by Susan M. McCurry, PhD
The 21st annual UW Alzheimer’s Disease Research Center (ADRC) Public Forum was held on June 7th at Olympic College in Bremerton, Washington. Over 75 people attended this informative and well-received event. The Northwest Research Group on Aging and the Alzheimer’s Association provided information booths, distributed educational materials, and answered questions before and after the presentations.
Dr. Susan McCurry introduced the speakers for the evening: Dr. Stennis Watson, Assistant Professor of Psychiatry and Behavioral Sciences at the UW School of Medicine and the VA Puget Sound Health Care System; and Dr. Rebecca Logsdon, Research Associate Professor in Psychosocial and Community Health at the Northwest Research Group on Aging in the UW School of Nursing. After their presentations, both speakers answered questions from the audience and provided an opportunity for individuals to share their stories and concerns about caregiving.
Dr. Watson presented, “Sugar on the Brain: What Do Diabetes and Insulin Have To Do with Alzheimer’s Disease?” He discussed the relationship between blood sugar regulation and cognition in older adults, and described several research studies investigating whether medications and exercise can improve insulin resistance and memory in older adults.
Diabetes affects the body’s ability to maintain stable blood sugar levels. There are two forms of diabetes: Type 1, which is an autoimmune disease that attacks cells in the pancreas so they are unable to secret insulin; and Type 2 (adult- onset diabetes), which causes insulin secreted by the pancreas to be less effective in keeping blood sugar levels at normal levels. Type 2 diabetes increases a person’s risk for memory loss, and recent research has found that persons with Alzheimer’s disease are more likely to have problems with blood sugar regulation.
This inability of the body to utilize insulin effectively (insulin resistance) is associated with chronic elevations in both blood sugar and blood insulin. Insulin resistance is a feature of Type 2 diabetes.
Dr. Watson, Dr. Suzanne Craft, Dr. Laura Baker, and their colleagues at the UW/VA Memory Wellness Program used PET scans (a neuroimaging technique that can measure the brain’s use of glucose) to show that insulin resistance is associated with lower brain activity in parts of the brain also affected by Alzheimer’s disease. They also found that individuals with insulin resistance who took pioglitazone (a diabetes medication that improves insulin sensitivity) had better blood sugar levels and scores on memory tests after sixteen weeks than subjects who took a placebo medication.
Drs. Watson and Craft’s research offers an exciting new approach to possibly preventing or treating cognitive decline in older adults. They are currently conducting research on another medication, rosiglitazone, to try and slow the rate of cognitive decline in older adults who are at risk for developing Alzheimer’s disease. In a separate study, they are also investigating the effects of exercise on insulin sensitivity and memory in older adults.
Persons who are 55 years or older and interested in participating in these studies should contact Donna Davis (206-764-2809) or Karen Hyde (253-583-2033) at the Memory Wellness Program for more information.
The second speaker, Dr. Rebecca Logsdon, presented “New Approaches to Dementia Care: Lessons from Quality of Life Research.” Her talk focused on the importance of understanding how quality of life (QOL) can be measured and improved in persons with dementia and their family caregivers.
Many factors influence QOL for someone with AD or another form of dementia. These include individual factors such as the individual’s physical health, mood, level of memory loss, and day-to-day activities. Environmental and interpersonal factors, such as the quality of one’s personal relationships, financial situation, and level of involvement in meaningful activities also contribute to quality of life.
Drs. Linda Teri, Rebecca Logsdon, Susan McCurry and Laura Biggons have developed several questionnaires to study quality of life. In her presentation, Dr. Logsdon described the Quality of Life-AD (QOL-AD), which rates thirteen different areas that can affect the QOL of persons with dementia and their caregivers; and the Pleasant Events Schedule (PES-AD), which helps determine whether persons with dementia are regularly participating in enjoyable activities. Notably, participation in pleasant activities is related both to higher ratings of QOL and to lower levels of depression and caregiver burden.
Dr. Logsdon described three research studies from the UW Alzheimer’s Disease Research Center and the Northwest Research Group on Aging. These studies show how quality of life in dementia can be improved. In the first study, caregivers increased pleasant activities in order to reduce depression in both persons with AD and their family caregivers. The second study helped improve the physical function and mood of persons with AD by teaching caregivers how to help their care-recipients follow a daily home exercise routine.
The exercises included strengthening, balance and flexibility, and aerobic activities. This study found that exercise improved both physical function and mood, and that persons in the exercise program were less likely than those receiving routine medical care to be placed in a nursing home because of disruptive problem behaviors.
The final study Dr. Logsdon described is currently investigating benefits of early-stage support groups conducted by the Alzheimer’s Association. Although the study is still under way, early results suggest that these groups improve participants’ quality of life and reduce stress and family conflict.
Persons interested in participating in this study can contact Amy Moore (toll free 1-866-292-4464).
Planning for next year’s Public Forum is already under way. It will take place in May or June 2007. Look for details in upcoming issues of DIMENSIONS.