Hearing is believing: Speech may be a clue to mental decline

In this July 6, 2017 photo, Kim Mueller, left, administers a test to Alan Sweet, where he describes an illustration, as part of a University of Wisconsin-Madison study on dementia. The study found that for some people subtle changes in everyday speech can be correlated with early mild cognitive impairment, which can be a precursor to Alzheimer's. (AP)
Updated 17 July 2017
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Hearing is believing: Speech may be a clue to mental decline

Your speech may, um, help reveal if you're uh ... developing thinking problems. More pauses, filler words and other verbal changes might be an early sign of mental decline, which can lead to Alzheimer's disease, a study suggests.
Researchers had people describe a picture they were shown in taped sessions two years apart. Those with early-stage mild cognitive impairment slid much faster on certain verbal skills than those who didn't develop thinking problems.
"What we've discovered here is there are aspects of language that are affected earlier than we thought," before or at the same time that memory problems emerge, said one study leader, Sterling Johnson of the University of Wisconsin-Madison.
This was the largest study ever done of speech analysis for this purpose, and if more testing confirms its value, it might offer a simple, cheap way to help screen people for very early signs of mental decline.
Don't panic: Lots of people say "um" and have trouble quickly recalling names as they age, and that doesn't mean trouble is on the way.
"In normal aging, it's something that may come back to you later and it's not going to disrupt the whole conversation," another study leader, Kimberly Mueller, explained. "The difference here is, it is more frequent in a short period," interferes with communication and gets worse over time.
The study was discussed Monday at the Alzheimer's Association International Conference in London.
About 47 million people worldwide have dementia, and Alzheimer's is the most common type. In the U.S., about 5.5 million people have the disease. Current drugs can't slow or reverse it, just ease symptoms. Doctors think treatment might need to start sooner to do any good, so there's a push to find early signs.
Mild cognitive impairment causes changes that are noticeable to the person or others, but not enough to interfere with daily life. It doesn't mean these folks will develop Alzheimer's, but many do — 15 to 20 percent per year.
To see if speech analysis can find early signs, researchers first did the picture-description test on 400 people without cognitive problems and saw no change over time in verbal skills. Next, they tested 264 participants in the Wisconsin Registry for Alzheimer's Prevention, a long-running study of people in their 50s and 60s, most of whom have a parent with Alzheimer's and might be at higher risk for the disease themselves. Of those, 64 already had signs of early decline or developed it over the next two years, according to other neurological tests they took.
In the second round of tests , they declined faster on content (ideas they expressed) and fluency (the flow of speech and how many pauses and filler words they used.) They used more pronouns such as "it" or "they" instead of specific names for things, spoke in shorter sentences and took longer to convey what they had to say.
"Those are all indicators of struggling with that computational load that the brain has to conduct" and supports the role of this test to detect decline, said Julie Liss, a speech expert at Arizona State University with no role in the work.
She helped lead a study in 2015 that analyzed dozens of press conferences by former President Ronald Reagan and found evidence of speech changes more than a decade before he was diagnosed with Alzheimer's. She also co-founded a company that analyzes speech for many neurological problems, including dementia, traumatic brain injury and Parkinson's disease.
Researchers could not estimate the cost of testing for a single patient, but for a doctor to offer it requires only a digital tape recorder and a computer program or app to analyze results.
Alan Sweet, 72, a retired state of Wisconsin worker who lives in Madison, is taking part in the study and had the speech test earlier this month. His father had Alzheimer's and his mother had a different type of dementia, Lewy body.
"Watching my parents decline into the awful world of dementia and being responsible for their medical care was the best and worst experience of my life," he said. "I want to help the researchers learn, furthering medical knowledge of treatment and ultimately, cure."
Participants don't get individual results — it just aids science.
Another study at the conference on Monday, led by doctoral student Taylor Fields, hints that hearing loss may be another clue to possible mental decline. It involved 783 people from the same Wisconsin registry project. Those who said at the start of the study that they had been diagnosed with hearing loss were more than twice as likely to develop mild cognitive impairment over the next five years as those who did not start out with a hearing problem.
That sort of information is not strong evidence, but it fits with earlier work along those lines.
Family doctors "can do a lot to help us if they knew what to look for" to catch early signs of decline, said Maria Carrillo, the Alzheimer's Association's chief science officer. Hearing loss, verbal changes and other known risks such as sleep problems might warrant a referral to a neurologist for a dementia check, she said.


Take a healthy approach to the issue of nutritional supplements

Updated 21 April 2018
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Take a healthy approach to the issue of nutritional supplements

JEDDAH: There is a growing need for dietary supplements in Saudi Arabia, given the increasing popularity of junk food and the effective role supplements can play in treating diseases caused by mineral and vitamin deficiencies.

A recent study found that 22 percent of Saudi people take nutritional supplements. It is no surprise, then, that many Saudi businesses have forged partnerships with international dietary-supplement companies.

Dr. Rowaidah Idriss, a Saudi dietitian with a Ph.D. in nutrition, said dietary supplements can be defined as substances that provide the human body with a nutrient missing from a person’s regular diet. However, she stressed that they are not intended to replace healthy eating.

She also warned against taking them without first talking to a doctor or dietitian, as some products can have side effects, especially if taken before surgery or with other medicines. 

“They can also cause problems if someone has a history of certain health issues,” she added.

A blood test can determine which nutrients we are not getting enough of in our diet, and therefore which supplements might be beneficial. Nutritional supplements are also used to help treat certain health conditions. 

“Vitamin C, for example, is often used to reduce cold symptoms,” said Idriss. “Fish oil is taken to lower elevated blood triglycerides.”

She suggested four daily essentials that can bridge nutritional gaps in our diet: a multivitamin, vitamin D, calcium and omega-3 fatty acids. 

“I routinely recommend a daily multivitamin and mineral supplement to my clients after consulting with their doctors,” she said. 

“For menstruating women, who require 18 milligrams of iron each day, a daily supplement helps boost iron intake.”

She said people over the age of 50 are advised to take a multivitamin to ensure they are getting enough B12, which plays a key role in the functioning of the nervous system and the development of red blood cells. 

“Older adults are more vulnerable to B12 deficiency because they are more likely to have decreased production of stomach acid, which is needed to release B12 from the proteins in food.” said Idriss. 

“It is also a good idea to take a daily multivitamin if one is following a low-calorie diet.”

She also pointed out that a high intake of DHA and EPA, the two omega-3 fatty acids found in fish oil, are linked with a lower risk of heart disease and Type 2 diabetes. A deficiency of DHA might also increase the risk of Alzheimer’s. 

“A daily intake of 1,000 milligrams of both DHA and EPA is equivalent to eating 12 ounces of salmon a week,” said Idriss.

The dietitian believes that the Saudis who take food supplements often do so more to benefit their appearance than their health. 

“Saudi women consume more dietary supplements than other people in Saudi Arabia,” she said. 

“They do so either to lose weight or to care for their hair and nails. Bodybuilders also take large amounts of supplements.”

However, both groups, according to Idriss, tend to take supplements on the recommendation of friends and trainers, not doctors. 

She warned that commercials and social-media rumors can persuade people to buy supplements online that may not be approved as safe by the Saudi Food and Drug Authority, and advised people to get as much of their daily nutrient needs as possible from healthy eating.

Dr. Rowaidah Idriss

“Along with vitamins and minerals, a healthy diet provides fiber and hundreds of protective phytochemicals, something a supplement cannot do,” she said, adding that the body absorbs natural food more effectively than supplements.

In addition, combining supplements with medications can have dangerous, even life-threatening, effects. 

“Drugs for heart disease and depression, treatments for organ transplants, and birth-control pills are less effective when taken with herbal supplements,” she said.

“Taking an anticoagulant, aspirin, and a vitamin E supplement together may increase the potential for internal bleeding or even stroke.”

 

Natural sources

With the spread of fast-food restaurants and their alluring ads, the long-term health of the Saudi people is in danger, as children and young people snub natural sources of nutrients, such as fruit and vegetables. 

“This can lead to many deficiency diseases. Moreover, vegetarians can develop similar illnesses due to the absence of meat in their diet,” she said.
Dr. Ashraf Ameer, a family-medicine consultant, said the importance of nutritional supplements lies in treating mineral and vitamin deficiency, especially for pregnant women, growing children, diabetics, people with chronic diseases, and the elderly. 

“However, these products should come from reliable companies and meet Saudi food and drug requirements,”he added.

Mohammed Yaseen, who has a food supplements business, said his company works with a leading British health-care company to provide the Saudi market with high quality products.

“With this we hope we can contribute to the national transformation program by raising private-sector spending in health care from 25 percent to 35 percent, which in turn would lead to the sector’s financial sustainability and boost economic and social development in the Kingdom,” Yaseen said.

Decoder

Vitamin Terms

DHA stands for docosahexaenoic acid. EPA stands for eicosapentaenoic acid.  Phytochemical is a biologically active compound found in plants.