Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Showing posts with label older. Show all posts
Showing posts with label older. Show all posts

Thursday, March 11, 2021

Your Eyes May Signal Your Risk for Stroke, Dementia

You'll have to ask your doctor what the definition of older is.

Your Eyes May Signal Your Risk for Stroke, Dementia 

Your Eyes May Signal Your Risk for Stroke, Dementia

THURSDAY, March 11, 2021 (HealthDay News) -- Your eyes may be a window into the health of your brain, a new study indicates.

Researchers found that older adults with the eye disease retinopathy were at increased risk of having a stroke, as well as possible symptoms of dementia. And on average, they died sooner than people their age without the eye condition.

Retinopathy refers to a disease the retina, the light-sensing tissue at the back of the eye. It's often caused by diabetes or high blood pressure, both of which can damage the small blood vessels supplying the retina.

Retinopathy can lead to vision changes, such as trouble reading or seeing faraway objects. In the later stages, the damaged blood vessels may leak and cause visual disturbances like dark spots or cobweb-like streaks, according to the U.S. National Eye Institute (NEI).

Studies have linked more severe retinopathy to a higher stroke risk -- possibly because both involve diseased blood vessels.

In the new study, researchers found that people with signs of retinopathy were twice as likely to report a history of stroke, versus those with no evidence of the eye disease. Similarly, they were 70% more likely to report memory problems -- a potential indicator of dementia.

Over the next decade, people with the most severe retinopathy faced a two to three times higher risk of dying.

It's not clear whether retinopathy actually foretells a future stroke or memory issues, said lead researcher Dr. Michelle Lin, an assistant professor of neurology at the Mayo Clinic in Jacksonville, Fla.

Study participants were asked about stroke history and memory problems at the same time they were evaluated for retinopathy. It's not clear which conditions came first, Lin said.

The next step, she added, is to follow patients with retinopathy over time, to see whether the condition predicts higher stroke risk -- and whether detecting retinopathy makes a difference in that risk.

Lin will present the findings at the American Stroke Association's annual meeting, being held virtually March 17-19. Studies reported at meetings are generally considered preliminary until they are published in a peer-reviewed journal.

The results are based on more than 5,500 U.S. adults who took part in an ongoing government health study. All underwent retinal scans to look for retinopathy.

Nearly 700 were found to have the eye condition, while 289 had a history of stroke, and about 600 reported memory problems.

On average, people with retinopathy had heightened risks of stroke and memory issues -- even after age, diabetes and high blood pressure were taken into account.

"It seems like there's something about retinopathy itself," Lin said. That is, the eye disease may give insight into what's happening in the blood vessels of the brain.

"It's really true that the eye is the window to the brain," she said.

Lin encouraged people with retinopathy to work with their doctor to get control of their risk factors for cardiovascular disease, which includes stroke and heart disease. That means reining in conditions like high blood pressure, diabetes and high cholesterol.

Those measures are also key in limiting vision loss from retinopathy. Beyond that, injectable medications and laser surgery are options for more severe cases, according to the NEI.

The findings support adding retinopathy to the list of factors doctors consider in gauging patients' stroke risk, according to Daniel Lackland, a volunteer expert with the stroke association.

That's, in part, because detecting retinopathy is fairly simple, said Lackland, who is also a professor of epidemiology at the Medical University of South Carolina.

"And then we can work on strategies for preventing a stroke, if a person seems to have a high risk," Lackland noted.

If people are already being treated for conditions like high blood pressure, would a retinopathy diagnosis change anything? Maybe not, though Lin said patients could be screened for memory impairment, or possibly referred for a brain MRI to look for tissue damage or problems with the blood vessels.

On the flip side, Lin said, people with cardiovascular risk factors should see an ophthalmologist to check their eye health.

More Information

The U.S. National Eye Institute has more on retinopathy.

SOURCES: Michelle Lin, MD, assistant professor, neurology, Mayo Clinic, Jacksonville, Fla.; Daniel Lackland, DrPh, professor, epidemiology, Medical University of South Carolina, Charleston, and volunteer expert, American Stroke Association; American Stroke Association virtual annual meeting, March 17-19, 2021

 

Wednesday, June 15, 2016

Senior moments explained: Older adults have weaker clutter control

Is this a potential reason for your memory problems instead of the stroke?
http://medicalxpress.com/news/2016-06-senior-moments-older-adults-weaker.html

A new study from the Georgia Institute of Technology finds that older people struggle to remember important details because their brains can't resist the irrelevant "stuff" they soak up subconsciously. As a result, they tend to be less confident in their memories.
Researchers looked at from EEG sensors and saw that older participants wandered into a brief "mental time travel" when trying to recall details. This journey into their subconscious veered them into a cluttered space that was filled with both relevant and . This clutter led to less confidence, even when their recollections were correct. Cluttering of the is one reason are more susceptible to manipulation, the researchers say. The study appears online in the journal Neuropsychologia.
Researchers showed older adults (60 years and up) and college students a series of pictures of everyday objects while EEG sensors were connected to their heads. Each photo was accompanied by a color and scene (e.g., living room). Participants were told to focus on one and ignore the other. An hour later, they were asked if the object was new or old, and if it matched the color and the scene.
Neither age group was very good at recalling what they were told to ignore. Both did well remembering the object and what they were supposed to focus on.
"But when we asked if they were sure, older people backed off their answers a bit. They weren't as sure," said Audrey Duarte, the associate professor of psychology who led the Georgia Tech study.
She and the researchers noticed differences in brain activity between the young and old. Older adults' brains spent more time and effort trying to reconstruct their memories.
"While trying to remember, their brains would spend more time going back in time in an attempt to piece together what was previously seen," she said. "But not just what they were focused on—some of what they were told to ignore got stuck in their minds."
Duarte uses a cocktail party as an example. Two older people are talking to each other. And even though they're only concentrating on the conversation, their brains absorb the other noise in the room.
"When it's time to remember the conversation, they may struggle a bit to recall some details. That's because their brains are also trying to decipher the other noises," she said. "What music was playing? What was the couple next to them saying? That extra stuff shouldn't be in their memories at all, but it is. And it negatively impacts their ability to clearly remember the conversation."
Younger people were quicker to recall details and used less brain power. The irrelevant information was never stored in the first place, which kept their memories relatively clutter-free. And that's why they were more confident than the older participants when remembering relevant details.
A lack of confidence, Duarte said, can lead to manipulation.
"If someone tells you that you should remember it one way, you can be more easily persuaded if you lack confidence," she said. "This memory clutter that's causing low confidence could be a reason why are often victims of financial scams, which typically occur when someone tries to trick them about prior conversations that didn't take place at all."
More information: "Age-related deficits in selective attention during encoding increase demands on episodic reconstruction during context retrieval," Neuropsychologia, 2016.

Journal reference: Neuropsychologia search and more info website
Provided by: Georgia Institute of Technology search and more info

Sunday, February 14, 2016

Health goes downhill when older adults stop driving

My doctor told me nothing about when or how I could get back to driving. Didn't even tell me anything about whether he had to report my driver license to the state as a result of my stroke. He was completely worthless. 2 years later I went on my own to another facility that had driver training,  The problem with that is that you get no practice time, you show up and are put in a car with a spinner knob and are expected to immediately function perfectly.

Is your doctor letting your health slide downhill because s/he has no stroke protocol on how to get back to driving?

Health goes downhill when older adults stop driving

Study shows seniors experience double the risk of depressive symptoms, along with declines in cognition and physical functioning.
Researchers at Columbia University’s Mailman School of Public Health examined the health and well–being of older adults after they stopped driving and found that their health worsened in a variety of ways. In particular, driving cessation nearly doubled the risk of depressive symptoms, while also contributing to diminished cognitive abilities and physical functioning. Findings are published online in the Journal of the American Geriatrics Society. “For many older adults, driving is more than a privilege; it is instrumental to their daily living and is a strong indicator of self–control, personal freedom, and independence,” said Guohua Li, MD, DrPH, Mailman School professor of Epidemiology, the founding director of the Center for Injury Epidemiology and Prevention at Columbia, and senior author. “Unfortunately, it is almost inevitable to face the decision to stop driving during the process of aging as cognitive and physical functions continue to decline.”

Wednesday, November 4, 2015

Resistance Training and White Matter Lesion Progression in Older Women: Exploratory Analysis of a 12-Month Randomized Controlled Trial

You'll have to send your doctor after the exact weight lifting protocol used in this study. Because our fucking failures of stroke associations do not have publicly available research findings.
http://www.ncbi.nlm.nih.gov/pubmed/26456233
Bolandzadeh N1,2,3,4,5, Tam R6, Handy TC7, Nagamatsu LS8, Hsu CL1,3,4,5, Davis JC1,5,9,10, Dao E1,3,4,5, Beattie BL5,11, Liu-Ambrose T1,2,3,4,5.

Abstract

OBJECTIVES:

To assess whether resistance training (RT) slows the progression of white matter lesions (WMLs) in older women.

DESIGN:

Secondary analysis of a 52-week randomized controlled trial of RT, the Brain Power Study.

SETTING:

Community center and research center.

PARTICIPANTS:

Of 155 community-dwelling women aged 65 to 75 enrolled in the Brain Power Study, 54 who had evidence of WMLs on magnetic resonance imaging (MRI) at baseline were included in this secondary analysis.

INTERVENTION:

Participants were randomized to once-weekly RT (1× RT), twice-weekly RT (2× RT), or twice-weekly balance and tone (BAT). Assessors were blinded to participant assignments.

MEASUREMENTS:

WML volume was measured using MRI at baseline and trial completion.

RESULTS:

At trial completion, the 2× RT group had significantly lower WML volume than the BAT group (P = .03). There was no significant difference between the BAT group and the 1× RT group at trial completion (P = .77). Among participants in the two RT groups, reduced WML progression over 12 months was significantly associated with maintenance of gait speed (correlation coefficient (r) = -0.31, P = .049) but not with executive functions (r = 0.30; P = .06).

CONCLUSION:

Engaging in progressive RT may reduce WML progression.

Wednesday, May 13, 2015

Noninvasive Neuromodulation in Poststroke Gait Disorders Rationale, Feasibility, and State of the Art

What is your therapist using from this to help you walk better? I can't tell from this if they have addressed spasticity at all. Spasticity is the reason I can't correct my gait to normal. But why are we allowing such a dangerous modality as walking to be the primary goal? Falling is a common result of walking and falls kill lots of older people each year.
http://nnr.sagepub.com/content/early/2015/05/06/1545968315586464.abstract?
  1. Raffaella Chieffo, MD, PhD1
  2. Giancarlo Comi, MD1
  3. Letizia Leocani, MD, PhD1
  1. 1Scientific Institute Vita-Salute University San Raffaele, Milan, Italy
  1. Raffaella Chieffo, MD, PhD, Neurological Department and Institute of Experimental Neurology—INSPE, Scientific Institute Hospital San Raffaele, Via Olgettina 48, 20133 Milan, Italy. Email: raffaella.chieffo@hsr.it

Abstract

Walking rehabilitation is one of the primary goals in stroke survivors because of its great potential for recovery and its functional relevance in daily living activities. Although 70% to 80% of people in the chronic poststroke phases are able to walk, impairment of gait often persists, involving speed, endurance, and stability. Walking involves several brain regions, such as the sensorimotor cortex, supplementary motor area, cerebellum, and brainstem, which are approachable by the application of noninvasive brain stimulation (NIBS). NIBS techniques, such as repetitive transcranial magnetic stimulation and transcranial direct current stimulation, have been reported to modulate neural activity beyond the period of stimulation, facilitating neuroplasticity. NIBS methods have been largely applied for improving paretic hand motor function and stroke-associated cognitive deficits. Recent studies suggest a possible effectiveness of these techniques also in the recovery of poststroke gait disturbance. This article is a selective review about functional investigations addressing the mechanisms of lower-limb motor system reorganization after stroke and the application of NIBS for neurorehabilitation.

Thursday, September 11, 2014

Effect of tai chi on physical function, fall rates and quality of life among older stroke survivors

How many decades is it going to take to get Tai Chi as a stroke protocol in all stroke hospitals? Unless YOU push this it will be at least 50 years.
http://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J68903&phrase=no&rec=125093
NARIC Accession Number: J68903.  What's this?
ISSN: 0003-9993.
Author(s): Taylor-Piliae, Ruth E.; Hoke, Tiffany M.; Hepworth, Joseph T.; Latt, L. Daniel; Najaafi, Bijan; Coull, Bruce M..
Publication Year: 2014.
Number of Pages: 9.
Abstract: Study examined the effect of a 12-week Tai Chi (TC) intervention on physical function and quality of life. A total of 145 community-dwelling survivors of stroke, aged 50 years or older, were randomly assigned to: (1) Yang style 24-posture short-form TC; (2) Silver Sneakers (SS), a program of strength and range of movement exercises for older adults; or (3) usual care (UC) for 12 weeks. The TC and SS groups attended a 1-hour class 3 times per week, whereas the UC group had weekly phone calls. Physical function was evaluated using the Short Physical Performance Battery, fall rates, and the 2-minute step test. Quality of life was assessed using the Medical Outcomes Study 36-Item Short-Form Health Survey, Center for Epidemiologic Studies Depression Scale, and Pittsburgh Sleep Quality Index. During the intervention, TC participants had two-thirds fewer falls (5 falls) than the SS (14 falls) and UC (15 falls) groups. There was a significant group-by-time interaction for the 2-minute step test. Post hoc tests indicated that the TC and SS groups had significantly better aerobic endurance over time, though not in the UC group. Intervention adherence rates were 85 percent. TC and SS led to improved aerobic endurance, and both are suitable community-based programs that may aid in stroke recovery and community reintegration. Results suggest that a 12-week TC intervention was more effective in reducing fall rates than SS or UC interventions. Future studies examining the effectiveness of TC as a fall prevention strategy for community-dwelling survivors of stroke are recommended.

Monday, August 25, 2014

Association of Cognitive Functioning, Incident Stroke, and Mortality in Older Adults

I would never sponsor research that doesn't solve one of the problems in stroke, like this one. Man, we're wasting time and money doing these.
http://stroke.ahajournals.org/content/45/9/2563.abstract?etoc
  1. Denis A. Evans, MD
+ Author Affiliations
  1. From the Rush Institute for Healthy Aging, Department of Internal Medicine (K.B.R., D.A.E.), Rush Alzheimer’s Disease Center (N.T.A., R.S.W.), Department of Neurological Sciences (N.T.A., R.S.W.), and Department of Behavioral Sciences (R.S.W.), Rush University Medical Center, Chicago, IL; and Department of Medicine, University of Minnesota, Minneapolis (S.A.E.-R.).
  1. Correspondence to Kumar B. Rajan, PhD, Department of Internal Medicine, Rush University Medical Center, 1645 W Jackson Blvd, Suite 675, Chicago, IL 60612. E-mail kumar_rajan@rush.edu

Abstract

Background and Purpose—Stroke increases the risk of dementia; however, bidirectional association of incident stroke and cognitive decline below dementia threshold is not well established. Also, both cognitive decline and stroke increase mortality risk.
Methods—A longitudinal population-based cohort of 7217 older adults without a history of stroke from a biracial community was interviewed at 3-year intervals. Cognitive function was assessed using a standardized global cognitive score. Stroke was determined by linkage with Medicare claims, and mortality was ascertained via the National Death Index. We used a Cox model to assess the risk of incident stroke, a joint model with a piecewise linear mixed model with incident stroke as a change point for cognitive decline process, and a time-dependent relative risk regression model for mortality risk.
Results—During follow-up, 1187 (16%) subjects had incident stroke. After adjusting for known confounders, lower baseline cognitive function was associated with a higher risk of incident stroke (hazard ratio, 1.61; 95% confidence interval, 1.46–1.77). Cognitive function declined by 0.064 U per year before incident stroke occurrence and 0.122 U per year after stroke, a nearly 1.9-fold increase in cognitive decline (95% confidence interval, 1.78–2.03). Both stroke (hazard ratio, 1.17; 95% confidence interval, 1.08–1.26) and cognitive decline (hazard ratio, 1.90; 95% confidence interval, 1.81–1.98) increased mortality risk.
Conclusions—Baseline cognitive function was associated with incident stroke. Cognitive decline increased significantly after stroke relative to before stroke. Cognitive decline increased mortality risk independent of the risk attributable to stroke and should be followed as a marker for both stroke and mortality.

Friday, August 22, 2014

Not only cardiovascular, but also coordinative exercise increases hippocampal volume in older adults

You will need to ask your doctor for what exactly is a coordination exercise and the stroke protocol that goes with it.
http://journal.frontiersin.org/Journal/10.3389/fnagi.2014.00170/full?
  • 1Jacobs Center on Lifelong Learning and Institutional Development, Jacobs University Bremen, Bremen, Germany
  • 2AgeAct Research Center, Jacobs University Bremen, Bremen, Germany
Cardiovascular activity has been shown to be positively associated with gray and white matter volume of, amongst others, frontal and temporal brain regions in older adults. This is particularly true for the hippocampus, a brain structure that plays an important role in learning and memory, and whose decline has been related to the development of Alzheimer’s disease. In the current study, we were interested in whether not only cardiovascular activity but also other types of physical activity, i.e., coordination training, were also positively associated with the volume of the hippocampus in older adults. For this purpose we first collected cross-sectional data on “metabolic fitness” (cardiovascular fitness and muscular strength) and “motor fitness” (e.g., balance, movement speed, fine coordination). Second, we performed a 12-month randomized controlled trial. Results revealed that motor fitness but not metabolic fitness was associated with hippocampal volume. After the 12-month intervention period, both, cardiovascular and coordination training led to increases in hippocampal volume. Our findings suggest that a high motor fitness level as well as different types of physical activity were beneficial to diminish age-related hippocampal volume shrinkage or even increase hippocampal volume.

Introduction

It has repeatedly been shown that physical activity is positively related to brain structure and function (see Kramer et al., 2006; Hillman et al., 2008; Park and Reuter-Lorenz, 2009) as well as cognitive performance (for a review see Etnier et al., 2006) and that it might reduce the risk of developing dementia (Sumic et al., 2007; Erickson et al., 2012). Particularly the hippocampal formation has been in the focus of these studies investigating the positive effect of physical activity on brain volume because this brain structure is thought to be significantly involved in diseases related to memory impairment like, e.g., Alzheimer’s disease (Driscoll et al., 2003; Barnes et al., 2009). Whereas positive correlations between cardiovascular activity and hippocampal volume have been shown, it is unknown whether this applies to other types of physical activity like, e.g., coordination training, as well. With this paper we aim to extend the knowledge about the effects of different physical activity interventions in older adults and its potential to diminish the decline in hippocampal volume during the aging process.

The Hippocampus and its Shrinkage Across the Adult Lifespan

The hippocampal formation as part of the limbic system is located in the medial temporal lobe. It is highly involved in processes of episodic memory formation (Tulving and Markowitsch, 1998; Van Petten, 2004) and spatial navigation (O’Keefe, 1990; Maguire et al., 2000). Both cognitive dimensions are especially vulnerable to performance loss in late adulthood (cf. Hedden and Gabrieli, 2004). Recently, the hippocampus has also been associated with motor sequence consolidation (Albouy et al., 2008). Over the adult lifespan, on average, hippocampal volume shrinks about 0.86% per year, but this development is highly non-linear (Raz et al., 2004b). Whereas for adults below the age of 50 annual hippocampal volume reductions of only 0.51% were observed, adults above the age of 50 revealed a much steeper annual volume decline of 1.18% (Raz et al., 2004b). These volume reductions are mainly attributed to reductions in the neuropil part of the brain structure and – to a smaller extend – to cell body shrinkage and changes in vascularization (Thomas et al., 2012).

Friday, November 15, 2013

Protective Effect of Time Spent Walking on Risk of Stroke in Older Men

At least I'm not older yet. But I'll have to do my nightly walks around the ponds on a regular basis, mainly to try to get a decent knee bend and leg swing. More cigars also. Now if we had legalized marijuana it could be really fun.
http://stroke.ahajournals.org/content/early/2013/11/14/STROKEAHA.113.002246.abstract
  1. S. Goya Wannamethee, PhD
+ Author Affiliations
  1. From the Department of Primary Care and Population Health (B.J.J., O.P., S.G.W.) and Physical Activity Research Group (B.J.J.), UCL, London, United Kingdom; and Division of Population Health Sciences and Education, SGUL, London, United Kingdom (P.H.W.).
  1. Correspondence to Barbara J. Jefferis, PhD, Department of Primary Care and Population Health, UCL, Rowland Hill St, London NW3 2PF, United Kingdom. E-mail b.jefferis@ucl.ac.uk

Abstract

Background and Purpose—Older adults have the highest risks of stroke and the lowest physical activity levels. It is important to quantify how walking (the predominant form of physical activity in older age) is associated with stroke.
Methods—A total of 4252 men from a UK population-based cohort reported usual physical activity (regular walking, cycling, recreational activity, and sport) in 1998 to 2000. Nurses took fasting blood samples and made anthropometric measurements.
Results—Among 3435 ambulatory men free from cardiovascular disease and heart failure in 1998 to 2000, 195 first strokes occurred during 11-year follow-up. Men walked a median of 7 (interquartile range, 3–12) hours/wk; walking more hours was associated with lower heart rate, D-dimer, and higher forced expiratory volume in 1 second. Compared with men walking 0 to 3 hours/wk, men walking 4 to 7, 8 to 14, 15 to 21, and >22 hours had age- and region-adjusted hazard ratios (95% confidence intervals) for stroke of 0.89 (0.60–1.31), 0.63 (0.40–1.00), 0.68 (0.35–1.32), and 0.36 (0.14–0.91), respectively, P (trend)=0.006. Hazard ratios were somewhat attenuated by adjustment for established and novel risk markers (inflammatory and hemostatic markers and cardiac function [N-terminal pro-brain natriuretic peptide]) and walking pace, but linear trends remained. There was little evidence for a dose–response relationship between walking pace and stroke; comparing average pace or faster to a baseline of slow pace, the hazard ratio for stroke was 0.65 (95% confidence interval, 0.44–0.97), which was fully mediated by time spent walking.
Conclusions—Time spent walking was associated with reduced risk of onset of stroke in dose–response fashion, independent of walking pace. Walking could form an important part of stroke-prevention strategies in older people.