Cognitive

health

Poverty affects brain development, cognitive performance in children, study finds

Nov. 3 (UPI) — Children living in poor neighborhoods don’t perform as well on cognitive function tests and have lower “brain volume” compared to those who reside in higher-income areas, an analysis published Tuesday by JAMA Network Open found.

Increased household income was associated with improved vocabulary, reading skills and memory, among other skills, the researchers said.

These differences were likely attributable to the fact that children in these settings had more developed prefrontal and hippocampal brain regions, they said.

The prefrontal cortex has been linked with behavior, personality and decision making, among other functions, while the hippocampus is believed to be involved in learning and memory skills, according to the researchers.

“This study found evidence for independent associations of household and neighborhood environment with brain and cognitive outcomes in preadolescent children,” the researchers, from Washington University in St. Louis, wrote.

“The study also provided evidence consistent with a pathway wherein variation in prefrontal and hippocampal volume partially explains the association between neighborhood poverty and scores on cognitive tests,” they said.

Earlier research has linked socioeconomic status with brain development and academic performance, according to the researchers.

However, much of this research has focused on the impact of the socioeconomic status of individual households and families on child development, rather than the effects of living in poorer neighborhoods, they said.

“Typically, studies of socioeconomic status and the brain focus on household characteristics,” researchers Bruce Ramphal told UPI. “This study shows … that neighborhood- and household-level socioeconomic factors are uniquely related to the structure of brain regions.”

Ramphal was not part of the JAMA study published Tuesday but has devoted much of his research work to related subjects.

“These findings … [suggest] that equitable child development may be best supported by intervention both at the household and neighborhood levels,” said Ramphal, a research assistant at Columbia University and the New York State Psychiatric Institute.

For this study, the Washington University researchers analyzed the cognitive performance and brain development of 11,875 9- and 10-year-old children.

Cognitive performance was assessed using an approach created by the National Institutes of Health to measure verbal ability, attention, executive functioning, working memory, brain processing speed, episodic memory and reading ability, the researchers said.

Brain development was measured using 3T magnetic resonance imaging, a more powerful version of MRI designed to provide highly detailed images, they said.

Household socioeconomic status was measured using both household income and the Parent-Reported Financial Adversity Questionnaire, which is used to determine “whether families generally have enough money to pay for basic life expenses, such as food and healthcare,” according to the researchers.

Using the addresses of study participants, the researchers identified those living in neighborhoods with higher poverty levels.

Children living in lower-income households and in poorer neighborhoods generally performed less well on cognitive function tests than those living in wealthier areas, the researchers said.

MRI scans of the children in the study also revealed less development in the prefontal cortex and hippocampus in the brains of those living in poorer

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Measuring brain tissue damage accurately identifies cognitive decline, researchers say

Oct. 27 (UPI) — By analyzing brain tissue damage using a new MRI evaluation tool, researchers accurately identified people with early signs of cognitive decline up to 70% of the time, a study published Tuesday by the journal Academic Radiology found.

The approach uses magnetic resonance imaging to identify — and measure the number and size — of bright spots on the mostly gray images of the brain called white matter hyperintensities, or lesions, the researchers said.

These spots have long been linked to memory loss and emotional problems, especially as people age. Now, newly available MRI technologies could make it possible for them to be used for diagnosis of dementia, the researchers said.

“White matter lesion captured by MRI scans may reveal cognitive decline much earlier than behavioral symptoms,” study co-author Jingyun “Josh” Chen told UPI.

“Amounts of white matter lesions above the normal range should serve as an early warning sign for patients and physicians,” said Chen, a research assistant professor of neurology at New York University Langone Health.

Roughly 6 million adults in the United States have dementia, according to the Alzheimer’s Association.

Although the condition is common, it remains challenging to accurately diagnose, and no effective treatments exist, according to Chen and his colleagues.

The bright spots seen on MRI scans represent fluid-filled holes in the brain — lesions that are believed to develop from the breakdown of blood vessels that nourish nerve cells.

Earlier research has shown that increased numbers of spots and their presence in the center of the brain is linked with worsening dementia and other brain-damaging conditions, such as stroke and depression.

Current methods for grading white matter lesions, however, rely on little more than the “trained eye” using an imprecise three-point scale, according to the researchers.

The new tool, called the white matter hyperintensities toolbox and developed by Chen and his colleagues at NYU Grossman School of Medicine, is intended to provide neurologists with a uniform, objective method for calculating the spots’ volume and location in the brain.

For this study, Chen and his colleagues randomly selected 72 MRI scans from a national database of adults age 70 and older who participated in the Alzheimer’s Disease Neuroimaging Initiative, a research project seeking to identify clinical, imaging, genetic and biochemical biomarkers for the early detection and tracking of Alzheimer’s disease.

Using MRI techniques to map the brain’s surface, the researchers then used the new tool to calculate the precise position and volume measurements for all observed white matter spots or lesions.

When researchers cross-checked their measurements, they found that seven out of 10 calculations correctly matched the patient’s actual diagnosis.

With the standardized tracking and measuring tool, physicians could monitor the growth of white matter lesions in patients with suspected dementia, the researchers said.

White matter brain measures alone are not sufficient to diagnose early dementia, Chen said, but should be considered along with other factors. This includes a history of brain injury, memory loss and hypertension, as well as clear symptoms

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Eisai and Cogstate Expand Agreement for Global Development and Commercialization of Digital Cognitive Assessment Technologies

MELBOURNE, Australia, Oct. 25, 2020 /PRNewswire/ — Eisai Co., Ltd. (Headquarters: Tokyo, CEO: Haruo Naito, “Eisai”) and Cogstate, Ltd. (Headquarters: Melbourne, Australia and New Haven, USA, CEO: Brad O’Connor, “Cogstate”) announced today that the companies have entered into a collaboration whereby Eisai has secured the global development rights and exclusive commercialization rights of all cognitive function tests developed by Cogstate, including the “Cogstate Brief BatteryTM” (CBB) for use in healthcare and other markets. This global licensing deal is an expansion of an existing partnership executed in August 2019 whereby Eisai secured exclusive development and commercialization rights in Japan for all cognitive function tests developed by Cogstate, including the CBB. Both companies plan to proceed with development globally of CBB as a tool for individuals to self-assess brain performance to support healthy lifestyle choices and preventative measures in daily life, as well as a medical device to aid healthcare professionals in clinical diagnosis decisions.    

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Developed by Cogstate, the CBB is a scientifically validated digital tool that enables cognitive function self-checks and consists of four tests evaluating psychomotor function, attention, learning and memory, and working memory. In the United States, Europe, Australia, New Zealand and Canada, the CBB has been adapted as a medical device named “CognigramTM” that has achieved marketing authorization by regulators in these jurisdictions and provides informative results for healthcare professionals to support clinical examination to aid in the diagnosis of MCI and dementia.

In its medium-term business plan, EWAY2025, Eisai is aiming to become a “Medico Societal Innovator” (a company that changes society through creating medicines and providing solutions). Eisai is creating next-generation medical remedies focused on the neurology and oncology areas as well as building disease ecosystem platforms, in order to provide environments and solutions including digital solutions for early diagnosis and early treatment.

Cogstate aims to make assessment of brain health as simple, common and informative as assessment of blood pressure. Cogstate’s technology, which is easy to use and available in over 70 languages, is supported by extensive scientific validation, including more than 600 peer reviewed publications. Cogstate technology has been used extensively in clinical trials, including trials conducted by Eisai.

The global agreement between Eisai and Cogstate will allow the two companies to replicate many of the advancements that have already been launched in Japan, where Eisai has developed and launched a new digital tool using the CBB, named “NouKNOWTM” (pronounced “NOH-NOH”), a non-medical device for self-assessment of brain performance (brain health). Eisai is currently investigating the possibility of developing a medical device using the CBB in Japan.

In recent years, various research has demonstrated the possibility that decline in brain performance may be mitigated through major readjustments to lifestyle, such as regular exercise and sleep, a well-balanced diet, and social interaction. However, according to a survey by Eisai, the number of people taking correct preventive actions or habitually performing self-checks of cognitive function are few,

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Insomnia With Short Sleep Linked to Cognitive Impairment



Dr Julio Fernandez-Mendoza

Insomnia with objective short sleep duration is associated with a significantly increased risk of cognitive impairment (CI), particularly as it relates to cardiometabolic health, new research suggests.

Results of a population-based analysis show that participants who reported poor sleep or chronic insomnia and who objectively slept less than 6 hours per night had a twofold increased risk for CI.

The findings suggest that insomnia with objective short sleep duration is a more severe phenotype that is associated with cardiovascular, cerebrovascular, and neurocognitive disease, according to the researchers. The findings also indicate that objective sleep measures may reflect a patient’s insomnia severity and phenotype.

“This is the first study to show that adults who complain of insomnia and sleep objectively fewer than 6 hours in the lab have a twofold increased prevalence of mild cognitive impairment, particularly cognitive impairment associated with vascular contributors such as stage 2 hypertension, type 2 diabetes, heart disease, or stroke,” Julio Fernandez-Mendoza, PhD, associate professor of psychiatry at Penn State University College of Medicine in Hershey, Pennsylvania, told Medscape Medical News.

The research was published online September 24 in Sleep.

Highly Prevalent

The prevalence of insomnia symptoms in the general population may be as high as 30%, and approximately 15% of the general population has chronic insomnia.

Previous research has established an association between insomnia and psychiatric disorders, but fewer studies have examined the association between insomnia and cognitive impairment.

Furthermore, many studies that have analyzed the relationship between sleep and cognitive impairment have relied on self-reported measures of sleep, rather than objective measures.

For the study, researchers examined data from the Penn State Adult Cohort, which was a random, population-based sample of 1741 adults. Each participant spent one night in the sleep laboratory, during which he or she underwent 8 hours of polysomnography.

Participants also completed a questionnaire about sleep disorders, physical and mental health status, and substance use. They reported having normal sleep, poor sleep, or chronic insomnia.

The investigators obtained each participant’s clinical history, including mental and physical health conditions. Participants also underwent a battery of neuropsychological tests, including the Mini-Mental State Examination, the Symbol Digit Modalities Test, and the Trail Making Test.  

The analysis included 1524 participants. The study population had a mean age of 48.9 years. Approximately 47% of participants were men, and about 92% were non-Hispanic Whites.

A total of 155 participants (10.2%) had CI. Overall, 899 participants (59%) reported normal sleep, 453 (30%) reported poor sleep, and 172 (11%) reported chronic insomnia.

Need for Objective Assessment

Poor sleep and chronic insomnia were not significantly associated with CI or possible vascular cognitive impairment (pVCI). However, objective short sleep duration was significantly linked to CI (odds ratio [OR], 1.90) and marginally associated with pVCI (OR, 1.53).

Participants with self-reported poor sleep or chronic insomnia who slept less than 6 hours had a significantly increased risk of CI (OR, 2.06 and 2.18, respectively), as well as increased risk of pVCI (OR, 1.94 and 2.33, respectively), compared with participants with

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