Language sample analysis may help predict future Alzheimer’s disease in people who are cognitively normal, suggesting that language patterns may be an early, detectable biomarker for the disease. Published in EClinicalMedicine, researchers at IBM Thomas J. Watson Research Center and Pfizer Worldwide Research and Development analyzed written language samples and were able to predict Alzheimer’s disease more than seven years before the diagnosis.

For the study, researchers used data from 270 participants in the long-running, NIH-funded Framingham Heart Study: 190 participants were in the training set and 80 participants were in the test set. The training set was used to develop the linguistic markers via a type of machine learning called automated linguistic analysis. The test set, determined by those participants whose data had been reviewed thoroughly by a panel of experts to assess their Alzheimer’s disease status, was used to assess the predictive performance of those linguistic markers in an independent sample.

In particular, for the test set, half of the 80 subjects had developed Alzheimer’s-like symptoms by age 85 (cases) and half did not (controls). Each of the 270 participants had performed a written picture analysis task when they were cognitively normal. For the training set, the researchers identified 87 language characteristics from the writing samples. They then used models to predict the future development of Alzheimer’s disease by assessing language performance.

Researchers found that language patterns such as writing short and simple phrases, repeating and misspelling words, and skipping punctuation were associated with future onset of Alzheimer’s. The language pattern analysis was about 70% accurate in predicting who developed Alzheimer’s disease. Additionally, combining language sample analysis with more traditional clinical data models, such as neuropsychological test scores, demographic and genetic information, and medical history, increased prediction accuracy from 59% to 69% when language was also included.

The researchers noted that exploring the relationships of linguistic and non-linguistic variables, along with verbal language patterns, may further the development of non-invasive tests for the early detection of Alzheimer’s.

The Framingham Heart Study Consortium data used in this research was supported in part by NIA grants R01AG016495 and R01AG008122.

These activities relate to NIH’s AD+ADRD Research Implementation Milestone 9.H, “Launch research programs to develop and validate sensitive neuropsychological and behavioral assessment measures to detect and track the earliest clinical manifestations of AD and AD-related dementias.”

Reference: Eyigoz E, et al. Linguistic markers predict onset of Alzheimer’s disease. EClinicalMedicine. 2020;28:100583. doi: 10.1016/j.eclinm.2020.100583.

As you age, you may have concerns about the increased risk of dementia. You may have questions, too. Are there steps I can take to prevent it? Is there anything I can do to reduce my risk? There are currently no approaches that have been proven to effectively treat or prevent Alzheimer’s disease and related dementias. However, as with many other diseases, there may be steps you can take to help reduce your risk.

Race and gender are also factors that influence risk. Research shows that African Americans, American Indians, and Alaska Natives have the highest rates of dementia, and that risk factors may differ for women and men. Researchers are investigating what’s behind these differences.

Although there is no effective treatment or proven prevention for Alzheimer’s and related dementias, in general, leading a healthy lifestyle may help address risk factors that have been associated with these diseases.

Control high blood pressure. High blood pressure, or hypertension, has harmful effects on the heart, blood vessels, and brain, and increases the risk of stroke and vascular dementia. Treating high blood pressure with medication and healthy lifestyle changes, such as exercising and quitting smoking, may help reduce the risk of dementia.

Manage blood sugar. Higher than normal levels of blood sugar, or glucose, can lead to diabetes and may increase the risk of heart disease, stroke, cognitive impairment, and dementia. Making healthy food choices, getting regular exercise, stopping smoking, and checking glucose levels can help manage blood sugar.

Maintain a healthy weight. Being overweight or obese increases the risk for related health problems such as diabetes and heart disease. Being active and choosing healthy foods can help maintain a healthy weight.

Eat a healthy diet. Aim for a mix of fruits and vegetables, whole grains, lean meats and seafood, unsaturated fats such as olive oil, low-fat or nonfat dairy products, and limited other fats and sugars.

Keep physically active. Physical activity has many health benefits, such as helping to prevent being overweight and having obesity, heart disease, stroke, and high blood pressure. Aim to get at least 150 minutes of moderate-intensity physical activity each week.

Stay mentally active. Lots of activities can help keep your mind active, including reading, playing board games, crafting or taking up a new hobby, learning a new skill, working or volunteering, and socializing.

Stay connected with family and friends. Connecting with people and engaging in social activities can prevent social isolation and loneliness, which are linked to higher risks for cognitive decline and Alzheimer’s disease.

Treat hearing problems. Hearing loss may affect cognition and dementia risk in older adults and can make it more difficult to interact with others. Protect your ears from loud sounds to help prevent hearing loss and use hearing aids if needed.

Take care of your mental and physical health. This includes getting your recommended health screenings, managing chronic health issues such as depression or high cholesterol, and regularly checking in with your health care provider.

Sleep well. Sleeping well is important for both your mind and body. Try to get seven to eight hours of sleep each night. Talk with your doctor if you are not getting enough sleep, sleeping poorly, or think you may have a sleep disorder.

Symptoms of frontotemporal disorders vary from person to person and from one stage of the disease to the next as different parts of the frontal and temporal lobes are affected. In general, changes in the frontal lobe are associated with behavioral symptoms, while changes in the temporal lobe lead to language and emotional disorders.

Symptoms are often misunderstood. Family members and friends may think that a person is misbehaving, leading to anger and conflict. For example, a person with bvFTD may neglect personal hygiene or start shoplifting. It is important to understand that people with these disorders cannot control their behaviors and other symptoms. Moreover, they lack any awareness of their illness, making it difficult to get help.

Behavioral Symptoms of Frontotemporal Disorders

Problems with executive functioning—Problems with planning and sequencing (thinking through which steps come first, second, third, and so on), prioritizing (doing more important activities first and less important activities last), multitasking (shifting from one activity to another as needed), and self-monitoring and correcting behavior.

Perseveration—A tendency to repeat the same activity or to say the same word over and over, even when it no longer makes sense.

Social disinhibition—Acting impulsively without considering how others perceive the behavior. For example, a person might hum at a business meeting or laugh at a funeral.

Compulsive eating—Gorging on food, especially starchy foods like bread and cookies, or taking food from other people’s plates.

Utilization behavior—Difficulty resisting impulses to use or touch objects that one can see and reach. For example, a person picks up the phone while walking past it when the phone is not ringing and the person does not intend to place a call.

Language Symptoms of Frontotemporal Disorders

Aphasia—A language disorder in which the ability to use or understand words is impaired but the physical ability to speak properly is normal.

Dysarthria—A language disorder in which the physical ability to speak properly is impaired (e.g., slurring) but the message is normal.

People with PPA may have only problems using and understanding words or also problems with the physical ability to speak. People with both kinds of problems have trouble speaking and writing. They may become mute, or unable to speak. Language problems usually get worse, while other thinking and social skills may remain normal longer before deteriorating.

Apathy—A lack of interest, drive, or initiative. Apathy is often confused with depression, but people with apathy may not be sad. They often have trouble starting activities but can participate if others do the planning.

Emotional changes—Emotions are flat, exaggerated, or improper. Emotions may seem completely disconnected from a situation or are expressed at the wrong times or in the wrong circumstances. For example, a person may laugh at sad news. Pseudobulbar affect, a condition of sudden, frequent outbursts of crying or laughing that cannot be controlled, may occur and is treatable.

Social-interpersonal changes—Difficulty “reading” social signals, such as facial expressions, and understanding personal relationships. People may lack empathy—the ability to understand how others are feeling—making them seem indifferent, uncaring, or selfish. For example, the person may show no emotional reaction to illnesses or accidents that occur to family members.

The links between sugar, obesity and addiction; an 80th birthday retrospective of music icon Neil Diamond; California’s medicinal herbs and the power of positive psychology on the aging process are all topics in CSU Channel Islands Osher LifeLong Learning Program (OLLI). “Taste of OLLI” consists of 25 two-hour a day courses that will enable adults aged 50 plus to sample OLLI’s university level courses taught by faculty and experts from many different walks of life. Registration for these affordable courses begins May 24. See the list of courses and register by visiting go.csuci.edu/OLLI.”

A stroke happens when something changes how blood flows through the brain. Blood brings oxygen and nutrients to brain cells. If blood can’t flow to a part of the brain, cells that do not receive enough oxygen suffer and eventually die. If brain cells are without oxygen for only a short time, they can sometimes get better. But brain cells that have died can’t be brought back to life. So, someone who has had a stroke may have trouble speaking, thinking, or walking.

There are two major types of stroke. The most common kind, ischemic, is caused by a blood clot or the narrowing of a blood vessel (an artery) leading to the brain. This keeps blood from flowing into other parts of the brain and keeps needed oxygen and nutrients from reaching brain cells. Blockages that cause ischemic strokes stem from three conditions:

Formation of a clot within a blood vessel of the brain or neck, called thrombosis

Movement of a clot from another part of the body, such as from the heart to the neck or brain, called an embolism

Severe narrowing of an artery (stenosis) in or leading to the brain, due to fatty deposits lining the blood vessel walls

In the second major kind of stroke, hemorrhagic, a broken blood vessel causes bleeding in the brain. This break in the vessel also stops oxygen and nutrients from reaching brain cells.

Some risk factors for stroke, like age, race, and family history, can’t be controlled. But you can make changes to lower your risk of stroke. Talk to your doctor about what you can do. Even if you’re in perfect health, follow these suggestions:

With stroke, treatment depends on the stage of the disease. There are three treatment stages for stroke: prevention, therapy immediately after stroke, and rehabilitation after stroke. Stroke therapies include medications, surgery, and rehabilitation.

Medication or drug therapy is the most common treatment for stroke. The most popular kinds of drugs to prevent or treat stroke are antithrombotics–which include antiplatelet agents and anticoagulants–and thrombolytics. Thrombolytic drugs, like t-PA, halt the stroke by dissolving the blood clot that is blocking blood flow to the brain. Antithrombotics prevent the formation of blood clots that can become stuck in an artery of the brain and cause strokes.

Surgery and vascular procedures can be used to prevent stroke, treat stroke, or repair damage to the blood vessels or malformations in and around the brain. These include angioplasty, stenting, and carotid endarterectomy.

Someone who has had a stroke might be paralyzed or have weakness, usually on one side of the body. He or she might have trouble speaking or using words. There could be swallowing problems. There might be pain or numbness.

Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. Someone who has had a stroke might feel depressed or find it hard to control emotions. Post-stroke depression may be more than general sadness resulting from the stroke incident. It is a serious behavioral problem that can hamper recovery and rehabilitation and may even lead to suicide.

There are many different ways to help people get better after a stroke. Many treatments start in the hospital and continue at home. Drugs and physical therapy can help improve balance, coordination, and problems such as trouble speaking and using words. Occupational therapy can make it easier to do things like taking a bath or cooking.

Some people make a full recovery soon after a stroke. Others take months or even years. But, sometimes the damage is so serious that therapy cannot really help.

For More Information on Stroke

National Institute of Neurological Disorders and Stroke
800-352-9424 (toll-free)
[email protected]
www.ninds.nih.gov