TIME Diet/Nutrition

Omega-3 Supplements Don’t Improve Memory: Study

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Popping fish oil pills may not be a boon to the brain, according to the latest study

The data has been building, slowly but surely, and now the strongest study yet may finally dispel the myth that taking omega-3 supplements can protect the brain from cognitive decline and dementia.

The connection between omega-3s, the fatty acids found most abundantly in foods like fish, and brain function emerged from large studies of people who answered questions about their diet and then performed tests on things like recall, memory and executive thinking functions. That data strongly suggested that people eating more omega-3s, including those who took supplements, tended to score higher on cognitive tests.

MORE: Omega 3s Reality Check: Are We Over-Exaggerating Their Benefits?

But in the latest study, published in JAMA, researchers found no such benefit when they explored the supplement in a group of 3,073 elderly people at risk of developing macular degeneration, a condition that causes vision loss with age. What set this study apart was the fact that the scientists did not rely on the participants’ recall of what they ate, but randomly assigned them to take omega-3 pills or a placebo for five years. All of the participants were tested on cognitive skills at the start of the study and came back every two years for additional assessments.

During that time, study leader Dr. Emily Chew, deputy director of the division of epidemiology and clinical applications at the National Eye Institute (part of the National Institutes of Health) says, she did not see significant differences in the cognitive scores between the two groups.

It’s possible that in Chew’s study, it was too little, too late in terms of seeing any effects of the omega-3s on cognition in this group of elderly participants. Something like omega-3 fatty acids may take years or decades to exert an effect, just as the decline associated with dementia takes place over a long time course. “The bottom line is that supplements are not the fast cure,” says Chew. “You are what you eat, and you’ve got to eat well. Maybe it was too late for some of the people in our study.”

MORE: Omega-3 Supplements Don’t Lower Heart Disease Risk After All

There are other important things to consider about Chew’s study, however, beginning with the fact that all of the participants were at high risk of developing macular degeneration. (The study was originally designed to test whether omega-3 supplements and other antioxidants could slow or reverse the vision loss in these patients.) Do people with macular degeneration differ in some ways from the average population? Does their condition make them less likely to respond to omega-3 fatty acids? The answers to those questions aren’t clear yet. Previous studies that have followed healthy participants over six years or also found that people with higher omega-3 intake did not score significantly higher on cognitive tests than those with lower levels.

Does that mean omega-3s aren’t the health-boon they were thought to be? Not necessarily. First, there’s the question of whether omega-3 fatty acids from the diet, from foods such as fatty fish, can have more potent effects on health than supplements. “It looks like high dose omega-3 supplementation is not the same as eating high amounts of omega-3s in a healthy dietary pattern high in marine fish and other beneficial foods and nutrients,” says Frank Hu, professor of nutrition and epidemiology at Harvard T.H. Chan School of Public Health, who was not involved in the study.

The takeaway for now, says Chew, is that it’s more important to adopt a long-term approach to healthy aging as opposed to a quick fix in a bottle of pills. Taking time and effort to live a healthy life, with a nutritious diet and regular exercise, may be far more potent when it comes to maintaining mental abilities than any supplement could accomplish. “Supplements cannot replace a healthy dietary pattern,” says Hu. “If you eat a healthy diet with high amounts of fruits, vegetables and marine fish, you probably don’t need to take fish oil supplements. The overall dietary pattern is more important than a single nutrient.”

TIME mental health

Study Finds That Women Slip Into Dementia Faster Than Men

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The study has no medical implications quite yet

Women who develop slight memory deficits and mental decline slide faster toward dementia than men, according to a new study presented Tuesday at the Alzheimer’s Association International Conference in Washington.

Researchers were quick to note that the study’s findings aren’t reflective of a difference in brain chemistry between genders and have no medical implications just yet. “All we can say at this point is that there appears to be a faster trajectory for women than men” in the direction of dementia, said P. Murali Doraiswamy, a professor of psychiatry at Duke University’s Institute for Brain Sciences and lead author of the study.

The study used cognitive test scores from 398 participants of both genders who were primarily in their 70s. After controlling for outside variables like education and genetics, the researchers found that women’s test scores fell by an average of two points per year, compared to just one point for men. This wasn’t the only negative effect for women: their standard of life—how they performed at home, work, and with family—also fell faster than men.

A vast majority—nearly two-thirds of the five million Americans afflicted with Alzheimer’s disease—are women, which scientists note can be traced to the fact that women live longer, but the reasons for their decline have remained indeterminate.

[New York Times]

 

TIME diabetes

How Diabetes Harms the Brain

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Diabetes can damage a number of organs, from the eyes to the kidneys and the heart. Now there’s fresh evidence that unchecked blood sugar can affect the brain as well, which may lead to drops in cognitive functions

When blood sugar levels start to climb in diabetes, a number of body systems are harmed—and that list includes the brain, since studies have linked diabetes with a higher risk of stroke and dementia. Now, a new study published in the journal Neurology reports that changes in blood vessel activity in the brains of diabetics may lead to drops in cognitive functions and their ability to perform daily activities.

Dr. Vera Novak, associate professor of neurology at Harvard Medical School and Beth Israel Deaconess Medical Center, and her colleagues followed a group of 65 older people. About half had type 2 diabetes, and half did not. After two years, the diabetic patients had lower scores on cognitive tests compared to when they began, while people without diabetes showed little change on the tests.

MORE: The Strange Way a Diabetes Drug May Help Skin Scars

What drove the decline, says Novak, were changes in the brains of the diabetic patients. Diabetes can cause blood vessels to be less responsive to the ebb and flow of demand in different parts of the brain. Normally, flexible vessels will swell slightly to increase blood flow and oxygen to areas that are more intensely active, such as regions involved in memory or higher reasoning during intellectual tasks. But unchecked blood sugar can make these vessels less malleable and therefore less responsive.

“When doing any task, from cognition to moving your fingers, you need to increase blood flow to that specific area of the brain,” says Novak. “With diabetes, however, that vasodilation ability is reduced, so you have fewer resources to perform any task.”

MORE: Statins May Seriously Increase Diabetes Risk

In the study, Novak measured the changes in the flexibility of the blood vessels and found that among the diabetic patients, their flexibility declined, while it remained essentially the same for those without the condition. When blood sugar levels fluctuate as they do among people with diabetes, it can damage cells and nerves and trigger inflammation. What’s concerning, says Novak, is that these changes occurred even among people who were taking medication and had their diabetes under relatively good control. “Blood sugar control alone cannot treat [cognitive declines] associated with diabetes,” Novak says. “We need a new medication to improve [blood vessel] reactivity, cognition and brain function in diabetics.”

Her group is continuing to study ways that brain function can be improved by addressing the health of blood vessels; one method they are investigating involves using insulin inhaled through the nose or blood pressure medications to get brain vessel activity back to normal.

Figuring out whether such therapies can improve the brain function among people with diabetes is critical, since more people are diagnosed with the disease earlier in life, including in childhood. In previous studies, Novak and her colleagues showed that people with diabetes have brains that look five years older than those of similar-aged controls; for children with the disease, that could take a drastic toll on their cognitive skills as they age. “We really don’t have any treatment for cognitive decline in diabetes,” she says, “because the brain is not listed as an organ of risk for this disease. So we need more research and evidence like this.”

TIME Innovation

We Were Wrong About Fat

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

These are today's best ideas

1. We were wrong about fat.

By Eliza Barclay at NPR

2. Want to boost graduation rates for poor students? End merit-based college scholarships.

By Meredith Kolodner at Hechinger Report

3. Here’s how the iPhone will help scientists study the unique health needs of LGBT Americans for the first time.

By Stephanie M. Lee in Buzzfeed

4. We can fight cholera by crowdsourcing better maps.

By Tom Gorman in Ozy

5. Does air pollution cause dementia?

By Aaron Reuben in Mother Jones

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Mental Health/Psychology

This Adam Sandler Movie Has Inspired a Method of Dementia Care

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One facility is using a technique from "50 First Dates"

One home for people suffering from Alzheimer’s disease and dementia is using a method inspired by an Adam Sandler movie to help jog residents’ memories at the start of each day.

In the 2004 film 50 First Dates, actor Adam Sandler’s character creates a video that actress Drew Barrymore (whose character loses her memory each day) plays each morning to remind her who she is and what happened to her. The Hebrew Home at Riverdale in New York City has family members of its residents doing the same thing as Sandler’s character, the Associated Press reports, recording videos of themselves providing messages and anecdotes for the patients to watch every morning.

“[The film] was fluff, but it made me think,`How could that translate to our residents with memory loss?'” Charlotte Dell, director of social services at the home told the AP.

The Associated Press notes that people with Alzheimer’s present differently and that one technique may not work for everyone.

[AP]

 

MONEY Aging

A Sad Lesson From My Mother’s Decline

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A diagnosis of dementia spotlights the importance of protecting against devastating outcomes.

Lessons of financial awareness and self-sufficiency began early for me. I was just 13 and my sister was 11 when our father left us. My mother was 35 at the time and had no work experience and only a high school diploma. She had dedicated her married life to our family and supporting my father’s career.

She never had access to our household finances, ever. In the blink of an eye she was faced with having to learn how to provide for the three of us. She found a retail position, making little more than minimum wage. My sister and I did what we could to help, both working full-time in addition to going to school.

When my mother was 53, I was 31 and married with two young children. My sister and I started to notice Mom’s increasingly odd behavior. She got lost while driving familiar places, acted like a child, and forgot to bathe and wash her clothes, among other worrisome behavior. We thought perhaps she was dealing with depression and we sought professional help. She was prescribed antidepressants and went to counseling. Over the next year she continued to decline, and lost her job as a customer service representative.

Shortly thereafter, she was a target of a financial scam. She initiated three outgoing wire transfers totaling nearly $30,000, her life’s savings. To her, in her increasing confusion, it was great news! She had won the Mexican lottery! We only learned of it from a bank teller who was suspicious of the wire instructions. (If a loved one is exhibiting early signs of dementia, it’s very helpful to get to know the local bank branch staff and title accounts so they can alert family if they notice odd or uncharacteristic behavior by a longtime customer).

She soon could not pay her mortgage and we were forced to sell her home. She moved in with us. I was able to find an adult daycare to care for her while my husband and I were at work. So on we went day by day. I’d drop my kids off at school and mom off at daycare, at my expense.

Several years later, when she needed around-the-clock care, we looked for a facility that approved Medicaid, since she had no resources to pay for long-term care. This was a painful, difficult lesson – and one that I share with my clients: The time to purchase long-term care is when you don’t need it. My mother would hate knowing that my sister and I are paying out of pocket for preventative care and day-to-day expenses.

Dementia may have a long life cycle. Today my mother is 68. She has not recognized my sister or me for over six years. We have seen firsthand how 13 years in long-term care facilities can devastate a family both financially and emotionally.

There was a time when we had resources to purchase protection again these risks, and we didn’t. Dementia or other disabilities can happen at any age, and the lessons have been painful on many levels. A proud woman, my mother never expected to be financially dependent on anyone. It is a painful lesson for all of us. But if there is a silver lining, it’s this: As a financial adviser, I have been able to help others avoid making a similar mistake.

As the Baby Boomer generation ages, some estimate that as many as one in three individuals will suffer some form of cognitive dysfunction, from mild impairment to full-blown dementia. Our family wasn’t ready for this. Is yours?

———

Margaret Paddock, who oversees U.S. Bank’s wealth managers and financial advisers in the Minneapolis/St. Paul market, is quick to advise her clients to make preparations for catastrophic care and provisions for situations that are hard to envision, but which can come to pass.

TIME neuroscience

Alzheimer’s May Be Caused by Misfiring Immune System, Study Suggests

Breakthrough may lead to innovative approaches to treatment

New research suggests that deprivation of an amino acid called arginine may contribute to Alzheimer’s disease — a finding that could help usher in new treatment strategies for patients suffering from the debilitating illness.

A team at Duke University focusing on the immune system found that cells designed to protect the brain from infection will uncharacteristically consume arginine during the early stages of Alzheimer’s, according to Agence France-Presse.

“Our approach is recognized as unique and opens new avenues to think about what causes Alzheimer’s disease and new ways to treat the disease,” senior author Dr. Carol Colton told TIME.

The team was also able to block the arginine consumption process using a drug called difluoromethylornithine, which is used to treat cancer. But according to Colton, they eventually need to find a more suitable agent.

Nevertheless, the mice that underwent the therapy performed better on memory tests.

“The response to this potential new mechanism … is favorable,” Colton said. “[We are] cautiously optimistic.”

The next step for researchers will be to test older mice that already have an advanced form of Alzheimer’s.

The study was published in the April 15 issue of Journal of Neuroscience.

In 2013, Alzheimer’s affected as many as 5 million Americans and in 2050 the number is projected to rise to 14 million people, according to the Center for Disease Control and Prevention.

MONEY retirement planning

The Smart Way to Choose a Retirement Community

The decision to move to a retirement community is never easy. But new pricing information can help you plan.

Moving into a retirement community is a complex and often emotional decision, especially if health issues are a reason. Figuring out the finances of this move adds to the challenge. But by understanding the expenses you’ll need to pay, seniors and their families can make the best possible choices.

The good news is more cost data is now available. A Place for Mom, a senior community placement service, just released what it claims is the first pricing survey of these residences—one that is does not rely primarily on data reported by the communities themselves. Its Senior Living Price Index is based on reports from seniors it has placed. The company works with 20,000 residences around the country and advises an average 50,000 families a month.

The prices are listed by category of residence—independent living, assisted living and memory care (for those with dementia) —as well as by region. (The prices for independent living do not include health care expenses, but they are included for assisted living and memory care.) The survey only covers larger communities—those with more than 20 residential units.

Here are the top-level results for each type of community by region, showing average monthly prices:

  • Independent Living — $2,520 (U.S.); $2,532 (West); $2,362 (Midwest); $2,765 (Northeast); $2,587 (South)
  • Assisted Living — $3,823 (U.S.); $3,771 (West), $3,825 (Midwest); $4,315 (Northeast); $3,562 (South)
  • Memory Care — $4,849 (U.S.); $4,787 (West); $4,958 (Midwest); $5,779 (Northeast); $4,345 (South)

Clearly, senior living can be expensive. But keep in mind, these are averages covering a wide range of prices, says Edward Nevraumont, chief marketing officer at A Place for Mom. So look at these figures as just a starting point. And be sure to consider future price hikes, which are likely to outpace inflation, thanks to rising demand for living units.

Prices don’t tell you everything you need to know about a residence—other factors can be just as important, though harder to compare. There are communities geared to a wide range of preferences, budget levels, and health status. Some provide a full range of food services and on-site healthcare. Some are tightly regulated (nursing homes), while others are less so (independent living). “In our space, people have no idea of what they’re even looking for,” says Nevraumont.

That’s largely because families tend to wait till the last minute to start planning a move—typically when an aging family member is having health issues. The average person working with A Place for Mom adviser is 80 years old vs. 77 a few years ago. Of the clients the company helps place, five of every eight are single women, while two are men, and one is a couple. The average length of stay is 20 months.

For those considering a senior community, Nevraumont offers these tips:

Start shopping before a move is needed. Aside from the research that you’ll need to do, many residences have waiting lists that are months long. You’ll also need to have a conversation with all the affected family members to avoid potential conflicts.

Expect the move to take time. You may think you’ll be able to get Uncle Matt into a new apartment in a couple of weeks. The actual process takes an average of three months—or longer, if you’re on a waiting list.

Keep cash on hand. No getting around it—senior living communities are costly, especially for those with serious health care needs. So you’ll need to build a cash cushion to tap for those bills. “For both your emotional sanity and your financial sanity,” Nevraumont said, “figuring out this stuff early is really important.”

For more advice on choosing a retirement community, take a look at this checklist from AARP.

Philip Moeller is an expert on retirement, aging, and health. He is co-author of The New York Times bestseller, “Get What’s Yours: The Secrets to Maxing Out Your Social Security,” and a research fellow at the Center for Aging & Work at Boston College. Reach him at moeller.philip@gmail.com or @PhilMoeller on Twitter.

Read next: The Secrets to Making a $1 Million Retirement Stash Last

TIME medicine

A Simple 3-Part Test May Predict Alzheimer’s

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Dementia is a part of aging, but how do doctors separate normal brain decline from the first signs of Alzheimer’s? A new test that any physician can perform in their office may help

Diseases like Alzheimer’s start years, even decades, before the first symptoms of memory loss shows up. And with rates of those diseases rising, experts say that more primary care physicians—not neurology experts—will have the task of identifying these patients early so they can take advantage of whatever early interventions might be available.

“If we had a simple blood test, a cholesterol test for Alzheimer’s disease, that would help,” says Dr. Ronald Petersen, director of the Alzheimer’s Disease Research Center at the Mayo Clinic, “but we don’t.” But Petersen has a potential solution, and according to a new paper released Wednesday in the journal Neurology, his Alzheimer’s test has promise.

Petersen and his team wanted to develop a test that any physician can administer to patients, without the need for any new technology or expensive equipment. Petersen believes that the test they came up with could become a useful tool for any physician, even those without special training in the brain. “What we are trying to do is give them some help so they can be as efficient as possible without ignoring these important cognitive issues,” he says.

In the first phase of the test, his researchers simply collected information from 1,500 patients’ medical charts—their age, family history of Alzheimer’s, factors such as diabetes or smoking that have been linked to Alzheimer’s, and whether the patient had ever reported problems with memory.

In the next phase they studied the results of the patient’s basic mental exam as well as of a psychiatric evaluation, because depression and anxiety have been connected to Alzheimer’s.

And another factor that emerged as important in developing the disease—how quickly the participant could walk a short distance. “We were a little surprised,” says Petersen. “But what’s nice about it is that it’s a nice non-cognitive, motor factor so it’s looking at another aspect of brain function.”

MORE: This Alzheimer’s Breakthrough Could Be a Game Changer

Petersen suggests that every physician should get this information on their patients at age 65; that way, they can have a baseline against which to compare any changes as their patients age. Only if they show such changes — a slower walk, for example, or worsening signs of depression or memory issues — should they move on to the third phase of the test, which is a blood analysis. That would look for known genetic factors linked to Alzheimer’s, including the presence of certain versions of the ApoE gene.

Currently, the only way to truly separate out those on the road to Alzheimer’s is to conduct expensive imaging tests of the brain, or to do a spinal tap, an invasive procedure that extracts spinal fluid for signs of the amyloid protein that builds up in the disease. “We have either expensive techniques or invasive techniques and it’s not practical to do them from a public health screening standpoint,” says Petersen.

MORE: New Test May Predict Alzheimer’s 10 Years Before Diagnosis

While his test is a possible solution to that problem, he acknowledges that the results need be repeated before it’s recommended on a wide scale to physicians across the country. But those who scored higher on the test of risk factors had a seven-fold higher chance of developing mild cognitive impairment than those with lower scores.

For now, even if doctors identify patients around age 65 who might be at higher risk of developing cognitive impairment, there isn’t much they can do to interrupt the process. But they can direct them toward clinical trials of promising new drugs to address Alzheimer’s dementia, which may slow the cognitive decline considerably.

TIME neuroscience

A Drug Has Been Found That Reverses a Precursor to Alzheimer’s

Researchers now want to proceed to substantial clinical trials

Researchers at John Hopkins University have found that low doses of a drug more commonly used to treat epilepsy can reverse a condition that increases the risk of developing Alzheimer’s disease.

According to statements issued Wednesday, the epilepsy drug, called antiepileptic levetiracetam, calms hyperactivity in the brain — a well-documented symptom of people with amnestic mild cognitive impairment, which is a condition that heightens the possibility of developing Alzheimer’s disease.

The team, lead by neuroscientist Michela Gallagher, now wants to pursue substantial clinical trials.

“What we want to discover now, is whether treatment over a longer time will prevent further cognitive decline and delay or stop progression to Alzheimer’s dementia,” Gallagher said.

The researchers studied 84 people with an average age of 70. Participants received various doses of the drug, as well as a placebo, and the scientists used imaging technology to map brain activity.

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