Telling Time

According to Dr. Morris Freedman, there is a marked difference between how a normal person draws a clock and how someone with certain cognitive problems will draw it. Dr. Freedman together with Dr. Larry Leach and their colleagues have pioneered tests to help physicians diagnose Alzheimer’s disease earlier. One such test in wide use involves asking a patient to draw a clock. The ability of a patient to reproduce a clock representing a specified time can help determine whether that patient’s cognitive function is normal or impaired. Diagnostic tools such as Dr. Freedman’s clock-drawing assist in the diagnosis of Alzheimer’s and other dementia, allowing physicians to begin treating the disease sooner.

Taking Care of Caregivers

While awareness of Alzheimer’s disease has grown in recent years, one unseen aspect of the disease is the effect it has on the children who are living at home with a family member who has Alzheimer’s or frontotemporal dementia. Until recently there have been no written resources to guide children and teens – or even for the well parent to assist their children though the caregiving experience.

Dr. Tiffany Chow, a clinical researcher specializing in diagnosing and treating early-onset dementia, is the driving force behind the website When Dementia is in the House. Developed in collaboration with writer Katherine Nichols, the site is designed to help family members learn strategies to manage the emotional conflicts and unpredictable behaviours associated with early-onset dementia in their loved ones – and to find ways, despite the upheaval, to enjoy quality moments of family time. Plans are underway to extend the educational effort to children too young to access the Internet yet and those families living with Alzheimer’s disease.

Facing the Challenge

Why is it harder to treat people who suffer from depression later in life? Dr. Linda Mah has identified an important clue in the search for the answer. In Dr. Mah’s study, researchers found that older adults with depression were less sensitive to the effects of positive or negative facial expressions. That is, when shown photos of different faces, depressed patients were less engaged by happy, sad or fearful faces compared to older adults without depression. Depressed patients also made more errors in labelling neutral faces. The study suggests that it’s more than cognitive decline that is behind the challenge of treating older patients with depression – and points to a greater need to focus on emotions in trying to understand the underlying factors of late-life depression.

Dr. Mah is currently using functional magnetic resonance imaging (fMRI) to evaluate emotional processing and brain activity in geriatric patients with depression. The hope is that this knowledge will inform the development of new and better strategies for treating depression in late life.

Prevention is the Best Medicine

There is currently no known cure for dementia. Until a cure is discovered, it’s important to develop tools and interventions that prevent or slow its progression. Dr. Nicole Anderson’s research looks at the measures we can take in our everyday lives to maintain cognitive functioning and reduce the risk of developing dementia.

In one ongoing study, she is exploring the protective benefits of volunteer work for people over the age of 55. The BRAVO study (which stands for “Baycrest Research About Volunteering among Older adults”) is based on the understanding that older adults who engage in more physical, cognitive and social activity in their daily lives demonstrate better cognitive functioning and a lower risk of dementia. The study assesses subjects at different stages of their volunteer program, factoring in the complexity of their volunteer role, to determine whether – and to what degree – these activities help to protect individuals’ physical, cognitive and psychosocial functioning.

Support Networked

Family caregivers and people self-managing chronic diseases in the home literally save the healthcare system billions of dollars in North America. Yet, these groups don’t often receive the adequate support services they need to manage such tasks at home. For more than a decade Dr. Elsa Marziali has been working to develop web-based, video conferencing intervention programs for family caregivers and older adults with neurological diseases such as dementia, Parkinson’s disease or stroke. Her studies have shown that providing effective online support to family caregivers helps to reduce stress and mental health problems among caregivers, which in turn prevents them from becoming ill and further burdening the healthcare system.

In another Web-based e-health program, Dr. Marziali is looking into the many barriers – be it social, economic or cultural – that prevent older people with chronic disease from adhering to their rehabilitation programs, and then devising ways to help them get back on track.

Long-term Gain

People living in long-term care homes typically have a variety of physical, social, and mental health needs. The complexity of caring for these individual poses unique challenges for healthcare providers, especially when staff at the point of care, such as personal support workers or nursing assistants, aren’t commonly trained in best practice approaches to care.

In a recent study, Dr. Kelsey Simons and her colleagues are looking to address this gap in knowledge by examining approaches to providing interprofessional psychosocial care in Canadian long-term care facilities. Their overall goal is to identify current and best practices for enhancing the well-being of elders and their family caregivers in long-term care.