week 14: class projects

what happens when older adults drive with unidentified pre-AD?

Driving skills decline lead to increased accidents when driving

driving behaviour changes (rapidly/subtly) in pre-AD

subtly

how does driving behaviour serve as a biomarker?

practical method to identify biomarkers for older persons early on

adverse driving behaviours are associated with...

sleep apnea severity and age in CN older adults at risk for AD

how can we distinguish between people who have pre-AD biomarkers and those who don't

Machine learning

people with AD and _______ ________ had a higher risk of engaging in erratic driving behaviour

sleep apnea

how can we measure driving behaviour?

GPS driving logging

what is one question to consider when thinking abt driving and AD?

how early can driving behaviour indicate to us AD?

why is it interesting to study autism and AD?

because they occur at opposite ends of the lifespan

Brain plasticity in people with ASD (does/does not) protect them from cognitive decline overall

does

people with AD have (high/low) brain plasticity. people with ASD have (high/low) brain plasticity

low, high

what is a potential link between AD and ASD development

heavy metals

how do heavy metals act as a potential link between AD and ASD?

blocks methylation

these types of mutations could cause not only ASD but AD

Activity-dependent neuroprotective protein mutations

4 commonalities between ASD and AD

• interaction between genetic, epigenetic, and environmental factors

• overlapping pathophysiology: processing mechanisms of amyloid precursor protein

• poor cognitive health

• anxiety and depression

2 major signs of ASD are

anxiety and depression

things to consider when thinking about ASD and AD?

What other characteristics of ASD could be a protective factor? Are there risk factors?

what is down syndrome?

aka trisomy 21

• born with 3 copies of chromosome 21, known as trisomy 21

• 1/800 births are DS

• Defining physical features

• Susceptibility to infections, hearing loss, etc.

• Increased risk of AD

what do DS and AD have in common?

accumulation of plaques and tangle deposits

how does chromosome 21 affect AD?

carries a gene that produces one of the key proteins, amyloid protein, involved with changes in the brain associated with Alzheimer's.
- Amyloid-β is a product of the chromosome 21 gene APP

what is a misconception about AD and DS?

Most never assume that a mutation in a single chromosome could lead to so many adverse outcomes

commonalities between DS and AD

Cognitive decline, shorter tempers, impulsivity, and memory issues

implications for understanding DS and AD

Raising awareness in both will hopefully help understand a cure for AD and helping people with DS live longer lives

what is a possible intervention for DS and AD research?

Manipulating chromosomes a possible step for intervention

the risk of MCI and AD is related to...

how much sleep you get

sleep disturbances are observed in...

AD patients

sleep disturbances often appear at what point in the disease?

may appear early in disease progression

4 reasons why sleep is so important

• Supports brain function

• Memory consolidation

• Promotes brain metabolic clearance

• Increases chromosome dynamicse

effects of sleep deprivation

• Fatigue, poor decision making, and greater risks of accident

• Decreases temporal lobe activity

• Poor concentration, emotional instability, immune dysfunction

• Increased sensitivity to pain

how must we sleep in order to improve QoL?

need to have a balanced sleep cycle

3 common sleep disorders include

Sleep apnea
Insomnia
Restless leg syndrome

sleep disorders are significantly associated with __________ but not ______________

increased risk of MCI, but not clinical conversion

(1) or (2) significantly increased risk of MCI. (3) predicted progression to AD. These findings are related to (4)

(1) insomnia (2) sleep apnea (3) sleep apnea (4) hypoxia

sleep disorders may affect levels of ____________

beta-amyloid and tau

sleep-wake cycles and circadian rhythm help regulate

beta amyloid levels in the brain

beta amyloid in cerebrospinal fluid is (highest/lowest) when awake and (highest/lowest) when asleep

highest, lowest

Sleep deprivation increases _________________ in brain in ISF and CSF in the brain

tau levels

Tau levels in _____ increased by more than 50% during sleep deprivation

CSF

things to consider when studying sleep and AD

effects based on sex, depression, comorbidities, and APOE e4

what is MBI?

late-life psychiatric symptoms not described by other psychiatric disorders

MBI is another _____-________ ________ for NDDs. This means that...

at-risk state. Can increase risk for NDD

MBI is an early indicator of...

dementia

What does MBI cover that MCI does not?

behavioural and psychiatric symptoms

who is dr. ismail?

clinical neuropsychiatrist studying MBI and AD in Calgary

what is ISTAART?

researchers and clinicians who work to further AD research

5 domains of MBI

• Decreases motivation: apathy and indifference

• Affective dysregulation: depression, anxiety, elation, euphoria

• Impulse decontrol: agitation, disinhibition

• Social inappropriateness

• Abnormal perception or thought content: delusions and hallucinations

conditions for MBI diagnosis

Symptoms must be de novo, diagnosed later in life (>50) and experienced for 6 months or more

how do we measure MBI?

MBI-C: - 34-item diagnostic checklist done by patient, informants, and physicians

• developed by dr. ismail

• covers all 5 domains

• yes/no questions and likert scale

how must we consider MBI for AD diagnosis?

considered alone and with other MCI symptoms

Of the people who progressed to dementia, _______% had only SCD+, whereas _____% had both MBI and SCD+ symptoms

16.5%, 30.9%

what is the most common MBI domain?

Affective Dysregulation

what is affective dysregulation in MBI?

Depression, anxiety, elation, euphoria

MBI-affective dysregulation has a higher incidence in...

black participants and APOEe4 carriers

some key areas that still need to be developed re: MBI

having an agreed-upon definition
- standardization

what is dance therapy?

Psychotherapeutic use of movement to promote emotional, social, cognitive, and physical integration

dance therapy is (the same as/different from) choreography done in regular dance classes

different from

why is movement used in dance therapy so beneficial?

people can express themselves through movement, opportunities for socialization, building community, developing vitality

can anyone teach dance therapy?

no. therapists are dancers with professional psychology knowledge

3 parts of dance therapy

• Warm-up part: clinicians will let clients dance and move freely to the rhythm and beat

• Development: clients will get their movements deeper and interact with others

• Closure: clients say goodbye and refocus on themselves

4 areas that dance movement therapy can assist with

• Physical issues: hypertension and cardiovascular disease

• Mental health (depression, anxiety)

• Cognitive issues (communication)

• Social issues (social interaction)

DMT can directly influence...

memory recall in people with late-stage AD

limitations of current research on dance therapy and AD

• Participant population pretty small

• Assessments not included

• LONG effects of DMT on memory should be studied

future directions for dance therapy and AD

• LONG studies

• Can DMT help with other symptoms?

an experiment on DMT and AD revealed that...

Participants at risk of AD showed more organized speech and acute memory recall

DMT can directly influence memory recall in people with (early/late)-stage AD. However, these findings are acute/long-term

late, acute

what is still unknown about DMT and AD?

the exact cause/mechanism underlying memory recall

what is caffeine?

drug/neuro stimulant that is found in many consumer substances like coffee, tea, energy drinks, medication, and chocolate

how does caffeine work in the body?

travels in bloodstream and across BBB and acts as a stimulant

caffeine is a possible (risk/protection) factor

protection

the current evidence regarding caffeine and AD is quite (consistent/contradictory)

contraidictory

what did the CAIDE study find re: mid-life coffee/tea consumption and dementia?

• Moderate coffee drinkers in midlife had 62-64% decrease in risk when compared to low coffee consumers

• Tea drinking mostly uncommon and did not show a relation to later risk of AD

what did the CAIDE study find re: caffeine consumption, APOE e4, and sex?

e4 carriers and men showed more prominent results

what are the proposed mechanisms underlying caffeine as a protective factor of AD?

• Caffeine is a nonselective A1 and A2 adenosine receptor agent

• Effect of coffee may be due to antioxidant capacity in circulating blood

• Decrease risk of type 2 diabetes – coffee abundant with magnesium, increase in insulin sensitivity

What did Maia and de Mendonca (2002) find re: caffeine and AD?

Caffeine exposure during 20-year period significantly inversely related to AD
- Caffeine intake associated with lower risk of AD, independent from other possible confounding variables

Maia and de Mendonca (2002) believe that:

an unknown genetic/environmental factor might favor the inclination to consume coffee

what is the coffee vs. caffeine bias issue?

there are substances in coffee, not just caffeine. not sure if caffeine specifically is an RF

what did Schreiner & Popescu find re: caffeine bias and AD?

• Caffeine PF effect directly related to beta amyloid

• Destabilized the beta amyloid structure through multiple mechanisms, potential inhibitory of acetylcholinesterase

what did Schreiner & Popescu find in their animal model trial?

positive effects: caffeine administration did have a neuroprotection effect: improved spatial learning ability and memory capacity, or a reduction in a neuroinflammation and oxidative stress

what did Schreiner & Popescu find in their human subject trial?

same as in their animal model study: numerous positive effects

what is the most frequent hypothesis for the pathophysiological basis of caffeine effects in AD?

reduction in oxidative stress and neuroinflammation

what else needs to be done to better understand AD and caffeine?

• clinical trials

• long-term administration

• replication trials

caffeine may play a direct role in destabilizing...

the beta-amyloid peptide

how can bilingualism be a protective factor?

contributes to cognitive reserve

how was bilingualism and AD studied?

assessed metabolic activity combined and connectivity in bilingual and monolingual individuals with AD using a PET scan

what was found in the correlation study re: bilingualism and AD?

Bilinguals with AD compensate better for loss of brain structure and function according to metabolic activity analysis

bilingual speakers manifest symptoms of AD (earlier/later) than monolinguals

later

an (increase/decrease) in white matter densities was found in bilinguals compared to monolinguals. This means that...

increase; using executive function to control two language systems vs. one result in plastic changes in the brain

effects of speaking 2 languages is more powerful than both these two factors in protecting one against AD:

age, education

T/F: loneliness affects everyone the same way

false

is loneliness biologically programmed?

at the moment it is believed to be biologically programmed

depression is a (modifiable/nonmodifiable) risk factor

modifiable

there is a correlation between loneliness and...

depression

depression can reduce onset of dementia by ___%

5%

what did Wilson et al. (2007) find in their LONG study re: loneliness and AD?

• Those with AD had higher levels of loneliness

• Social isolation have been associated with dementia/cognitive decline in older people

• Number of people with dementia was more than doubled in lonely people

what did Salinas et al (2002) find re: loneliness and dementia?

LONG study found that lonely adults who are under age 80 were 3x more likely to get dementia even without e4

Salinas et al (2020) found that lonely adults have these 3 features:

• Poorer executive function

• Lower total cerebral volume

• Loneliness is major risk factor

implications of understanding loneliness and dementia

need to implement programs to help older adults not lose and create social ties (PFs)

how might AD cause crime?

NDDs can cause impairments of many neural processes and pathways related to judgment sexual behaviour, violence, and self awareness

in the study exploring FTD and criminal behaviour, it was found that:

only 7.7% of patients displayed criminal behaviour
- 2% of AD patients exhibited criminal behaviours as a first presentation compared to 14% of FTD and 7.8% PPA

AD patients were the least likely to commit crimes, but the crimes were also...

less severe in nature