FeedRSS Feed

Tag cloud
March 2, 2010 07:47  by Dr. Marla Shapiro

Two months ago, a report called "Rising Tide – The Impact of Dementia on Canadian Society"  was released. It reported that one new case of Alzheimer's disease is diagnosed every five minutes in Canada, and by 2038, a diagnosis will be made once every two minutes. Cumulative costs over the next three decades of caring for dementia will be a staggering $875 billion.

Without a doubt, dementia is one of the most feared consequences of aging. Not a day goes by when a patient who has misplaced a key asks me if this could mean they are losing their memory. Clearly, the concern of dementia is on our mind.

It becomes increasingly more important to identify risk factors that we can modify to decrease our risk. There have been a number of studies that have suggested being physically fit, lowering risk factors for cardiac disease, such as smoking, poor diet, high cholesterol.

An active mind can impact favourably on brain health. Recently, a new hypothesis has suggested that purpose in life can decrease the risk of Alzheimer's and its precursor, called mild cognitive impairment (MCI).

What exactly is purpose in life? That phrase refers to the tendency to feel that we find meaning in our life and that we have a sense of a goal that influences and guides our behaviour. We know that purpose in life has been linked to positive outcomes. According to a study in this week's Archives of General Psychiatry, having a sense of purpose in life is linked to better mental health and happiness. In fact, purpose in life is associated with longevity.

In the study, the authors tested that hypothesis with respect to dementia and MCI risk.  As well, the authors examined the rate of change in cognitive function in older people. Would having a sense of purpose reduce the risk of developing these diseases and would it delay the rate of change in those who developed changes in cognitive function?

Purpose of life was measured by a series of statements.

  1. I feel good when I think of what I have done in the past and what
    I hope to do in the future.
  2. I live life 1 day at a time and do not really think about the future. 
  3. I tend to focus on the present because the future nearly always
    brings me problems.
  4. I have a sense of direction and purpose in life.
  5. My daily activities often seem trivial and unimportant to me.
  6. I used to set goals for myself, but that now seems like a waste
    of time.
  7. I enjoy making plans for the future and working them to a reality.
  8. I am an active person in carrying out the plans I set for myself.
  9. Some people wander aimlessly through life, but I am not one
    of them.
  10. I sometimes feel as if I have done all there is to do in life

In their follow-up of seven years, about 16% or so developed Alzheimer's Disease (AD). As expected, those who developed AD were older, but compared to those who did not develop AD, they reported a lower purpose of life. They also were noted to report higher levels of something called neuroticism. Neuroticism is a personality trait that defines people who tend to experience psychological distress.

After controlling for a number of other variables, it was found that for those who had the highest purpose of life scores (90th percentile), they were 2.4 times more likely to be free of AD than a person with a lower score.

In the same period of follow -p, about 41% of people developed MCI. These people too were older and also reported a lower purpose in life and a higher number of depressive symptoms compared with those who did not develop MCI.

In the study, persons with a sense of greater purpose started at a higher level of cognition and declined less rapidly than those with a low purpose.

Psychological wellbeing has been associated with a number of disease related markers. We also know that immune function and vascular health are related to cognitive function. Those with positive psychological scores are noted to have better cholesterol levels and waist hip ratios. It may be that by benefiting vascular health, psychological well being benefits AD risk.

Improving psychological well being is target that we can help older individuals to achieve and may be an important modifiable factor in reducing the risk of AD and MCI.

WATCH: My segment on Canada AM this week: Having a purpose in life

Please Add Comments (8)    E-mail this    Permalink

Comments

Add comment


 
  Country flag

Click to change captcha
biuquote
  • Comment
  • Preview
Loading




Dr. Marla Shapiroclose [x]

Dr. Marla Shapiro, MDCM CCFP MHSc FRCP(C) FCFP, is a family physician and the Health and Medical Contributor for CTV's Canada AM as well as the editor of Parents Canada magazine, launched in March 2007.

She completed medical school at McGill University and trained at the University of Toronto for her Masters of Health Science in Community Health and Epidemiology. She holds a Fellowship in Family Medicine and is a NAMS credentialed menopause specialist. She is an associate professor in the Department of Family and Community Medicine at the University of Toronto, where she recently won an award for Creative Professional Activity.

Dr. Shapiro won the Society of Obstetricians and Gynaecologists of Canada/Canadian Foundation for Women's Health Award for Excellence in Women's Health Journalism in 2006 for her documentary "Run Your Own Race." Her book, "Life in the Balance: My Journey with Breast Cancer" was released in the fall of 2006 and is a national bestseller.

For her lifelong commitment to family medicine, Shapiro was awarded the College of Family Physicians of Canada's Award of Excellence for 2008.

Angela Mulhollandclose [x]

Angela Mulholland is the editor of CTV News' semi-weekly health newsletter MedNews Express as well as the MedNews Express Blog.

She has been a journalist for CTV News since 2000, covering current affairs, health and entertainment for CTV.ca. Before CTV, she worked for CBC.ca for two years.

She has a degree from St. Jerome's University in Waterloo, ON, and studied journalism at Sheridan College in Oakville. She lives in Toronto with her husband and two children.

Monica Matysclose [x]

Monica Matys has been the health and wellness reporter for CTV News Toronto since 2001. Her feature health report, Lifetime, can be seen on CTV Toronto's News at Noon and at 6 p.m.

Her interest in the medical field began while working for a medical publishing company as the editor of a monthly magazine. One of Monica's favourite days on the job was the time she got to spend a day in Credit Valley Hospital's Emergency unit. "It really opened my eyes to the strains on our system," Monica explains.

Matys grew up in Scarborough, and has an honours degree in Journalism from Carleton University in Ottawa. She lives in Toronto with her husband and two children.

Avis Favaroclose [x]

Avis Favaro has been with CTV News since 1992, producing stories for CTV National and CTV News Channel - Newsnet- as well as for CTV affiliate stations across the country.

Avis and producer Elizabeth St. Philip won the 2008 Media Awards for Excellence in Health Reporting handed out by the Canadian Nurses Association and the Canadian Medical association for a story on BPA found in food cans.

She has been nominated for an impressive 12 Geminis, winning once for a unique story on an experimental cancer treatment developed in Winnipeg in the 1940's.

Avis has a masters in journalism from UWO and a Bachelor's degree in History, and launched her journalism career as a writer/reporter at Global in 1982.

Dr. Yoni Freedhoffclose [x]

Dr. Yoni Freedhoff, MD CCFP Dip ABBM, is the founder and Medical Director of the Bariatric Medical Institute in Ottawa, a multi-disciplinary behavioural weight management program. Formally trained in family medicine, since 2004 his practice has been exclusively dedicated to the treatment of overweight and obesity.

Dr. Freedhoff has been referred to as a "nutritional watchdog" by the Canadian Medical Association Journal and a national "obesity expert" by the Canadian Obesity Network. His advocacy efforts for improved public policies regarding nutrition and obesity have found him testifying in front of the Canadian House of Commons, giving press conferences with the Ontario Medical Association, commenting regularly in the national media, and as a sought after lecturer.

Dr. Freedhoff explores issues pertinent to nutrition, obesity, public policy and advocacy in his daily blog Weighty Matters which is ranked among the world's top health blogs and was voted the top Canadian health blog of 2008 by the Canadian Blog Awards.

Dr. Grant Lumclose [x]

Dr. Lum is a sports medicine physician. He is the medical director and founder of Athletic Edge Sports Medicine, a multidisciplinary sports medicine organization offering services to the athletic and active public.

He is involved in the care of recreational, elite amateur and professional athletes, including players in the NHL, NFL and NBA. He is also involved in the performing arts medical community, taking care of musicians, vocalists, dancers and other performing artists.

Dr. Lum studied medicine at the University of Toronto, where he graduated in 1992. He completed a two-year residency in Family Medicine, and then specialty training in Sports Medicine.

He is a lecturer at the University of Toronto's Faculty of Medicine, an adjunct professor at York University's Faculty of Fine Arts, and medical director of George Brown College's Fitness and Lifestyle Management Program.

Dr. Lorne Brandesclose [x]

A senior oncologist at CancerCare Manitoba, Dr. Brandes received his MD from the University of Western Ontario in 1968.

Following post-graduate training at the Royal Marsden Hospital (London) and the University of Manitoba, he joined the faculty at U. Of M. in 1975, where he is a professor in the Departments of Medicine and Pharmacology.

He is also affiliated with the Manitoba Institute of Cell Biology.

Dr. Katy Kamkar, Ph.D., C. Psych.close [x]

Dr. Katy Kamkar, Ph.D., C. Psych., is a Clinical Psychologist at the Work, Stress and Health Program/Psychological Trauma Program, at the Centre for Addiction and Mental Health (CAMH). She also provides private practice at the CBT Associates of Toronto and is a lecturer in the Department of Psychiatry, University of Toronto.

She completed her Honours Degree in Psychology and Mathematics at York University and her Masters and Ph.D. in Clinical Psychology at Concordia University. She also completed a Clinical/Research Postdoctoral Fellowship at CAMH. She has received numerous academic awards and distinctions.

Kamkar provides consultation, comprehensive assessments, and evidence-based Cognitive-Behavioural treatment for Mood and Anxiety Disorders, including psychological distress related to stress and anxiety in the workplace. She also provides training, education, and supervision as well as various educational seminars and workshops. She adheres to a scientist-practitioner model of practice and integrates research and science with practice.

One of Dr. Kamkar's greatest interests has been to provide education to enhance public awareness of mental health/illness in general and of psychological distress in the workplace. She has written articles for comprehensive public resources and provided numerous public relations - media work.

Dr. Neil Rauclose [x]

Dr. Neil Rau grew up in Ottawa. He initially studied mathematics at the University of Waterloo before completing his MD at the University of Toronto in 1991. He completed training in Internal Medicine and Infectious Diseases at McGill University in 1996, before establishing a busy private practice in Oakville. He is currently the medical director of Infection Prevention and Control at Halton Healthcare Services.

In 2008, he completed his training in medical microbiology at the University of Toronto and he now serves as the medical microbiologist and chair of the patient safety steering committee at his hospital.

He is a lecturer at the University of Toronto. Since 2008, he has also been Infectious Diseases section head at the Association for Medical Microbiology and Infectious Disease Canada. He is also a frequent contributor to CTV News.

He lives in Toronto with his wife and two children, and is an avid amateur concert pianist.

Cara Rosenbloom, RD close [x]

Registered dietitian Cara Rosenbloom believes that nutrition can make a difference in overall health and wellness and enjoys translating complex nutrition information into usable and helpful advice.

Rosenbloom holds a literature degree from the University of Western Ontario and a Bachelor of Applied Science in Food & Nutrition from Ryerson University. She completed a dietetic internship at North York General Hospital to become a registered dietitian.

Prior to becoming a nutrition columnist, Rosenbloom worked as a dietitian at The Hospital for Sick Children for three years. She is a member of Dietitians of Canada and the College of Dietitians of Ontario and the president of Words to Eat By, a nutrition communications company.