dementia

CMS: anti-amyloid drug Leqembi (lecanemab) doesn’t meet the “reasonable and necessary” standard required for wider Medicare coverage

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CMS Sticks to Sharply Lim­it­ed Cov­er­age of New Alzheimer’s Drug, Leqem­bi (Man­aged Health­care Executive):

For now, CMS (Note: Cen­ters for Medicare & Med­ic­aid Ser­vices) is stick­ing to the cov­er­age deci­sion it made for Aduhelm (adu­canum­ab) and apply­ing it Leqem­bi (lecanemab). The deci­sion lim­its Medicare cov­er­age of the two Alzheimer disease’s drugs to Medicare ben­e­fi­cia­ries who have enrolled in clin­i­cal tri­als of the drugs

The deci­sion, which was announced in a press release yes­ter­day, was denounced in strong lan­guage by the Alzheimer’s Asso­ci­a­tion. [Read more…] about CMS: anti-amy­loid drug Leqem­bi (lecanemab) doesn’t meet the “rea­son­able and nec­es­sary” stan­dard required for wider Medicare coverage

Ballroom dancing can reduce aging-related brain atrophy in the hippocampus (and, more than treadmill walking!)

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Social ball­room danc­ing can improve cog­ni­tive func­tions and reduce brain atro­phy in old­er adults who are at increased risk for Alzheimer’s dis­ease and oth­er forms of demen­tia. That’s the key find­ing of my team’s recent­ly pub­lished study in the Jour­nal of Aging and Phys­i­cal Activity.

In our study, we enrolled 25 adults over 65 years of age in either six months of twice-week­ly ball­room danc­ing class­es or six months of twice-week­ly tread­mill walk­ing class­es. None of them were engaged in for­mal danc­ing or oth­er exer­cise pro­grams. [Read more…] about Ball­room danc­ing can reduce aging-relat­ed brain atro­phy in the hip­pocam­pus (and, more than tread­mill walking!)

On cognitive-physical training, brain biomarkers, dementia, ketamine, brain teasers, riddles and more

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Wel­come to the last 2022 edi­tion of Sharp­Brains e‑newsletter, fea­tur­ing a few select­ed brain health news and fun teasers to chal­lenge your brain and help us all think out­side the box.

#1. “Every­one agrees that Google Glass failed when it came to mar­ket, but to me, it’s a sym­bol of hope … It inspired peo­ple to think beyond tra­di­tion­al ways of mov­ing about our envi­ron­ment. Instead of look­ing down at a device, we could look out at the world and have an over­lay of dig­i­tal infor­ma­tion. It was one of the first steps in physical–digital con­ver­gence that we are see­ing today through­out many indus­tries. And as some­one who has cre­at­ed many inven­tions that nev­er left the lab or were too ear­ly for the mar­ket, I love the fact that Glass came out at all!” — wise words by neu­rotech entre­pre­neur Dr. Cori Lath­an in her new (and excel­lent) book. See Tech­nol­o­gy as a bridge in time: Shap­ing the future of brain health via today’s innovations–including those that “fail”

#2. “Some peo­ple want to do cog­ni­tive train­ing while mov­ing rather than sit­ting down, and that real­ly spoke to me as a pos­si­bil­i­ty for real ben­e­fits giv­en anec­do­tal sto­ries about games like ‘Dance Dance Rev­o­lu­tion.’” — Joaquin A. Anguera, asso­ciate pro­fes­sor at UCSF and direc­tor of Neuroscape‘s Clin­i­cal Divi­sion. See Study: A com­bined cog­ni­tive-phys­i­cal train­ing approach may enhance both mind and body as we age

#3. “Giv­en that ketamine’s rapid action and unex­pect­ed dis­so­cia­tive effects make it a poten­tial­ly worth­while option for treat­ing men­tal health prob­lems, we are on a mis­sion to unpack this mys­tery, at the cross­roads between phar­ma­col­o­gy and neu­ro­science.” See Study iden­ti­fies cog­ni­tive ben­e­fits of ket­a­mine in patients with treat­ment-resis­tant depression

#4. “The grat­i­tude writ­ing group main­tained grat­i­tude lev­els and decreased stress and neg­a­tive affect at one-month post-inter­ven­tion” — that main­te­nance aspect is espe­cial­ly inter­est­ing. See Thanks­giv­ing works: Grat­i­tude jour­nal­ing seen to low­er stress and neg­a­tive cog­ni­tive processes

#5. Impres­sive new funding–especially giv­en mar­ket conditions–with a goal to iden­ti­fy “brain bio­mark­ers by ana­lyz­ing EEG activ­i­ty, behav­ioral task per­for­mance, wear­able data, genet­ics, and oth­er fac­tors to match each patient with the right Alto drug.” See Pre­ci­sion psy­chi­a­try pio­neer Alto Neu­ro­science rais­es $35M to advance dig­i­tal bio­mark­er-to-treat­ment platform

#6. Some bad news. See The FDA ends pre­cer­ti­fi­ca­tion (Pre-Cert) pilot pro­gram, say­ing new author­i­ty required to reg­u­late soft­ware as a med­ical device (SaMD)

#7. And some great news: “(Péter Hudomi­et, study’s lead author) said it’s also pos­si­ble that, giv­en numer­ous stud­ies being released on steps to take to avoid demen­tia, some of the decline may be attrib­uted to peo­ple heed­ing such advice.” See Study finds sharp decrease (near­ly one-third) in the preva­lence of demen­tia among those 65+ in the Unit­ed States

#8. Final­ly, here are a few brain teasers to stim­u­late those neu­rons in your tem­po­ral lobes and to help us all think out­side the box.

 

Have a healthy and won­der­ful 2023!

 

Study finds sharp decrease (nearly one-third) in the prevalence of dementia among those 65+ in the United States

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Demen­tia plum­mets by near­ly one-third among U.S. seniors, RAND says (UPI):

The preva­lence of demen­tia in the Unit­ed States is declin­ing among peo­ple over age 65, falling dra­mat­i­cal­ly from 2000 to 2016, a RAND Corp. study says.

Nation­wide, the age-adjust­ed preva­lence of demen­tia fell to 8.5% of peo­ple over age 65 in 2016, down by near­ly one-third from 12.2% of peo­ple over age 65 in 2000, accord­ing to the researchers. [Read more…] about Study finds sharp decrease (near­ly one-third) in the preva­lence of demen­tia among those 65+ in the Unit­ed States

Combined tDCS neurostimulation and cognitive training found to improve working memory among older adults–especially those with lower starting capacity

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Giv­ing mem­o­ry a lift: Can games and brain stim­u­la­tion do it? (Med­ical­New­sTo­day):

A person’s work­ing mem­o­ry may decline with age or if they have demen­tia, Parkinson’s dis­ease, or have had a stroke. When this occurs, the loss can affect their day-to-day qual­i­ty of life, turn­ing even sim­ple tasks into often-demor­al­iz­ing chal­lenges. [Read more…] about Com­bined tDCS neu­rostim­u­la­tion and cog­ni­tive train­ing found to improve work­ing mem­o­ry among old­er adults–especially those with low­er start­ing capacity

Building cognitive reserve helps delay memory and thinking decline regardless of genetic or childhood markers

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Wel­come to a new edi­tion of Sharp­Brains’ e‑newsletter, fea­tur­ing time­ly brain news and a few fun brain teasers to test your per­cep­tu­al and cog­ni­tive skills.

#1. Study: Build­ing cog­ni­tive reserve helps delay mem­o­ry and think­ing decline regard­less of genet­ic or child­hood markers

“While our child­hood can influ­ence our mem­o­ry and think­ing skills lat­er in life, this research under­lines the mes­sage that it’s nev­er too late to take action to sup­port cog­ni­tive health.” — Dr Sara Imari­sio, Head of Strate­gic Ini­tia­tives at Alzheimer’s Research UK

#2. Ful­ly-auto­mat­ed analy­sis of voice recordings–from neu­ropsy­cho­log­i­cal tests–found to help dif­fer­en­ti­ate nor­mal cog­ni­tion from demen­tia and mild cog­ni­tive impairment

As the researchers point out, “The pro­posed approach offers a ful­ly auto­mat­ed iden­ti­fi­ca­tion of MCI and demen­tia based on a record­ed neu­ropsy­cho­log­i­cal test, pro­vid­ing an oppor­tu­ni­ty to devel­op a remote screen­ing tool that could be adapt­ed eas­i­ly to any language”

#3. Debunk­ing the “chem­i­cal imbal­ance” the­o­ry yet not throw­ing out the anti­de­pres­sant baby with the bathwater

“Depres­sion is usu­al­ly man­aged effec­tive­ly with anti­de­pres­sants or by talk­ing treat­ments, such as cog­ni­tive behav­iour ther­a­py, despite an incom­plete under­stand­ing of the con­di­tion and how these treat­ments work. We can­not know if treat­ments address the under­ly­ing prob­lem because we haven’t yet iden­ti­fied what that is. To imply that SSRI anti­de­pres­sants may not be worth­while is to mis­un­der­stand an evi­dence base that says the very opposite.”

#4. Q&A with researcher Robb Rut­ledge on men­tal health, expec­ta­tions, deci­sion-mak­ing and hol­i­day planning

“Recent events have a big­ger impact on hap­pi­ness than ear­li­er events, so it can be a good strat­e­gy to save a cou­ple things that have a chance of a big pos­i­tive sur­prise for the last few days of your trip. It could be a nov­el expe­ri­ence that a lot of peo­ple like but you’re not sure what to expect … It prob­a­bly isn’t anoth­er muse­um. Just make sure it’s not some­thing that could get rained out”

#5. How much should you trust Bet­ter­Help, Talk­space, Cere­bral and oth­er men­tal health start-ups tout­ed by celebrities?

“Many U.S. adults aren’t able to find help because of a short­age of ther­a­pists. Near­ly 40% are strug­gling with men­tal health or sub­stance abuse issues, accord­ing to the Cen­ters for Dis­ease Con­trol and Prevention.
So mil­lions of peo­ple are turn­ing to online companies…”

#6. Dig­i­tal men­tal health inter­ven­tion by the World Health Orga­ni­za­tion (WHO) found to low­er anx­i­ety and depres­sion, with improve­ments main­tained at 3?month follow-up

As acknowl­edged “The main lim­i­ta­tion of the cur­rent tri­al is the high dropout rate”, but con­text is key: “Most dis­placed peo­ple with men­tal dis­or­ders in low- and mid­dle-income coun­tries do not receive effec­tive care, and their access to care has dete­ri­o­rat­ed dur­ing the Coro­n­avirus Dis­ease 2019 (COVID-19) pan­dem­ic”. — Inno­va­tion does­n’t need to be per­fect, just better/ cheaper/ more acces­si­ble than alternatives.

#7. Dig­i­tal ther­a­peu­tics pio­neer Akili Inter­ac­tive Labs goes pub­lic, rais­ing $150M+; trades down 49% first day

Quite dif­fi­cult mar­ket envi­ron­ment for an impor­tant evi­dence-based inno­va­tion — good news is they raised enough funds to test approach in the real world over the next 12–24 months. Let’s see!

#8. Arti­fi­cial Intel­li­gence (AI) meets Cog­ni­tive Behav­ioral Ther­a­py (CBT): Wysa rais­es $20M to scale up men­tal health chatbot

“Typ­i­cal­ly, access to a men­tal health ser­vice is gat­ed. It is restrict­ed by some kind of diag­no­sis — say­ing only if you are severe enough you will be able to get to speak to a ther­a­pist because obvi­ous­ly ther­a­py is expen­sive and somebody’s got to pay for it” … the app offers “ear­ly engage­ment and a safe space where peo­ple can come in and anony­mous­ly just talk about what’s both­er­ing them.”

Final­ly, here are three quick brain teas­er games to test your per­cep­tu­al and cog­ni­tive skills. Wish­ing you and yours a healthy and stim­u­lat­ing month of September!