Archive for June, 2013

What is the most useful way to enhance and protect my cognitive skills as I age?  Brain exercise products, “brain fitness computer programs,” have burgeoned over the last few years to the point that they have already become a $300 million industry.   The programs promise to improve memory, attention, and creativity.  They promise to prevent or delay Alzheimer’s disease and dementia.  The programs are heavy on marketing but lean on rigorous evaluation.  Are the programs worth the investment?  Is it better to work-face-to-face or to use a computer program? In an attempt to answer these questions, I just read a complicated review article “Computerized cognitive training with older adults” (PLoS One, 2012, 7, e40588, 1-13).  The intent, in part, was to compare the efficacy of face-to-face cognitive training to computer based programs in healthy older adults (those over 50).  First, […]


To quote from my article for August 2011,  “It is clear that anesthetic agents may be neurotoxic for some and more so after 60.”  This statement was predicated on findings from that time suggesting that undergoing general anesthesia may cause cognitive decline especially in the elderly.  Delirium and postoperative cognitive decline are the two most common untoward effects of surgery.  Delirium is transient and obvious but may last days to weeks.  Postoperative cognitive decline is a more long lasting condition, often subtle at first. But not so fast, understanding is a process that evolves over time and must integrate new information as it becomes available.  A new study (Mayo Clinic Proceedings, May 2013) states that there is no association between anesthesia and dementia.  The data were obtained from medical records on nearly 2000 cases.  Results were based on individuals that […]


I just finished reading a very interesting book that was suggested by a couple of my clients.  They are aware that I love cats.  I recall the empty feeling that Pamela and I had between cats.  Pepper, our cat of 22 years, died and we spent a year and a half without another cat.  Our home lacked completion during that time.  We are so pleased to have Gracie and Vanna add their energies to our home. Making Rounds with Oscar is set in a nursing home. David Dosa, the author of the book, and a special cat named Oscar are the two main characters in this memoir.  David Dorsa is the attending physician at a nursing home in the northeast.   Being classically trained, he begins by being skeptical about the ability of a resident cat, Oscar, to sense and to […]


I am often asked about potential treatments for Alzheimer’s disease.  The intention behind the question is to solicit my assessment of whether there are any medications that show promise for the future.  Anyone who has talked to me or followed my columns knows that I am frustrated by the rigid commitment and inflexibility of many clinical trials that focus on treating brain proteins called amyloids that cause the build up of plaques in the brain.  This strategy has channeled so many intellectual and financial resources into a collective tunnel vision despite many failures of the concept. There are two recent studies that merit attention in that they each add intriguing findings that are not directly connected to amyloid pathology.  They focus on slowing progressive diseases as well as suggest new strategies in the search for disease modifying treatments of Alzheimer’s […]

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