Canadian researchers have found that mice who engage in a single bout of intense exercise right before taking a dose of the antipsychotic drug olanzapine (Zyprexa) do not experience a drug-induced increase in blood sugar, a common side effect of the medication.
Olanzapine, commonly prescribed for schizophrenia, causes blood sugar levels to rise with each dose taken. If the findings translate to humans, schizophrenia patients may be able to ward off the weight gain and type 2 diabetes often caused by long-term use of the drug.
“Acute repeated spikes in blood sugar that you see with each dose of this drug have long-term impacts — and can predispose patients to the development of insulin-resistance Type 2 diabetes and cardiovascular disease,” said study author Dr. David Wright, associate professor in the Department of Human Health and Nutritional Sciences at the University of Guelph.
Patients typically take such drugs as olanzapine over a long period of time, potentially resulting in serious impacts on patients’ overall health, added Wright.
“If you look at the average life expectancy of an individual with schizophrenia versus someone in the general population, it’s a 20-year gap. If we can reduce the side effects associated with blood glucose levels, hopefully we can improve life expectancy and the overall quality of life,” he said.
And while clinicians often attempt to prevent higher blood glucose levels by prescribing anti-diabetic drugs, Wright said his lab is interested in exercise physiology and trying to figure out how exercise can improve glucose homeostasis.
“Cardiovascular disease is the leading cause of death in individuals that have schizophrenia,” said Wright. “And obviously not everything can be attributed to the metabolic effects of these drugs. But if we can look at the big picture and reduce these side effects, hopefully life expectancy and quality of life can be improved because once you go on these drugs you can’t really go off of them.”
For the study, Wright and PhD student Laura Castellani exercised mice by having them run until they reached exhaustion before giving them a dose of olanzapine. They found that the exercise prevented the rise in blood glucose levels that usually occurs when taking the medication.
However, the findings show that it must be intense exercise. When the tests were repeated with only moderate exercise similar to a fast jog, blood glucose levels still increased in mice because of the medication.
Although these findings are encouraging, Wright notes some challenges.
“Translating these findings to humans will be difficult, especially considering that patients taking anti-psychotics have a very low level of exercise adherence,” he said. “The next step is to see if we can identify the pathways that are activated during exercise so that we can perhaps target them pharmacologically or nutritionally.”
The findings are published in the journal Scientific Reports.
Researchers have found that simple statements of praise can significantly improve the amount of exercise young adults with autism perform. Investigators from the University of North Carolina, Chapel Hill, also found that praise can be administered via pre-recorded messages through iPhones and iPods.
“As people with autism age, they tend to exercise less and less than their peers without autism,” said Melissa N. Savage of the Frank Porter Graham Child Development Institute (FPG), who headed the study.
“Previous studies have shown that individuals with autism are at special risk for health challenges like obesity, as well as for secondary conditions like depression and diabetes.”
Exercise and regular physical activity is important for everyone and may be even more important for people with autism. Savage explains that in addition to health benefits that regular physical activity carries for everyone, exercise conveys addition behavioral benefits for people with autism.
“Prior research has demonstrated that regular moderate-to-vigorous exercise for people with autism can increase their academic engagement in the classroom,” she explained. “They tend to spend more time on task and display fewer challenging behaviors.”
Due to the benefits of regular physical activity for people with autism, Savage wanted to explore how to increase their engagement in a regular exercise routine through positive reinforcement.
Positive reinforcement is a well-established practice for use with people with autism. This approach was documented in a seminal 2014 report by FPG researchers. This study established online evidence-based modules called Autism Focused Intervention Resources and Modules (AFIRM) to provide technology-aided assistance and instruction for caregivers and providers.
Savage’s study was different from prior research on reinforcement, though, for two main reasons. First, she focused on the impact of praise in and of itself, rather than pairing it with other reinforcement. Second, she examined the impact of how that praise was delivered, either in person or by technology.
“With technology use in physical activity becoming more commonplace, it was important to determine its advantages or disadvantages to provide needed support,” Savage said. “We wanted to know under which condition participants would engage in more aerobic activity and which condition they preferred.”
For this small single-subject design study, she implemented an exercise program for three young adults with autism, ages 20-22, and followed their daily progress through multiple sessions under different conditions.
While participants were running laps around cones, they heard the same voice either in-person or through headphones on a fixed schedule, delivering various praise statements, such as “Good job running around the cones!” or “You are doing a great job running, Mason!”
These praise statements incorporated the target behavior (running) – a technique the which the autism team’s AFIRM online instruction highlights as an important feature of effective reinforcement.
“We found that introducing praise statements corresponded with more physical activity for all participants,” Savage said. “The number of laps increased for all of them, regardless of whether they received praise in person or through technology.”
According to Savage, though, the impact of praise on exercise may not have been the most important finding.
“When it comes to motivating young adults with autism to exercise, part of the solution may lie in making use of technology,” she said.
“Participants who excelled when hearing praise statements through technology also maintained their performances even when we thinned out the praise statements and generalized the exercise to a new setting.”
Savage also said that using technology has several additional advantages. Especially among young adults, cell phones and iPods are popular and carry no stigma. Using them for support may also help people with autism feel more independent.
Relying on technology to deliver praise statements or provide other support also saves time.
“In-person praise required much more attention to the participant during intervention, and it was harder to be consistent with the time-based schedule,” she said. “Using the mobile devices required about 5 minutes to record and upload the praise statements, but there wasn’t any additional work needed once that was done.”
With funding from the Organization of Autism Research, Savage has begun the new “Step It Up” study at FPG to evaluate the effectiveness of a self-managed exercise program in which adults with autism and an intellectual disability will use Fitbits.
“As technologies become more available in schools and homes, we have to keep abreast of the advantages they can have for people with autism,” she said.
In a new rodent study, University at Buffalo researchers found that biological changes that accompany puberty and the social behavior transformation that happen during adolescence simply occur at the same time, and are not a cause-and-effect relationship.
“Changes in social behavior during adolescence appear to be independent of pubertal hormones. They are not triggered by puberty, so we can’t blame the hormones,” said Dr. Matthew Paul, an assistant professor in UB’s Department of Psychology.
Paul is lead author of the paper that appears in the journal Current Biology.
Disentangling the adolescent changes that are triggered by puberty from those unrelated to puberty is difficult because puberty and adolescence occur simultaneously. To untangle the association, Paul and his collaborators used a seasonal-breeding animal model.
“Puberty and adolescence are happening at the same time. So if you want to know if one causes the other, one of the elements must be moved. We have no way of doing that in a human, but we have found a way to do it using Siberian hamsters,” says Paul.
His new model, explained in the study with co-authors Dr. Clemens Probst, a scientist at Massachusetts General Hospital, Dr. Geert de Vries, a professor at Georgia State University, and Lauren Brown, a UB graduate student, provides a basic understanding that did not previously exist for what drives adolescent social development.
Adolescence is a critical period of development for individuals, said Paul. Complex thinking develops; many mental health disorders arise; and it is associated with the beginning of high-risk behaviors, like drug use.
For social behavior, it is a time when the focus of children’s social relationships shifts from the family to peers. In other words, teens stop wanting to hang out with mom and dad. In the past, it has been widely assumed that these changes can be attributed to increases in gonadal hormones at puberty.
“What we’ve done here is find a new way to ask the question of how puberty plays a role in adolescent development, a new way to determine which developmental changes pubertal hormones trigger and which changes they do not.”
The new findings suggest that although conversationally, we might hear puberty and adolescence used interchangeably, biologically, they are two distinct processes.
Puberty is the process by which individuals develop the ability to reproduce. It is triggered by the activation of the reproductive axis, which is responsible for the development of reproductive capability, the appearance of secondary sexual characteristics, and the increase in gonadal hormones.
Adolescence is broader. It encompasses puberty, but also includes cognitive, social, and emotional changes that occur during the teenage years.
Because puberty and adolescence occur concurrently, answering the fundamental question of whether puberty causes non-reproductive adolescent behavioral changes or merely coincides with them has confounded researchers, until now.
Using a seasonal breeding species, like Siberian hamsters, Paul was able to control the timing of puberty.
Siberian hamsters born at the beginning of the breeding season (when days are long) go through puberty quickly in order to breed that year. Those born late in the breeding season (when days are shorter) experience a delay in puberty so as not to give birth in the middle of winter.
Controlling the amount of light a hamster receives in the lab delays arrival of puberty, which comes around 30 days of age for “long-day” hamsters and around 100 days of age or later for “short-day” hamsters.
With two groups going through puberty at different times, Paul can now observe behavioral changes in each group to determine whether these changes are always locked to puberty. In this study, they looked at the transition from play-fighting to social dominance, which is an important step for these young animals to be able to leave home and find their own territory (also called dispersal).
“Play is an important behavior in many species, especially mammals,” said Paul. “It’s evolutionarily conserved, meaning it hasn’t been lost from a common ancestor as species broke off from each other in the evolutionary tree. Because play is expressed in so many species, it’s likely to be serving an important function, including in humans.
“It also suggests that what we learn from our hamsters will likely be true for many other species.”
If pubertal hormones were responsible for the shift from play to dominance, this transition would occur early for long-day hamsters and late for short-day hamsters; always co-occuring with puberty. But Paul found that the transition occurred at the same time for both groups, regardless of when they went through puberty. For the short-day hamsters, the transition was completed before puberty had even begun.
“This is a surprising finding, because we tend to think that pubertal hormones are responsible for the changes we see during adolescence. But our research suggests otherwise,” said Paul.
“These findings are also important for adolescent mental health — understanding the underlying mechanisms responsible for adolescent development will provide insight into why so many mental health disorders arise during this time in life.”
A new study reveals that living abroad can help clarify one’s sense of self. According to the findings, living in other parts of the world encourages us to reflect on the various cultural values and norms that we encounter both at home and in the host cultures.
In turn, these reflections can help us discover which values define us personally and which simply reflect our cultural upbringing. This is particularly true for those who live abroad for a long period of time.
The research was conducted by a team of social scientists from Rice University, Columbia University and the University of North Carolina. Their paper is published in the journal Organizational Behavior and Human Decision Processes.
Previous research has shown that transitional experiences, such as getting divorced or losing a job, typically decrease individuals’ self-concept clarity. In contrast, this study looks at the possibility that living abroad is a rare kind of transitional experience that actually increases self-concept clarity.
“In a world where living-abroad experiences are increasingly common and technological advances make cross-cultural travel and communication ever easier, it is critical that research keeps pace with these developments and seeks to understand how they affect people,” the authors wrote.
“In this vein, our studies demonstrate that living abroad affects the fundamental structure of the self-concept by enhancing its clarity. The German philosopher Hermann von Keyserling wrote in the epigraph to his 1919 book ‘The Travel Diary of a Philosopher,’ ‘The shortest path to oneself leads around the world.’ Almost 100 years later, our research provides empirical evidence in support of this idea.”
The researchers conducted six studies involving 1,874 participants who were recruited from online panels as well as from U.S. and international MBA programs. The participants, including those who have and have not lived abroad, completed surveys.
Most research on foreign experiences has focused on whether people have lived abroad or not, but this new study takes a more nuanced approach to distinguish between the depth and the breadth of international experiences. The findings suggest that depth (the length of time lived abroad) rather than breadth (the number of foreign countries lived in) enhances a clear sense of self.
The authors found that the longer people live abroad, the more self-discerning reflections they accumulate. As a result, they are more likely to develop a better understanding of themselves and show increased clarity about career decision-making, the authors said.
Understanding the impact of living abroad has practical implications for organizations as they operate across national borders and recruit foreign talent.
Extended periods of time spent in a foreign country can yield a myriad of benefits, including greater life satisfaction, decreased stress, improved job performance and enhanced clarity regarding a fulfilling career. Having a clearer sense of self is increasingly important in today’s world with its unprecedented range of available career options, according to the authors.
New research finds that a particular type of antidepressant medication is more effective for treatment of anxiety among children and teens.
Currently, two primary classes of antidepressants are prescribed for childhood and adolescent anxiety: selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors (SNRIs).
In a new study, University of Cincinnati (UC) researchers discovered that SSRIs are more effective.
Common SSRIs include: citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and vilazodone (Viibryd).
Common SNRIs include: esvenlafaxine (Pristiq), duloxetine (cymbalta), venlafaxine (effexor), venlafaxine XR (effexor XR), milnacipran (Savella), and levomilnacipran (Fetzima)
The study is published online ahead of the print issue of the Journal of the American Academy of Child and Adolescent Psychiatry.
“For a long time there had been this sense that SSRIs work better than the SNRIs in treating anxious youth, but there wasn’t clear evidence to back this up, so we wanted to put that notion to the test,” said Jeffrey Strawn, M.D., associate professor at the UC of Cincinnati College of Medicine, and lead author on the study.
“What we found is that with the SSRIs, compared to SNRIs, people get better faster and see greater improvement overall. There had been some suggestion of this in some individual studies, but this is the first to evaluate the magnitude and trajectory of treatment, or in other words, how much and how quickly people get better.”
Researchers compiled the data from nine randomized controlled trials for the meta-analysis. In the study, Strawn partnered with Jeffrey Welge, Ph.D., research associate professor of psychiatry, and econometricians Dr. Jeffrey Mills and doctoral student Beau Sauley, who created a model to examine two things: how quickly the patients got better and by how much.
The models showed that patients started to see improvements from medication around two weeks, with the more significant improvement occurring in the fourth week of treatment.
Strawn says it was also important to look at medication dosage to find out whether the dose of the medication affected improvement.
“We saw that [dosage] didn’t necessarily affect how much the patients improve, but it did affect how quickly they get better,” said Strawn, indicating that a higher dosage helped this.
Mills and Sauley used statistical analysis common in economic modeling to apply it to the clinical data.
“We have very complementary skill sets, so interdisciplinary research of this nature is a great example of work that could not be accomplished by any one author,” said Mills. “Everyone’s contributions results in more robust research that none of us would be able to produce alone.”
Mills’ particular expertise is in Bayesian statistical inference and modeling. “As an econometrician, I have mostly applied these tools to analyzing economic data, so it’s refreshing and exciting to get to apply my expertise to a different field like psychopharmacology,” he said.
Strawn said one significant aspect of this study lies in the fact that it may be immediately applicable to clinical practice.
“In research, many findings impact our work in the clinic years down the road, but this type of work potentially changes how we select medications to treat children and adolescents with anxiety disorders today,” he added.
Although impulsivity may increase the risk for obesity in children, the trait appears to be linked to better outcomes during family-based behavioral treatment (FBT) for weight loss.
FBT is designed to change parent and child behaviors and is currently the recommended intervention for children with obesity. The new study was presented, at ENDO 2018, the 100th annual meeting of the Endocrine Society in Chicago, Ill.
“Our novel results indicate that impulsivity may be a risk factor for uncontrolled eating and excessive weight gain,” said lead study author Christian L. Roth, M.D., professor of pediatrics at the Seattle Children’s Research Institute in Washington.
“Children who rated high in impulsivity had higher body mass index (BMI) measures and greater body fat mass compared to those who rated lower in impulsivity.”
“However, we found that children with obesity who were rated as more impulsive prior to starting FBT had greater weight-loss success in the program compared to children with obesity who were rated as less impulsive,” added co-author Kelley Scholz, M.S.W., research supervisor at Seattle Children’s Research Institute.
Researchers assessed the impact of a six-month long FBT obesity intervention delivered to 54 children with obesity and 22 healthy-weight children, all between 9 and 11 years of age.
The authors rated the children for impulsivity using attention and inhibition tasks from a standardized test — the Developmental NEuroPSYchological Assessment — NEPSY-II.
The healthy-weight children did not take part in the FBT program but were tested at the beginning and end of the study along with the participants who had obesity.
At baseline, a larger proportion of children with obesity scored as high-impulsivity compared with healthy-weight children. Among children with obesity, those who scored high in impulsivity had higher BMI and greater fat mass.
The children with obesity and their families took part in 24 weekly FBT session that involved a meeting between the family and a staff member in a private room for about 30 minutes with discussion of issues specifically related to that family. Also, 45-minute parent and child group sessions were held in a large conference room.
Therapy meetings focused on food, physical activity education and behavioral skills such as self-monitoring and environmental control, using praise and rewards to reinforce positive eating and physical activity.
The NEPSY-II inhibition test results predicted weight loss. Of the 40 children with obesity who completed the study, the 18 who were rated high-impulsivity had a greater drop in BMI than the lower-impulsivity obese children.
Inhibition scores improved at the end of the FBT program, and the children whose inhibition scores improved most had greater drops in BMI and fat mass.
Although the results look promising, the researchers recommend further related research.
Young people face a sharply higher risk of suicide in the months following a deliberate self-harm attempt, according to a new study led by Columbia University Irving Medical Center (CUIMC). After a nonfatal self-harm event, males are four times more likely to die of suicide than females and Native Americans are five times more likely than white non-Hispanics.
The findings, published in the journal Pediatrics, highlight the need to have clinical interventions during this critical period for youth who survive such attempts.
“Our latest study shows that time is of the essence in preventing a nonfatal self-harm event from leading to a fatality,” said Mark Olfson, M.D., M.P.H., professor of psychiatry at Columbia University Vagelos College of Physicians and Surgeons and lead author of the study.
“Although young adults compared to adolescents had a higher risk of suicide over the year after self-harm, adolescents had a particularly high risk during the first few weeks.”
Nonfatal self-harm, such as cutting or poisoning oneself with or without suicidal intent, is common among young people. Research has shown that approximately one-third of young people who die of suicide engage in nonfatal self-harm events in the last three months of life; however, it has remained unclear which young people with self-harm are at the highest short-term risk of suicide.
The researchers looked at Medicaid data from 45 states to determine the 1-year suicide risk in 32,395 adolescents and young adults (age 12 to 24 years) who had been clinically diagnosed with deliberate self-harm. The information was linked to the U.S. National Death Index to confirm dates and cause of death.
The researchers analyzed several risk factors, including demographic characteristics, recent treatment for a psychiatric disorder, and method of self-harm. Among young people with self-harm, the researchers compared the risk of repeated nonfatal self-harm and suicide. They also compared the risk of suicide in the self-harm group to the general population of similar age and demographic characteristics.
The findings show that about 17 percent had a repeated nonfatal self-harm episode in the first year, and 0.15 percent percent died of suicide. Adolescents in the self-harm group were 46 times more likely than the controls to die of suicide in the 12 months after a nonfatal self-harm attempt. The risk of suicide was especially high after self-harm events using violent methods such as firearms or hanging.
Although only around 4 percent of young people in the self-harm group used violent methods, they accounted for approximately 40 percent of the suicide deaths. In previous research, Olfson found that adults also had a greater risk of suicide in the year after a self-harm episode, particularly after a self-harm incident involving violent methods.
“For many people, young and old, the same problems that led them to harm themselves in the first place — such as depression, substance use, and anxiety disorders — may continue to put them at risk of suicide,” said Olfson.
Following nonfatal self-harm, males were four times more likely to die of suicide than females, and Native Americans were five times more likely than white non-Hispanic individuals.
“We suspect that lower use of mental health services among males and Native Americans may partially explain the higher suicide rates in these groups,” said Olfson.
The study suggests that clinical priority should be given to ensuring the safety of young people after a self-harm event. This may include treating underlying psychiatric disorders, restricting access to lethal means of self-harm, strengthening supportive relationships, and close monitoring for emerging suicidal symptoms.
Dr. Jeffrey Lieberman, chair of Columbia Psychiatry and former president of the American Psychiatric Association, added that “this report is a wake-up call to a public mental health problem that has been neglected for too long. It’s time to act on these results to provide services that can prevent self-inflicted harm to mentally distressed youth.”
New research finds that adults’ political tendencies can be traced back to early childhood temperament, those aspects of personality that are thought to be biologically based, or innate, rather than learned.
Researchers in the U.K. looked at data from more than 16,000 participants in two longitudinal studies. Their analysis revealed links between conduct problems at ages 5 and 7 and economic and political discontent 25 years later.
The findings are published in Psychological Science, a journal of the Association for Psychological Science.
“Findings from both studies indicate that children who showed higher levels of conduct problems – that is, aggression, fighting, stealing from peers – were more likely to be economically left leaning and distrustful of the political system as adults,” said study author Dr. Gary J. Lewis of Royal Holloway, University of London. “Some, but not all, of this link was explained by educational attainment and socioeconomic status in adulthood.”
The findings shed light on the relationship between personality traits and political sentiment, suggesting a link that spans more than two decades.
Lewis investigated this link by analyzing data from the British Cohort Study and the National Child Development Study, two longitudinal cohort studies following individuals in the United Kingdom.
Participants’ parents completed an assessment of their children’s behavior when the children were either 5 or 7 years old, reporting on behaviors related to anxiety, conduct problems and hyperactivity.
At age 30 or 33, the participants completed measures that gauged their economic conservatism, political cynicism, racism, authoritarianism and attitudes about gender inequality. These measures cohered into two broad factors: economic/political discontent and social conservatism.
The studies also included data about the parents’ social class and the participants’ childhood intelligence, educational attainment and social class in adulthood.
Modeling the relationships among these variables, Lewis found that childhood conduct problems were associated with economic/political discontent in adulthood, even after parental social class and childhood intelligence were taken into account. It is possible, Lewis noted, that conduct problems in childhood may reflect difficulty with self-control and long-term planning or early rejection of authority, either of which could lead to economic/political discontent.
The models also indicated indirect pathways in both cohorts, by which conduct problems were associated with lower educational attainment and adult social class and, ultimately, greater economic/political discontent.
These associations may be modest in strength, said Lewis, but they are stable over a 25-year span, suggesting early foundations of later political attitudes. Future research with more detailed and frequent assessments will help to illuminate the exact nature of these long-term associations.
“We all wonder from time to time why it is that those on the other side of the fence came to be that way,” Lewis said. “These findings take us a little further down the road to answering that question.”
The Mediterranean diet has been linked to several mental and physical benefits, including a lower risk for depression, heart disease, diabetes and cancer.
Now a new Brazilian study finds that postmenopausal women who adhere to this diet tend to have greater bone and muscle mass compared to those who don’t. The findings are being presented at ENDO 2018 in Chicago, the Endocrine Society’s 100th annual meeting. The society is one of the foremost groups devoted to hormone research and clinical endocrinology.
The Mediterranean diet involves a high intake of fruits and vegetables, grains, potatoes, olive oil and seeds; moderately high fish intake; low saturated fat, dairy and red meat consumption; and regular but moderate drinking of red wine.
Few studies are available about the Mediterranean diet and its impact on body composition after menopause, said the study’s lead investigator, Thais Rasia Silva, Ph.D., a postdoctoral student at Universidade Federal do Rio Grande do Sul in Brazil.
The findings are important, she said, because menopause, with its decline in estrogen, increases a woman’s loss of bone mass, raising her risk of the bone-thinning disease osteoporosis and broken bones.
Menopause and aging also reduce muscle mass. Declines in skeletal muscle mass and strength in older people are major contributors to increased illness, poorer quality of life and higher death rates, said Silva.
The study involved 103 healthy women from southern Brazil, who had an average age of 55 and who had gone through menopause 5.5 years earlier, on average. All participants were given bone scans to measure their bone mineral density, total body fat and appendicular lean mass, which was used to estimate skeletal muscle mass. They also filled out a food questionnaire asking what they ate in the past month.
A higher Mediterranean diet score (MDS), meaning better adherence to the diet, was significantly tied to higher bone mineral density measured at the lumbar spine and with greater muscle mass, Silva reported. This link was independent of previous hormone therapy, prior smoking behavior or their current level of physical activity, as measured by wearing a pedometer for six days.
“We found that the Mediterranean diet could be a useful nonmedical strategy for the prevention of osteoporosis and fractures in postmenopausal women,” Silva said.
Given the many health benefits of the Mediterranean diet, Silva added, “Postmenopausal women, especially those with low bone mass, should ask their doctor whether they might benefit from consuming this dietary pattern.”
A new study has found that dementia patients are not undergoing evaluation at the onset of the dementia process, a delay that prevents early, beneficial treatment.
The study, conducted by a multidisciplinary Spectrum Health neurology team, also found that home-based, patient-centered care may improve early screening and detection of dementia.
For the new study, researchers reviewed 110 randomly-chosen initial evaluations from the Spectrum Health Medical Group Neurocognitive Clinic in Grand Rapids, Michigan, from 2008 to 2015.
They discovered that 78.9 percent of the patients evaluated already had moderate or severe dementia at the time of diagnosis.
“The findings indicate that people are living with dementia for significant periods of time before seeking diagnosis and treatment,” said Timothy Thoits, M.D., lead author and neurology division chief, Spectrum Health Medical Group. “The earlier the diagnosis, the earlier treatment can begin and the earlier the benefit to the patient and his or her family and caregivers.”
The researchers reviewed the initial diagnostic patient evaluations, which included a neurological examination, Montreal Cognitive Assessment, and a battery of neuropsychological testing. They determined dementia stage and severity by correlating it with the number of lifestyle changes recommended at the time of diagnosis, which they say is a novel study method that has not previously been used.
Lifestyle changes included medication assistance, financial assistance, driving restrictions, and institutional care. At the time of diagnosis, providers recommended lifestyle changes in 75.8 percent of patients with dementia.
The study concludes that “an increase in home-based, patient-centered medical care, regardless of the patient’s living status, may be one way to improve recognition of cognitive deficits and increase the frequency of important and necessary early cognitive evaluations.”
The World Health Organization (WHO) defines home-based care as “any form of assistance provided to a sick person referred to as the patient directly in the home by family, friends, and members of the local community, cooperating with the advice and support from the trained health workers.”
The study was published in The American Journal of Alzheimer’s Disease & Other Dementias.