(Press-News.org) An important new study led by the Centre for Addiction and Mental Health (CAMH), and with partnership across several Toronto Dementia Research Alliance (TDRA) sites— Baycrest, Sunnybrook Health Science Centre, Unity Health Toronto, and University Health Network— has demonstrated that a combination therapy can slow cognitive decline in older adults at risk for dementia.
The study was published today in JAMA Psychiatry: "Slowing cognitive decline in major depressive disorder and mild cognitive impairment: A randomized controlled trial," and reports the primary results of the Prevention of Alzheimer’s dementia with Cognitive remediation plus transcranial direct current stimulation in Mild cognitive impairment and Depression (PACt-MD) study.
PACt-MD was made possible by a grant from the Canada Brain Research Fund, a unique arrangement between Brain Canada and the Government of Canada through Health Canada, the Chagnon Family, and the CAMH Discovery Fund. The work focused on preventing cognitive decline in older adults with a condition that increases the risk for dementia: Major Depressive Disorder in remission (rMDD), Mild Cognitive Impairment (MCI), or both.
"Investing in long-term, comprehensive research like this is not only a commitment to science, but to the millions of individuals, families, and caregivers affected by dementia,” said the Honourable Mark Holland, Minister of Health. “This research contributes to advancing dementia care in Canada and improving quality of life for people living with dementia and caregivers.”
The study involved 375 older adults who received either a control (“sham”) intervention or a combination of two active therapies: the first involved specially designed Cognitive Remediation (CR) techniques—therapeutic interventions designed to improve cognitive functioning, like puzzles and logic problems. The second was transcranial direct current stimulation (tDCS)—a form of non-invasive brain stimulation. These therapies were delivered five days per week for eight weeks, followed by 5-day "boosters" every six months. The study was randomized, controlled, and double-masked, with assessments conducted at baseline, month-2, and yearly for three to seven years.
The study found that participants receiving CR plus tDCS experienced slower cognitive decline over a median follow-up period of 4 years compared to those receiving the control intervention. The effects were more prominent in individuals with low genetic risk for Alzheimer's disease, and participants with rMDD (with or without MCI) showed better outcomes than those with MCI alone.
Cognitive decline is often the result of overlapping conditions, making combination therapies especially pertinent – they can improve patient outcomes by targeting different disease pathways in a synergistic way.
"We are very pleased to show, after seven years of close monitoring, that this combination of therapies is effective in slowing down cognitive decline for some of our most vulnerable populations," said Dr. Tarek Rajji, lead author and one of the study Principal Investigators. "This study shows promise that multi-prong, non-pharmacological approaches for people with a high risk of developing dementia could help them live a more independent life for a longer time." Dr. Rajji is a former CAMH Senior Scientist, and now serves as Chair of the Department of Psychiatry at the University of Texas Southwestern Medical Center.
Dr. Benoit Mulsant, senior author and research team lead, explained the focus on the prefrontal cortex: "While there are several presumed mechanisms underlying the increased risk for dementia in older adults with depression, impaired brain plasticity, or the ability of the brain to compensate for damage, is thought to be one common pathway. In this study we targeted the prefrontal cortex for treatment because this is believed to be an area of the brain that is highly adaptable to change and critical to executive functioning." Dr. Mulsant is a Senior Scientist at CAMH, and the Labatt Family Chair for the Department of Psychiatry, Temerty Faculty of Medicine, at the University of Toronto.
-30-
About the Centre for Addiction and Mental Health (CAMH)
CAMH is Canada's largest mental health and addiction teaching hospital and a world leading research centre in this field. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental illness and addiction. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit camh.ca or follow @CAMHnews on Twitter.
About the Toronto Dementia Research Alliance (TDRA)
Established in 2012, the Toronto Dementia Research Alliance (TDRA) is a collaboration among the University of Toronto, Baycrest, the Centre for Addiction and Mental Health (CAMH), Ontario Shores Centre for Mental Health Sciences (Ontario Shores), Sunnybrook Health Sciences Centre, Unity Health Toronto, and the University Health Network. TDRA is working together to better understand, prevent, and treat dementia by creating a stronger link between basic science and clinical research, embedding research into care, improving outreach and education to the community, and increasing the efficiency of collaborative research processes across the city.
Media Contact:
CAMH Media Relations
media@camh.ca
END
About The Study: This study showed that cognitive remediation and transcranial direct current stimulation, both targeting the prefrontal cortex, is efficacious in slowing cognitive decline in older adults at risk of cognitive decline, particularly those with remitted major depressive disorder (with or without mild cognitive impairment) and in those at low genetic risk for Alzheimer disease.
Corresponding Author: To contact the corresponding authors, email Benoit H. Mulsant, MD, MS, (benoit.mulsant@utoronto.ca) and Tarek K. Rajji, MD, (tarek.rajji@utsouthwestern.edu)
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(10.1001/jamapsychiatry.2024.3241)
Editor’s ...
About The Study: In this cross-sectional study of children and adults in the U.S., autism spectrum disorder diagnosis rates increased substantially between 2011 and 2022, particularly among young adults, female children and adults, and children from some racial or ethnic minority groups. Diagnosis prevalence trends generated using health system data can inform the allocation of resources to meet the service needs of this growing, medically complex population.
Corresponding Author: To contact the corresponding author, Luke P. Grosvenor, PhD, email luke.p.grosvenor@kp.org.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamanetworkopen.2024.42218)
Editor’s ...
After a heart attack, aging adults face double or triple the risk of life-threatening complications – like a debilitating stroke or another heart attack – when they move forward with elective noncardiac surgeries too soon, according to new University of Rochester research published in JAMA Surgery.
A deep dive into the Medicare database of 5.2 million surgeries from 2017 to 2020 for patients 67 and older suggests delaying surgery for three to six months following a heart attack, known as a non-ST-segmented elevation myocardial infarction (NSTEMI).
Researchers aim to identify the “sweet spot” for safely scheduling additional surgical procedures ...
Philadelphia, October 30, 2024 – Researchers from Children’s Hospital of Philadelphia (CHOP) found that non-Hispanic Black children and those with public insurance and lower Child Opportunity Index (COI) scores were much more likely to seek care for concussions in the emergency department than in primary care or specialty care settings. The findings underscore the need to ensure emergency medicine physicians have specific training and education for diagnosing and managing pediatric concussion and suggest that establishing up-to-date community-level resources could improve care equity for children with possible concussion. The findings were published today by JAMA Network ...
Energy-making chloroplasts from algae have been inserted into hamster cells, enabling the cells to photosynthesize light, according to new research in Japan. It was previously thought that combining chloroplasts (chlorophyll containing structures in the cells of plants and algae) with animal cells was not possible, and that the chloroplasts would not survive or function. However, results showed that photosynthetic action continued for at least two days. This technique could be useful for artificial tissue engineering. ...
A new, large study led by American Cancer Society (ACS) researchers found that lack of health insurance coverage accounts for a significant proportion of racial and ethnic disparities in advanced-stage diagnosis of multiple cancers. The findings are published today in the Journal of the National Cancer Institute (JNCI).
“Health insurance coverage is a key determinant of access to high-quality healthcare across the cancer continuum from prevention to early detection, treatment, and survivorship in the United States,” said Dr. Parichoy Pal Choudhury, Principal Scientist, Biostatistics at the American ...
— By Jessica Scully
Retrofitting a portion of the US shipping fleet from internal combustion engines to battery-electric systems could significantly reduce greenhouse gas emissions and be largely cost effective by 2035, according to a new study from Berkeley Lab researchers recently published in Nature Energy.
Shipping represents 3% of total US greenhouse gas emissions from transportation, making it an important target for decarbonization. But electrifying ships is more challenging than ...
Australian researchers have developed a new method for spotting plastic rubbish on our beaches and successfully field tested it on a remote stretch of coastline.
The satellite imagery tool developed by RMIT University scientists picks up differences in how sand, water and plastics reflect light, allowing plastics to be spotted on shorelines from more than 600km above.
Satellite technology is already used to track the massive amounts of plastic floating around our oceans – from relatively small drifts containing thousands of plastic bottles, bags and fishing nets, up to gigantic ...
Three teams led by Weill Cornell Medicine scientists have received awards from the Starr Cancer Consortium in its 17th and final annual grant competition. The grants will fund research on the deep mechanisms of common cancers and related treatment strategies.
The Starr Cancer Consortium, established in 2006 with generous support from The Starr Foundation, includes The Broad Institute of MIT and Harvard, Cold Spring Harbor Laboratory, Memorial Sloan Kettering Cancer Center, The Rockefeller University and Weill Cornell Medicine. The consortium’s goal has been to encourage highly collaborative and transformative research on cancer biology and novel treatment strategies. ...
Homelessness among people over the age of 50 is on the rise, a phenomenon formal housing strategies often overlook -- but researchers from the University of Toronto and McGill hope to prevent this oversight in the future.
A new study published in The Gerontologist now provides a clear definition of late life homelessness informed by the lives and experiences of older adults. Drawing on interviews with older people who are unhoused and community workers in Montreal, Canada, the researchers aim to spark ...
