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Featured article: NEUROSCIENCE NEWS on September 2, 2019

Summary: Researchers have identified the location of dysfunctional brain networks that lead to impaired sentence production and word-finding in primary progressive aphasia (PPA). PPA can occur in those with neurodegenerative diseases, such as frontotemporal dementia and Alzheimer’s disease. Mapping the networks allows clinicians to apply non-invasive brain stimulation to potentially improve speech in those with PPA.

For the first time, Northwestern Medicine scientists have pinpointed the location of dysfunctional brain networks that lead to impaired sentence production and word finding in primary progressive aphasia (PPA), a form of dementia in which patients often lose their language rather than their memory or thought process.

With this discovery, the scientists have drawn a map that illustrates three regions in the brain that fail to talk to each another, inhibiting a person’s speech production, word finding and word comprehension. For example, some people can’t connect words to form sentences, others can’t name objects or understand single words like “cow” or “table.”

The map can be used to target those brain regions with therapies, such as transcranial magnetic stimulation (TMS), to potentially improve an affected person’s speech.

“Now we know where to target people’s brains to attempt to improve their speech,” said lead author Dr. Borna Bonakdarpour, assistant professor of neurology at Northwestern University Feinberg School of Medicine’s Cognitive Neurology and Alzheimer Disease Center and a Northwestern Medicine neurologist.

PPA occurs in patients with neurodegenerative disorders, including Alzheimer’s disease and frontotemporal degeneration.

Interactions among three main regions in the brain is responsible for how people process words and sentences. PPA occurs when there is a lack of connectivity among these areas. Different patterns of connectivity failure among these regions can cause different subtypes of PPA.

The findings will be published Sept. 1 in the journal Cortex. The large study (73 patients) recruited from the extensive pool of patients with PPA at Northwestern’s Cognitive Neurology and Alzheimer Disease Center, one of the largest centers in the world.

The study used functional MRI, which monitors brain activity by detecting blood flow, to locate the regions of the brain that are talking to each other or not. That cannot be shown with structural MRI.

Previous research used structural MRI to locate only regions of the brain that had atrophied, and scientists did not clearly know how physiological impairment in these regions correlated with symptoms a patient was experiencing. This study is novel because it examined brain regions that were still functional (had not atrophied) and focused on the networks among the functional regions to see if they were connecting or not. This allowed the scientists to correlate the functional areas in the brain with symptoms of patients with PPA.

“Previous studies of structural changes in the brain were like archeology, in which scientists were locating areas of the brain that had already died,” Bonakdarpour said. “But we are looking at the parts of the brain that are still alive, which makes them much easier to target with treatment.”

Bonakdarpour and his colleagues have begun testing TMS on the three targeted brain regions in healthy individuals with the goal of applying it to patients with PPA in a future clinical trial.

Source: https://neurosciencenews.com/speech-dementia-network-14848/

APATHY strikes 90% of people with dementia, sooner or later. Faster decline and care problems result. Apathy is the most common neuropsychiatric symptom of dementia, with a bigger impact than memory loss. Proper stimulation makes all the difference. Learn why. reduce2
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A new study from the University of Exter has found that apathy is present in nearly half of all people with dementia, at any single point in time. 90% of the people with dementia experience apathy at some point.

Apathy is the most common neuropsychiatric symptom of dementia, with a bigger impact on function than memory loss -- yet it is under-researched and often forgotten in care. It is often distinct from depression.

Even though it is so incredibly common, apathy is often ignored, as it is less disruptive in settings such as care homes than symptoms like aggression. Defined by a loss of interest and emotions, it is extremely distressing for families and it is linked with more severe dementia and worse clinical symptoms.


Stimulation Keeps Dementia from Declining

People with dementia are less likely to be apathetic if they live in an appropriately stimulating environment, according to nursing researchers at Penn State.

According to a report by The Centers for Disease Control, about half the people in nursing homes have dementia. 90% of them experience apathy at some point, one of the most common neurobehavioral symptoms in dementia. Those with mild dementia will decline more quickly into severe dementia if they also suffer from apathy.

A stimulating environment made all the difference in this revealing study of 5 factors. Specifically, moderate stimulation did the most to lift people out of their apathy, while none or too much made it worse.

Help Them Stay Engaged

Ying-Ling Jao, assistant professor of nursing, Penn State, identified 4 negative consequences of apathy in dementia:

  1. Persons with dementia who are also apathetic won't be curious about the world around them;
  2. They are not motivated to carry out activity nor engage with those around them, in either a positive or a negative way.
  3. The individuals' cognitive function will likely decline faster.
  4. Caregivers will have more difficulty with their caregiving and are more likely to become depressed.

Jao observed 40 nursing home residents with dementia. She watched videos of each taken throughout a typical day. Three videos were chosen for each resident from recordings made during a previous study:

  • One taken at a mealtime,
  • One during a direct interaction between the resident and staff
  • One that was randomly selected.

Jao reports her results in The Gerontologist. She said,

'The purpose of this study was to examine the relationship between environmental characteristics and apathy in long-term care residents with dementia. My interest in apathy was mainly driven by my clinical observations in nursing homes when I was a nurse practitioner student. I remember that no matter which nursing home I visited, I often saw a crowd of residents sitting in the living room or hallway with no interest in the surroundings and no emotional expression.'

5 Influences on Apathy in Dementia

Jao zoomed in on five key characteristics that affect the quality of life in nursing homes:

  1. Environmental stimulation
  2. Ambiance
  3. Crowding
  4. Staff familiarity
  5. Light and sounds.

Of the five, clear and strong environmental stimulation associated most strongly with lower apathy in residents. This means an environment without competing background noise, and with a single straightforward stimulus. A good example is music therapy in a quiet room. A strong stimulus is intense, persistent, interesting and out of the ordinary. Even routine activities, such as a regular conversation or meal, count as moderate stimulation. A birthday party is considered strong simulation.

How Common is Apathy in Dementia?

"Apathy strikes 90% of people with dementia at some point in time. Researchers digging deeper into the prevalence of apathy in dementia took a look at how much apathy would you find in a specific point in time. Led by the University of Exeter and presented at the Alzheimer's Association International Conference, the research analysed 4,320 people with Alzheimer's from 20 cohort studies."

At the start of the study, 45% presented with apathy, and 20% had persistent apathy over time. Researchers found that a proportion had apathy without depression, which suggests that the symptom might have its own unique clinical and biological profile when compared to apathy with depression and depression only.

Why is Apathy Ignored in Dementia?

Dr Miguel de Silva Vasconcelos, of the University of Exeter and King's College London, said :

"Apathy is an under-researched and often ignored symptom of dementia. It can be overlooked because people with apathy seem less disruptive and less engaging, but it has a huge impact on the quality of life of people living with dementia, and their families. Where people withdraw from activities, it can accelerate cognitive decline and we know that there are higher mortality rates in people with apathy. It's now time this symptom was recognised and prioritised in research and understanding."

Professor Clive Ballard, of the University of Exeter Medical School, said:

"Apathy is the forgotten symptom of dementia, yet it can have devastating consequences. Our research shows just how common apathy is in people with dementia, and we now need to understand it better so we can find effective new treatments. Our WHELD study to improve care home staff training through personalised care and social interaction included an exercise programme that improved apathy, so we know we can make a difference. This is a real opportunity for interventions that could significantly benefit thousands of people with dementia. "


Strong Stimulation, No Stimulation, Overwhelming Stimulation

Assistant Professor Jao said,

'Interestingly, our results showed that clear and strong environmental stimulation is related to lower apathy, while no stimulation or an overwhelming environment with no single clear stimulation is related to higher apathy.'

 

'One of the innovative features of this study is that we used the Person-Environment Apathy Rating scale to measure environmental stimulation at an individual level. I believe that the same stimulation may be perceived differently or bring about different responses for different individuals in the same environment based on the individual's characteristics, interests and relevance to the stimulation. In fact, a stimulus may be clear to one person but unclear to another because of differences in hearing or visual abilities, especially in older adults.'

 

'One of the most important implications of these findings is that they will guide us in designing appropriate physical and social environments for dementia care that helps prevent or decrease apathy. We need more people to care about apathy for older adults with dementia.'

Jao plans to continue this research by replicating the study with a larger sample size and by looking more closely at the quality of interaction and communication between nursing home residents and their caregivers.

Sources:

Reference:

  1. Y.-L. Jao, D. L. Algase, J. K. Specht, K. Williams. The Association Between Characteristics of Care Environments and Apathy in Residents With Dementia in Long-term Care Facilities. The Gerontologist, 2015; 55 (Suppl 1): S27 DOI: 10.1093/geront/gnu166

Retrieved August 27, 2019 from http://www.alzheimersweekly.com/2015/06/beating-apathy-in-dementia.html

The seven stages of Alzheimer's are helpful in finding the words to discuss Alzheimer's. Caregivers find them particularly useful in support groups, as well as in conversations with doctors and other professionals. 


Although the progression of Alzheimer's disease can be slowed down today thanks to today's medications, it cannot as of yet be stopped. The process is described in general terms as going through 3 steps:

  1. Mild Alzheimer’s
  2. Moderate Alzheimer’s
  3. Severe Alzheimer’s.

For more meaningful terms between professionals, caregivers and patients, a more detailed process has been characterized in seven stages. The seven stages are based on a system developed by Barry Reisberg, M.D., clinical director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center.

STAGE 1 – NORMAL

This system calls a mentally healthy person at any age “Stage 1”.

  • No memory problems
  • No problems with orientation
  • person – your name, who you are;
  • place – what country, state, city you live in, where you are;
  • time – what day, date, season it is
  • No problems with judgment
  • No difficulties with communication skills
  • No problems with daily activities

STAGE 2 – NORMAL AGED FORGETFULNESS

More than half of all people ages 65 and older complain of cognitive difficulties. This is considered a normal part of aging.

  • Occasional lapses in memory, usually undetectable to family and friends
  • Slight cognitive problems, also undetectable to friends and family, might also not be visible on medical exam

STAGE 3 – MILD COGNITIVE IMPAIRMENT

At this point, there are mild changes in memory, communication skills and/or behavior, noticeable to family members and friends. Symptoms might be picked up by an alert physician. Many people will not decline further than this point. Notwithstanding, a majority do progress to Mild Alzheimer’s within two to four years.

  • Problems remembering names, words for objects
  • Difficulties functioning at work and in social settings
  • Problems remembering newly-read material
  • Misplacing important items with increasing frequency
  • Decline in organizational skills and the ability to plan
  • Repeating questions and evident anxiety

STAGE 4 – MILD ALZHEIMER’S

Cognitive symptoms are more obvious now. A neurologist can confidently diagnose Alzheimer's disease and treat it with medications that have been proven effective in slowing it down.

  • Difficulty remembering personal details, recent events
  • Some confusion possible (ie: might put towel in fridge)
  • Impaired mathematical ability, financial management (trouble managing a checkbook – for those who did not have trouble managing one before)
  • Social withdrawal
  • Moodiness, depression

STAGE 5 – MODERATE ALZHEIMER'S

This is the stage at which it is not possible for a person with Alzheimer's to live alone.

  • Severe memory loss, e.g., may not remember basic personal contact information such as current address or phone number
  • Disorientation (not knowing the day/date/season, and/or location/country/state/city)
  • No longer safe to cook, even if the sufferer can manage or remember the logistics of the process, due to severe short-term memory difficulties and confusion
  • Wandering risk; might get lost once leaving the home
  • Decreased personal hygiene skills
  • Increased desire to sleep is common

STAGE 6 – MODERATELY SEVERE ALZHEIMER'S

It is at this stage that family members often suffer the most, because the loved one with Alzheimer's loses much of the ability to recognize those around him or her, even a spouse, sibling, parent or child. Personality changes are common as well.

  • Severe memory loss continues to intensify
  • Withdrawal from surroundings
  • Wandering
  • Reduced awareness of recent events
  • Problems recognizing loved ones, although it is still possible to differentiate between those who are familiar and those who are not
  • "Sundowning", if it has not yet begun, makes its appearance at this point – this is the phenomenon of increased restlessness and agitation toward sundown (hence the name), in the late afternoon and evening hours
  • Bathroom management becomes difficult; at this stage it often is necessary to switch to diapers due to incontinence, wetting and other such problems using the bathroom independently
  • Paranoia, suspiciousness
  • Shadowing, extreme anxiety, following a loved one around the house due to fears of being alone
  • Repetitive, compulsive behavior (verbal and/or nonverbal)

STAGE 7 – SEVERE ALZHEIMER'S

This is the final stage of Alzheimer's disease, at which the long goodbye comes to an end. Even though the Alzheimer's person may somewhere inside really hear and understand what is being said, he or she can no longer respond, other than possibly to speak a word or phrase.

  • Communication is very limited
  • Physical systems begin to deteriorate
  • Gross motor coordination shuts down, may not be able to sit
  • Swallowing may become difficult, choking is a risk

The last stage of Alzheimer's disease, as with any other illness, is a very individual matter and no two journeys end the same way. People with Alzheimer’s seem to experience little physical pain. What is certain, however, is that every Alzheimer's journey ends – as does every other. May they all be peaceful and pain free.

Source for this article: http://www.alzheimersweekly.com/2013/01/7-stages-of-alzheimers.html

Important note: Through research, it is now possible to achieve containment of a dementia, regain cognitive and physical ability, and live life more fully. For more information, please go to https://internationalcaregiversassociation.com/energy-medicine.html

Original article by Dee Rapposelli July 5, 2017

RESEARCH UPDATE

Distinguishing dementia with Lewy bodies (DLB) from Alzheimer disease (AD) has been a challenge. DLB is often misdiagnosed as AD only to be correctly revealed at autopsy. Missed or misdiagnosed DLB has persisted despite consensus diagnostic criteria published at the end of 2005.1 A recently updated consensus report of the DLB Consortium aims to bring greater clarity and diagnostic precision to the identification and management of DLB.2

Revised consensus criteria

The revised DLB consensus criteria provide clear guidance regarding the recognition and interpretation of clinical signs and symptoms and diagnostic biomarkers of DLB. Of note is that increased diagnostic weight is given to REM sleep behavior disorder (RBD) and 123iodine-metaiodobenzylguanidine (MIBG) myocardial scintigraphy.

In defining the primary clinical criteria for DLB, the authors noted the importance of attention/executive function and visuospatial processing when assessing cognitive decline, as these measures can differentiate DLB from AD and normal aging. The panel noted that deficits in these areas are more pronounced in DLB than are memory deficits and may occur early in the disease process.

Core features

Core clinical features that can differentiate DLB from AD or other forms of dementia, as noted by the consensus panel, include fluctuations in cognition, attention, and arousal; hallucinations; parkinsonism; and RBD. The presence of 2 or more clinical features has been deemed grounds for a probable diagnosis of DLB. Fluctuations include episodes of erratic behavior, incoherent speech, or “zoning out.” Application of interview questions and rating scales regarding these symptoms can help distinguish DLB symptomatology from that of AD.

Hallucinations and parkinsonism are somewhat telltale symptoms: hallucinations occur in up to 80% of patients with DLB, and parkinsonism in up to 85%. RBD, a parasomnia characterized by the absence of REM sleep atonia, has been elevated to a core symptom in the updated consensus criteria; it is overwhelmingly prevalent in autopsy-confirmed DLB cases.3 Furthermore, it may act as a key sign of DLB risk, often emerging before signs and symptoms of DLB-associated cognitive decline occur.

Supportive features

Supportive clinical features—those that are common but lack diagnostic specificity—outlined by the panel include severe sensitivity to antipsychotic drugs, postural instability, fainting spells or related loss of consciousness, severe autonomic dysfunction, hypersomnia, loss of smell, hallucinations that differ from those common to DLB, delusions, apathy, anxiety, and depression. Hypersomnia and loss of smell (hyposmia) are the new additions to the updated criteria.

Biomarkers

Biomarkers that have shown high specificity and sensitivity in differentiating DLB from AD and are considered indicative biomarkers by the panel include reduced dopamine transporter uptake on single-photon emission computed tomography or positron emission tomography and reduced 123iodine-MIBG uptake on myocardial scintigraphy. Polysomnographic confirmation of RBD (ie, REM sleep without atonia) is also among the indicative biomarkers of DLB. One or more of these found in association with one or more clinical features are cause for a diagnosis of probable DLB.

Management

In discussing management, the panel declared that cholinesterase inhibitors currently are the preferred pharmacotherapeutic option for management of cognitive and neuropsychiatric symptoms. Although some patients may benefit, the authors noted that dopaminergic therapies can worsen neuropsychiatric symptoms of DLB and that other strategies should be pursued to prevent fall injuries in patients with parkinsonism. Finally, the panelists stressed the urgent need for guidelines and outcome measures for clinical trials with the aim of developing disease-modifying drugs, effective pharmacologic and nonpharmacologic strategies, and support for patients with DLB and their caregivers.

References: 

http://www.pediatricsconsultantlive.com/geriatric-psychiatry/updated-key...1.http://www.pediatricsconsultantlive.com/geriatric-psychiatry/updated-key... Vann Jones SA, O’Brien JT. The prevalence and incidence of dementia with Lewy bodies: a systematic review of population and clinical studiesPsychol Med. 2014;44:673-683.

2. McKeith IG, Boeve BF, Dickson DW, et al. Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB ConsortiumNeurology. 2017 Jun 7. [Epub ahead of print]

3. Ferman TJ, Boeve BF, Smith GE, et al. Inclusion of RBD improves the diagnostic classification of dementia with Lewy bodiesNeurology. 2011;77:875-882.

Source for this article: https://www.psychiatrictimes.com/lewy-body/updated-key-diagnosis-dementia

Dementia and Gut Bacteria: New Research Shows Link

A new study presented at the International Stroke Conference and published online in the Scientific Reports journal has found a correlation between dementia and gut bacteria – finding that the depletion of certain gut bacteria results in an increased risk of the disease.

Learn more about the study and what it means for the future of dementia research.

Dementia and Gut Bacteria

The study involved 128 outpatients visiting a memory care clinic. Researchers accounted for demographics, including other dementia risk factors, and used MRI brain scans and neuropsychological tests to assess cognitive function. To determine gut microbiota (organisms that live in the digestive tract and account for about a thousand different species of bacteria), researchers used fecal samples.

Study participants were divided into people with and without the disease. Their analysis revealed differences in components of gut microbiota between the two groups. For the group with dementia, levels of bactericides (enterotype I) was decreased compared to the group without dementia. Meanwhile, other bacteria types (enterotype II) were increased in the group with dementia. The fecal samples also revealed higher concentrations of ammonia, indole, phenol and skatole, in the group with dementia.

“Although our study has numerous limitations, the results suggest that the gut microbiome could be a new target for the management of dementia,” study author Naoki Saji, MD, Ph.D., vice director of the Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology in Japan, says.

 

intestines

Please note: “Changes they saw included increasing levels of a bacterium that makes short chain fatty acids, which can help the body better utilize glucose. The image is credited to in the public domain.” https://neurosciencenews.com/whole-body-vibration-diabetes-14739/

 

Strong Evidence of Link Between the Two

While the study was unable to prove a causal relationship and had a small sample size, researchers believe the odds ratios in the study were high, suggesting an underlying mechanism in the effects of gut microbial composition on brain health.

Costantino Iadecola, MD, professor of neurology at Weill Cornell Medical College and director of the Feil Family Brain and Mind Research Institute in New York City, remarked, “It’s difficult for studies in this field to draw correlations. The microbiota is variable and it can be modified by a wide variety of factors….”

Acknowledging its limitations, the study still supports previous data linking brain health and diet. Some researchers believe a Mediterranean diet rich in fish, fruits and vegetables may be beneficial while others promote a traditional Japanese diet. Most agree that processed foods and sugars have a negative impact on brain health.

Source of this article published on April 17, 2019: https://www.alzheimers.net/dementia-and-gut-bacteria-new-research-shows-link/

Note to readers: The content provided by the author is offered on an informational basis only and as a service made available to those interested in energy medicine. . Each individual is unique and each has a different optimal health measure. The Good Shepherd Healing System (GSHS) does not require any herbal or nutritional supplements, any special diet, or any physical activity. The GSHS does not cause unwanted side effects, death, or worsening of an existing condition as it uses energy to create optimal health in each individual. Energy medicine, and the GSHS in particular, does not heal your body. It facilitates your body to heal itself by using specific frequencies.

Always consults with your physician first who is qualified to make a diagnosis and is also qualified to confirm any change in your condition following a GSHS treatment.

For more information on this article or to set up a GSHS consultation, please go to https://internationalcaregiversassociation.com/energy-medicine.html 

Originally published on March 26, 2015 by Larissa Romensky

The monochord sound bed and its powers

https://www.weplaywelltogether.com/products/monochord-table

Sound therapist Denise Davis of Harcourt strums her monochord sound bed (ABC Central Victoria:Larissa Romensky)

As Denise strums the strings beneath the large wooden 'bed' the vibrations can be felt beneath the surface.

This wooden instrument with 55 strings beneath it is what she uses to deliver sound therapy to her clients.

Half of the strings are made of stainless steel and the other half of copper, each tuned to a particular note, which make up a chord.

The strings are tuned by the pegs at the end of the table.

Built in Switzerland, Denise said it's the only one of its kind in Australia.

It was developed by German Swiss music therapist Dr Joachim Marz in the 1980s.

Denise came across the instrument about 12 years ago while in France.

"It really captured me as far as how the sound of this instrument resonated through all the cells of the body," she said.

"I knew there was much more to it than it just being a music instrument for listening."

The large 7ft long table made of elm, works by having someone lie on it while Denise strums the strings beneath, causing them to vibrate.

"It sets up a real harmonic resonance," she said.

"When you lie on it the client feels like they're in the middle of a sound bath.

"They forget that they are lying on a wooden table and go deeper into relaxation."

Denise flew to Switzerland, met Dr Marz, and together they built it.

"I had to learn how to sand it, varnish it and he showed me how to string it and tune it," she said.

https://www.linkedin.com/in/minerva1/

Transporting it proved more difficult.

They then had to source wood to build a box big enough and strong enough to carry it on its six week journey across the ocean to Australia.

It took two people to lower it into the well-padded box in two pieces.

"It's like lifting a dining room table; it's not a light instrument to move around, "she said

Denise claims there are therapeutic benefits to the table.

"There is a lot of research that says acoustic music has an effect on the brain," she said

She sites Dr Marz's research into it.

He studied the use of music therapy in patients in psychosomatic neuro-rehabilitation.

Working at a rehabilitation hospital in Switzerland, he teaches music therapy to paraplegics and quadriplegics.

"The process is for people to be able to heal," Denise said.

Dr Marz's study found that patients can experience additional psychiatric disorders after a car accident and need a more complex rehabilitation process.

He found that music therapy using the therapeutic monochord bed can improve a patient's healing process.

Denise says it is not only a healing tool but is also used for relaxation.

"I use it to make people feel relaxed and rejuvenated, "she said

"There is a sense of deep relaxation. People go to a quieter level."

She sees many people in her practice including people with disabilities.

One of her clients was a severely disabled eight-year-old boy who arrived with his family. Unable to speak, he wore hearing aids.

He lay on the table for about 20 minutes with his hearing aids removed.

"A week later the mother said he had slept all night for the first time in his life without waking up and yelling, "Denise said.

"The person on the table feels the vibrations go through their muscles."

The effects continue long after the session has finished.

"It resonates in the body for a lot longer, even after the person had gotten off the table, "Denis said.

Source of original article: http://www.abc.net.au/local/photos/2015/03/25/4204563.htm

Please note: As with any new form of therapy, please consult your physician before starting a new routine to support your health or the health of a loved one. Dr. Lord is reprinting this article because she has experienced this form of therapy.

Reprint of an article on improving sleep and the life of someone living with a dementia: Dementia Care: Re-Connecting with The Sleep Kit May 23, 2018 Author is Eve Baird

My nightly routine consists of washing my face, brushing my teeth, and reading my book. I’m sure that as you read this, you’re thinking about what your own bedtime routine is like. Perhaps you simply brush your teeth and hop into bed, or maybe your bedtime is more of an elaborate ritual, like my Granddad’s was. He used to spend at least an hour in the evening washing his face, combing his hair and shaving, all while singing very loudly with his radio on full blast.  

When a person is living with dementia, bedtime is often a very different story. They may not have the ability to fulfill their nightly bedtime routine in the way they once did. They may also have trouble sleeping, which can exacerbate the other physical and cognitive changes they’re dealing with. These individuals may experience reversal of day-night sleep patterns, which results in sleeping more during the day and not getting enough sleep at night. Other sleep disturbances could include frequent nighttime awakenings, and decreases in REM sleep, which can negatively affect one’s memory and mood. These sleep disturbances can lead to changes in behavior and appetite, and can aggravate the other symptoms of dementia. This creates added stress for both care partners, as it’s likely that neither person is getting adequate sleep. 

During my 4th year studying Gerontology at St. Thomas University, I decided to research sleep disturbances among persons living with dementia, as it’s an important health issue that has somehow been overlooked. Current solutions are few and far between. One frequent suggestion is to increase exercise, while other studies recommend reducing caffeine intake, practicing light therapy, and using certain types of medications. Medications can of course be helpful for some, but they’re not the solution for everyone. Some medications have the potential to cause dizziness, and because dementia can affect gait, the combination makes walking even more difficult and increases the risk of falling. Some doctors won’t prescribe sleep medications to older adults, as they can interfere with other prescribed medications. 

During my research into all these different factors affecting sleep hygiene in individuals living with dementia, one study in particular piqued my interest. Researchers measured the benefits of social interaction and how it might help people living with dementia achieve better sleep. The researchers found that if someone engaged in social activity throughout the day, of any kind at all, their sleep quality substantially improved. Having had some experience in recreational therapy during my summer student positions at York Care Centre, this angle really intrigued me, and I wanted to explore it further. 

TESTIMONIALS: https://www.thesleepkit.org/testimonials.html

With this information I explored further, and eventually developed a care package called The Sleep Kit. The Sleep Kit is a small box of alternative sleep therapies for individuals who are living with dementia. Each item in the kit was chosen based on its ability to stimulate one of the five senses, and all are focused on promoting one-on-one social interaction before bedtime. These items include a deck of playing cards, lotion, and essential oil, as well as other objects and products that help both the caregiver (whether formal or informal) and the individual living with dementia prepare together for a good night's rest. No part of The Sleep Kit is mandatory, and each activity can be easily modified to cultivate a positive experience that easily fits into any stage of the dementia journey. The Sleep Kit also contains a custom-made sleep diary that outlines each item, suggesting how it can be used and why it’s important. 

I currently work as an Activity Coordinator at York Care Centre in Birch Grove, where 24 people with some form of dementia call home. When I started, I mostly worked evening shifts, and I’d often see people experience the effects of “sundowning”, an increase in agitation beginning late afternoon and extending into the evening. In many instances, even just sitting down and spending some time with that person was helpful. Sometimes I’d bring them into a quiet room, where I would play music and organize an aromatherapy session with them. The success of these small gestures showed me how extremely powerful human interaction can be. Caregivers are extremely busy, and sometimes it can be difficult to find the time to spend quality time together. However, taking the time is always, always worth it. 

During my work at York Care Centre, I read a call for applications for a research grant awarded for projects centered on caregiver support. I applied, and was soon elated to discover that I’d received a $50,000 award from the Centre for Aging and Brain Health Innovation to test and validate The Sleep Kit. This award was then matched by the New Brunswick Health Research Foundation. I developed a research plan with the help of my co-researcher and friend, Claire Hargrove, as well as my former professor, Dr. Janet Durkee-Lloyd, who I consider my mentor— she encouraged The Sleep Kit idea from the beginning.

We’re now seeking 26 participants from Fredericton community to be involved in this research study during the summer months. In the fall, we’ll be doing another study with 24 participants who are living in the nursing home. 

Participants will be divided into two groups. group one will wear a Fitbit Alta HR (which tracks your sleep based on heart rate) for 30 days. Group two will also wear the Fitbit for 30 days, but they’ll also be asked to administer activities from The Sleep Kit as an intervention. The results of the study will then be analyzed and compiled into a final report for CABHI and NBHRF. 

The Sleep Kit is an easily accessible tool kit that I hope can be helpful in improving quality of life for both care partners in any given situation. If anyone is interested in being involved, we are seeking participants who are living at home with someone who is affected by dementia. For more information, please contact: This email address is being protected from spambots. You need JavaScript enabled to view it. or This email address is being protected from spambots. You need JavaScript enabled to view it..

Source of this important article: https://www.personcentreduniverse.com/single-post/2018/05/23/Dementia-Care-Re-Connecting-with-The-Sleep-Kit

If a man lives to be 100, how many people will take the time to honor his long and productive life?

The International Caregivers Association, LLC is mourning following the death of our first Chairman of the Board, Sir Norman Duncan. He always served the association well and without reservation. He died at Martinsburg VA Center in Virginia, USA on Friday, August 16, 2019. 

Norman suffered a major stroke in January 2019 and barely recovered so he could fly to Normandy France this past June. Sitting in the front row in his wheelchair along other veterans, he actively participated in the 75th anniversary of D-Day celebration.

I was able to take numerous photos from my television and create a souvenir photo album for him upon his return to the United States. Grateful as usual, he called me to let me know he would use that album in his presentation about WWII to other veterans at the home.

 

Sir Norman Duncan, First Chairman of the ICA Board of Directors

His death is unsettling, especially because he was involved with the ICA up to a few weeks ago. Norman will be remembered for his ideas, support, sense of humor and rolling laughter. At the end of July, Richard Efthim who is part of the ICA team, treated Norman to a coffee in a coffee shop. Here is one of the photos taken by Richard at the coffee shop.

Norman Duncan with Richard Efthim having a coffee break at the end of July 2019.

Last week, I received word from his daughter, Tina, that Norman was very ill. It is not uncommon for a person at this late stage in life to suddenly fight for their life. 

Norman Duncan with his daughter, Tina Duncan Barden.

Here are a few of Norman’s contribution to this world. A devoted husband and father of three, he took care of his wife, Elsie, in their home for many years before she died with Alzheimer’s.

·        Love for family, especially his war bride, Elsie (from England)

·        Love for country (WWII Veteran honored in 2018 by the French government)

·        Love of opera and music; honorary board member of the Loudoun Symphony

·        Love of women, especially French women in Normandy

·        First Chairman of the Board at the International Caregivers Association

·        Always interested in research into Alzheimer’s, training topics, etc.

·        Proclamation to declare “Labor of Love Weekend” for all caregivers (in September)

·        Never too busy to hold a telephone conference, even late in the evening

·        Always interested in the work of the International Caregivers Association

·        …so much more

Because of his caregiving responsibilities to Elsie, he discovered the International Caregivers Association (ICA) and volunteered to support our mission: Changing the course of dementia care through education and research, and to become the first Chairman of the Board.

Norman Duncan with his wife, Elsie Sheldon Duncan, in the 40s.

Until we meet again, Norman… It was good to know you and work with you. Thank you for serving this country and thank you for serving so well as Chairman of the Board at the ICA.

Norman Duncan attending D-Day 75th Anniversary in Normandy, France, June 2019.

Obituary at https://www.colonialfuneralhome.com/obituary/norman-duncan

Remembering Norman Duncan: To honor his work and life, you may donate to the Loudoun Symphony at https://www.loudounsymphony.org/donate

Thank you,

Dr. Ethelle Lord, President at the ICA

This article is a reprint of "4 MYTHS ABOUT AGING" at Aging Defeated. These guidelines apply to everyone and also apply to those living with a dementia; especially someone who has been able to contain their dementia with Energy Medicine.

More information on containing a dementia is available at https://internationalcaregiversassociation.com/

Not long ago, most folks – including scientists – believed that our bodies simply wear out as we age. And that does seem to be sort of a common sense way of looking at it. So most of us resigned ourselves to the march of time, which meant achy joints, fragile bones, withering muscles, failing eyesight, wrinkled skin and unreliable memory.

But before you start wallowing in this defeatist mentality, take a look at some inspiring new research that proves you can stem the tide of physical aging.

Below we’ll debunk four common myths about how the body ages …

#1 Myth: You can’t escape creaky, achy joints

It turns out that not exercising is one of the main mistakes that make painful joints inevitable. Researchers at Monash University School in Australia observed 176 women aged 40 to 67 with no clinical osteoarthritis or history of significant knee injury1.

The women all had magnetic resonance imaging on their dominant knee to assess tibial cartilage volume and defects. The participants also completed a questionnaire to determine exercise habits. Researchers found that those who exercised at least once every two weeks for 20 minutes or more had more healthy cartilage in their knees. This study suggests that people who are physically active are less likely to develop arthritis.

#2 Myth: Muscles will wither

There is a bit of truth here, as it’s normal to experience loss of muscle mass (a condition called sarcopenia) after age 40. This is largely because aging muscle becomes populated with malfunctioning mitochondria, the little powerhouses found in all cells. When mitochondria tank, muscle cells waste away and fat cells set up housekeeping.

But this doesn’t have to be everyone’s fate! An important study2 published in Public Library Science offers hope. Canadian researchers biopsied muscle from active and sedentary adults between 53 and 75 years old. It turned out the couch potatoes’ muscles had few robust mitochondria. In contrast, active adults’ muscles featured almost as many thriving mitochondria as you’d find in much younger adults.

And here’s the good news: the study found just about any exercise can improve and even reverse the signs of aging in muscles.

#3 Myth: It’s too late to benefit from exercise

Nothing could be further from the truth! In the oft cited Nurses’ Health Study3, researchers surveyed more than 13,500 women on their lifestyle habits. The scientists found that even if you don’t become active until middle age, exercise still greatly improves your odds of aging without cognitive or physical issues or developing a chronic disease.

In more good news, researchers in the United States and Europe have deduced that just about any kind of activity, at any age, helps preserve telomeres – the caps on the ends of chromosomes in your cells. When these caps become shorter, the cell stops dividing and dies. Exercise can help maintain telomere length, which potentially extends a cell’s life span. Even better, research shows that even moderate physical activity can provide this protective effect.

#4 Myth: Bones are more likely to break with age

Not necessarily! You see, researchers now believe inactivity is the biggest threat to bone health. Indeed, it’s proven that the best type of activity for bone health is weight-bearing exercise, which promotes formation of new bone.

Multiple studies4 with older men and women who performed weight-bearing exercise, or wore weighted vests, showed increases in bone mineral density, bone strength and bone size. In other studies5, researchers found that exercise can also help protect against bone loss in post-menopausal women, including those with osteoporosis or osteopenia.

Now, you don’t have to become a gym rat – merely walking is a weight-bearing exercise! Using exercise bands or carrying light weights while you walk will give you additional benefit, but proceed with caution as apparently some people injure themselves.

References"


  1. Menopause. 14(5):830-834, SEP 2007
  2. Melov S, Tarnopolsky MA, Beckman K, Felkey K, Hubbard A (2007) Resistance Exercise Reverses Aging in Human Skeletal Muscle. PLoS ONE 2(5): e465.
  3. Nurses’ Health Studies“. The Nurses’ Health Study. 2016-08-16. Retrieved 2017-07-17.
  4. J Biomech Eng. 2015 Jan;137(1). doi: 10.1115/1.4028847.
  5. https://cals.arizona.edu/cpan/files/Metcalfe%20ACSM%20final%20article.pdf

NOTE: Always check with your physician prior to starting a physical fitness program.

Source: https://agingdefeated.com/4-myths-about-aging/ retrieved for my network members on August 12, 2019

Reprint from NEUROSCIENCE NEWSJULY 20, 2019

Summary: A neuroimaging study on house sparrows reveals changes in the dopaminergic system could be a physiological mechanism underlying the negative behavioral effects of chronic stress. The findings shed light on stress and resilience in wildlife and humans.

Source: Louisiana State University

A biologist at Louisiana State University conducted a pioneering research study that could help us to better understand the role of dopamine in stress resilience in humans through analyzing wild songbirds. This study could lead to increased prevention and treatment of stress-related disorders.

Dopamine is a chemical in the brain that is important for learning and memory. Department of Biological Sciences Assistant Professor Christine Lattin, and colleagues conducted this study of wild songbirds showing that dopamine is important in responding to chronic stressors, which can help wildlife conservation efforts in response to environmental stressors such as habitat destruction, natural disasters, extreme weather events and increases in predation.

Lattin, who is the lead author on the study published in Nature’s Scientific Reports, applied a biomedical imaging technology called Positron Emission Tomography, or PET, scans that are used commonly on humans but rarely on wild animals to quantify dopamine receptors in house sparrows.

“This study is exciting because it is the first time PET scans have been used in wildlife to quantify dopamine receptors in the brain. Developing this technique has opened the door to being able to scan animals and release them back into the wild,” she said.

“We need to know how these wild birds are coping with stressors and responding to changes to the environment so we can understand how to best protect them.”

In addition to the biomedical imaging, Lattin and colleagues tracked changes in the birds’ body mass and hormone levels, and observed their behavior using a remotely operated video camera to study wild house sparrows’ response to captivity over four weeks. The birds were scanned after being brought in to the lab and then again four weeks later. By using PET scans, they were able to study how the stress of captivity affected the birds over time.

They found that one type of dopamine receptor decreased over time during captivity, which suggests that birds became less resilient to stress over time. The greater the decrease in dopamine receptors, the more they exhibited anxiety-related behaviors such as feather-ruffling. All of the wild birds also decreased body mass.

They found that one type of dopamine receptor decreased over time during captivity, which suggests that birds became less resilient to stress over time. The image is in the public domain.

“These physiological, neurobiological and behavioral changes suggest that songbirds are not able to habituate to captivity, at least over short periods of time. It is very important that scientists studying stress in wildlife find more ways to study them in their natural habitat,” Lattin said.

This research complies with all existing laws and regulations and the Ornithological Council’s Guidelines for the Use of Wild Birds in Research.

Abstract

In vivo imaging of D2 receptors and corticosteroids predict behavioural responses to captivity stress in a wild bird

Individual physiological variation may underlie individual differences in behavior in response to stressors. This study tested the hypothesis that individual variation in dopamine and corticosteroid physiology in wild house sparrows (Passer domesticus, n = 15) would significantly predict behavior and weight loss in response to a long-term stressor, captivity. We found that individuals that coped better with captivity (fewer anxiety-related behaviors, more time spent feeding, higher body mass) had lower baseline and higher stress-induced corticosteroid titres at capture. Birds with higher striatal D2 receptor binding (examined using positron emission tomography (PET) with 11C-raclopride 24 h post-capture) spent more time feeding in captivity, but weighed less, than birds with lower D2 receptor binding. In the subset of individuals imaged a second time, D2 receptor binding decreased in captivity in moulting birds, and larger D2 decreases were associated with increased anxiety behaviors 2 and 4 weeks post-capture. This suggests changes in dopaminergic systems could be one physiological mechanism underlying negative behavioral effects of chronic stress. Non-invasive technologies like PET have the potential to transform our understanding of links between individual variation in physiology and behavior and elucidate which neuroendocrine phenotypes predict stress resilience, a question with important implications for both humans and wildlife.

Source: https://neurosciencenews.com/stress-dopamine-14534/

This article is reprinted from NEUROSCIENCE NEWS

The brain’s pathways to imagination may hold the key to altruistic behavior

Summary: Imagination helps us act altruistically, a new study reports. When we see others in trouble, we imagine how we can help before acting. Researchers implicate the medial temporal lobe subsystem in guiding our prosocial behaviors.

Source: Boston College

In those split seconds when people witness others in distress, neural pathways in the brain support the drive to help through facets of imagination that allow people to see the episode as it unfolds and envision how to aid those in need, according to a team of Boston College researchers.

The underlying process at work is referred to as episodic simulation, essentially the ability of individuals to re-organize memories from the past into a newly-imagined event simulated in the mind.

Neuroimaging helped the researchers identify multiple neural pathways that explain the relationship between imagination and the willingness to help others, researchers from Boston College and the University of Albany, SUNY, reported recently in the journal Social Cognitive and Affective Neuroscience.

The team explored two separate brain regions with different functions: the right temporoparietal junction (RTPJ), a key brain region thought to be involved in representing the minds of other people, also known as “perspective-taking”; and the medial temporal lobe (MTL) subsystem, a set of brain regions that support the simulation of imagined scenes.

The study discovered evidence for the direct impact of scene imagery on willingness to help, according to Boston College Associate Professor of Psychology Liane Young, a co-author and the principal investigator on the project. While study participants imagined helping scenes, neural activity in MTL predicted overall willingness to help the person in need, according to the article, “A role for the medial temporal lobe subsystem in guiding prosociality: the effect of episodic processes on willingness to help others,” which was published in the journal’s April 14 edition.

“If we are able to vividly imagine helping someone, then we think we’re more likely to actually do it,” said Young, director of the Morality Lab at BC.

“Imagining the scenery surrounding the situation can also prompt people to take the perspective of the people in the situation who need help, which in turn prompts prosocial action.”

This may be because of a phenomenon known as imagination inflation, where humans use the vividness of their imagination as a kind of cue to estimate the likelihood of an event, according to the co-authors, which also included former BC postdoctoral researcher Brendan Gaesser, now an assistant professor of psychology at the University of Albany, SUNY, research assistants Joshua Hirschfeld-Kroen and Emily A. Wasserman, and undergraduate research assistant Mary Horn.

The team set out to learn how the capacity to simulate imagined and remembered scenes of helping motivate individuals to form more altruistic intentions. The goal was to uncover the cognitive and neural mechanisms that explain the relationship between episodic simulation and the enhanced willingness to help those in need.

In the first experiment, which allowed the team to look at both brain regions, the researchers collected functional brain images as people imagined and remembered helping others in hypothetical scenarios. In the second experiment, while people were imagining helping another person, the team used transcranial magnetic stimulation (TMS) to disrupt activity in their right temporoparietal junction (RTPJ), a key brain region thought to be involved in representing the minds of other people.

Neuroimaging revealed that the willingness to help was also predicted by activity in the RTPJ, a critical node that’s involved in taking the perspective of other people, according to the researchers. However, in the second experiment, when the team used TMS to temporarily inhibit activity in the RTPJ, they found that the altruistic effect of vividly imagining helping remained significant, suggesting that this effect doesn’t depend exclusively on perspective-taking.

“We had initially expected that higher neural activity in the medial temporal lobe subsystem would be associated with a greater willingness to help,” the team reported. “Surprisingly, we found the opposite: the more activity a person had in their MTL subsystem while they were imagining helping scenes, the less willing they were to help the person in need.”

However, in the second experiment, when the team used TMS to temporarily inhibit activity in the RTPJ, they found that the altruistic effect of vividly imagining helping remained significant, suggesting that this effect doesn’t depend exclusively on perspective-taking. The image is in the public domain.

This contradiction may be explained by lower MTL activity reflecting greater ease of imagining episodes, and that ease of imagination means that participants are more willing to help. Consistent with this account, the team found that when participants reported finding it easier to imagine or remember helping episodes, they also tended to report being more willing to help the person in need.

Young and Gaesser recently found in a separate study, led by BC postdoctoral researcher Jaclyn Ford and Professor Elizabeth Kensinger, that vividly remembering helping was associated with making more generous donations in the wake of the 2013 Boston Marathon bombing. Next steps in the research will further connect the lab’s neuroimaging approach with measures of real-world altruistic behavior.

ABSTRACT

A role for the medial temporal lobe subsystem in guiding prosociality: the effect of episodic processes on willingness to help others

Why are we willing to help others? Recent behavioral work on episodic processes (i.e. the ability to represent an event that is specific in time and place) suggests that imagining and remembering scenes of helping a person in need increases intentions to help. Here, we provide insight into the cognitive and neural mechanisms that enhance prosocial intentions via episodic simulation and memory. In Experiment 1, we scanned participants using functional neuroimaging as they imagined and remembered helping episodes, and completed non-episodic control conditions accounting for exposure to the story of need and conceptual priming of helping. Analyses revealed that activity in the medial temporal lobe (MTL) subsystem, as well as the right temporoparietal junction (RTPJ) predicted the effect of conditions on the strength of prosocial intentions. In Experiment 2, we used transcranial magnetic stimulation to disrupt activity in the RTPJ, and better isolate the contribution of MTL subsystem to prosocial intentions. The effect of conditions on willingness to help remained even when activity in the RTPJ was disrupted, suggesting that activity in the MTL subsystem may primarily support this prosocial effect. It seems our willingness to help may be guided, in part, by how easily we can construct imagined and remembered helping episodes.

Source: https://neurosciencenews.com/altruism-imagination-14470/

Dr. Ethelle Lord can be contacted via email at This email address is being protected from spambots. You need JavaScript enabled to view it.

Contributing article by Karoline Gore, an experienced care home worker and writer.

3 Helpful Tips to Lower Risks of Dementia

The number of people affected with dementia is expected to triple in the next 30 years making it important to do everything possible to lower the risk of decline in cognitive functioning. Nearly 50 million are affected worldwide and there are 10 million new cases each year according to the World Health Organization (WHO). Although there is no cure for the condition, it is possible to reduce the risks of dementia and avoid the devastating consequences.

Healthy Diets and Exercise

Dementia affects the physical, physiological, and mental condition of patients as well as caregivers, family, and the society. It not only requires medical attention and caregiving but also entails home modifications to make the environment safe for an affected person. One of the guidelines issued by the WHO to diminish the risks of dementia is to eat well. It recommends the Mediterranean diet which is based on fruits, vegetables, nuts, whole grains, and legumes.

By focusing on healthy fats such as olive oil, you’ll be able to maintain good cholesterol and blood pressure levels essential for a healthy heart. McEvoy et al concluded that adherence to this type of diet during adulthood is associated with better cognitive performance indicating that what is good for the heart is also good for the brain. In addition to eating well, it is also important to exercise regularly. Physical movement reduces the risk of stroke and heart diseases which are risk factors linked to dementia as well as prevent obesity, type 2 diabetes, and high blood pressure.

Smoking and Alcohol Consumption

Smoking damages the heart and the brain with research indicating that those who smoked or people who kicked the habit were less likely to develop dementia vis-à-vis current smokers. Excessive consumption of alcohol and binge drinking can also cause brain damage and as such, increase your chances of getting the condition.

Over time, too much alcohol reduces the brain’s white matter which assists in transmitting signals to the different regions of the brain. Moreover, long-term alcohol intake can also lead to memory disorders such as Korsakoff’s Syndrome.

Improving Mental Health and Cognitive Activity

Good diets, exercise, and lifestyle changes not only improve your physical health, but also your mental health. Exercise produces endorphins that are natural painkillers. It also improves moods and sleep and reduces stress. Studies indicate that brain training such as puzzles, games, and crosswords can improve some areas of memory and thinking. It helps older people manage their life better although no conclusive studies exist that prove brain training prevents dementia.

Thus, eating healthy meals, exercising, avoiding tobacco and alcohol, and improving mental health and brain training can lower the risks of developing the condition.

 

The author of this article, Karoline Gore, can be reached via email at This email address is being protected from spambots. You need JavaScript enabled to view it.

Energy is at the very source of life. Someone living with DEMENTIA, or someone providing care to someone living with dementia, can benefit by applying one or more of these three energy areas:

  • BOTANICAL ENERGY (for the person living with dementia and the care providers)
  • MEMORY ENERGY (for the care providers)
  • ENERGY MEDICINE (for the person living with dementia and their care providers)

knott

BOTANICAL ENERGY refers to supplements that controls the most basic bodily functions necessary to experiencing optimal physical health. At the very foundation of optimal health to create energy that protects and sustains us are 4 simple supplements: D3; Super B Complex, Garlic Oil, and Selenium. Many herbal preparations have the same benefits as prescription drugs. However all prescription drugs can have negative affects. Read more here: https://internationalcaregiversassociation.com/botanical-energy.html
insight logo

MEMORY ENERGY refers to emotional feelings past experiences or long-held ideas that turn into burdens and impediments. These beliefs affect every area of life. This therapeutic method can even be done by a child who experiences bullying or high anxiety in social situations. It is especially beneficial for someone living the PTSD and chronic conditions. High stress is often reported by those working in the field of dementia care. Change the way you work, the way you love, the way you control your weight, the way you treat others and others treat you by having clearer emotional control. Read more here: https://internationalcaregiversassociation.com/what-is-memory-energy-therapy.html
GSHS Logo

ENERGY MEDICINE refers to a new way of alternative treatment used in the field of dementia and other areas of health. Biofeedback, in the 50s and 60s, discovered how energy could lower or increase blood pressure at will. This new form of energy is somewhat similar only in the way the GSHS Practitioner has the ability to request the human body to reach it's optimal functioning and apply the proper frequencies necessary to correct a functioning problem whether it has to do with the brain, blood system, or any other function. The human body is 'electrical'; we run on 'energy'. Energy refers to anything that vibrates. Every vibration has a frequency. When the organs do not vibrate properly, sickness is the end result. Read more here: https://internationalcaregiversassociation.com/energy-medicine.html

Disclosure:

"Fundamentally, life is an energy-handling process. What most clearly separates the living from the non-living is the fact that life uses energy to maintain itself." (http://www.elasmo-research.org/education/white_shark/life.htm)

The 3 forms of energy techniques described in this article have been shown to be beneficial in the field of dementia and dementia care. None have unwanted side effects such as death, or worsening of an existing condition. In fact a trained and experience practitioner in each area is able to quickly recognize when such an approach or technique may or may not be recommended.

Always consult with your physician first who is qualified to make a diagnosis and to confirm any change in your condition should you venture to apply one or more of these 3 energy forms of healing yourself.

For more information on this article please go to https://InternationalCaregiversAssociation.com or email your comments to the author at This email address is being protected from spambots. You need JavaScript enabled to view it.

Norman Duncan is the first and current Chairman of the Board at the International Caregivers Association. This week he traveled from his home in Virginia, USA to Normandy, France to celebrate 75 years since D-Day.
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If you wish to correspond with him via email, please write him a note at This email address is being protected from spambots. You need JavaScript enabled to view it.

Norman is an exceptional man with a century of life experience. We are extremely grateful to have him as our chairperson and also to call him a friend. I am certain he will appreciate you reaching out.

PS: Norman took care of his love of his life, Elsie Duncan who was British and his war bride, for several years until her death with dementia on August 2, 2015. He is my hero for those two reasons: US Army WWII veteran and dementia care provider well into his 90s.

 

Visit us at www.ICareAssoc.com

The research may one day give voice to people who lost speech from neurological disorders.

Originally printed on April 24, 2019 and written by Michael Greshko & Maya Wei-Hass

Someday, people who have lost their ability to speak may get their voice back. A new study demonstrates that electrical activity in the brain can be decoded and used to synthesize speech.

The study, published on Wednesday in Nature, reported data from five patients whose brains were already being monitored for epileptic seizures, with stamp-size arrays of electrodes placed directly on the surfaces of their brains.

As the participants read off hundreds of sentences—some from classic children's stories such as Sleeping Beauty and Alice in Wonderland—the electrodes monitored slight fluctuations in the brain's voltage, which computer models learned to correlate with their speech. This translation was accomplished through an intermediate step, which connected brain activity with a complex simulation of a vocal tract—a setup that builds on recent studies that found the brain's speech centers encode the movements of lips, tongue, and jaw.

“It's a very, very elegant approach,” says Christian Herff, a postdoctoral researcher at Maastricht University who studies similar brain-activity-to-speech methods.

The device marks the latest in a rapidly developing effort to map the brain and engineer methods of decoding its activity. Just weeks ago, a separate team including Herff published a model in the Journal of Neural Engineering that also synthesized speech from brain activity using a slightly different approach, without the simulated vocal tract.

“Speech decoding is an exciting new frontier for brain-machine interfaces,” says the University of Michigan's Cynthia Chestek, who was not involved in either study. “And there is a subset of the population that has a really big use for this.”

Both teams, as well as other researchers around the world, hope to help people who have been robbed of their ability to speak by conditions such as amyotrophic lateral sclerosis (ALS)—the neurodegenerative disorder known as Lou Gehrig's disease—and strokes. Though their brains' speech centers remain intact, patients are left unable to communicate, locked away from the world around them.

Past efforts focused on harnessing brain activity to allow patients to spell out words one letter at a time. But these devices' typing speeds top out at around eight words per minute—nowhere near natural speech, which rushes by at around 150 words per minute.

“The brain is the most efficient machine that has evolved over millennia, and speech is one of the hallmarks of behavior of humans that sets us apart from even all the non-human primates,” says Nature study coauthor Gopala Anumanchipalli of the University of California, San Francisco. “And we take it for granted—we don’t even realize how complex this motor behavior is.”

While the studies' results are encouraging, it will take years of further work before the technology is made available for patients' use and adapted to languages other than English. And these efforts are unlikely to help people who suffered from damage to the speech centers of the brain, such as some traumatic brain injuries or lesions. Researchers also stress that these systems do not equate to mind-reading: The studies monitored only the brain regions that orchestrate the vocal tract's movements during conscious speech.

“If I'm just thinking, 'Wow, this is a really tough day,' I'm not controlling my facial muscles,” says Herff. “Meaning is not what we are decoding here.”

Eavesdropping on the brain

To translate thoughts into sentences, Anumanchipalli and his colleagues used electrodes placed directly on the brain's surface. Though invasive, this direct monitoring is key to success. “Because the skull is really hard and it actually acts like a filter, it doesn’t let all the rich activity that's happening underneath come out,” Anumanchipalli says.

Once they collected high-resolution data, researchers then piped the recorded signals through two artificial neural networks, which are computer models that roughly mimic brain processes to find patterns in complex data. The first network inferred how the brain was signaling the lips, tongue, and jaws to move. The second converted these motions into synthetic speech, training the model using recordings of the participants' speech.

Next came the true test: Could other humans understand the synthetic speech? For answers, researchers recruited a group of 1,755 English speakers using Amazon's Mechanical Turk platform. Subgroups of these listeners were assigned to 16 different tasks to judge the intelligibility of both words and sentences.

Participants listened to 101 sentences of synthesized speech and then tried to transcribe what they heard, choosing from a group of 25 or 50 words. They were correct 43 and 21 percent of the time, respectively, depending on the number of words to choose from.

Not every clip was equally intelligible. Some simple sentences, such as “Is this seesaw safe?,” got perfect transcriptions every time. But more complicated sentences, such as “At twilight on the twelfth day, we'll have Chablis,” came out perfectly less than 30 percent of the time.

Some sounds were also more easily decoded than others. Sustained signals, such as the sh in “ship,” came through the analysis cleanly, while sharp bursts of noise—such as the b in “bat”—were smoothed-over and muddled.

While the output isn't perfect, Chestek points out that the data used to train the system is still fairly small. “Arguably they’re still kind of operating with one hand behind their back because they’re limited to epilepsy surgeries and epilepsy patients,” she says, adding that potential future systems implanted solely for brain-to-speech translation could be slightly more optimized. “I’m cautiously very excited about this.”

It's electric

The Nature study's authors used a two-step process to make their synthesized speech that much clearer. But in principle, it's feasible to go straight from brain activity to speech without using the simulated vocal tract as an in-between, as shown in the Journal of Neural Engineering study.

In that work, researchers recorded the brain activity and speech of six people undergoing surgery to remove brain tumors, using an on-brain electrode grid similar to the one in the Nature study. The team then trained a neural network to find the associations between each participant's spoken words and brain activity, designing the system so that it could work with just eight to 13 minutes of input audio—all the data they could collect mid-surgery.

“You just have to imagine how stressful the situation is: The surgeon opens up the skull and then places this electrode grid directly, and they do it to map where the cancer stops and where the important cortex [brain matter] starts,” says Herff. “Once they finish that, they have to calculate what to cut out—and during that interval, our data is being recorded.”

Researchers next fed the neural network's output into a program that converted it into speech. Unlike the Nature study, which attempted to synthesize full sentences, Herff and his colleagues focused on synthesizing individual words.

It's tough to directly compare how the two methods performed, emphasized Northwestern University's Marc Slutzky, a coauthor of the Journal of Neural Engineering study. But they do show some similarities. “From the few metrics we used in common,” he says, “they seem to be somewhat similar in performance—at least for some of the subjects.”

Lingering challenges

Considerable hurdles remain before this technology ends up in the hands—or brains—of patients. For one, both studies' models are based on people who can still speak, and they haven't yet been tested in people who once spoke but no longer can.

“There's a very fundamental question ... whether or not the same algorithms will work,” says Nature study coauthor Edward Chang, a neurological surgery professor at the University of California, San Francisco. “But we're getting there; we're getting close to it.”

Anumanchipalli and his team tried to address this in some trials by training on participants who did not vocalize, but instead just silently mouthed sentences. While this successfully generated synthetic speech, the clips were less accurate than ones based on audibly spoken inputs. What's more, miming still requires the patients to be able to move their face and tongue—which isn't a given for people suffering neurological issues that limit their speech.

“For the patients that you’re most interested on [using] this in, it’s not really going to help,” Slutzky says of the miming trials. While he sees the work as a strong demonstration of current possibilities, the field as a whole still struggles to make the leap to people who no longer can speak.

The hope is that future brain-speech interfaces can adapt to their users, as the users themselves adapt to the device—while also retaining control over the interfaces, as well as a semblance of the privacy that able-bodied people routinely enjoy in their speech. For instance, how do users maintain control over their data, such as the personalized vocabulary their systems build up over time?

“You can turn off that [smartphone] feature, but what if you don't have that physical control?” asks Melanie Fried-Oken, a speech-language pathologist at Oregon Health & Science University and expert on assistive speech technologies. “At what level do you want privacy and identity impinged upon for the function of communication? We don't know the answers.”

In decades to come, people with disorders like cerebral palsy, who often lack control of their speech muscles from early on, may well grow up with the devices from childhood—helping organize their brains for speech from the beginning.

“Wouldn’t it be great to be able to give this to a three-year-old who can now interact with the environment, who hasn't been able to do it yet?” Fried-Oken says. “Just like we're giving cochlear implants to [deaf] infants—the same! There's such potential here, but there's so many neuroethical issues."

Source: https://www.nationalgeographic.com/science/2019/04/new-computer-brain-interface-translates-activity-into-speech/?fbclid=IwAR0tSSvwhNEic2t7u6wJud6jQoaDUpP7v9bUiegCl5x4QSdeimuphb8ZU3I