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Mature Focus: March 7

Exercising twice per week and taking a curcumin supplement may both help to improve memory for older adults, new research shows.

Memory boosting methods

Exercising just twice a week may improve thinking ability and memory in people with mild cognitive impairment [MCI], according to a new guideline released by the American Academy of Neurology and endorsed by the Alzheimer’s Association.

A condition that becomes increasingly common with age, MCI affects more than 6 percent of people in their 60s and 37 percent of people age 85 and older. While people with MCI may have problems with thinking and memory, their symptoms generally are milder than in those with dementia. However, there is significant evidence that MCI can lead to dementia.

According to the guideline, doctors should recommend that people with MCI exercise regularly as part of an overall approach to managing their symptoms. Although long-term studies have not been conducted, six-month studies suggest that twice-weekly workouts may improve memory; working out more frequently was not shown to provide additional benefit.

“It’s exciting that exercise may help improve memory at this stage, as it’s something most people can do, and of course it has overall health benefits,” said lead author Ronald C. Petersen, M.D., Ph.D., of the Mayo Clinic in Rochester, Minnesota, who also is a Fellow of the American Academy of Neurology. “Because MCI may progress to dementia, it is particularly important that MCI is diagnosed early.”

The guideline also states that, while exercising may provide some benefit, there are no FDA-approved medications or proven dietary strategies for the treatment of MCI. There is weak evidence that cognitive training may be beneficial in improving measures of cognitive function, so the guideline states that doctors may recommend cognitive training for people with MCI.

The American Academy of Neurology developed the current recommendations after reviewing all available studies on MCI. The guideline recently was published in the journal Neurology.

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Older adults seeking natural ways to boost their memory skills also may want to eat more Indian food. Curcumin, a substance found in turmeric root that gives Indian curry its bright yellow color, has been found to improve memory and mood in people with mild, age-related memory loss.

A recent study conducted at UCLA looked at the effects of taking a curcumin supplement on memory performance in older people without dementia. It included 40 adults between the ages of 50 and 90 who had mild memory complaints. Participants received either 90 milligrams of curcumin or a placebo two times per day for 18 months.

All 40 subjects received standardized cognitive assessments at the start of the study and at six-month intervals, along with monitoring of curcumin levels in their blood at the start of the study and after 18 months. Those who took the curcumin experienced significant improvements [an average of 28 percent] in their memory and attention abilities as measured by the assessments, while those who took a placebo did not improve. Those taking curcumin also experienced mild improvements in mood.

Curcumin previously has been shown in lab studies to have anti-inflammatory and antioxidant properties. It has long been well-regarded in India as a natural treatment for many health concerns – in fact, it has been suggested as a possible reason why senior citizens in India, where curcumin is a dietary staple, have a lower incidence of Alzheimer’s disease.

“Exactly how curcumin exerts its effects is not certain, but it may be due to its ability to reduce brain inflammation, which has been linked to both Alzheimer’s disease and major depression,” said Dr. Gary Small, the study’s first author and director of geriatric psychiatry at UCLA’s Longevity Center. The research was published online in the American Journal of Geriatric Psychiatry.

A recent study attempted to determine how dealing with life’s challenges relates to the development of wisdom as people age.

The origin of wisdom

The old saying “with age comes wisdom” may not be accurate – rather, it’s how a person responds to challenging life events that seem to come with getting older, such as divorce, a health crisis or the death of a loved one, that shapes the development of wisdom over time, a new study from Oregon State University suggests.

The study’s goal was to better understand how coping with adversity leads to greater wisdom and, ultimately, to healthier aging. “What we [were] really looking at is ‘when bad things happen, what happens?,’” said Carolyn Aldwin, director of the Center for Healthy Aging Research in the College of Public Health and Human Sciences at OSU. “The event can become a catalyst for changes that come afterward. Generally, the people who had to work to sort things out after a difficult life event are the ones who arrived at new meaning.”

The study included 50 adults between the ages of 56 and 91 who had experienced one or more major difficult life events. The participants were asked to identify those events, describe how they coped, and detail whether and how the experience changed their outlook or future actions. While some participants considered the events as merely something that could not be changed, the largest group [32 participants] agreed that dealing with these events disrupted their sense of personal meaning, forcing them to re-evaluate their fundamental beliefs and their understanding of the world. “For these folks, the event really rocked their boat and challenged how they saw life and themselves,” Aldwin said.

A person’s social environment and interactions with family, friends and others also were shown to be key factors in shaping their responses to difficult life events, as well as their development of wisdom. Those who received unsolicited emotional support, for example, developed wisdom around compassion and humility. Seeking others with similar experiences exposed some participants to new ideas and interactions, leading to deeper exploration and a new sense of self.

The findings recently were published in the Journals of Gerontology: Series B.

Partial hysterectomy risks

Hysterectomy [surgical removal of the uterus] is the second most common major surgical procedure performed among women in the U.S. Although there has been ongoing debate in the medical community about whether a woman’s ovaries should also be removed during a hysterectomy, the current recommendation by the American College of Obstetricians and Gynecologists is that “strong consideration should be made for retaining normal ovaries in premenopausal women who are not at increased genetic risk of ovarian cancer.”

However, Mayo Clinic researchers recently conducted a study which showed that having a partial hysterectomy – one that leaves the ovaries in place – is associated with a long-term risk of several cardiovascular diseases and metabolic conditions, especially in women who have the surgery at younger ages. Their findings recently were published in Menopause.

“This is the best data to date that shows women undergoing a hysterectomy have a risk of long-term disease – even when both ovaries are conserved,” said Dr. Shannon Laughlin-Tommaso, study author and Mayo Clinic obstetrician/gynecologist. “While women are increasingly aware that removing their ovaries poses health risks, this study suggests hysterectomy alone has risks, especially for women who undergo hysterectomy prior to age 35.”

Women in the study were identified from a database of all medical providers in Olmsted County, Minnesota. The women included were 2,094 Olmsted County residents over 18 years of age who had a hysterectomy with ovarian conservation for benign [non-cancerous] disease in the 22 years between January 1980 and December 2002. Each of those women was age-matched to a woman residing in the same county during the same time period, who had not had a hysterectomy or any ovarian removal. The study determined cardiovascular and metabolic conditions that existed prior to surgery and looked only for new onset of disease after hysterectomy.

The study showed that women who had a hysterectomy without ovary removal had a 14-percent increased risk of lipid abnormalities, a 13-percent increased risk of high blood pressure, an 18-percent increased risk of obesity and a 33-percent increased risk of coronary artery disease compared to women in the control group. Additionally, women who had surgery prior to age 35 had nearly a five times greater long-term risk of congestive heart failure and a 2.5 times greater risk of coronary artery disease.

“Most [hysterectomies] are done for benign reasons because most physicians believe that this surgery has minimal long-term risks,” said Laughlin-Tommaso. “With the results of this study, we encourage people to consider nonsurgical alternative therapies for fibroids, endometriosis and prolapse, which are leading causes of hysterectomy.”

In order to mitigate any type of risks associated with the surgery, Dr. JoAnn Pinkerton, executive director of the North American Menopause Society, also suggested in a statement that “hormone therapy should be considered for added protection, because ovarian function appears to be impaired by the surgery,” in addition to identifying alternatives to hysterectomy for benign conditions.

On the calendar

The St. Louis Chapter of the Alzheimer’s Association presents an Alzheimer’s Care Consultation Day, sponsored by BJC, from 9:30 a.m.-3 p.m. on Tuesday, April 3 at Barnes-Jewish St. Peters Hospital, 10 Hospital Drive in St. Peters, in Suite 108-B of Medical Office Building 1. One-hour consultations, provided at no charge, are conducted by a social worker to answer questions and address concerns about caring for someone with Alzheimer’s or dementia. Appointments should be made by March 26 to guarantee a consultation, but walk-ins will be accommodated if time permits. Call (314) 801-0399 to schedule an appointment time.

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