Swedish researchers find that a growing number of middle-aged adults between the ages of 50 and 60 appear to be seeking help for memory-related problems — often concerned they are in the beginning stages of dementia — but after testing, they are found to be quite normal.
“We are seeing a growing number of people who are seeking help because of self-perceived cognitive problems, but have no objective signs of disease despite thorough investigation,” said Marie Eckerström, doctoral student at the Institute of Neuroscience and Physiology and licensed psychologist at the Memory Unit of Sahlgrenska University Hospital in Gothenburg.
These patients represent one-third of those coming to the memory unit at the hospital, and clinicians wanted to get an idea of who they are. The memory unit investigates suspicions of early stages of dementia in those who seek help.
For her study, Eckerström followed a few hundred of these patients, both women and men, for an average of four years.
These patients are often highly educated professionals who are relatively young in this context, between the ages of 50 and 60. When tested at the hospital, their memory functions are intact. However, in their daily environment where they are often under pressure to learn new things, they believe something is not right.
The link between self-perceived memory problems and stress was shown to be quite strong. Seven out of 10 in the group had experiences of severe stress, clinical burnout, or depression.
“We found that problems with stress were very common. Patients often tell us they are living or have lived with severe stress for a prolonged period of time and this has affected their cognitive functions to such an extent that they feel like they are sick and are worried about it,” said Eckerström.
“In some cases, this is combined with a close family member with dementia, giving the patient more knowledge but also increasing their concern.”
Perceived memory problems are common and may be an early sign of future development of dementia. Among the study participants who also had deviating biomarkers in their cerebrospinal fluid (beta-amyloid, total-tau, and phospho-tau), the risk of deteriorating and developing dementia was more than double. And yet, the majority of participants showed no signs of deterioration after four years.
“These individuals have no objective signs of dementia. The issue instead is usually stress, anxiety, or depression,” Eckerström said.
Only one in 10 patients with self-perceived memory problems only developed dementia during the study period. And while this is a higher percentage than the population in general, it is still low, according to Eckerström.
“It is not a matter of just anyone who has occasional memory problems in everyday life. It is more a matter of individuals who sought medical attention to investigate whether they are developing serious problems,” said Eckerström.
Source: University of Gothenburg
“Doctors urge me to take my meds. When I don’t, they become agitated. I take their meds to calm them down.” – Brian Spellman Up until…
Children who are suspended from school are more likely to develop a range of mental disorders, such as depression and anxiety as well as behavioral disturbances, according to a new study published in the journal Psychological Medicine.
Researchers at the University of Exeter in England investigated the impact of exclusion from school among the general population and found that suspension may lead to a new onset mental disorder, and that, separately, poor mental health can lead to suspension from school.
The findings show that consistently poor behavior in the classroom is the primary reason for school exclusion, with many students, particularly those in middle and high school, facing repeated dismissal from school. Relatively few pupils are completely expelled from school, but the researchers warn that even temporary exclusions can exacerbate psychological distress.
The researchers assert that identifying and supporting children who struggle in class could prevent suspension and improve their success at school.
“For children who really struggle at school, exclusion can be a relief as it removes then from an unbearable situation with the result that on their return to school they will behave even more badly to escape again,” said Professor Tamsin Ford, a child and adolescent psychiatrist at the University of Exeter’s Medical School.
“As such, it becomes an entirely counterproductive disciplinary tool as for these children it encourages the very behavior that it intends to punish. By avoiding exclusion and finding other solutions to poor behavior, schools can help children’s mental health in the future as well as their education.”
Suspension is more common among boys, secondary school students and those living in socio-economically deprived circumstances. Poor general health and learning disabilities, as well as having parents with mental illness, is also associated with suspension.
The study involved analyzing the responses of more than 5000 school-aged children, their parents and their teachers in the British Child and Adolescent Mental Health Surveys. The research team omitted children who had a previous mental disorder from this analysis.
The findings show that children with learning difficulties and mental health problems such as depression, anxiety, ADHD, and autism spectrum conditions were more likely to be excluded from the classroom. In addition, during the follow-up, the researchers found more children with mental disorders among those who had been excluded from school, than those who had not been excluded.
The researchers conclude that there is a “bi-directional association” between psychological distress and suspension: Children with psychological distress and mental-health problems are more likely to be suspended in the first place but suspension predicted greater levels of psychological distress three years later.
“Although an exclusion from school may only last for a day or two, the impact and repercussions for the child and parents are much wider. Exclusion often marks a turning point during an ongoing difficult time for the child, parent and those trying to support the child in school,” said Claire Parker, a researcher at the University of Exeter Medical School, who carried out doctoral research on the project.
Source: University of Exeter
A new study from Brazil compares the benefit of medicinal therapy against low-intensity electrical brain stimulation for relief of depression.
Specifically, investigators attempted to determine if transcranial direct-current stimulation (tDCS) is a comparable alternative to treatment with antidepressant drugs.
In the clinical trial, researchers at the University of São Paulo’s teaching hospital (HU-USP) and the Psychiatry Institute of Hospital das Clínicas (HC-FMUSP-IP), the largest general hospital in Brazil, compared tDCS to escitalopram (Lexapro), a common antidepressant medication.
André Brunoni, a professor in the Psychiatry Department of the University of São Paulo’s Medical School and colleagues randomly divided 245 patients with depression into three groups.
One group was treated with tDCS plus oral placebo, the second received sham tDCS treatment plus the anti-depressant, and the third received sham tDCS treatment plus oral placebo.
The tDCS treatment was administered in 30-minute sessions for 15 consecutive weekdays, followed by seven once-weekly sessions. Escitalopram was administered at a dose of 10 mg per day for three weeks and 20 mg per day for another seven weeks.
tDCS treatment involves transmission of very mild direct current stimulation via a headband with twin electrodes placed on the patient’s temples. Positioning the electrodes is important so that the current runs through the dorsolateral prefrontal cortex – a brain area that displays diminished activity in depressed people.
In the trial, researchers found that tDCS treatment was less beneficial that oral medications.
“We found that treatment with tDCS was not half as effective as treatment with escitalopram and concluded that transcranial stimulation cannot be recommended as first-line therapy. The anti-depressant is easier to administer and much more effective. On the other hand, tDCS performed better than placebo in our previous studies,” explains Brunoni.
The discovery is important as about 12 -14 percent of the world’s population is estimated to suffer from depression. Moreover, given the ubiquity of the internet it is relatively easy to find self-help websites with videos showing how to administer tDCS at home.
“It’s very striking,” Brunoni said. “These sites that claim to show how to stimulate your brain represent a huge risk for patients with depression.
“‘Do-it-yourself’ solutions are strongly contra-indicated. In fact, they’re dangerous. I expect our study to have an impact on this phenomenon because we’ve proved there are adverse side effects and that it’s not as effective as many people think.”
According to the study, patients who received tDCS treatment presented with higher rates of skin redness, tinnitus (ringing in the ears) and nervousness than the other two groups, and new-onset mania developed in two patients in this group.
Brunoni stressed the importance of not confusing tDCS with other methods such as electroconvulsive therapy (ECT). ECT involves a far stronger current — typically 800 milliamperes, or 800 times the current used in tDCS — and is designed to produce a controlled seizure.
Other differences include the fact that ECT delivers a brief pulse rather than a steady current.
“People with depression display cerebral hypoactivity, especially in this brain region but also in others,” Brunoni said. “The action mechanism of stimulation was believed to increase brain activity in this region, but no such effect has yet been proven.”
Other techniques designed to change the brain’s electrical activity include transcranial magnetic stimulation, transcranial alternating-current stimulation, deep-brain stimulation and focused ultrasound.
“Of these, only transcranial magnetic stimulation and electroconvulsive therapy are currently cleared by the Food and Drug Administration [FDA] for the treatment of depression, and deep-brain stimulation has a humanitarian device exemption for the treatment of obsessive-compulsive disorder,” writes Sarah H. Lisanby, director of the Division of Translational Research at the US National Institute of Mental Health (NIMH), in an editorial in the same issue of the New England Journal of Medicine.
Lisanby believes the study performed in Brazil shows that parameters are needed to measure the functioning of tDCS.
Brunoni agreed. “There are no parameters that enable us to know whether the tDCS dose is right,” he said. “I know two pills are a higher dose than one. Moreover, some drugs can be measured in the bloodstream. The most common example is lithium. You can dose magnetic stimulation. In electrical stimulation, however, it isn’t what you see. It’s a very weak current that can be altered even by anatomical aspects in each patient.”
Brunoni is currently a visiting postdoctoral fellow at the University of Munich in Germany, where he plans to finish analyzing data collected from his clinical trial. He hopes the data will suggest if tDCS works better for a particular patient profile — as some believe those who have never experienced stimulation will show a better response.
He also plans to question the stimulation parameters to discover if a specific type of depression may respond more readily to the treatment.
Study findings appear in the New England Journal of Medicine.
Source: University of São Paulo
When parents divorce often the most important issue, and perhaps the most difficult negotiation, involves the children. Parents typically have strong views on legal and physical custody of the children and how the arrangements should be structured.
New research finds that children who live full time with one parent are more likely to feel stressed than children in shared custody situations. Perhaps surprisingly, this finding persists regardless of the level of conflict between the parents or between parent and child.
Investigators from Stockholm University’s Demography Unit believe habitation with each parent is important because children who spend most of the time away from one parent may lose contact with friends, relatives and even struggle with resources like money.
Previous research has also shown that children may worry about the parent they rarely meet, which can make them more stressed, said Dr. Jani Turunen, a child and adolescent mental health researcher at Stockholm and Karlstad Universities.
Investigators explain that the understanding that children who live full time with one parent are worse psychologically than children in shared physical custody has been previously shown, However, the new study is the first to look specifically at stress.
Shared physical custody is not to be confused with shared legal custody. Shared legal custody only gives both parents the legal right to decisions about the child’s upbringing, school choices, religion, and so on. Shared physical custody means the child actually lives for equal, or near equal, time with both parents, alternating between separate households.
Researchers analyzed data from the Surveys of Living Conditions in Sweden, ULF, from 2001-2003, combined with registry data. Sweden is a country that is often considered a pioneer in emerging family forms and behaviors like divorce, childbearing and family reconstitution.
Turunen believe the progressive Swedish environment may help other countries deal with comparable issues. Her paper appears in the Journal of Divorce & Remarriage.
In the survey, a total of 807 children with different types of living arrangements answered questions about how often they experience stress and how well, or badly, they get along with their parents. The parents were also queried on how well they get along with their former partner.
Researchers discovered children living with only one of the parents have a higher likelihood of experiencing stress several times a week, than children in shared physical custody. This generally applied even if the parents have a poor relationship, or if the children don’t get along with either of them.
Study results conflict with a previous concern that shared physical custody could be an unstable living situation, which can lead to children becoming more stressed. However, many of the earlier concerns were built on theoretical assumptions, rather than empirical research, says Turunen.
What probably makes children in shared physical custody less stressed is that they can have an active relationship with both their parents, which previous research has shown to be important for children’s well-being.
As the relationship between the child and both of its parents becomes stronger, the child finds the relationship to be better and the parents can both exercise more active parenting.
In other words, living with both parents does not mean instability for the children. It’s just an adaptation to another housing situation, where regular relocation and a good contact with both parents equals stability, Turunen said.
Source: Stockholm University
Menopause is a challenging time for many women as hormonal changes can create a cascade of physical and mental health issues. Notably, experts explain that between 40 and 60 percent of women in perimenopause and early menopause face issues with sleep because of this physical change.
The majority also report hot flashes and night sweats, which can be disruptive to falling and staying asleep. Sleep deprivation can influence mood and also increase the risk for serious physical health conditions.
In a new study, researchers from the Mayo Clinic found that low-dose hormone therapy may be effective in easing sleep issues in this population. The goal of the study was twofold: find out how two forms of hormone therapy affect sleep quality and assess the ties between hot flashes, sleep quality and hormone therapy.
The study appears in Menopause: The Journal of The North American Menopause Society.
“Poor sleep quality over time affects more than just mood,” said Virginia Miller, Ph.D., director of Mayo Clinic’s Women’s Health Research Center and the study’s corresponding author.
“Sleep deprivation can lead to cardiovascular disease, among other health risks. There can be serious consequences — mental and physical — if you’re not getting quality sleep over a long period of time.”
The study looked at two forms of hormone therapy — oral estrogen (conjugated equine estrogen) and a patch (17 beta-estradiol) — to find out how their use affected sleep quality.
The participants were part of the Kronos Early Estrogen Prevention Study, and all were recently menopausal women. The women self-reported on the quality of their sleep using the Pittsburgh Sleep Quality Index. They also recorded the intensity of hot flashes and night sweats during this time.
Study participants were found to have improved sleep quality over four years when using low-dose hormone therapy — twice the improvement of those in the placebo group.
Researchers also found that sleep quality improved with changes in hot flashes and night sweats, but Miller said it remains difficult to determine if the low sleep quality is caused by these symptoms or if they are a consequence of poor sleep.
“Menopause affects such a large portion of the population, so it is important to keep researching how we can best promote a woman’s overall health during this phase in her life,” Miller said.
Source: Mayo Clinic
In the largest brain-imaging study of cardiovascular stress physiology to date, researchers have introduced a brain-based explanation of why stress might impact a person’s heart health.
The findings, published in the Journal of the American Heart Association/American Stroke Association, show that as we experience stressful events, our brains produce a distinct pattern of activity that appears to be directly tied to bodily reactions — such as rises in blood pressure — that increase the risk for cardiovascular disease.
“Psychological stress can influence physical health and risk for heart disease, and there may be biological and brain-based explanations for this influence,” said Peter Gianaros, Ph.D., the study’s senior author and psychology professor at the University of Pittsburgh in Pennsylvania.
For the study, the researchers conducted mental stress tests and monitored the blood pressure and heart rates of 310 participants (157 men and 153 women) undergoing an MRI procedure. The mental tests were designed to create a stressful experience by having the participants receive negative feedback as they came up with time-pressured responses to computer challenges.
The participants (aged 30 to 51 years) were enrolled in the Pittsburgh Imaging Project, an ongoing study of how the brain influences cardiovascular disease risk. As expected, the mental stress tests increased blood pressure and heart rate in most of the volunteers compared to a non-stress baseline period.
Using machine-learning, the researchers discovered that a specific brain activity pattern could reliably predict the size of the participants’ blood pressure and heart rate reactions to the mental stress tests.
The brain regions that were especially predictive of stress-related cardiovascular reactions included those that determine whether information from the environment is threatening and that control the heart and blood vessels through the autonomic nervous system.
The research involved middle-aged healthy adults at low levels of risk for heart disease, so the findings may not be applicable to people with existing heart disease. In addition, brain imaging does not allow researchers to draw conclusions about causality.
“This kind of work is proof-of-concept, but it does suggest that, in the future, brain imaging might be a useful tool to identify people who are at risk for heart disease or who might be more or less suited for different kinds of interventions, specifically those that might be aimed at reducing levels of stress,” Gianaros said.
“It’s the people who show the largest stress-related cardiovascular responses who are at the greatest risk for poor cardiovascular health and understanding the brain mechanisms for this may help to reduce their risk.”
Source: American Heart Association
Taking care of an ailing spouse is no easy matter, and the stress many Americans experience as a caretaker is extreme.
Yet University of Buffalo researchers noted that helping behaviors, which are at the core of caregiving, typically relieve stress. Indeed, the caretaking role is paradoxical as the draining demands of caregiving appear to conflict with the uplifting effects of helping.
Resolving that paradox was part of the aim of a new study by Dr. Michael Poulin, an associate professor in psychology and an expert in empathy, human generosity and stress. Poulin and his co-authors found that the strress of caregiving is eased when it is seen to make a difference and is appreciated by the spouse.
The findings of the study, led by Drs. Joan Monin, Yale School of Public Health, Stephanie Brown, Stony Brook University, Kenneth Langa, University of Michigan, and Poulin, appear in the American Psychological Association’s journal Health Psychology.
Poulin said more than 30 years of research shows that being a caregiver is among the most stressful, emotionally burdensome and physically demanding roles a person can take on. Spouses who are caregivers show decreased immune function, increased signs of physiological stress and are at greater risk for physical and mental illness.
Yet other studies, including much of Poulin’s own research, suggest that the act of providing help to somebody is typically stress-relieving and is associated with better emotional and physical well-being.
“The problem is that when you’re a caregiver, not all of your time is spent helping,” says Poulin. “Sometimes all you can do is witness the person’s state while being passively on duty.”
But previous research also confirmed that the act of helping in this context was associated with improving the caretakers’ well-being, a finding that was true even when general caregiving was broken downs into tasks, like feeding or bathing.
“This is what we wanted to get at,” says Poulin. “We knew that something about being helpful is good in these circumstances. But why? Is it just being active? Is doing something better than doing nothing? Or is it that doing something to improve another person’s well-being is what matters?”
The research team conducted two studies with spouses caring for partners with chronic pain.
In the first study, 73 participants reported caregiving activity and their accompanying emotions in three-hour intervals. This allowed the researchers to look at the amount of help given and how much that help pleased the spouse and subsequently affected the caregiver.
The second study involved 43 caregivers who completed a diary at the end of the day that detailed the help they provided and the appreciation they received.
The findings suggest that spouses caring for a partner feel happier and report fewer physical symptoms when they believe their help is appreciated.
“Spending time attempting to provide help can be beneficial for a caregiver’s mental and physical well-being, but only during those times when the caregiver sees that their help has made a difference and that difference is noticed and recognized by their partner,” he said.
“Importantly, this study adds to a growing body of evidence showing that it is important to target emotional communication between spouses in daily support interactions to improve psychological well-being in the context of chronic conditions and disability,” the authors write.
Source: University of Buffalo
New research suggests less than 15 minutes of mindfulness training helps heavy drinkers reduce the amount they drink.
Investigators from University College London found that after an 11-minute training session — and encouragement to continue practicing mindfulness — heavy drinkers drank less over the next week than people who were taught relaxation techniques.
Mindfulness training helps individuals focus, without judgement, on what’s happening in the present moment.
“We found that a very brief, simple exercise in mindfulness can help drinkers cut back, and the benefits can be seen quite quickly,” said the study’s lead author, Dr. Sunjeev Kamboj.
In the study, which appears in the International Journal of Neuropsychopharmacology, researchers brought in 68 drinkers, who drink heavily but not to the point of having an alcohol use disorder.
Half of them were trained to practice mindfulness, which teaches a heightened awareness of one’s feelings and bodily sensations, so that they pay attention to cravings instead of suppressing them.
They were told that by noticing bodily sensations, they could tolerate them as temporary events without needing to act on them. The training was delivered through audio recordings, and only took 11 minutes. At the end of the training participants were encouraged to continue practicing the techniques for the next week.
The other half were taught relaxation strategies, chosen as a control condition that appeared to be just as credible as the mindfulness exercise for reducing alcohol use. The study was double-blind, meaning neither experimenters nor participants knew which strategy was being delivered.
“We used a highly controlled experimental design, to ensure that any benefits of mindfulness training were not likely explained by people believing it was a better treatment,” said co-author Dr. Tom Freeman.
The mindfulness group drank 9.3 fewer units of alcohol (roughly equivalent to three pints of beer) in the following week compared to the week preceding the study, while there was no significant reduction in alcohol consumption among those who had learned relaxation techniques.
“Practicing mindfulness can make a person more aware of their tendency to respond reflexively to urges. By being more aware of their cravings, we think the study participants were able to bring intention back into the equation, instead of automatically reaching for the drink when they feel a craving,” Kamboj said.
Severe alcohol problems are often preceded by patterns of heavy drinking, so the researchers are hopeful that mindfulness could help to reduce drinking before more severe problems develop.
“Some might think that mindfulness is something that takes a long time to learn properly, so we found it encouraging that limited training and limited encouragement could have a significant effect to reduce alcohol consumption,” said co-author Dr. Damla Irez.
Source: University College London