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Published on: February 16, 2017
by Dr. Benoit Musant & Dr. Tarke Rajji University of Toronto for The Star:
Everyone can make lifestyle choices to prevent Alzheimer’s dementia, but we’re now exploring a promising approach using technology, rather than pills, to help people at high risk.
In a novel study based in Toronto, we’re testing an intervention that targets brain plasticity, its natural ability to change and adapt. By targeting brain plasticity, and specifically in the frontal lobes of the brain, we aim to improve the resiliency and reserve of the brain to prevent decline in brain function and Alzheimer’s dementia. The frontal lobes are critical for processing new information (e.g. learning a new recipe), and manipulating information (e.g. doing mental calculations), or planning for an event in the future. By improving brain plasticity in the frontal lobes, our goal is to make them more efficient in these tasks.
How do we intend to enhance brain plasticity in the frontal lobes? By combining electrical stimulation to the frontal lobes with computerized brain exercises. Electrical stimulation primes the brain to respond better to these exercises, and the exercises build brain resiliency and reserve.
Companies that sell “brain games” to improve your memory and concentration are trying something similar. Unfortunately, there is no evidence they have much of a real-world effect. Those games train you to get better at the game, but they do not help you in real life to remember people’s names, your shopping list, or balance your chequebook. In contrast, we train you with the brain game, and a coach in the classroom guides you to apply the strategies you learn in these games to your real-word memory problems.
We’re focusing on older adults with conditions that predispose them to develop Alzheimer’s dementia. People with a history of depression, even years earlier, have a higher chance of developing Alzheimer’s dementia later in life. So do those with early symptoms of mild memory loss, called mild cognitive impairment. If we can prevent or delay the start of the dementia in these high-risk people, it will translate into a better quality of life for them, their families and caregivers.
Called the PACt-MD, the study originated at the Centre for Addiction and Mental Health (CAMH), and now involves four of the city’s other leading research hospitals: Baycrest, St. Michael’s, Sunnybrook, and University Health Network (UHN).
Through daily weekday sessions on-site, the study involves eight weeks of brain stimulation and computer-based brain training in people who are at least 60. The stimulation and training happen in group sessions led by a therapist. These exercises target different aspects of memory and thinking.
We’re partway through the study, and some patients are doing spectacularly well. We’ll have to wait until we analyze the results in four years to determine whether these patients are truly benefiting from the intervention itself, or just from the socialization associated with participating in the study: some participants tell us they feel like they’re back in college or university, and have developed ongoing friendships.
But even without access to these high-tech approaches in our study, there are other ways to prevent Alzheimer’s dementia that are backed by research. Socializing and staying mentally active in a variety of ways is beneficial. So is eating well, exercising and quitting smoking. Getting regular checkups and treatment for diabetes or high blood pressure is also important.
We’re starting to see evidence that prevention works: there’s a slowing in the increase in number of new dementias in developed countries, which is attributed to higher levels of education, lower smoking rates, improved diets, and better treatments for diabetes and heart disease.
Still, the problem remains urgent: close to 1 million Canadians are expected to live with dementia by 2031, according to the latest projections. Currently, there’s no cure, although several drugs are available to help with memory loss and other symptoms related to Alzheimer’s dementia.
If you are concerned about early memory loss or have a history of depression, it’s worth talking to your doctor. You may benefit from prevention efforts or from enrolling in a clinical trial such as the PACt-MD study.
If you, a family member or a friend are interested in learning more about the PACt-MD study, please call 416-583-1350 or email firstname.lastname@example.org .
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