training in processing speed, memory, or reasoning. Those who received memory or reasoning training trended toward lower rates of dementia diagnoses over 20 years compared with controls, but the results were not significant, reported Marilyn Albert, PhD, of Johns Hopkins School of Medicine in Baltimore, and co-authors.

Only a subgroup of people who received both speed training and subsequent booster sessions had a long-term association with dementia diagnoses (HR 0.75, 95% CI 0.59-0.95), the researchers said in Alzheimer's & Dementia: Translational Research & Clinical Interventions.

Speed-trained participants who did not have booster sessions did not have a lower risk of dementia.

"The fact that the memory or reasoning trainings did not show statistical significance in any of the analyses presented here was somewhat surprising," Albert and colleagues wrote.

Speed training was adaptive and increased in difficulty with performance; the other trainings were not, they noted. "It is possible that this led to broader brain activation, contributing to the differential findings between the intervention arms," the researchers observed.

"The findings reported here suggest that moderate cognitive training could delay the onset of dementia over subsequent years," said Richard Hodes, MD, director of the National Institute on Aging (NIA), which funded the research.

While more research needs to be done, "this promising lead may move the field further into developing effective interventions to delay or prevent onset of dementia," Hodes said in a statement.

In 1999, the ACTIVE trial randomized 2,832 older adults with a mean age of 74 to a no-contact control group or to 10 sessions of memory, reasoning, or processing speed training over 5 to 6 weeks. Half of participants who completed the training were randomly chosen to have booster sessions 11 and 35 months later.

The trial was completed in 2010. Each intervention maintained effects on its specific targeted cognitive ability through 5 years. Memory training effects were no longer present at 10 years.

In the current analysis, Albert and colleagues linked 2,021 trial participants -- representing 72.1% of the original ACTIVE sample -- to Medicare claims records through 2019, excluding Medicare Advantage beneficiaries. During the 20-year follow-up period, 77% of the ACTIVE trial population died at a mean age of 84.

The primary outcome of this analysis was a diagnosis of Alzheimer's disease or related dementia that appeared in Medicare claims. Dementia diagnoses were not adjudicated.

Overall, 48.7% of participants in the control arm (239 of 491 people) had a Medicare claim for dementia, compared with 39.77% of participants who received both speed training and booster sessions (105 of 264 people).

Missing data and mortality were likely sources of bias in this study, pointed out Baptiste Leurent, PhD, of the UCL Department of Statistical Science in London, who wasn't involved with the research.

"None of the primary analyses found significant differences in dementia risk between the training groups and the control group. Although one subgroup analysis produced a significant result, this single finding is not generally regarded as strong enough evidence to demonstrate the intervention's effectiveness," Leurent wrote on the U.K. Science Media Centre website.

"Diagnoses were identified through health records rather than specialist clinical testing, so we do not know whether this training changed the underlying diseases that cause dementia or affected specific types of dementia," added Susan Kohlhaas, PhD, of Alzheimer's Research U.K. in Cambridge, England.

Still, the results may hold promise, the study authors said. "Our findings provide support for the development and refinement of cognitive training interventions for older adults, particularly those that target visual processing and divided attention abilities," noted co-author George Rebok, PhD, of the Johns Hopkins Bloomberg School of Public Health, in a statement.

"It is possible that adding this cognitive training to lifestyle change interventions may delay dementia onset, but that remains to be studied," Rebok said.

Cognitive speed training linked to lower dementia risk over 20 years

 Will your doctor GUARANTEE NOT GETTING DEMENTIA by doing this? You are at a high risk of dementia.

I bet your fuckingly incompetent stroke medical 'professionals' DID NOTHING WITH THIS: 9+ years of incompetence and still has a job. Boy, your board of directors is a shitworthy piece of world class incompetence!

This Type of Brain Training Can Keep You From Getting Dementia September 2016

One particular type of brain training exercise cut the long-term risk of dementia by 29% November 2017 

The latest here:

Cognitive speed training linked to lower dementia risk over 20 years

In a 20-year follow-up linking the randomised Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial to Medicare claims, older adults who received speed-of-processing training with booster sessions had a 25% lower risk of being diagnosed with Alzheimer’s disease and related dementias (ADRD), while memory and reasoning training showed no protective effect.

The findings, published in Alzheimer’s & Dementia: Translational Research and Clinical Interventions, provide the first long-term evidence that targeted, speed-based cognitive training may delay dementia diagnosis, offering clinicians a scalable, nonpharmacologic strategy to reduce ADRD risk in aging populations.

“Seeing that boosted speed training was linked to lower dementia risk 2 decades later is remarkable because it suggests that a fairly modest nonpharmacological intervention can have long-term effects,” said Marilyn Albert, PhD, Johns Hopkins Medicine, Baltimore, Maryland. “Even small delays in the onset of dementia may have a large impact on public health and help reduce rising health care costs.”

The researchers analysed the very long-term impact of cognitive training by linking participants from the ACTIVE trial to Medicare claims data spanning 1999 to 2019. The original trial enrolled a large, diverse cohort of older adults and randomised them to 1 of 4 groups: speed-of-processing training, memory training, reasoning training, or a control condition.

For the current analysis, the researchers focused on 2,021 participants enrolled in traditional Medicare at baseline and identified diagnoses of Alzheimer’s disease and related dementias using the Chronic Conditions Warehouse algorithm. Importantly, the speed-training arm included optional booster sessions, allowing researchers to assess whether continued reinforcement influenced long-term outcomes.

Over a 20-year follow-up period, participants who received speed-of-processing training and completed ≥1 booster sessions had a significantly lower risk of being diagnosed with ADRD compared with controls. In contrast, speed-trained participants who did not receive booster sessions showed no reduction in dementia risk, and neither memory nor reasoning training was associated with long-term protection.

“Our findings provide support for the development and refinement of cognitive training interventions for older adults, particularly those that target visual processing and divided attention abilities,” said George Rebok, PhD, Johns Hopkins Bloomberg School of Public Health. “It is possible that adding this cognitive training to lifestyle change interventions may delay dementia onset, but that remains to be studied.” 

Reference: https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/trc2.70197

SOURCE: Johns Hopkins Medicine

Predictive Validity of the Johns Hopkins Fall Risk Assessment Tool for Older Patients in Stroke Rehabilitation

 Instead of predicting falls why not do the research that will prevent those falls? Like maybe all this perturbation research. It's only been a decade for your hospital to create fall prevention protocols. Have they done that?

The Johns Hopkins Fall Risk Assessment Tool (JHFRAT) is the intellectual property of the Johns Hopkins Healthcare System and may not be used without a license.(So you're screwed trying to evaluate yourself.)

• perturbations (68 posts to January 2013)

Predictive Validity of the Johns Hopkins Fall Risk Assessment Tool for Older Patients in Stroke Rehabilitation

by Seungho Hong ¹, Ji-Sook Kim ² and Young-Ah Choi ^1,*

¹

Department of Rehabilitation Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea

²

Department of Nursing, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon 21431, Republic of Korea

^*

Author to whom correspondence should be addressed.

Healthcare 2024, 12(7), 791; https://doi.org/10.3390/healthcare12070791 (registering DOI)

Submission received: 21 February 2024 / Revised: 21 March 2024 / Accepted: 2 April 2024 / Published: 6 April 2024

(This article belongs to the Special Issue Fall Prevention and Geriatric Nursing)

Abstract

The aim of this retrospective, cross-sectional, observational study was to assess the frequency of falls and evaluate the predictive validity of the Johns Hopkins Fall Risk Assessment Tool (JHFRAT) among patients aged ≥65 years, transferred to the rehabilitation ward of a university hospital. The predictive ability was assessed using receiver operating characteristic curve analysis, and the optimal threshold was established using the Youden index. We analyzed the overall cohort (N = 175) with subacute stroke and the subgroup with a low unaffected handgrip strength (HGS; men: <28 kg, women: <18 kg). Overall, 135/175 patients (77.1%) had a low HGS. The fall rate was 6.9% overall and 5.9% for patients with a low HGS. The JHFRAT predictive value was higher for patients with a low HGS than that for the overall cohort, but acceptable in both. The optimal cutoff score for the overall cohort was 11 (sensitivity, 67%; specificity, 68%), whereas that for the subgroup was 12 (sensitivity, 75%; specificity: 72%). These results are expected to aid nurses working in rehabilitation wards in more effectively utilizing JHFRAT outcomes for post-stroke older patients with a low HGS and contribute to the development of more appropriate fall prevention strategies for high-risk patients in the future.

 

Stroke patients will have access to “the best possible chance at full recovery”, thanks to a link-up between the Bermuda Hospitals Board and Johns Hopkins Medicine.

And you really think you are going to be one of the lucky ones in either of these two categories? 

A 12% chance of getting fully recovered using tPA and only a 10% chance getting fully recovered by rehab.

Stroke patients will have access to “the best possible chance at full recovery”, thanks to a link-up between the Bermuda Hospitals Board and Johns Hopkins Medicine.

The move, welcomed as a “dream come true” by campaigners, will see a primary stroke centre established in Bermuda, with accreditation for acute stroke care in place by 2021.
The clinical affiliation with the Maryland-based medical institute will also include improvements in psychiatric care, a continuing medical education programme for physicians in Bermuda and a residency programme.
Michael Richmond, Chief of Staff at the BHB, told a press conference: “Stroke treatment and rehabilitation is a key focus. We have four to five stroke cases come to the hospital per week.
“We want to ensure we are giving every stroke patient the best possible chance at full recovery, and also identifying people at risk even earlier to try and prevent one altogether.
“We are also looking at psychiatry for opportunities to improve and find more effective ways to structure and deliver our services.”
Dr Richmond said
 the aim was to provide treatment that matches “the best of the best”.( The best right now is a complete failure at getting anywhere close to 100% recovery. This is total wishful thinking.)
The agreement with Johns Hopkins will cost $1.6 million over two years.
Mark Selley, chairman of the Bermuda Family Stroke Association, said of the plans for a stroke centre: “It would be like a dream come true.”
Mr Selley said that he had lobbied for 26 years for a stroke unit that also deals with road traffic accidents and neurological problems, but that they were “placed on the back burner”.
He added: “I am happy to see this arrangement. If the BHB can team up with Johns Hopkins, we would be so far ahead in the game.”
Mr Selley pointed out that the longer it took for stroke patients to get the help needed, the less likely they were to recover.
He said rehabilitation by trained specialists was important in the first few days after a stroke.
“Like chemo is key to cancer treatment, rehab is key to stroke treatment,” he said.
Mr Selley said a local centre that addressed all the needs of a stroke patient would also reduce travel costs.
Mr Richmond said quality access to education for doctors was also an important part of the agreement.
He said: “Our Continuing Medical Education programme is now accredited by one of the world’s best known and highly respected healthcare providers, and our first CME was held last night.”
Venetta Symonds, CEO of the BHB, said: “I’m excited that we are on this journey to improve on-island care for our families, friend and communities with them.
“It is BHB’s vision to deliver exceptional through strong partnerships and support a healthy community.
“We ran a robust and lengthy RFP process for our clinical affiliate and six highly acclaimed hospitals applied and went through extensive review.
“Johns Hopkins won not only due to their quality and status in the healthcare world, but their deep affinity to and understanding of Bermuda.”
Mohan Chellappa, executive vice-president and president of Global Ventures, Johns Hopkins Medicine International, said: “We are honoured to contribute to the Bermudian healthcare journey.
“Johns Hopkins Medicine’s mission is to improve the health of the community and the world by setting the standard of excellence in medical education, research and patient care. And the unique community of Bermuda holds a special place in our hearts at Johns Hopkins.”
He pointed out that one of Johns Hopkins’ best doctors, Malcolm Brock, was from Bermuda.
He said: “We will support BHB staff with education and training and, together, we’re now in the process of establishing a primary stroke centre and preparing for accreditation in the area of acute stroke care in 2021.”
The affiliation includes a programme for medical doctors who have graduated from an accredited medical school and are completing additional specialist training at Johns Hopkins.
Those doctors will complete four-week rotations to Bermuda to perform short-term clinical and quality improvement projects.
Dr Chellappa said: “Our clinical affiliation with Bermuda Hospitals Board is an important part of Johns Hopkins’s vision to enhance healthcare around the world, by sharing our latest clinical advances and research findings in a way that contributes to local healthcare needs and goals, for many years to come.”

Johns Hopkins receives $50M gift to transform stroke diagnosis, treatment, rehabilitation

Unless they can articulate a strategy and exactly which problems in stroke they are trying to solve, this will be a total waste of money and time.
https://hub.jhu.edu/2018/02/01/johns-hopkins-stroke-institute-uae-gift/

Sheikh Khalifa Stroke Institute, funded by gift from the United Arab Emirates, will bring together experts in neurology, rehabilitation, biomedical engineering, and patient safety to address a significant global health challenge

Video: Hopkins Medicine

By Hub staff report
/ Published 2 hours ago

Johns Hopkins and the United Arab Emirates Embassy in Washington, D.C., today announced a new institute for stroke research and clinical care funded by a $50 million gift from the UAE.
The Sheikh Khalifa Stroke Institute will enable top clinician-scientists at Johns Hopkins to build on their pioneering work in neurology and neurosurgery, leveraging advances in biomedical engineering, artificial intelligence, and precision medicine to better diagnose, treat, and restore function to stroke patients.

About one-third of people who have strokes die each year, accounting for 5.5 million people worldwide. Of the survivors, two-thirds leave the hospital with a disability.

The gift, believed to be the largest ever for a stroke-specific initiative, was announced this afternoon at an event in New York City, where speakers included Johns Hopkins University President Ronald J. Daniels; Paul Rothman, dean of JHU's medical faculty and CEO of Johns Hopkins Medicine; philanthropist, Johns Hopkins alumnus, and former New York City Mayor Michael R. Bloomberg; and Yousef Al Otaiba, UAE Ambassador to the U.S.
"We are grateful for the UAE's gift, which enables us to leverage our considerable strengths in neurology, physical medicine, and rehabilitation—in combination with our expertise in biomedical engineering and patient safety—to develop new tools for stroke diagnosis, treatment, and recovery," Rothman says. "These efforts will improve the health of millions of people in Baltimore, the UAE, and around the world."
The new institute, with locations in Baltimore and Abu Dhabi, builds upon Johns Hopkins' leadership in the treatment of stroke and other neurological conditions. It will house two centers of excellence around which new research and patient care efforts will be designed:

• The center of excellence in stroke detection and diagnosis will focus on both analyzing the genetic underpinnings of stroke and developing new interventions that might include digital neurological exams or automated bedside diagnosis, or using imaging in new ways to better understand stroke.
• The center of excellence in stroke treatment, recovery, and rehabilitation will focus on developing new approaches to get blood vessels to regrow, delivering drugs and medications past the blood-brain barrier, and stimulating the brain to coax it to relearn movement post-stroke.

About one-third of people who have strokes die each year, accounting for 5.5 million people worldwide, according to the World Health Organization. Of the survivors, two-thirds leave the hospital with a disability, the U.K. Stroke Association reports.
"This new institute will not only generate better outcomes for stroke patients in the UAE and the U.S. but will also strengthen opportunities for collaboration between UAE and U.S. scientists and researchers," Otaiba says. "We are grateful to Johns Hopkins for their continued leadership in patient-centered medicine and are proud of our longstanding partnership."
The Sheikh Khalifa Stroke Institute will be directed by Justin McArthur, professor and director of neurology at Johns Hopkins.
"Standard clinical approaches to stroke do not leverage new knowledge about brain repair, neural plasticity, or learning, and treatment options for stroke patients are extremely limited," McArthur says. "But with this support from the UAE, we will be able to really bring stroke research and patient care to a new level."
Added Pablo Celnik, an expert in brain injury rehabilitation who directs the Johns Hopkins Department of Physical Medicine and Rehabilitation: "We are particularly excited to innovate how we care for patients with stroke, initiating recovery and novel rehabilitation strategies from the very onset of the disease."
Johns Hopkins and the UAE have a longstanding partnership dating back several decades. Johns Hopkins has provided specialized care to thousands of Emiratis since the 1970s and has helped build and improve overall health care delivery in the UAE by assisting with management and oversight of three of the UAE's major hospitals: Tawam, Al Rahba, and Corniche. In 2012, The Johns Hopkins Hospital and the UAE dedicated the Sheikh Zayed Tower, a state-of-the-art center for adult care at Johns Hopkins made possible through a gift from His Highness Sheikh Khalifa bin Zayed Al Nahyan, president of the UAE.

Posted in Health
Tagged stroke, philanthropy, interdisciplinary research

New Hope To Recovery For Severe Stroke Patients

There are numerous things wrong with this article, will discuss inline. 

New Hope To Recovery For Severe Stroke Patients

While more people are surviving strokes, many still face long-term disability. But Johns Hopkins research finds promising ways to retrain the brain and regain independence. Here’s what experts have learned about the power of physical rehab.

RESEARCH SHOWS

Another Potential Key to Stronger Stroke Recovery

In the research, Johns Hopkins expert Steven Zeiler, M.D., Ph.D. and colleagues also found that lower levels of a protein called parvalbumin indicated that the premotor cortex had rewired after stroke. Parvalbumin marks the activity of a special class of nerve cells called inhibitory interneurons. Low levels of parvalbumin, and therefore lowered levels of inhibitory activity, is thought to help uninjured parts of the brain take over the injured parts, say researchers. This finding suggests that reducing inhibition in certain parts of the uninjured post-stroke brain (perhaps by using different medications and/or electrical stimulation) might promote recovery.

The good news about stroke: More people are surviving the initial stroke. The bad news about stroke: More people are surviving the initial stroke with disabilities which might have been minimized if they had received the kind of early, intensive physical rehabilitation that researchers find can improve function and reduce long-term disability. In fact, as many as 60 percent are left with diminished use of an arm or leg.
“When we speak about recovery we’re really talking about how the nervous system adapts to the brain missing a part of functioning tissue,” explains Johns Hopkins expert Steven Zeiler, M.D., Ph.D. “We’ve done all we could in the acute period(bullshit, you have done fucking nothing for the neuronal cascade of death), but the damage is done and it’s irreversible.” The question then becomes, “How do you get the remainder of the nervous system to adapt?” In other words, can we get other parts of the brain to pick up the slack? Turns out that yes, we can.

Since Pedro Bach-y-Rita fully recovered with only a partial brain then our stroke medical 'professionals' can duplicate that! Way back in 1958 so plenty of time to analyze and create 100% recovery protocols!

Brainstem stroke recovery How Pedro recovered in here. 

Retraining the Brain

A groundbreaking Johns Hopkins study from Zeiler and his colleagues confirmed what clinicians have long suspected—we can rewire the brain so that one part takes over functions typically handled by another, now damaged, area.
In studies conducted with mice, the researchers first taught the mice a special way to reach for food. The task is typically directed by a part of the brain called theprimary motor cortex, which is involved in physical coordination. Then they gave the mice mild strokes that damaged this motor cortex(NO testing of very damaging strokes, limited applicability to real life. In my case most of the motor cortex is dead, so start testing for dead brain rehab!). As expected, the mice could no longer perform the reaching task with their pre-stroke level of precision. Two days after the stroke, however, researchers began retraining the mice and, after a week, the mice performed the task just as well as before the stroke.
The damaged part of the brain hadn’t recovered, says Zeiler. Instead, another part of the brain called the medial premotor cortex took over. To show that, researchers gave the mice strokes in that part of the brain and saw the reaching ability again disappear. But, once again, the mice relearned the task as yetanother part of the brain stepped in to handle the job of the medial premotor cortex.
In a similar study, the researchers found that the earlier retraining started, the better. “If you retrained the mice after a one-day delay they got better, but after a seven-day delay they didn’t improve,” Zeiler says.
Johns Hopkins’ Kata Project, a collaboration between neuroscientists, engineers, animal experts, artists and entertainment industry experts, has designed an immersive experience for post-stroke patients who will try to “swim” as a virtual dolphin named Bandit. Upcoming clinical trials will determine if this unique experience helps patients recover motor function faster than the current conventional treatment of repetitive exercises.

The Power of Stroke Rehab

The take-home message of the research, says Zeiler, is that “early and intense” rehabilitation—even while still hospitalized—is critical in stroke recovery. Unfortunately, that’s not always the standard practice, he says. “As a medical community we need to push for immediate and intense change in rehabilitation.” (Why the hell not an intense change in stopping the neuronal cascade of death?)
Rehab paired with healthy living will help stroke recovery and help prevent a second stroke. If you experience an ischemic stroke (caused by a lack of blood flow to a part of the brain), your doctor will recommend aspirin or another anti-clotting medication, Zeiler says. If you have atrial fibrillation, talk to your doctor about an anticoagulation medication such as warfarin. Other smart steps to take:

• Maintain healthy blood pressure and cholesterol levels, which differ depending on your age and medical history.
• Eat a Mediterranean-type diet: high in olive oil, legumes, cereals, fruits, and vegetables and low in saturated fat, cholesterol, and sodium.
• Get moderate physical exercise such as brisk walking, jogging, cycling, or swimming for 30 to 60 minutes at least four days a week.
• Aim for a healthy weight, including a waist circumference of less than 31.5 inches for women and 37 for men.