7.15.2004

In Japan, seniors try Learning Therapy to Prevent Alzheimer's. Not only can they stave off the progression of the disease, they improve in many instances.
 
SENDAI, Japan (Reuters) - Sachiko Murase is a changed woman. A year ago, Alzheimer's disease was so advanced in her that she could hardly recognize a pencil. Now, after having an increasingly popular treatment in Japan called "Learning Therapy," her once blank expression is punctuated with smiles.

"You see it's not only me. We're all having fun," said a beaming Murase, 83, at a nursing home in the city of Sendai, 190 miles north of Tokyo.

Alzheimer's, a brain disease whose causes are not fully understood, can start with mild forgetfulness but gradually ravages the memory and makes it hard to think and use language.

Murase is one of an estimated 1.5 million afflicted among the 24 million Japanese over the age of 65.

She is not cured of the disease, however, and no one is pretending to be able to turn back the clock.

But thanks to methods developed by Professor Ryuta Kawashima of Tohoku University in Sendai and backed up by an army of volunteers and textbooks from Kumon Institute of Education Co. - Japan's largest private education company - she has regained an ability to communicate and interact with people.

The "Learning Therapy" method consists of meeting regularly in classes to perform simple calculations and read aloud passages from essays or novels.

Advocates say it works like a mental exercise to rehabilitate the frontal cortex, part of the brain thought to be important for higher-level functions, memory, reasoning and judgment.

According to Kawashima, who began his research in the Sendai nursing home, a majority of Alzheimer's patients who regularly performed these simple tasks showed improvements in their scores in a test used to determine the severity of Alzheimer's disease.

Even those who did not improve saw little or no deterioration in their mental state during the time they were tested, he said.

While a range of remedies from crossword puzzles to berries has been claimed to help prevent Alzheimer's, Kawashima says this is a full treatment that has been thoroughly researched with a salvo of medical tests.

For staff at the Evergreen nursing home, the improvements have been very noticeable.

"In the past we used to have many behavioral problems because many of our patients had severe symptoms," nurse Rika Murakami said as she checked responses from one of the elderly women attending a recent session.

"But what we've seen since is that they've begun smiling more and many have become more serene," she said.

SIMPLE IS BEST

But the course is far from guaranteeing a full recovery, and the spotlight remains on prevention. 

"Even after three years we found that there was no way we could return them to their old selves," Kawashima said. "So the next step then was to think about prevention."
Thus began courses for healthy and less elderly seniors.
These experimental classes began in Sendai, where twice a week some 40 people aged 70 and over gather at a local school to perform tasks that are similar to but slightly more difficult than those done in the nursing home. "The course would probably be easy even for my grandchildren," grumbled one participant, Takao Kumagaya, 74.

"But that's OK. That's how it should be," he added. "Simple subjects like these are what stimulate the brain to keep it young."
These concepts have caught on in Japan like wildfire. Even local governments have taken notice.
In the Shinagawa district of central Tokyo, plans are in place to start similar classes to those in Sendai. Another Tokyo district and one other prefecture are following suit.
Officials at Shinagawa, which like the rest of the country has seen a rapid increase in retired people who need extra medical care, say they fear the day when the increase in elderly patients stretches their welfare support system to the limits.

"Our greatest concern right now is preventing elderly people from being marginalised in our society," said Mari Niimi, head of Shinagawa Welfare and Senior support department.

"So there is great interest in the prevention of Alzheimer's as the care of elderly people with this disease is very difficult," she said. "If we can truly prevent this, it would be revolutionary."




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High intake of the vitamin niacin, particularly from food sources, may reduce the risk of Alzheimer's disease and age-related mental decline.

The study in the Journal of Neurology, Neurosurgery, and Psychiatry points out that severe niacin deficiency is known to cause dementia. However, the researchers note that it is unclear if more subtle variations in niacin intake influence the risk of mental deterioration.

"There have been no epidemiologic studies to look at the association between dietary niacin and Alzheimer's disease or cognitive decline," lead author Dr. Martha C. Morris, from the Rush Institute for Healthy Aging in Chicago, told Reuters Health.

Moreover, "animal studies and other studies have really focused on the effects of very high therapeutic dose levels of niacin," not amounts found in a standard diet.

To investigate, the researchers asked several thousand elderly people living in a Chicago community about the types and amounts of food they ate and tested their mental abilities.

The study focused on 815 randomly selected subjects who were free from Alzheimer's disease at the start of the study. After an average of nearly four years, 131 of the participants were diagnosed with Alzheimer's disease.

A high level of total niacin intake seemed to protect against both Alzheimer's disease and cognitive decline. The association was stronger for niacin intake from foods than for niacin taken in vitamin supplements.

"We were surprised to see a fairly strong association between niacin intake from foods and Alzheimer's disease," Morris said. Compared with the lowest intake, the highest intake "was linked to an 80 percent reduction in risk."

In the overall study population, high niacin intake was also linked to a reduced risk of cognitive decline.

Although the finding are provocative, Morris concluded, they will require verification before any changes to current dietary guidelines can be recommended.


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