dementia

When caring for relatives with dementia, develop a good relationship: U of T expert

ullahnor — Tue, 23 Jan 2018 17:56:49 +0000

When caring for relatives with dementia, develop a good relationship: U of T expert

ullahnor Tue, 01/23/2018 - 12:56

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Dr. Michael Gordon talks about caring for loved ones who develop dementia (photo by Adam Berry/Getty Images)

Topic

City & Culture

dementia

Doctors' Notes

Faculty of Medicine

With more Canadian families becoming caregivers for people living with dementia, it's important to establish positive relationships with loved ones who will be receiving the care, says Dr. Michael Gordon, a professor of medicine at the University of Toronto and a geriatric specialist at Baycrest Health Sciences.

Over the next 15 years the number of Canadians living with dementia will almost double, Gordon writes in this week's edition of Doctors' Notes, the Toronto Star's weekly column created by U of T Medical experts. He writes that having the perfect relationship should not be a prerequisite for being a caregiver, but he found with his late parents, his positive relationship with them, as well as his sister’s, helped them navigate difficult next steps.

Read previous Doctors' Notes columns from U of T medical experts

As people with dementia experience a progressive decline in their ability to remember, understand, communicate and complete day-to-day tasks, being overprotective can be a common source of conflict, he writes.

“Though dementia hampers a person’s capacities, their independence still matters a great deal," Gordon writes. “Caregivers can overstep boundaries when they take over ordering at a restaurant, criticize clothing choices and arrange activities the person being cared for doesn’t enjoy.”

Read the full Doctors' Notes column in the Toronto Star

Study shows dementia-related brain changes are identifiable even before problems are noticeable

Romi Levine — Wed, 10 May 2017 18:22:03 +0000

Study shows dementia-related brain changes are identifiable even before problems are noticeable

Romi Levine Wed, 05/10/2017 - 14:22

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U of T's Morgan Barense is a senior author of a study that found a potential predictor for dementia (photo by Diana Tyszko)

Arts & Science news staff

Baycrest Rotman Research Institute

Author legacy

Arts & Science news staff and Baycrest Rotman Research Institute

Topic

Breaking Research

Research & Innovation

Health

dementia

Faculty of Arts & Science

Subheadline

Discovery could inform development of therapies to treat or slow the disease

Researchers at the University of Toronto and Baycrest Rotman Research Institute (RRI) have discovered a potential brain imaging predictor for dementia, which illustrates that changes to the brain’s structure may occur years prior to a diagnosis, even before individuals notice their own memory problems.

The joint study, published in the Neurobiology of Aging journal on May 8, looked at older adults who are living in the Toronto community without assistance and who were unaware of any major memory problems, but who scored below the normal benchmark on a dementia screening test.

Within these older adults, researchers also found evidence of less brain tissue in the same subregion of the brain where Alzheimer’s disease originates (the anterolateral entorhinal cortex located in the brain’s temporal lobe).

This U of T-Baycrest study is the first to measure this particular brain subregion in older adults who do not have a dementia diagnosis or memory problems that affect their day-to-day routine. It is also the first study to demonstrate that performance on the Montreal Cognitive Assessment (MoCA) dementia screening test is linked to the volume (size) of this subregion, along with other brain regions affected early in the course of Alzheimer’s disease.

“This work is an important first step in determining a procedure to identify older adults living independently at home without memory complaints who are at risk for dementia,” says Morgan Barense, associate professor in the department of psychology in the Faculty of Arts & Science at U of T and senior author on the study.

The team studied 40 adults between the ages of 59 and 81 who live independently (or with a spouse) at home. All participants were tested on the MoCA. Those scoring below 26 – a score that indicates a potential problem in memory and thinking skills and suggests further dementia screening is needed – were compared to those scoring 26 and above.

“The early detection of these at-risk individuals has the potential to facilitate drug developments or other therapeutic interventions for Alzheimer’s disease,” says Rosanna Olsen, first author on the study, RRI scientist and assistant professor in U of T’s department of psychology.

“This research also adds to our basic understanding of aging and the early mechanisms of Alzheimer’s disease.”

Scientists were able to reliably measure the volume of the anterolateral entorhinal cortex by using high-resolution brain scans that were collected for each participant.

The strongest volume differences were found in the exact regions of the brain in which Alzheimer’s disease originates. The researchers are planning a follow-up study to determine whether people who demonstrated poor thinking and memory abilities and smaller brain volumes indeed go on to develop dementia.

“The MoCA is good at diagnosing mild cognitive impairment (MCI) (a condition that is likely to develop into Alzheimer’s) and we are seeing that it may identify MCI in people who are not aware of a decline in their memory and thinking skills,” said Barense.

Alzheimer’s disease is a devastating neurodegenerative illness with widespread personal, societal and economic consequences. An estimated 564,000 Canadians live with dementia and 1.1 million Canadians are affected by the disease, according to the Alzheimer Society of Canada. There are 25,000 new cases of dementia diagnosed every year in Canada and it costs $10.4 billion to care for those living with dementia.

“A key take-away from the study is that it highlights the utility of the MoCA test in identifying individuals who are at-risk for dementia,” said Olsen.

Adults who are older than 40 and interested in testing their memory and attention prior to raising concerns with their doctor can consult Baycrest’s online brain health assessment tool, Cogniciti.

Research for this study was conducted with support from the Canadian Institutes of Health Research, the Canada Research Chairs program, the James S McDonnell Foundation, the Natural Sciences and Engineering Research Council, and an Early Researcher Award from the Ontario Government.

The research team included RRI senior scientist Jennifer Ryan, former RRI post-doctoral fellow Maria D’Angelo, graduate students Lok-Kin Yeung and Alix Noly-Gandon, and research assistants Arber Kacollja and Victoria Smith.

U of T researchers part of study linking dementia to living near major traffic

ullahnor — Fri, 06 Jan 2017 21:15:59 +0000

U of T researchers part of study linking dementia to living near major traffic

ullahnor Fri, 01/06/2017 - 16:15

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Toronto traffic jam on Spadina Avenue (photo by James Schwartz via Flickr)

Topic

Researchers from U of T's Dalla Lana School of Public Health are part of an international team that has found a link between people living close to high-traffic roadways to greater risk of dementia.

Published in The Lancet, the study found that people who lived within 50 metres of high-traffic roads like Ontario’s Highway 401 have a seven-per cent higher likelihood of developing dementia compared to those who lived more than 300 metres away from busy roads.

Researchers from the Dalla Lana School of Public Health, Public Health Ontario (PHO) and the Institute for Clinical Evaluative Sciences (ICES) examined records of more than 6.5 million Ontario residents, ranging in age from 20 to 85, to investigate the correlation between living close to major roads and dementia, Parkinson’s disease and multiple sclerosis.

Scientists identified 243,611 cases of dementia, 31,577 cases of Parkinson’s disease, and 9,247 cases of multiple sclerosis in Ontario between 2001 and 2012. In addition, they mapped individuals’ proximity to major roadways using the postal code of their residence. The findings indicate that living close to major roads increased the risk of developing dementia but not Parkinson’s disease or multiple sclerosis.

“Little is known in current research about how to reduce the risk of dementia,” said Hong Chen, assistant professor of occupational and environmental health at the Dalla Lana School of Public Health. “Our findings show the closer you live to roads with heavy day-to-day traffic, the greater the risk of developing dementia.

“With our widespread exposure to traffic and the greater tendency for people to live in cities these days, this has serious public health implications.”

The lead author of the paper, Chen is also scientist at Public Health Ontario and adjunct scientist at ICES.

“Our study is the first in Canada to suggest that pollutants from heavy, day-to-day traffic are linked to dementia,” said Dr. Raymond Copes, a co-author on the paper who is the associate professor of occupational and environmental health at U of T and chief of environmental and occupational health at Public Health Ontario.

“We know from previous research that air pollutants can get into the bloodstream and lead to inflammation, which is linked with cardiovascular disease and possibly other conditions such as diabetes,” Copes said. “This study suggests air pollutants that can get into the brain via the bloodstream can lead to neurological problems.”

As urban centres become more densely populated and more congested with vehicles on major roads, Copes suggests the findings of this paper could be used to help inform municipal land use decisions as well as building design to take into account air pollution factors and the impact on residents.

The research was conducted in collaboration with scientists from the University of Toronto, Carleton University, Dalhousie University, Oregon State University and Health Canada. The study was funded by Health Canada.

Declining dementia rates: U of T's Carmela Tartaglia talks about a new U.S. study

ullahnor — Mon, 28 Nov 2016 15:20:53 +0000

Declining dementia rates: U of T's Carmela Tartaglia talks about a new U.S. study

ullahnor Mon, 11/28/2016 - 10:20

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Professor Carmela Tartaglia talks about what types of exercise help protect against dementia (photo by Dan Haves)

Jim Oldfield

Author legacy

Jim Oldfield

Topic

A U.S. study released last week found that dementia rates in America dropped sharply for a decade after 2002 – from about 12 to 9 per cent. That means roughly 1.5 million fewer cases of dementia today among people over 65.

Carmela Tartaglia is an assistant professor in U of T's Faculty of Medicine and the Tanz Centre for Research in Neurodegenerative Diseases.

She spoke with U of T's Jim Oldfield about the University of Michigan study, and what Canadians can take away from it.

What do you make of this study?

Well, it’s really good news. People tend to think they have no control over whether they get sick, but here we have more evidence that what you do in mid-life impacts later life.

Studies from Scandinavian countries and the UK have made similar findings but in smaller groups that were less representative of the population at large. They found that by controlling cardiovascular risk factors such as blood pressure, cholesterol and blood sugar, and by making lifestyle changes around smoking, drinking and exercise, you can make a big dent in the incidence of dementia.

What factors might explain the drop in this study?

The researchers do point to control of cardiovascular risk factors among people with diabetes as a possible factor along with better management of diabetes. But they also found that higher levels of education were associated with lower rates of dementia, which is consistent with other studies.

A leading theory on this connection is the idea of “cognitive reserve.” Basically, education may improve brain function in a way that allows you to live later with preserved cognition. It’s not completely protective, but it can delay the onset of disease and enable people to better compensate for neurodegeneration.

That said, other factors can confound that link – more education is also associated with exercise, eating well, access to health care and mentally demanding employment, all of which may protect against dementia.

Do we have data on declining rates in Canada?

I’m not aware of any studies that show a decline in Canadian dementia rates although because we’re seeing a drop in some other developed countries, it’s reasonable to think it may be happening here. But we’re still worried about a ‘tsunami’ of dementia.

The total number of people with dementia is still rising. That’s a function of age, and more and more people are living longer.

There’s no doubt that it will be a very expensive problem. The annual cost of caring for dementia patients in Canada today is about $10 billion, and we expect that will rise to more than $16 billion by 2031. So we really need a more targeted approach.

This current study speaks well to prevention, but we’re not seeing much investment in prevention in this country, especially as it relates to exercise. ‘Participaction’ activities for kids and access to gyms has been cut in many places. Sports are expensive. We’re not doing a good job on that front.

What type of exercise is most protective against dementia?

It looks like aerobic activity is best. Other types of activity are good, such as weight training and stretching. But there is growing evidence in favour of aerobic activity.

In animal studies it stimulates release of BDNF (brain-derived neurotrophic factor), a protein that’s good for brain function. In research on the human brain, BDNF has been shown to stimulate formation of new blood vessels, new cells and synaptic connections. In my lab we’re studying the effects of aerobic activity in people with established Alzheimer’s disease. We’re using MRI to evaluate the structure of the brain and the connections within it, and our preliminary results on exercise are very encouraging.

In my clinical practice, I feel we’re making progress with exercise as well – more families are trying to engage family members to be active. It can be a hard sell at times, but we try to stress that this is effective therapy without side-effects, and I think we’re making headway.

U of T startup’s Alzheimer detection technology takes first prize in nation-wide competition

lavende4 — Tue, 02 Aug 2016 18:21:56 +0000

U of T startup’s Alzheimer detection technology takes first prize in nation-wide competition

lavende4 Tue, 08/02/2016 - 14:21

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Liam Kaufman makes his pitch for Winterlight at the AGE-WELL Pitch Competition

Topic

Faculty of Arts & Science

An Alzheimer-detection technology developed by U of T startup company Winterlight Labs has won the AGE-WELL Pitch Competition: Technology to Support People with Dementia, beating competitors from across the country and internationally.

The new tablet-based assessment tool records short samples of a person’s speech as they describe a picture on the screen. It extracts hundreds of variables from the samples, producing results in less than five minutes.

Winterlight Labs has its origins in the computer science department at the University of Toronto. CEO Liam Kaufman holds both a degree in computer science and a master’s degree from U of T’s Institute of Medical Science. Co-founder Katie Fraser is a PhD student in computer science. Master’s student Maria Yancheva and computer science assistant professor Frank Rudzicz also worked on the application.

Can natural language processing help detect dementia? This U of T grad student is trying to find out

krisha — Tue, 21 Jun 2016 14:16:09 +0000

Can natural language processing help detect dementia? This U of T grad student is trying to find out krisha Tue, 06/21/2016 - 10:16

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Katie Fraser is seeking a computational solution for the detection of dementia (Orbelina Cortez‐Barbosa photo)

Carolyn Morris

Orbelina Cortez-Barbosa

Orbelina Cortez-Barbosa with files from Carolyn Morris

Author legacy

Orbelina Cortez-Barbosa with files from Carolyn Morris

Topic

“Your speech can offer a lot of information and clues into how your brain is functioning,” says Katie Fraser, a PhD candidate in the department of computer science at the University of Toronto.

“Dementia is often linked to language, and using today’s computational tools we can quickly evaluate a person’s speech.”

Dementia is a disease affecting 47.5 million people worldwide (World Health Organization). Research has consistently shown that particular changes in speech and language can signal early onset of the disease.

For Fraser, finding a computational solution for the detection of dementia has been the focus of her research and the idea behind the startup Winterlight Labs Inc.— software that uses natural language processing and machine learning technology to detect signs of dementia using speech samples.

“It’s important to get this research out of the academic sphere and into hands of people who can actually benefit from it,” says Fraser. “I think the best way to do this is to develop a product that people can use.”

Fraser, who specializes in computational linguistics, is supervised by computer science Professor Graeme Hirst and Jed Meltzer, an assistant professor in the department of psychology and a scientist with the Rotman Research Institute at the Baycrest Centre for Geriatric Care.

Several years ago, Hirst, his graduate student Xuan Le, and department of English Professor Ian Lancashire, in consultation with Regina Jokel, assistant professor department of speech-language pathology, used natural language processing techniques to examine the writing of authors Iris Murdoch (who is known to have died of Alzheimer’s), P.D. James (who did not have Alzheimer’s) and Agatha Christie. Hirst says Christie’s writing showed an incredible decline in her vocabulary in her last books, but surprisingly, not in her syntax. They concluded Christie likely died of the disease.

“Our thinking in those days was that what matters is change in a person over time,” says Hirst. “That axiom is not as clear-cut as we thought. Our more recent work is a lot less longitudinal.”

Hirst says that aging inevitably leads to changes in language. Older people do talk more abstractly, and have minor vocabulary-seeking problems. People with dementia rapidly slide down in their vocabulary and noun to verb ratio, and their syntax becomes simpler.

As part of her thesis research, Fraser conducts research on text and speech processing to look for symptoms of dementia. She collects speech samples and analyzes them through speech recognition software and machine learning classifiers. Machine learning classifiers are algorithms that have been trained to classify data into a category or class. In this case the classifiers have been trained to distinguish between a healthy individual and a person with dementia.

Fraser founded Winterlight Labs alongside her colleagues who share similar research interests in computer science and healthcare.

“We had discussed trying to build a company by bringing together all of our expertise.”

The startup was created in the summer of 2015 and includes computer science assistant professor, status-only, Frank Rudzicz, a scientist with the Toronto Rehabilitation Institute – an expert in acoustic processing; Liam Kaufman, whose experience includes Alzheimer’s research, and holds both a degree in computer science and a master’s degree from U of T’s Institute of Medical Science; and computer science master’s student Maria Yancheva, a computational linguistics student with a background in software engineering and assistive technologies.

Winterlight’s current prototype works by recording a one-to-five-minute speech sample of a person describing an image. The speech sample is then transcribed using automatic speech recognition. Various features of the speech and text sample, including acoustic, lexical, syntactic and semantic aspects are extracted and examined. These features are then put into the machine learning classifier. The prototype has an 81 per cent accuracy rate in classifying speech samples.

In an interview with Faculty of Medicine writer Carolyn Morris, Rudzicz explained how the technology is able to detect cognitive impairment through observations of diction and syntax.

“When it comes to word choice and grammar, for example, one of the signs of cognitive impairment would be the use of simple verbs versus gerunds — so “the kid runs” instead of “there’s a kid running.” People with early signs of dementia will often use pronouns instead of more specific nouns. So “she is washing dishes” instead of “The mother is washing dishes.” Then there’s the interpretation of the images. So, for example, in what we call the “cookie theft” image there’s a woman in a kitchen, an overflowing sink and kids reaching up to steal cookies. Someone with cognitive impairment might notice “a kid on a stool,” but not take that next step to point out that “the son is trying to steal cookies.” Or they’ll comment on the overflowing sink, but not on the woman failing to notice it.”

dementia

When caring for relatives with dementia, develop a good relationship: U of T expert

Read previous Doctors' Notes columns from U of T medical experts

Read the full Doctors' Notes column in the Toronto Star

Study shows dementia-related brain changes are identifiable even before problems are noticeable

U of T researchers part of study linking dementia to living near major traffic

Declining dementia rates: U of T's Carmela Tartaglia talks about a new U.S. study

U of T startup’s Alzheimer detection technology takes first prize in nation-wide competition

Read more about Katie Fraser and her research

Can natural language processing help detect dementia? This U of T grad student is trying to find out

Read more from Rudzicz’s interview with Morris