Postcards from the Id

Baby-Boomers and Online Social Networking Needs

Interesting article about online social networking, and how baby boomers have different expectations than younger people.  In particular, and not surprisingly, two areas of concern are privacy, and attention-seeking.  From the article:

According to a study to be published in HCI2009 conference 55-65 year-old Finns consider social network sites unsecure. In addition, they consider the behaviour at these sites often inappropriate. According to researchers Vilma Lehtinen, Jaana Näsänen and Risto Sarvas young people, for instance, usually find it natural to publish a personal pictures on the web, but many Finnish baby-boomers consider that inappropriate as self-assertion.

Another idea brought up in the article, related to the above, is that boomers were brought up in a less photo-intensive world, which contributes to the discomfort with the frequent visual images regularly displayed by younger networkers.  Given the importance of social networking in general, and the potential benefits of online sites in facilitating social contact, addressing these issues with respect to boomers would likely provide a number of benefits, whether it be educating older users on security issues, tweaking existing sites for older users, or developing boomer-friendly sites.  I know there are sites out there that market themselves as “40+ sites,” but I’m not sure whether they address the concerns noted in this article.

Better News on the Alzheimer's Front

Yesterday I posted about the increasing difficulty in assessing the early onset of dementia in older adults.  Those results were based on the usual way of assessing dementis - the use of cognitive testing.  I mentioned at the end of the article that medical assessment, such as neuroimaging, may help pick up the slack as a method of early detection, as the science continues to progress in these areas.

Today, I came across this article, which suggests science is heading in exactly that direction.  Researchers have noted the presence of a phosphate in an amino acid is a major cause of Alzheimer's Disease.  The article goes into some detail on the mechanics involved - I simply wanted to point out the speed at which medical research seems to be advancing.  from the article:

In a study published in the Journal of Biological Chemistry on May 15, Dr. Hemant Paudel, his PhD student Dong Han and postdoctoral fellows Hamid Qureshi and Yifan Lu, report that the addition of a single phosphate to an amino acid in a key brain protein is a principal cause of Alzheimer's. Identifying this phosphate, one of up to two-dozen such molecules, could make earlier diagnosis of Alzheimer's possible and might, in the longer term, lead to the development of drugs to block its onset.

The crucial protein, called a tau protein, is a normal part of the brain and central nervous system. But in Alzheimer's patients, tau proteins go out of control and form tangles that, along with senile plaques, are the primary cause of the degenerative disease.

The article goes on to point out the obvious benefit of this knowledge to the process of brain imaging, in terms of early detection.  It also provides new leads for the development of treatments.  Good news, especially when studies like the one I discussed yesterday come out.  In addition, it may just be that I'm a psychic...

Early Detection of Dementia in the Eldery Increasingly Difficult to Assess

Here is an interesting article about the increasing difficulty of assessing dementia in the eldery, compared to thirty years ago.  The article discusses research that suggests older adults today retain far more of their cognitive skill set that used to deteriorate with the onset of dementia, with only the loss of memory remaining a significantly impacted function.   From the article:

Several of the tests previously used to predict which elderly individuals risk developing dementia do not seem to work any longer. The thesis shows that memory loss is the only factor that can still be used to indicate who is at risk, although not among the very old.

The study compared nondemented 70-year-olds examined in the early 1970s with nondemented 70-year-olds examined in the year 2000. The results show that those who were examined in 2000 scored much higher on psychological tests than those examined 30 years earlier. This finding clearly indicates that such tests can no longer be used to predict future dementia. In the early 1970s, several different tests could be used to predict people's risks of developing dementia, but today it seems like psychiatric evaluation of the memory is the only useful test. In addition, it is more difficult to predict dementia the higher the person's level of education, says physician PhD Simona Sacuiu, the author of the thesis.

Unfortunately, the article does not go into details regarding the tests utilized, which would allow for a better understanding of what the researchers saw.  Overall, though, with an increasingly educated population that has seen the demand for cognitive effort increase as well (as Steven Johnson has noted), it makes intuitive sense that slippage caused by dementia would be harder to detect in the early stages.  On the other side, it will be interesting to see if brain inaging will, in the long run, help out in terms of early detection of dementia - hopefully coinciding with an increase in effective interventions.

Fire Up the X-Box, Gramps!

According to this article, older adults who played video games improved their cognitive functioning, particularly their processing speed, and ability to switch rapidly between tasks. This actually isn’t all that surprising, insofar as video games would load heavily on fluid intelligence, otherwise known as performance IQ. As opposed to Verbal IQ (or crystallized intelligence), performance IQ measures the ability of an individual to learn and adapt to novel tasks, including visual-spatial stimuli. Verbal IQ, by contrast, has more to due with acquired knowledge and language. Video games clearly fall into the performance IQ domain, with the heavy emphasis on solving different puzzles along the way, a reliance on performing quickly, and information being provided primarily through visual cues. This sort of task would be particularly novel to older adults, who would have no latent skills in hibernation from childhood, given that this stuff didn’t exist 30 years ago. All kidding aside, this is a good recommendation. Older adults are prone to developing a rigidly of thought as they age, and being exposed to activities like video games is an excellent way for older adults to flex certain mental muscles they may not have used in a long time. Conversely, younger kids would do well to make efforts to engage in activities like reading full-length books, in order to develop attention spans that don’t require the incessant reinforcement provided by video games.

Bright Lighting May Improve Symptoms of Dementia

Thought to be a result of its impact on the circadian rhythm, bright lighting may improve symptoms of dementia in the elderly. Not only that, but symptoms of depression were also positively impacted. From the article:

In an effort to evaluate the effects of circadian rhythm modification on dementia, Rixt F. Riemersma-van der Lek, M.D., of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, and colleagues performed a trial in 12 different elderly group care facilities on 189 facility residents with an average age of 85.8 years. Of the total, 90% were female, and 87% of the subjects already presented with dementia. The trial examined the effects of up to 3.5 years of daily supplementation with bright light and/or melatonin on several different health outcomes, including dementia and sleep disturbances.

In six of the facilities, bright lighting was installed on ceiling fixtures. The lights were turned on every day between nine in the morning and six in the evening. The participants were a part of this trial for an average of 15 months, with a maximum period of 3.5 years. It was found that the bright light had a positive effect on cognitive deterioration by 5% relative to those without the light, while depressive symptoms were reduced by 19%. The increase in functional limitations usually experienced by those with dementia was decreased by a relative 53%.

This looks to be an interesting finding. Of course, additional lighting has already been found to be effective in the treatment of seasonal affective disorder (SAD), so there may be some overlap between the two conditions, at least with respect to mood. Helping people regulate their circadian rhythms, sleep cycles, etc. can also be an effective way to improve overall functioning, and this may be especially true for the elderly, who often sleep more frequently, but less consistently. It’ll be interesting to see if these findings can be replicated, and if so, how we can take advantage of it.

A 115-Year Old Dutch Woman Demonstrates Alzheimer’s is NOT Inevitable

A 115-year old Dutch woman who agreed to donate her body to science showed virtually no signs of cognitive decline, or structural changes associated with memory decline and Alzheimer’s Disease. According to this article, she was tested at the age of 111 with a battery of neurological and psychological assessment measures, and was found to have cognitive functioning that would be considered above-average for a person in the 60-75 age range.

After her death, her brain was examined, and there was no significant evidence of structural deterioration, or other signs associated with the development of dementia. The researchers found she had the same number of brain cells as a healthy 60-80 year old.

What to do with this information? Well, as the article points out, this type of data is extremely useful, as researchers aren’t able to come across it every day. On the other hand, I would imagine that is changing. I would guess that with the improvements in medicine, and the subsequent aging of our population, it will become easier over time to gather data from larger and larger samples of older and older people. While people living to the age of 115 are still quite rare, more and more people are making it past 100, so the data may be on its way.

Once that happens, data can then be collected. What types of variables set these individuals apart, both from those who don’t make it so long, as well as between group differences? The initial data likely will be gathered retrospectively, but eventually longitudinal studies will be possible, as well as true experimental designs. All in good time.

From this report alone, however, we can at least glean that cognitive deterioration is not, in fact, a foregone conclusion (at least through the age of 115). It’ll be interesting to hear about the habits and lifestyle of this woman, and whether that can lead to any additional insights with respect to healthy aging. For example, the article notes she lived independently until the age of 105, and was an “active thinker.” What that means, exactly, would have to be described, but I would assume she was engaged in the world, both cognitively and behaviorally, which would be consistent with what is recommended for healthy aging already. Hopefully more can be learned.

Socializing Has Positive Impact on Cognitions of Elderly Women

This article reviews research indicating significant socializing helps to maintain (or improve) cognitive functioning, and may ward off dementia. The study examined the records of over 2,200 women at least 78 years old, and found that those with higher “social network” scores (based on regular contact with family and friends, as well as availability of said support network) developed dementia at almost a 50% lower rate than those women who were rated as having a lower “social network” score. From the article:

"Finding ways to help older adults remain engaged in productive and enjoyable activities is an important component of successful aging," said Cathleen Connell, Ph.D., head researcher at the Center for Managing Chronic Disease at the University of Michigan. "Not only have social networks been linked to positive physical and mental health outcomes, but also to quality of life."

The article does point out that research conducted in this manner does not solve the “chicken vs. egg” question: Did the women in the study have poor social networks because their cognitive abilities were declining, or did their cognitive abilities decline as a result of low social connectivity? Given the overwhelming evidence demonstrating the importance of social connectivity to positive functioning, it would seem helping older adults maintain social relationships, as well as form new ones, would be of immense benefit to this population. Older women in particular would seem to be vulnerable to isolation, as they live longer than men, and more often outlive their spouse, who I’d imagine would often be one of their primary sources of social support. I’ll close with another quote from the article:

"Our findings indicate that it's important to think about ways to try to reduce the amount of isolation people have even those with families," Crooks said. "It's also important for us to find out what kinds of social support groups we can create for people who are isolated based on extreme age or lack of family."

Regular Exercise Helps Seniors Ward Off Disability

This is research simply confirming what is becoming common knowledge, but in this study, regular-weight seniors and overweight seniors were rated on their level of physical activity - “Active” (at least 60 minutes per week) or “Inactive” (under 60 minutes per week). The study found that the “Active” groups subsequently experienced fewer physical disabilities than their inactive counterparts, regardless of weight (though the normal weight “Active” group experienced the lowest overall number of disabilities). From the article:

The normal-weight physically active seniors reported an average of 303 minutes of exercise per week, compared with an average of 16 minutes for normal-weight inactive seniors. On the other hand, overweight seniors who were physically active reported an average of 251 minutes per week, compared with 12 minutes for the overweight inactive seniors.

After 13 years, the overweight active seniors (average disability score 0.14) had significantly less disability than the overweight inactive (average disability score 0.19) and normal-weight inactive seniors (average disability score 0.22) seniors.

The researchers concluded that being physically active, regardless of body weight, helped lessen disability. Bruce said that public health efforts that promote physically active lifestyles among seniors may be more feasible than those that emphasize body weight to remain healthy.

The article did touch on a problem of getting people to be more active. Essentially, the long-term potential threat of poor health, disability, etc. does not always translate into action on the part of the client. This is nothing new - how many people have been told over and over again to give up smoking, to no avail? I tend to agree with the sentiments expressed here:

Brian Martinson, Ph.D., senior investigator at HealthPartners Research Foundation in Minneapolis, agreed that "it's better to be active than inactive," but said it's often difficult for physicians without specific training to motivate patients to think of the long-term health benefits of exercise and activity.

Physicians should focus some discussions on the health benefits of physical activity because they have the most influence over their patients' behavior," he said. "However, I'm not sure how motivating the health benefits are to people. Most people, unfortunately, exercise because they want to look good in a dress or suit or want to look good for a high school reunion. The aim of decreasing disability long-term may not be enough of a motivator."

Now, I don’t see a problem with people initiating the process of exercise for less noble reasons, such as looking god in a bathing suit. The trick is twofold: getting people to start, then getting people to maintain. Again, this is where the convergence of psychology and medicine will continue to make its impact. While physicians are very good at what they do, the concepts of long-term motivation, facilitating behavior change, addressing relapses, etc. fall squarely into the areas of the psychologist. Mental health professionals need to remain engaged in the process of determining how best to implement all of this important knowledge in a way that positively impacts the lives of others.

Memory Problems in Older Adults Impact Men More than Women

According to this article, the onset of mild cognitive impairment (often considered a potential precursor to Alzheimer’s Disease) afflicts men more than women. Mild cognitive impairment is defined as a display of memory difficulties and other mild cognitive deficits that are above and beyond what would typically be expected, given the person’s age and level of education. Over 2,000 individuals were assessed as part of the study, as well as a family member or other person familiar with the person’s functioning. The researchers found:

* 16.7 per cent of the group had mild cognitive impairment.

* Men were 1.6 times more likely to have mild cognitive impairment than women.

* This statistic was the same regardless of the men's level of education or marital status.

Interestingly, the study also found men and women have the same levels of full dementia. This suggests that while men show signs of impairment earlier, their decline is less steep, compared to women. In other words, there is a delayed progression from normal cognitive functioning to dementia for men, when compared with women.

In addition, the article also mentions other lifestyle factors that influence the onset and progression of cognitive difficulties, including fitness level and diet.

People Happier With Age

At least according to the survey reviewed in this short article. While only 1-33% of 18-year olds described themselves as “happy,” more than half of those over the age of 80 stated they were happy. From the article:

"With age comes happiness. That is, overall levels of happiness increase with age, net of other factors," wrote Yang Yang, a University of Chicago sociologist, in a report on the survey published in the American Sociological Review.

I don’t find these results all that surprising, at least in general. While I think older adults face certain challenges that lend themselves to feeling down (particularly in the context of loss, be it loss of occupation, “empty nest” syndrome, loss of physical abilities, losses in health, etc.), aging also tends to allow for the development of perspective, and maybe a increase in the flexibility of one’s world view. Cognitively speaking, in general people do not seem to be so beholden to their “cognitive rules” regarding their feelings, their attitudes towards themselves, or their attitudes regarding others. As a simple example, I think this is one of the reasons that, everything else being equal, a violence risk marker is age, with those under the age of 25 statistically more likely to act violently than someone over 25. Being able to consider both the long and short term implications of an act, as well as to be able to place it in context, helps to make better decisions, as well as to not respond quite as strongly to all life experiences. Hey, why do you think of all the arts, poets achieve their greatest success at the youngest average age? Because poets are wearing their hearts on their sleeve, and putting their responses to the world on paper in a very visceral, emotional way. As that perspective tempers, the intensity of the poetry lessens. Other forms of art may improve with that technique, but poetry tends to suffer.

Wow, how the heck did I get to poetry from the top of this post? Talk about being tangential! Anyway, I thought the study was interesting, whether you agree with my ramblings or not.