Alzheimer&#8217;s disease

Medical News Today: Mindfulness training for individuals with early-stage dementia and their caregivers together in the same class was beneficial for both groups, easing depression and improving sleep and quality of life, reports new Northwestern Medicine study.

“The disease is challenging for the affected person, family members and caregivers,” said study lead author Ken Paller, professor of psychology at Weinberg College of Arts and Sciences at Northwestern and a fellow of the Cognitive Neurology and Alzheimer’s Disease Center at Northwestern University Feinberg School of Medicine. “Although they know things will likely get worse, they can learn to focus on the present, deriving enjoyment in the moment with acceptance and without excessive worry about the future. This is what was taught in the mindfulness program.”

The study was published in the American Journal of Alzheimer’s Disease and Other Dementias.

Neurodegenerative diseases such as Alzheimer’s are particularly hard on caregivers, who are often close family members. They tend to have an increased incidence of anxiety, depression, immune dysfunction and other health concerns as well as an increased mortality rate, according to prior studies.

This is the first study to show that the caregiver and the patient both benefit from undergoing mindfulness training together. This is important because caregivers often don’t have much time on their own for activities that could relieve their emotional burden.

The training also helps the patient and caregiver accept new ways of communicating, scientists said.

“One of the major difficulties that individuals with dementia and their family members encounter is that there is a need for new ways of communicating due to the memory loss and other changes in thinking and abilities,” noted study co-author Sandra Weintraub, a professor of psychiatry and behavioral sciences at Feinberg and a neuropsychologist at Northwestern Memorial Hospital. “The practice of mindfulness places both participants in the present and focuses on positive features of the interaction, allowing for a type of connection that may substitute for the more complex ways of communicating in the past. It is a good way to address stress.”

The study included 37 participants including 29 individuals who were part of a patient-caregiver pair. Most of the patients were diagnosed with dementia due to Alzheimer’s disease or mild cognitive impairment, often a precursor to dementia. Others had memory loss due to strokes or frontotemporal dementia, which affects emotions as well as speaking and understanding speech. Caregivers included patients’ spouses, adult children, a daughter-in-law and a mother-in-law.

Although the individuals with Alzheimer’s had mild to severe memory loss, they still were able to use other cognitive functions to participate in the mindfulness training and to experience emotion and positive feelings, Weintraub noted.

The participants attended eight sessions designed specifically for the needs of patients with memory loss due to the terminal neurodegenerative illness (dementia) and for the needs of their caregivers. Both groups completed an assessment within two weeks of starting the program and within two weeks of completing it.

Paller had expected mindfulness to be helpful for dementia caregivers based on previous research in the field. But he was uncertain whether a program would be successful for patients with memory impairments and whether patients and their caregivers could be trained together.

“We saw lower depression scores and improved ratings on sleep quality and quality of life for both groups,” said Paller, director of the cognitive neuroscience program. “After eight sessions of this training we observed a positive difference in their lives.”

“Mindfulness involves attentive awareness with acceptance for events in the present moment,” Paller said. “You don’t have to be drawn into wishing things were different. Mindfulness training in this way takes advantage of people’s abilities rather than focusing on their difficulties.”

Developing mindfulness is about learning different habits and a person has to practice a new habit for it to stick, Paller noted.

Paller said he hoped the study findings would encourage caregivers to seek out resources for learning mindfulness for themselves and the individuals with illness.

Meditation, memory loss, Alzheimer’s and aging

November 14, 2012

Gordon Richman, WASHINGTON, November 12, 2012 – Alzheimer’s is devastating and terrifying. Our grandparents are fighting it now, our parents preparing to fight it, and we know that we’re next. A recent bittersweet NPR piece explained that in order for most currently-conceived Alzheimer’s drugs to work effectively, patients would have to start treatment early— up to 20 years early.

Most of us, as much as we fear Alzheimer’s, don’t want to take a cocktail of drugs for something that may or may not happen in 20 years. Although there are brilliant scientists and physicians working on helping people with Alzheimer’s (and those who might suffer from it in the future), most of this is theoretical. Fortunately, there are some fairly innocuous, easy and relatively inexpensive things older and middle aged people can do to fight memory loss. One of those things is the opposite of a modern miracle drug—it’s a health practice that’s over 5000 years old. That practice is meditation.

Yoga reduces inflammation response

August 7, 2012

UCLA study helps caregivers of people with dementia

Six months ago, researchers at UCLA published a study that showed using a specific type of yoga to engage in a brief, simple daily meditation reduced the stress levels of people who care for those stricken by Alzheimer’s and dementia. Now they know why.

As previously reported, practicing a certain form of chanting yogic meditation for just 12 minutes daily for eight weeks led to a reduction in the biological mechanisms responsible for an increase in the immune system’s inflammation response. Inflammation, if constantly activated, can contribute to a multitude of chronic health problems.

Reporting in the current online edition of the journal Psychoneuroendocrinology, Dr. Helen Lavretsky, senior author and a professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, and colleagues found in their work with 45 family dementia caregivers that 68 of their genes responded differently after Kirtan Kriya Meditation (KKM), resulting in reduced inflammation.

Caregivers are the unsung heroes for their yeoman’s work in taking care of loved ones that have been stricken with Alzheimer’s and other forms of dementia, said Lavretsky, who also directs UCLA’s Late-Life Depression, Stress and Wellness Research Program. But caring for a frail or demented family member can be a significant life stressor. Older adult caregivers report higher levels of stress and depression and lower levels of satisfaction, vigor and life in general. Moreover, caregivers show higher levels of the biological markers of inflammation. Family members in particular are often considered to be at risk of stress-related disease and general health decline.

As the U.S. population continues to age over the next two decades, Lavretsky noted, the prevalence of dementia and the number of family caregivers who provide support to these loved ones will increase dramatically. Currently, at least five million Americans provide care for someone with dementia.

“We know that chronic stress places caregivers at a higher risk for developing depression,” she said “On average, the incidence and prevalence of clinical depression in family dementia caregivers approaches 50 percent. Caregivers are also twice as likely to report high levels of emotional distress.” What’s more, many caregivers tend to be older themselves, leading to what Lavretsky calls an “impaired resilience” to stress and an increased rate of cardiovascular disease and mortality.

Research has suggested for some time that psychosocial interventions like meditation reduce the adverse effects of caregiver stress on physical and mental health. However, the pathways by which such psychosocial interventions impact biological processes are poorly understood.

In the study, the participants were randomized into two groups. The meditation group was taught the 12-minute yogic practice that included Kirtan Kriya, which was performed every day at the same time for eight weeks. The other group was asked to relax in a quiet place with their eyes closed while listening to instrumental music on a relaxation CD, also for 12 minutes daily for eight weeks. Blood samples were taken at the beginning of the study and again at the end of the eight weeks.

“The goal of the study was to determine if meditation might alter the activity of inflammatory and antiviral proteins that shape immune cell gene expression,” said Lavretsky. “Our analysis showed a reduced activity of those proteins linked directly to increased inflammation.

“This is encouraging news. Caregivers often don’t have the time, energy, or contacts that could bring them a little relief from the stress of taking care of a loved one with dementia, so practicing a brief form of yogic meditation, which is easy to learn, is a useful too.”

Lavretsky is a member of UCLA’s recently launched Alzheimer’s and Dementia Care Program, which provides comprehensive, coordinated care as well as resources and support to patients and their caregivers. Lavretsky has incorporated yoga practice into the caregiver program.

When we don’t make anything “wrong”

June 23, 2012

Tara Brach

on practice

Sometimes when I talk about Radical Acceptance, I like to tell the story about Jacob, a man who at almost seventy and in the mid-stages of Alzheimer’s disease attended a 10-day retreat I was leading.

A clinical psychologist by profession and a meditator for more than twenty years, Jacob was well aware that his faculties were deteriorating. On occasion his mind would go totally blank; he would have no access to words for several minutes and become completely disoriented. He often forgot what he was doing and usually needed assistance with basic tasks—cutting his food, putting on clothes, bathing, getting from place to place.

A couple of days into the retreat, Jacob had his first interview with me. These meetings, which students have regularly with a teacher while on retreat, are an opportunity to check in and receive personal guidance in the practice. During our time together Jacob and I talked about how things were going both on retreat and at home. His attitude towards his disease was interested, sad, grateful, even good-humored.

Intrigued by his resilience, I asked him what allowed him to be so accepting. He responded, “It doesn’t feel like anything is wrong. I feel grief and some fear about it all going, but it feels like real life.” Then he told me about an experience he’d had in an earlier stage of the disease.

Jacob had occasionally given talks about Buddhism to local groups and had accepted an invitation to address a gathering of over a hundred meditation students. He arrived at the event feeling alert and eager to share the teachings he loved. Taking his seat in front of the hall, Jacob looked out at the sea of expectant faces in front of him … and suddenly he didn’t know what he was supposed to say or do. He didn’t know where he was or why he was there. All he knew was that his heart was pounding furiously and his mind was spinning in confusion.

Putting his palms together at his heart, Jacob started naming out loud what was happening: “Afraid, embarrassed, confused, feeling like I’m failing, powerless, shaking, sense of dying, sinking, lost.” For several more minutes he sat, head slightly bowed, continuing to name his experience. As his body began to relax and his mind grew calmer, he also noted that aloud. At last Jacob lifted his head, looked slowly around at those gathered, and apologized.

Many of the students were in tears. As one put it, “No one has ever offered us teachings like this. Your presence has been the deepest dharma teaching.”

Rather than pushing away his experience and deepening his agitation, Jacob had the courage and training simply to name what he was aware of, and, most significantly, to bow to his experience. In some fundamental way he didn’t create an adversary out of feelings of fear and confusion. He didn’t make anything wrong.

We practice Radical Acceptance by pausing and then meeting whatever is happening inside us with this kind of unconditional friendliness. Instead of turning our jealous thoughts or angry feelings into the enemy, we pay attention in a way that enables us to recognize and touch any experience with care. Nothing is wrong—whatever is happening is just “real life.” Such unconditional friendliness is the spirit of Radical Acceptance.

Yoga can enhance quality of life and slow cellular aging in caregivers

March 13, 2012

For every individual who’s a victim of Alzheimer’s — some 5.4 million people in the United States alone — there’s a related victim: the caregiver. Spouse, son, daughter, other relative or friend; the loneliness, exhaustion, fear, and most of all stress and depression, takes a toll

While care for the caregivers is difficult to find, a new study out of UCLA suggests that using yoga to engage in very brief, simple daily meditation can lead to improved cognitive functioning and lower levels of depression for caregivers.

“Ten Thousand Joys and Ten Thousand Sorrows”: an interview with Olivia Ames Hoblitzelle

September 12, 2011

Bodhipaksa

on practice

This book is intensely personal. Was it difficult to write?

Yes, at times it was difficult to write, but I felt a great sense of purpose. just before Hob died, I promised him that I would write a book and his voice would be in it. That became like a covenant between us. Also, I felt compelled to write the book. I realized that our background with meditation and the wisdom traditions gave us valuable perspectives which could be helpful to others. I hadn’t seen any books about how spiritual perspectives or practices could help with Alzheimer’s, and that’s what had helped us more than anything. In fact, the book can be helpful for people dealing with any serious illness and no matter what their spiritual tradition.

“Ten Thousand Joys and Ten Thousand Sorrows,” by Olivia Ames Hoblitzelle

September 9, 2011

Vidhuma

reviews

To be clear from the start, this book is worthy of the rich praise it has received. The inner jacket liner contains three pages crammed with accolades from what could be easily construed as the Who’s Who of leading contemporary spiritual leaders and health professionals. The book is a moving and loving story of this extraordinary couple’s experience.

It is a love story. It is a love story written from the deeply touching and personal perspective of a remarkable woman living through her equally remarkable husband’s dementia and death. The book covers the six years from his first symptoms to his death as she emotionally lived the various pieces of their life together as it changed profoundly. The book is drawn from her journals, giving the reader the direct expression of her emotions as they went through her.

Brains of Buddhist monks scanned in meditation study

April 24, 2011

Matt Danzico: In a laboratory tucked away off a noisy New York City street, a soft-spoken neuroscientist has been placing Tibetan Buddhist monks into a car-sized brain scanner to better understand the ancient practice of meditation.

But could this unusual research not only unravel the secrets of leading a harmonious life but also shed light on some of the world’s more mysterious diseases?

Zoran Josipovic, a research scientist and adjunct professor at New York University, says he has been peering into the brains of monks while they meditate in an attempt to understand how their brains reorganise themselves during the exercise.

Since 2008, the researcher has been placing the minds and bodies of prominent Buddhist figures into a five-tonne (5,000kg) functional magnetic resonance imaging (fMRI) machine.

The scanner tracks blood flow within the monks’ heads as they meditate inside its clunky walls, which echoes a musical rhythm when the machine is operating.

Dr Josipovic, who also moonlights as a Buddhist monk, says he is hoping to find how some meditators achieve a state of “nonduality” or “oneness” with the world, a unifying consciousness between a person and their environment.

“One thing that meditation does for those who practise it a lot is that it cultivates attentional skills,” Dr Josipovic says, adding that those harnessed skills can help lead to a more tranquil and happier way of being.

“Meditation research, particularly in the last 10 years or so, has shown to be very promising Read the rest of this article…

When one relaxes into a state of oneness, the neural networks in experienced practitioners change as they lower the psychological wall between themselves and their environments, Dr Josipovic says.

And this reorganisation in the brain may lead to what some meditators claim to be a deep harmony between themselves and their surroundings.
Shifting attention

Dr Josipovic’s research is part of a larger effort better to understand what scientists have dubbed the default network in the brain.

He says the brain appears to be organised into two networks: the extrinsic network and the intrinsic, or default, network.

The extrinsic portion of the brain becomes active when individuals are focused on external tasks, like playing sports or pouring a cup of coffee.

The default network churns when people reflect on matters that involve themselves and their emotions.

But the networks are rarely fully active at the same time. And like a seesaw, when one rises, the other one dips down.

This neural set-up allows individuals to concentrate more easily on one task at any given time, without being consumed by distractions like daydreaming.

“What we’re trying to do is basically track the changes in the networks in the brain as the person shifts between these modes of attention,” Dr Josipovic says.

Dr Josipovic has found that some Buddhist monks and other experienced meditators have the ability to keep both neural networks active at the same time during meditation – that is to say, they have found a way to lift both sides of the seesaw simultaneously.

And Dr Josipovic believes this ability to churn both the internal and external networks in the brain concurrently may lead the monks to experience a harmonious feeling of oneness with their environment.
Self-reflection

Scientists previously believed the self-reflective, default network in the brain was simply one that was active when a person had no task on which to focus their attention.

But researchers have found in the past decade that this section of the brain swells with activity when the subject thinks about the self.

The default network came to light in 2001 when Dr Marcus Raichle, a neurologist at the Washington University School of Medicine in the US state of Missouri, began scanning the brains of individuals who were not given tasks to perform.

The patients quickly became bored, and Dr Raichle noticed a second network, that had previously gone unnoticed, danced with activity. But the researcher was unclear why this activity was occurring.

Other scientists were quick to suggest that Dr Raichle’s subjects could have actually been thinking about themselves.

Soon other neuroscientists, who conducted studies using movies to stimulate the brain, found that when there was a lull of activity in a film, the default network began to flash – signalling that research subjects may have begun to think about themselves out of boredom.

But Dr Raichle says the default network is important for more than just thinking about what one had for dinner last night.

“Researchers have wrestled with this idea of how we know we are who we are. The default mode network says something about how that might have come to be,” he says.

And Dr Raichle adds that those studying the default network may also help in uncovering the secrets surrounding some psychological disorders, like depression, autism and even Alzheimer’s disease.

“If you look at Alzheimer’s Disease, and you look at whether it attacks a particular part of the brain, what’s amazing is that it actually attacks the default mode network,” says Dr Raichle, adding that intrinsic network research, like Dr Josipovic’s, could assist in explaining why that is.

Cindy Lustig, associate professor of psychology and neuroscience at the University of Michigan, agrees.

“It’s a major and understudied network in the brain that seems to be very involved in a lot of neurological disorders, including autism and Alzheimer’s, and understanding how that network interacts with the task-oriented [extrinsic] network is important,” she says. “It is sort of the other piece of the puzzle that’s been ignored for too long.”

Dr Josipovic has scanned the brains of more than 20 experienced meditators, both monks and nuns who primarily study the Tibetan Buddhist style of meditation, to better understand this mysterious network.

He says his research, which will soon be published, will for the moment continue to concentrate on explaining the neurological implications of oneness and tranquillity – though improving understanding of autism or Alzheimer’s along the way would certainly be quite a bonus.

Chappaqua resident gives Alzheimer’s patients hope

January 15, 2011