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AD and Cognitive Reserve
llee08032
Posted: Friday, November 20, 2015 6:23 AM
Joined: 5/20/2014
Posts: 4406


Alzheimer’s and Cognitive Reserve: Education Effect Varies with [11C]PIB Uptake

Catherine M. Roe, Mark A. Mintun, Gina D’Angelo, Chengjie Xiong, Elizabeth A. Grant, John C. Morris
Arch Neurol. 
Published in final edited form as: Arch Neurol. 2008 November; 65(11): 1467–1471. doi: 10.1001/archneur.65.11.1467
PMCID:  PMC2752218

Mimi S.
Posted: Friday, November 20, 2015 8:39 AM
Joined: 11/29/2011
Posts: 7035


Hi Llee,

Loos like a good read, but I doubt I'll get to it. Too many other things to do.

Note publication date of 2008, which is 7 years ago.

Have you read it?

Are the authors recognizing the effect of high intelligence/ high cognitive reserve on the diagnosis of dementia?


alz+
Posted: Friday, November 20, 2015 8:51 AM
Joined: 9/12/2013
Posts: 3549


Llee - what do you think of this theory and study?

"education" meant, I assumed, USA level of college education.

When one considers most education in USA  now -  no history, no literature, no lectures, no classrooms (except at elite schools), it makes me wonder if they mean what a Formal Education USED to be.

 I do not get what this means to me as an "uneducated person" with ALZ. I fear it will affect treatment worthiness perception.

I trained for 24 months as radiologic technician, and trained in massage therapy over 15 years in advanced work, wrote novels and columns for a newspaper, yet am considered "uneducated". The  neurologist who diagnosed me said I was very competent and had all kinds of skill at working around cognitive losses, which gave me instant hope and more confidence.

Saw an article a couple days ago that 'scientists had discovered that during sleep the brain in cleaned by a fluid system"... that would be the lymphatics.

 https://www.urmc.rochester.edu/news/story/3584/scientists-discover-previously-unknown-cleansing-system-in-brain.aspx

 I used to do manual lymphatic drainage as taught by a French M.D. and cranio-sacral work as taught by John Upledger D.O.

despite huge health improvements in the people we worked on this was considered quackery. To think the lymph system helps feed and clean the brain is NEW makes me doubt a lot of medical views. Or that they are still on the tau and tangle and plaque concept.

When you read this article what was your take in terms of relevance to people who are PHDs and so on who get a virulent form of ALZ and those of us without formal education who seem to keep plugging along?

Interested in what anyone else thinks about what this concept means to those of us with the illness. Thanks for finding this!


Iris L.
Posted: Friday, November 20, 2015 1:55 PM
Joined: 12/15/2011
Posts: 16236


Alz+, the drainage system of the brain is not the same as the lymphatic system of the body.  But it is encouraging to learn that processes that occur during sleep may reduce tau and beta amyloid in our brains.  I have always believed that disordered sleep was a factor in my illness.

I believe following Best Practices is the best hope we have for treating the dementias.  It may be possible that those with more education search for "proof" before they begin Best Practices, whereas others begin Best Practices, and let their response be their proof.  The proof is better functioning and prolongation of the early stages.  

Iris L.


alz+
Posted: Friday, November 20, 2015 5:13 PM
Joined: 9/12/2013
Posts: 3549


Iris - Yes on how important sleep is!

   CSF and blood not filtered by lymphatics? Been 20 years - what system is cleaning up during sleep then?

Was it me who was again mentioning an article not relevant to this topic?

I am curious what effect there is (if any) on the QUALITY of treatment, or manner of treatment, having a formal education  a patient vs. people who learned through Life or Trade Schools or informal studies.

 I thought the educated nun study implied that education did not protect against ALZ or lessen it's course, and evidence of Tau or lack of it did not correspond to ALZ.

 I think I am misinterpreting what these connections mean or why they would be true.

Do uneducated people get different care than educated people if the doctor expects the formally educated to do better?

Maybe that was stated in article which I could not really grasp, and probably could not grasp even before ALZ. Looking for help with that. Too late for me now to try for a degree, but are they saying IQ, or competency is no protection, where a formal university education is?

 

That is what I am asking, if there was any way to even determine that. 

 

 


JeanetteD
Posted: Saturday, November 21, 2015 9:34 AM
Joined: 10/27/2015
Posts: 38


I've worked rotating shifts for most of 28 years, and as a result have developed insomnia. I wake after 2 or less hours, and just get short bursts of sleep after that. I average 4 hours of sleep every 24 hours. I definately think lack of quality sleep has contributed to my cognitive decline.
alz+
Posted: Saturday, November 21, 2015 9:57 AM
Joined: 9/12/2013
Posts: 3549


Jeanette - I have had years of waking at night and finally gave into it and used the time for what ever I wanted to get done in peace and quiet.

Only recently have I begun to sleep 6+ hours a night. Not sure why. At the same time daily living has become easier for me to do, I have more energy.  I also have been back on a nutritional tea and a couple other things, including living camp style in a house under do it yourself renovation.

Do you have anything that extends your sleep time? Do you feel rested after 4 hours? I read about a woman who slept twice a day, 4 hours each time and had been that way for years.

Some people use music in background, white noise machines, etc. I'm sure you have tried everything. Maybe some one has a similar experience. Depending on one's degree of brain changes we might just start to sleep more or less.

Do you dream? I just started having dreams again, or dreams I can recall a bit of when I wake up. I always thought dreaming was important. Unsure about most things now. 

 


alz+
Posted: Saturday, November 21, 2015 10:16 AM
Joined: 9/12/2013
Posts: 3549


Off topic as usual...about the way the brain cleans up the junk and waste...

I posted link to article in post above. Seems there are 2 systems that clean at night...

 

From article:

 “We’re hopeful that these findings have implications for many conditions that involve the brain, such as traumatic brain injury, Alzheimer’s disease, stroke, and Parkinson’s disease,” she added.

Nedergaard’s team has dubbed the new system “the glymphatic system,” since it acts much like the lymphatic system but is managed by brain cells known as glial cells. The team made the findings in mice, whose brains are remarkably similar to the human brain.

Scientists have known that cerebrospinal fluid or CSF plays an important role cleansing brain tissue, carrying away waste products and carrying nutrients to brain tissue through a process known as diffusion. The newly discovered system circulates CSF to every corner of the brain much more efficiently, through what scientists call bulk flow or convection."

  At any rate, it has to be good to know our brains clean themselves all the time, but especially during sleep. This is not meant to infer people with problems sleeping are devoid of this cleansing activity. Not intended as more info to worry about.

 


JeanetteD
Posted: Saturday, November 21, 2015 10:19 AM
Joined: 10/27/2015
Posts: 38


I have not recalled a dream in years. I only sleep about 4 hours total in 24, and that is broken up in bits. I do feel tired a lot, but I'd just accepted that's the way it is for me and just gone about my business. Not much I can do about it. Chronic sleep deprivation is possibly a contributing factor in cognitive decline/Alz; from something I saw somewhere. I don't know. My shift changes each week from nights to evenings to days then to nights; with one or two days off between each 5 day work week. You never get used to a shift before you are switching to the next one. It is what it is.
Iris L.
Posted: Saturday, November 21, 2015 3:18 PM
Joined: 12/15/2011
Posts: 16236


alz+ wrote:

That is what I am asking, if there was any way to even determine that. 

 

Alz+, I am having trouble just understanding your question!!  It's not you, it's me.  I have not yet recovered from my overseas trip.  My brain is sluggish.  Not due to cognitive impairment, but due to PAIN.  I am in pain after the moderate amount of walking that I did.  I must accept that I cannot exert myself as other people can.

I don't know if I am answering your question, but this is what I know.  Here goes.

People of any level of intelligence and education can develop a degenerative dementia. 

A patient with a high education may still function adequately in daily life, even after losing half of cognitive functioning.  But a patient with a sixth grade education may be unable to function adequately in daily life, after losing half of her cognitive functioning.

An analogy might be the following.  A patient who weighs 200 lbs may still function by losing half her body weight, down to 100 lbs.  A patient who weighs 100 lbs would be significantly impaired if she lost half her body weight, down to 50 lbs.

So, I believe what people are saying, is that having a cognitive reserve gives a patient a good "cushion" of cognition that could be lost before severe impairment in daily functioning sets in.

How does that sound?  Does it make any sense?

Iris L.

 



llee08032
Posted: Monday, November 23, 2015 7:01 AM
Joined: 5/20/2014
Posts: 4406


Iris,

That is the best explanation of the cognitive reserve theory which the article does support. 


alz+
Posted: Monday, November 23, 2015 6:38 PM
Joined: 9/12/2013
Posts: 3549


Iris and Llee, I think my question is confusing because I don't know what I am asking, something about the difference of impact of IQ and Formal education.

The weight loss analogy though and cognitive reserve I can see that clearly.

The speed at which we decline is not related to initial cognitive "weight" though, that is random? The more educated people are, the longer they function but not necessarily live longer? Not important.

There are so many kinds of intelligence, wisdom of another sort, a good heart, wit, how to love and be loved...

I wish us all a gentle journey!

 

 


llee08032
Posted: Monday, November 23, 2015 9:40 PM
Joined: 5/20/2014
Posts: 4406


The speed at which we decline is not related to initial cognitive "weight" though, that is random? The more educated people are, the longer they function but not necessarily live longer? Not important.

There are so many kinds of intelligence, wisdom of another sort, a good heart, wit, how to love and be loved...


alz+ I don't think intellect has anything to do with the rate of decline or if someone lives longer. From what I gather it can take longer or be more difficult for someone with high cognitive reserve to get diagnosed because they can test in the average range even though the average range is a decline from their previous level of functioning. 


You are right there are so many kinds of intelligence and "life lessons" that you can't learn from a chalk board or classroom. 


Iris L.
Posted: Monday, November 23, 2015 11:58 PM
Joined: 12/15/2011
Posts: 16236


I think nobody knows about the rate of decline, except that it varies.  

Most patients are well into their disease before diagnosis, and most get no treatment at all. 

We are the first group of patients who are actively using Best Practices to treat ourselves.  

As far as I know, there are no studies done on us, except for our own anecdotal reports.  

That's why I call us Dementia Pioneers.  

I feel that my co-morbidities are more bothersome than cognitive impairment, at this time.

Iris L.