Olive Oil Variety Affects Brain Function and Gut Health: Study

Will this finally get your competent? doctor to have the dietician create diet protocols?

Olive Oil Variety Affects Brain Function and Gut Health: Study

High-Fat Cheese May Have Cognitive Benefit, Study Suggests

 

Your doctor has informed you of the benefits of dairy fat, right?

 Maybe ask about Grana Padano cheese and see how long your doctor has been incompetent!

Study: Aged Cheese Lowers Blood Pressure September 2019

Eating cheese may offset blood vessel damage from salt Article no longer available so have your doctor find it.

Dairy fat from milk, butter, and cheese could actually PREVENT a heart attack September 2021 

Oh no, your doctor is totally fucking incompetent? And you're paying them?

But a more nuanced analysis here:

A Study Linked Cheese to Lower Dementia Risk. Is That Too Good to Be True?

The latest here:

High-Fat Cheese May Have Cognitive Benefit, Study Suggests

Key Takeaways

• A higher intake of high-fat cheese and cream was linked to lower dementia risk in a large Swedish study.
• Low-fat cheese, milk, and butter had no association with dementia risk over 25 years.
• The findings align with data from other studies, challenging long-held assumptions about fat and brain health.

Higher intake of high-fat cheese and cream in midlife was tied to a lower risk of subsequent dementia, a 25-year study in Sweden showed.

Adults who ate 50 g or more of high-fat cheese daily had a 13% lower risk of all-cause dementia (HR 0.87, 95% CI 0.78-0.97) and a 29% lower risk of vascular dementia (HR 0.71, 95% CI 0.52-0.96) compared with those who ate less than 15 g a day, said Yufeng Du, PhD, of Lanzhou University in China, and co-authors.

Those who consumed 20 g or more of high-fat cream daily had a 16% lower dementia risk compared with those who consumed no high-fat cream (HR 0.84, 95% CI 0.72-0.98), the researchers reported in Neurology.

Low-fat cheese, low-fat cream, and other dairy products, including milk (regardless of fat content), fermented milk, and butter, had no significant association with dementia risk.

High-fat cheeses have more than 20% fat and include cheddar, Brie, and Gouda; two slices of cheddar were roughly equal to 50 g. High-fat creams typically contain 30-40% fat and include whipping cream, double cream, and clotted cream.

This study was observational and cannot prove causality, noted co-author Emily Sonestedt, PhD, of Lund University in Sweden. "The most likely interpretation is that high-fat cheese was part of a broader dietary pattern that supported vascular health in this population," she told MedPage Today.

The study results "align with previous research showing that certain fermented dairy products are not harmful -- and may even be beneficial -- for cardiovascular health, which is closely linked to brain health," Sonestedt said.

Nonetheless, the outcomes challenge "some long-held assumptions about fat and brain health," she noted.

The data come on the heels of other research that suggested that the risks associated with high-fat foods may be overstated.

"For decades, public health advice has championed low-fat dairy, a recommendation born from concerns that the saturated fat in whole-fat products would elevate the risk of cardiovascular disease," wrote Tian-Shin Yeh, MD, MMSc, PhD, of Taipei Medical University in Taiwan, in an accompanying editorial.

"More recently, this view has been challenged by publications suggesting that dairy fat may have a neutral association with cardiovascular outcomes, reigniting the controversy," Yeh added. "When the focus shifts from the heart to the brain, the picture becomes even murkier."

The Swedish findings need to be replicated in other populations with varying dietary patterns, she noted.

"To move beyond association and toward causation, randomized trials should test the effects of specific dairy products, such as high-fat versus low-fat and fermented versus non-fermented options, as well as the impact of replacing dairy with high-quality plant-based alternatives on cognitive outcomes," Yeh wrote.

"While the development of dementia requires extended follow-up to capture, trials using cognitive decline or other intermediate outcomes may offer more feasible paths forward," she suggested.

Du and colleagues studied 27,670 participants in the prospective Malmö Diet and Cancer cohort who had baseline dietary assessments that involved a 7-day food diary, a food frequency questionnaire, and a dietary interview.

Participants had a mean baseline age of 58 years, and 61% were female. The researchers identified dementia diagnoses using Swedish National Patient Register data through 2020, validating cases before 2014.

The median follow-up was 24.9 years. During that period, 3,208 incident dementia cases were recorded, including diagnoses of vascular dementia and Alzheimer's disease. High-fat cheese intake was associated with a lower risk of Alzheimer's among APOE4 noncarriers, but not among carriers.

The study had several limitations, the researchers acknowledged. Unmeasured confounding may have influenced outcomes. Diet was assessed only at baseline and changes may have occurred over the follow-up period. The findings are based on Swedish people and may not apply to other populations.

"A major strength of our study is the detailed dietary assessment and validated dementia diagnoses, but we need similar studies in other populations with different eating habits," Sonestedt said.

"For clinicians, the key message is that moderate amounts of high-fat cheese do not appear detrimental to brain health and may fit within an overall healthy diet," she noted.

Third COSMOS study links daily multivitamin supplementation to cognitive benefits

 Does your competent? doctor follow research? Will this be prescribed in your hospital in the next week? NO? Then you don't have a functioning stroke doctor or hospital!

Third COSMOS study links daily multivitamin supplementation to cognitive benefits

Key takeaways:

• The findings are consistent with those from two previous substudies.
• Daily supplementation could be a “safe and accessible” approach to support cognitive function, an expert said.

Perspective from Megan Hilbert, MS, RDN

Daily multivitamin supplementation was linked to benefits in both memory and cognition, according to a study published in the American Journal of Clinical Nutrition.

“Preserving memory and cognition is a major priority for most older adults,” Chirag M. Vyas, MBBS, MPH, an instructor in clinical investigation at Massachusetts General Hospital, told Healio. “This study found that multivitamin supplements show promise as a safe and accessible approach to supporting cognitive function in aging.”

 

Daily supplementation could be a “safe and accessible” approach to support cognitive function, an expert said. Image Source: Adobe Stock

According to Vyas, the findings are consistent with those previously reported in two separately conducted substudies of the Cocoa Supplement and Multivitamin Outcomes Study (COSMOS), which examined the effects of multivitamin supplementation on cognition through telephone- and web-based assessments.

In the latest study, the researchers evaluated a COSMOS subcohort of 573 participants aged 60 years and older — known as COSMOS-Clinic — who conducted in-person cognitive assessments at baseline and at 2 years.

Vyas and colleagues also conducted a meta-analysis that included more than 5,000 nonoverlapping participants across the three substudies “to evaluate the strength of evidence.”

Among COSMOS-Clinic participants, multivitamin supplementation had “modest” beneficial effects on global cognition scores over 2 years, with a mean difference (MD) in standard deviation units (SU) of 0.06 (95% CI, –0.003 to 0.13) compared with placebo. However, they found “a significantly more favorable change” in episodic memory scores (MD = 0.12 SU [95% CI, 0.002-0.23]).

These benefits were not seen in executive function and attention, they said.

Meanwhile, the meta-analysis confirmed clear benefits of multivitamin supplementation on global cognition scores (MD = 0.07 SU; 95% CI, 0.03-0.11) and episodic memory scores (MD = 0.06 SU; 95% CI, 0.03-0.1).

The researchers explained that there is “biological plausibility” behind the findings: “combinations of vitamins and minerals interact with multiple biological pathways that support cognitive health, and nutritional and micronutrient deficiencies in older adults may elevate risk of cognitive decline,” they said.

Vyas and colleagues explained that the study had its limitations. For example, the cohort had “relatively low racial and ethnic diversity,” limiting the generalizability of the findings. Additionally, whether the benefits derived from the multivitamin supplements used in COSMOS — Centrum Silver — can be seen in other supplements is unknown.

Vyas concluded that further research is warranted to determine who would benefit the most from multivitamins, and to identify “the specific micronutrients contributing the most to the observed benefits and to explore the underlying mechanisms.”

References:

• Third major study finds evidence that daily multivitamin supplements improve memory and slow cognitive aging in older adults. https://www.massgeneralbrigham.org/en/about/newsroom/press-releases/multivitamins-improve-memory-and-slow-cognitive-aging. Published Jan. 18, 2023. Accessed Jan. 18, 2023.
• Vyas C, et al. Am J Clin Nutr. 2024;doi:10.1016/j.ajcnut.2023.12.011.

An umbrella review of randomized control trials on the effects of physical exercise on cognition

Did hell just freeze over? Physical activity doesn't provide cognitive benefits?  But you can dispute it for stroke survivors because this was in healthy subjects. Ask your doctor if that is correct?

An umbrella review of randomized control trials on the effects of physical exercise on cognition

• Luis F. Ciria,
• Rafael Román-Caballero,
• Miguel A. Vadillo,
• Darias Holgado,
• Antonio Luque-Casado,
• Pandelis Perakakis &
• Daniel Sanabria 

Nature Human Behaviour volume 7, pages 928–941 (2023)Cite this article

• 3702 Accesses

• 522 Altmetric

• Metrics details

Abstract

Extensive research links regular physical exercise to an overall enhancement of cognitive function across the lifespan. Here we assess the causal evidence supporting this relationship in the healthy population, using an umbrella review of meta-analyses limited to randomized controlled trials (RCTs). Despite most of the 24 reviewed meta-analyses reporting a positive overall effect, our assessment reveals evidence of low statistical power in the primary RCTs, selective inclusion of studies, publication bias and large variation in combinations of pre-processing and analytic decisions. In addition, our meta-analysis of all the primary RCTs included in the revised meta-analyses shows small exercise-related benefits (d = 0.22, 95% confidence interval 0.16 to 0.28) that became substantially smaller after accounting for key moderators (that is, active control and baseline differences; d = 0.13, 95% confidence interval 0.07 to 0.20), and negligible after correcting for publication bias (d = 0.05, 95% confidence interval −0.09 to 0.14). These findings suggest caution in claims and recommendations linking regular physical exercise to cognitive benefits in the healthy human population until more reliable causal evidence accumulates.

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Study shows no significant cognitive benefit of adhering to Mediterranean diets regardless of calorie intake

Since the Mediterranean Diet has zero specificity this research is not repeatable and thus no conclusions can be drawn.

So you've proven this earlier research wrong?

Modified Mediterranean ketogenic diet may improve brain health April 2023 

Mediterranean and MIND diets reduced signs of Alzheimer’s in brain tissue, study finds March 2023

 

Study shows no significant cognitive benefit of adhering to Mediterranean diets regardless of calorie intake

By Pooja Toshniwal PahariaApr 24 2023Reviewed by Lily Ramsey, LLM

In a recent study published in Preventive Medicine Reports Journal, researchers performed a randomized clinical trial (RCT) to investigate whether adhering to the Mediterranean diet (MedDiet) with or without limiting calorie intake could improve cognition.

Study: Effect of Mediterranean diet and Mediterranean diet plus calorie restriction on cognition, lifestyle, and cardiometabolic health: A randomized clinical trial. Image Credit: ElenaEryomenko/Shutterstock.com

Background

Obesity, lifestyle choices including diet and exercise, and cardiometabolic comorbidities elevate the risk of cognitive decline. To date, there are no efficient pharmaceutical therapeutics available to prevent, retard, or manage cognitive deficits.

However, studies have shown that MedDiet and weight loss benefit cognition, and combining the two may enhance cognitive function. However, RCTs have shown inconsistent results, with either a favorable or negligible impact of nutrition on cognition, warranting further research.

About the study

In the present three-arm RCT, researchers evaluated the potential cognitive benefit of adhering to MedDiet with or without limiting calorie intake.

The Building Research in Diet and Cognition study was conducted between January 2017 and October 2020, involving 185 residents of Chicago, aged 55 to 85 years, largely female sex (86.0%), with obesity. The participants were randomly allocated to the MedDiet with calorie limitation (n=72, 25.0% kcal restriction for 5.0 to 7.0% loss of weight) intervention group, MedDiet alone group (n=72), or control group (n=36).

The period of the dietary interventions was eight months, including 26 sessions for the intervention groups and 25 sessions for the control group, and follow-up assessments were performed over 14.0 months.

The primary study outcome was a change in the cognitive assessment scores for attention, information, and processing (AIP); learning, memory, and recognition (LMR); and executive function (EF).

Forensics And Toxicology eBook Compilation of the top interviews, articles, and news in the last year. Download the latest edition

Secondary study outcomes were changes in body weight, cardiometabolic biomarkers, and lifestyle. The team estimated habitual dietary consumption using the Harvard food frequency questionnaires (HFFQS), and physical activity was estimated using a triaxial accelerometer worn on the non-dominant wrist for ≥4.0 days and ≥10.0 hours daily.

To assess cardiometabolic risk, blood pressure, serological levels of low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), total cholesterol, triglycerides (TGs), insulin, glycated hemoglobin (HbA1c), high sensitivity C-reactive protein (hs-CRP), and glucose levels were measured in blood samples provided by the patients.

Individuals were recruited via presentations in senior facilities and advertisements in local neighborhoods, and they underwent telephonic and physical screening before enrollment.

Individuals with body mass index (BMI) ranging from 30.0 to 50.0 kg/m², Mediterranean diet adherence screener score ≤6.0, Montreal Cognitive Assessment (MoCA) scores ≥19.0, and those who could speak in English were included in the analysis.

The team excluded individuals who could not exercise according to the EASY physical activity screener, serological HbA1c values >9.0 at screening, and significant comorbidities such as autoimmune disorders or severe cardiovascular, pulmonary, renal, and hepatic diseases.

In addition, individuals using warfarin, suffering from severe psychiatric conditions, individuals with a history of bariatric surgery, individuals concurrently involved in formal bodyweight reduction programs, and those who participated in cognition-associated research activities in the previous 12.0 months were excluded from the analysis. The MedDiet-adhering individuals received one oz of almonds and three tablespoons of extra virgin olive oil daily.

The theories of social determination and social cognition were used to guide adherence to the study interventions. In addition, participants underwent hands-on (meal preparation) and didactic dietary training. All individuals were advised to attain moderate-vigorous physical activity levels at 150.0 minutes weekly. The control group participants received general health newsletters weekly.

Results

The dietary interventions did not significantly impact the LMR, EF, AIP, or MoCA scores. The mean increase in scores for adherence to the MedDiet plus calorie limitation and MedDiet alone interventions were 6.30 points and 4.80 points, respectively, in relation to the control group (+0.60 points).

The mean reductions in weight among individuals in the MedDiet plus calorie limitation group, the MedDiet alone group, and the control group were 4.60 kg, 2.60 kg, and 0.60 kg, respectively.

The dietary interventions showed no significant influence on the physical exercise and cardiometabolic biomarker levels, although lower fasting insulin levels and lower body weight values were observed in the MedDiet plus calorie limitation group participants compared to the other groups.

Particularly, a significant decrease in visceral adiposity was observed; however, the percentage of total body fat did not differ significantly among the groups post-intervention. Both intervention group participants had similar attendance for group sessions, and 67.0% of the study participants were hypertensive.

Conclusions

The study findings showed that MedDiet adherence with or without calorie limitation had no significant influence on cognition. However, the MedDiet interventions significantly reduced central obesity and body weight and improved dietary quality.

The cognitive benefit of adherence to MedDiet with or without limiting calorie intake could be associated with preventing or retarding pathological cognitive aging instead of maintaining normal cognitive aging.

Alternatively, the strength of the effect could have been lowered due to the use of different cognitive assessment scores instead of one composite score. Moreover, the limited sample size and short duration of interventions could have lowered the impact of the dietary interventions.

Further research must be conducted using objective dietary evaluations, larger sample sizes, and longer intervention durations for accounting for the alteration in the nutritional intake of processed food items in MedDiet.

Journal reference:

• Tussing-Humphreys, L. et al. (2022) "Effect of Mediterranean diet and Mediterranean diet plus calorie restriction on cognition, lifestyle, and cardiometabolic health: A randomized clinical trial", Preventive Medicine Reports, 29, p. 101955. doi: 10.1016/j.pmedr.2022.101955. https://www.sciencedirect.com/science/article/pii/S2211335522002625

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Pooja Toshniwal Paharia

Dr. based clinical-radiological diagnosis and management of oral lesions and conditions and associated maxillofacial disorders.

Cognition Boosted by Thinking Positively About Aging

 How positive can you be when your doctor knows nothing and does nothing to get you 100% recovered?  I'm positive I'm going to live to 100 which means I'll be disabled half my life.

Part of my Hunter S. Thompson journey;
“Life should not be a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside in a cloud of smoke, thoroughly used up, totally worn out, and loudly proclaiming "Wow! What a Ride!”

Therapy gets in the way of living, so I stopped attempting it until somebody comes up with EXACT protocols. I can't waste my time on guidelines.

 I'm not afraid of dying. I'm afraid I haven't been alive enough. It should be written on every school room blackboard: Life is a playground — or nothing.
— "Mr. Nobody," 2009

"Your body is not a temple: It's an amusement park. Enjoy the ride." Anthony Bourdain

Oops, I'm not playing by the polite rules of Dale Carnegie;  'How to Win Friends and Influence People'. 

Telling supposedly smart stroke medical persons they know nothing about stroke is a no-no even if it is true. 

Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke 'leader' will try to ream me out for making them look bad by being truthful, I look forward to that day. 

 The latest here:

Cognition Boosted by Thinking Positively About Aging

Adults with mild cognitive impairment more likely to recover if they held positive age beliefs

by Judy George, Deputy Managing Editor, MedPage Today April 12, 2023

Older adults with mild cognitive impairment were more likely to regain normal cognition if they held positive beliefs about aging, a cohort study showed.

Across 1,716 participants with mild cognitive impairment and a mean baseline age of 78, those with positive age beliefs had a 30.2% greater likelihood of recovery than those with negative age beliefs, reported Becca Levy, PhD, of the Yale School of Public Health, and Martin Slade, PhD, of the Yale School of Medicine, both in New Haven, Connecticut.

This recovery advantage persisted regardless of how severe mild cognitive impairment was at baseline, they said in a JAMA Network Openopens in a new tab or window research letter.

People with positive age beliefs also had a faster transition from mild cognitive impairment to normal cognition (HR 1.26, 95% CI 1.08-1.46, P=0.003) and recovered cognition up to 2 years earlier than people with negative age beliefs.

Nearly half of older adults with mild cognitive impairment can regain normal cognitionopens in a new tab or window. "Little is known about why some recover while others don't," Levy said in a statement. "That's why we looked at positive age beliefs, to see if they would help provide an answer."

"Our previous research has demonstrated that age beliefs can be modified," she added. "Therefore, age-belief interventions at the individual and societal levels could increase the number of people who experience cognitive recovery."

Participants came from the national longitudinal Health and Retirement Studyopens in a new tab or window (HRS), were 65 or older, and had mild cognitive impairment. They had at least one follow-up cognition assessment measured by the Telephone Interview for Cognitive Status (TICSopens in a new tab or window) and a positive age-belief measure assessed by a subscale of the Philadelphia Geriatric Center Morale Scaleopens in a new tab or window, which gauged disagreement with the statement "the older I get, the more useless I feel."

Levy and Slade dichotomized participants based on whether they had positive or negative age beliefs. Age, sex, race, education, marital status, smoking history, APOE status, depression, cardiovascular or diabetes diagnosis, social isolation, sleep issues, and physical inactivity were covariates in their analysis.

The primary outcome was cognitive recovery, defined as the first transition from mild cognitive impairment to normal cognition based on TICS cut points. Seven data collection waves were performed in the study, every 2 years from 2008-2020.

Of 1,716 participants in the primary analysis, 55.5% were women. Most participants (74.2%) were white; 21.5% were Black and 11.5% were Hispanic. About half (51.6%) were married at baseline.

A total of 609 (35.5%) people were in the positive age-belief group and 1,107 (64.5%) were in the negative age-belief group. At baseline, participants in the positive age-belief group were less likely to have chronic disease (77.3% vs 83%), depression (8.3% vs 24.0%), or to often feel isolated (2.4% vs 10.9%) than those in the negative age-belief group (all P<o.05).

In a secondary analysis that included a wider sample of HRS participants with normal cognition at baseline, those with positive age beliefs were less likely to develop mild cognitive impairment over the next 12 years than those with negative age beliefs, regardless of baseline age and physical health.

A limitation is that the study did not examine mechanisms of positive age beliefs and cognitive recovery, Levy and Slade acknowledged. "However, previous studies have reported that cognition is predicted by stress levels and health behaviors, both of which can be improvedopens in a new tab or window by positive age beliefs," they noted.

• Judy George covers neurology and neuroscience news for MedPage Today, writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more. Follow

Disclosures

This study was supported by the National Institute on Aging.

Levy and Slade reported no disclosures.

Primary Source

JAMA Network Open

Source Reference: opens in a new tab or windowLevy BR, Slade MD "Role of positive age beliefs in recovery from mild cognitive impairment among older persons" JAMA Netw Open 2023; DOI: 10.1001/jamanetworkopen.2023.7707.

Effect of Vitamin D on Cognitive Functions in Older Adults: 24-Week Follow-Up Study

So it didn't work. What is your doctors' Plan B improving cognitive functioning? 

Effect of Vitamin D on Cognitive Functions in Older Adults: 24-Week Follow-Up Study

First Published January 1, 2019 Research Article

https://doi.org/10.1177/1533317518822274

Article information

Abstract

The purpose of this study is to assess the effect of vitamin D replacement on cognitive function in older adults. A total of 560 patients who underwent comprehensive geriatric assessment including Global cognitive assessment, Basic Activities of Daily Living (BADL), and Instrumental Activities of Daily Living (IADL) twice in 6-month period were retrospectively reviewed. Oral cholecalciferol was replaced to patients with vitamin D deficiency routinely. In baseline cognitive scores, BADL-IADL scores were lower in the severe deficiency group than in the deficiency and adequate groups (P < .05). With regard to the relation between changes in cognitive functions, BADL-IADL scores on the 6-month versus baseline, no difference was determined in patients with and without dementia (P > .05). Vitamin D replacement may not improve cognitive performance in older adults, even if vitamin D is raised to adequate level, suggesting that longer term replacement therapy may be needed to improve cognitive function.

1-Hour Exercise, 3 Times a Week Boosts Cognition in Older Adults

How is your doctor making sure you can accomplish this post stroke? This is your doctors' responsibility, don't let them weasel their way out of it.
https://www.medpagetoday.com/neurology/dementia/73179?

But no improvement in memory

• by Judy George, Contributing Writer, MedPage Today May 30, 2018

Exercising for 52 hours over a 6-month period may be an optimal dose for cognitive improvement in older adults, a systematic review of 98 randomized clinical trials suggested.

Interventions that averaged 52 hours over a span of 6 months -- averaging about an hour, 3 times a week -- were linked to specific cognitive improvements in adults with and without cognitive impairment, reported Joyce Gomes-Osman, PT, PhD, of the University of Miami Miller School of Medicine, and colleagues in Neurology: Clinical Practice

.

"The constructs of cognition that were most amenable to exercise were processing speed and executive function," Gomes-Osman told MedPage Today. "This is an encouraging result because those two constructs are among the first that start to go with the aging process. "This is evidence that you can actually turn back the clock of aging in your brain by adopting a regular exercise regimen."

Interestingly, statistical associations did not hold for memory improvement, noted Art Kramer, PhD, of Northeastern University in Boston, who was not involved in the study. "Despite the fact that animal studies have found robust memory benefits from exercise, memory benefits were not consistently observed in the human studies that were reviewed."

Gomes-Osman's group searched medical databases in December 2016 for randomized controlled trials that tested the effect of exercise on cognition. After a review of 4,612 relevant studies, they included 98 trials with a total of 11,061 participants in their review. Participants had an average age of 73 and 67.58% were female. Of the total sample, 59.41% of participants were classified as older healthy adults, 25.74% had mild cognitive impairment (MCI), and 14.85% had dementia.

The clinical trials assessed exercises that included walking, biking, dancing, strength training, tai chi, and yoga over spans from 4 weeks to 1 year. Most participants (58.2%) did not exercise regularly before enrolling in a study. Most studies used either high (37.8%) or medium intensity (36.7%) exercise.

Aerobic exercise, strength training, mind-body exercises like yoga and tai-chi, and combinations of exercises all were linked to improved cognitive skills in both healthy individuals and those with MCI. Only the total length of time over a 6-month period was linked to improved cognitive skills, not weekly exercise minutes.

"Although half of the exercise in the studies we assessed was in support of aerobic exercise, it doesn't mean that aerobic exercise necessarily was more effective," said Gomes-Osman. "It just means that more trials have actually studied aerobic exercise."

Within aerobic exercise interventions, the most common exercise was walking, Gomes-Osman noted. "It's encouraging to know that you don't need to be running. If you start walking, you're going to get benefit. But this is not window-shopping; this is walking. It's physical exercise, not just physical activity."

Since most participants did not exercise regularly before joining a trial, this data also "strongly supports that decreasing sedentary behavior is something associated with brain health," Gomes-Osman said.

The effect of exercise on overall cognition is not clear because so few studies have assessed this, she added. And it's possible that future trials -- ones that compare different types of exercise, or evaluate exercise in both physically fit and sedentary people -- may show different results.

Nonetheless, some cognitive benefit is clear. "I believe in giving people knowledge about outcomes," Gomes-Osman said. "If you tell people to be active, they may be less interested overall than if you say 'You can do this, this, this, or this, and you need to keep it up a couple times a week for about 6 months, and then you should get a benefit.' I think that's a better sell for patients."

The study was supported by the Evelyn F. McKnight Institute at the University of Miami Miller School of Medicine.

Gomes-Osman and co-authors disclosed relevant relationships with Neosync, Starlab, Neuronix, Neuroelectrics, Constant Therapy, Cognito, and Novavision.

• Primary Source

  Neurology: Clinical Practice

  Source Reference: Gomes-Osman J, et al "Exercise for cognitive brain health in aging: A systematic review for an evaluation of dose" Neurology Clin Pract 2018; DOI:10.1212/CPJ.0000000000000460.

Lower blood pressure targets for older adults may offer cognitive benefits, study suggests

See how up-to-date your doctor is on this subject.

Lower blood pressure targets for older adults may offer cognitive benefits, study suggests

Emory's Woodruff Health Sciences Center News

An Emory study published in JAMA Neurology journal examined how various systolic blood pressure (SBP) targets for older patients receiving treatment for hypertension were associated with cognitive function and whether racial differences existed in long–term cognitive outcomes.

Systolic blood pressure, the amount of pressure exerted by the heart as it pumps blood throughout the body, is the top or first number in a blood pressure reading.

"The relationship between high blood pressure and the risk for mental decline has long been established. But the ideal systolic blood pressure for older adults has been less clear, with various recommended targets ranging from 120 mm Hg to 150 mm Hg," said lead researcher Ihab Hajjar, MD, MS, associate professor of medicine and neurology at Emory University School of Medicine.

The Eighth Joint National Committee (JNC–8) recommended treating systolic blood pressure (SBP) to a target below 150 mm Hg in older adults, while the Systolic Blood Pressure Intervention Trial (SPRINT) suggested a SBP level lower than 120 mm Hg decreases cardiovascular event rates.

In the observational study, Hajjar and colleagues studied 1,657 cognitively intact older adults from the Health Aging and Body Composition (Health ABC) study. A total of 908 participants were women and 784 were black, with a mean age of 73.7. All participants received treatment for hypertension and were studied for a decade, from 1997 to 2007.

During the Health ABC study, cognition was assessed using the Modified Mini–Mental State Examination (3MSE) four times and the Digit Symbol Substitution Test (DSST) five times. At each visit, participants were classified as having an SBP level of 120 mm Hg or lower, 121 to 139 mm Hg, 140 to 149 mm Hg, or 150 mm Hg or higher based on the mean SBP level of two seated readings.

The Emory researchers found that a greater decline in cognitive scores was associated with patients with SBP of 150 mm Hg or higher and less decline in those with SBP of 120 mm HG or lower. The findings suggest a lower SBP target for black patients may be associated with greater cognitive benefits.

"Overall, our analysis suggests that lower systolic blood pressure levels are associated with greater cognitive protection in older adults," said Hajjar. "A blood pressure below 140 in treated hypertensive older adults is not associated with worsening cognitive function. It also suggests that a lower level is more important in African Americans being treated for hypertension."

Over a 10–year period, the greatest decline in cognitive status was seen in people with SBP levels of 150 mm Hg or higher (adjusted decrease was 3.7 for 3MSE and 6.2 for DSST). Conversely, the least cognitive decline occurred in those with SBP levels of 120 mm Hg or lower (adjusted decrease was 3.0 for 3MSE and 5.0 for DSST).

The results showed significant racial differences in the progression of cognitive function. Black participants had a greater mean 10–year decrease in 3MSE scores (–4.1 [0.4]; P<.001) compared with white participants (–2.6 [0.3]; P<.001; P<.001 for race × year) after adjusting for covariates and baseline performances.

However, similar results were not found with DSST – with the mean 10–year decrease of –5.8 (0.4) for white participants (P<.001) and –4.7 (0.4) for black participants (P<.001; P=.09 for race × year).

Additionally, compared with white participants, black participants had a greater difference between the higher and lower SBP levels in the decrease in cognition.

Hajjar and colleagues advised that future guidelines should consider this racial difference when reviewing or providing recommendations for the management of hypertension.

Cognitive Benefits of Social Dancing and Walking in Old Age: The Dancing Mind Randomized Controlled Trial

I want every single cognitive benefit possible post stroke. What the hell is your stroke department doing to implement this? I bet nothing because your stroke department doesn't read research at all. You're screwed and your stroke department doesn't care, they aren't paid for results.
http://journal.frontiersin.org/article/10.3389/fnagi.2016.00026/full?

Dafna Merom¹*, Anne Grunseit², Ranmalee Eramudugolla³, Barbara Jefferis⁴, Jade Mcneill⁵ and Kaarin J. Anstey³

• ¹School of Science and Health, Western Sydney University, Penrith, NSW, Australia
• ²Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia
• ³Centre for Research on Aging, Health and Wellbeing, The Australian National University, Canberra, ACT, Australia
• ⁴Department of Primary Care and Population Health, University College London, London, UK
• ⁵Early Start Research Institute, School of Education, University of Wollongong, Wollongong, NSW, Australia

Background: A physically active lifestyle has the potential to prevent cognitive decline and dementia, yet the optimal type of physical activity/exercise remains unclear. Dance is of special interest as it complex sensorimotor rhythmic activity with additional cognitive, social, and affective dimensions.

Objectives: To determine whether dance benefits executive function more than walking, an activity that is simple and functional.

Methods: Two-arm randomized controlled trial among community-dwelling older adults. The intervention group received 1 h of ballroom dancing twice weekly over 8 months (~69 sessions) in local community dance studios. The control group received a combination of a home walking program with a pedometer and optional biweekly group-based walking in local community park to facilitate socialization.

Main outcomes: Executive function tests: processing speed and task shift by the Trail Making Tests, response inhibition by the Stroop Color-Word Test, working memory by the Digit Span Backwards test, immediate and delayed verbal recall by the Rey Auditory Verbal Learning Test, and visuospatial recall by the Brief Visuospatial Memory Test (BVST).

Results: One hundred and fifteen adults (mean 69.5 years, SD 6.4) completed baseline and delayed baseline (3 weeks apart) before being randomized to either dance (n = 60) or walking (n = 55). Of those randomized, 79 (68%) completed the follow-up measurements (32 weeks from baseline). In the dance group only, “non-completers” had significantly lower baseline scores on all executive function tests than those who completed the full program. Intention-to-treat analyses showed no group effect. In a random effects model including participants who completed all measurements, adjusted for baseline score and covariates (age, education, estimated verbal intelligence, and community), a between-group effect in favor of dance was noted only for BVST total learning (Cohen’s D Effect size 0.29, p = 0.07) and delayed recall (Cohen’s D Effect size = 0.34, p = 0.06).

Conclusion: The superior potential of dance over walking on executive functions of cognitively healthy and active older adults was not supported. Dance improved one of the cognitive domains (spatial memory) important for learning dance. Controlled trials targeting inactive older adults and of a higher dose may produce stronger effects, particularly for novice dancers.

Trial registration: Australian and New Zealand Clinical Trials Register (ACTRN12613000782730).