Why Do People With Schizophrenia Die Prematurely?

That is the title of this article I am reviewing today. "Schizophrenia affects approximately 1% of the US population. This serious psychiatric  illness is characterized by psychotic symptoms (hallucinations and delusions), cognitive symptoms (difficulties with attention, memory, and decision making ), and negative symptoms (withdrawn behavior, low speech output and content, and diminished motivation). Although there is no cure for schizophrenia, treatment can decrease symptoms. Currently, these treatments include medications and psychosocial interventions. Many individuals with schizophrenia can work, live independently or with limited assistance, and enjoy life. Unfortunately, some individuals have symptoms that do not respond to treatment and interfere with their ability to lead independent lives and comply with treatment. Persons with schizophrenia have a greatly diminished life span. In general, people with this disorder die more than 25 years earlier than the general population. In other words, these individuals can only expect to live about 70% of the normal life span. Why do they die early? In a paper recently published in JAMA Psychiatry, Mark Olfson and colleagues set out to answer this question. They examined reasons for premature mortality in a group of over 1 million people with schizophrenia covered by Medicaid, the largest insurance provider for persons suffering from schizophrenia in the U.S. They identified causes of death for over 65,500 of the 74,000 people who died during the study period and found that individuals with schizophrenia had an increased rate of death across all ages and all demographic groups when compared to the general population." Does it include people who have no symptoms?  Why do they die if they are getting general health physicians.  What is the cause?
The article goes on to say: "What were the causes of death in these individuals? Olfson and colleagues found that both natural causes and unnatural causes of death were increased by over three-fold. The most common causes of death were cardiovascular disease, cancer (particularly lung cancer), diabetes, influenza, accidental deaths, and suicides. The large majority of deaths (almost 55,750) resulted from natural causes. However, the rates of death from suicide and accidents were also substantially elevated. Smoking is a significant risk factor for a number of diseases on this list. It has been known for a long time that a large majority of persons with schizophrenia smoke. In fact, the rate of smoking for individuals with schizophrenia is more than twice the rate observed in individuals without schizophrenia. Many are also very heavy smokers. This increased rate of smoking accounts for some of the increased death rate, but not all of it. Can something be done to decrease premature death in people with schizophrenia? Helping individuals stop smoking would greatly improve life expectancy. Premature deaths from cardiovascular disease can also be reduced by treating high blood pressure and high cholesterol levels. The effects of diabetes and cardiovascular disease can also be diminished by regular exercise, eating right, and, in those who are obese, weight loss." Lung cancer I already had that I was not worrying about dying from it I just did not want to be sick from it.  It was terrible and having a lung taken out is worse although I did not have to do chemotherapy that I was happy about.  I have high blood pressure and even though I walk and lost weight I still have high blood pressure.
The article ends: "Health care professionals should routinely screen for suicidality, depression, and use of alcohol and other drugs of abuse, and recommend treatment when appropriate. Encouraging individuals to minimize their use of alcohol and marijuana may lead to a decrease in accidental deaths and deaths from suicide. Treatments for drug addiction can help a number of individuals avoid premature death. Although implementing the above recommendations may be a challenge in persons with psychotic illnesses, such treatment programs can and do work in this population. Investing in educational and psychosocial resources will save lives. It is important that families and friends of people living with schizophrenia not give up and continuously encourage their loved ones to engage in programs that include smoking cessation, drug cessation, exercise, healthy eating, maintenance of healthy body weight, and control of high blood pressure and high cholesterol." Anyone can stop doing drugs and alcohol they just have to hit rock bottom.  That is what happen to me I could go no lower and alcohol just made me end up in prison or the state hospital the latter I really hate and that is what helped me.  I do not want to go back to the state hospital it is worse than jail or prison. To many head games there.

Brain Training App Improves Memory of People With Schizophrenia

That is the title of this article I am writing about today. "A new brain training iPad game developed by researchers at the University of Cambridge may improve the memory of patients with schizophrenia, according to new research. While the psychotic symptoms of schizophrenia are reasonably treated by current medications, patients are still left with debilitating cognitive impairments, including in their memory, and so are frequently unable to return to school or work, the researchers said.  They added that while there are no medications to improve cognitive function for people with schizophrenia, there is increasing evidence that computer-assisted training can help them overcome some of their symptoms, with better outcomes in daily functioning and their lives.
In a study published in the Philosophical Transactions of the Royal Society B, a team of researchers led by Professor Barbara Sahakian from the Department of Psychiatry at Cambridge describe how they developed and tested Wizard, an iPad game aimed at improving episodic memory.
Episodic memory is the type of memory required when you have to remember where you parked your car in a multi-story parking garage after going shopping for several hours or where you left your keys several hours ago, for example. It is one of the facets of cognitive functioning affected in patients with schizophrenia, the researchers said.  The game is the result of a nine-month collaboration between psychologists, neuroscientists, a professional game developer, and people with schizophrenia. It is intended to be fun, attention-grabbing, motivating and easy to understand, while at the same time improving the player’s episodic memory."I would love to try it the last game I tried for memory was posit.  It does work if you use it everyday  like I did and I could see the improvement each day.  It is hard for some people as a coworker with schizophrenia just said it is repeating and you just have to remember where the things are.  That gets your memory working.
The article goes on to say: "The memory task was woven into a narrative in which the player is allowed to choose their own character and name. The game rewards progress with additional in-game activities to provide the user with a sense of progression independent of the cognitive training process, the researchers explain.  For the study, the researchers recruited 22 people diagnosed with schizophrenia. They were then randomly assigned to either the cognitive training group or a control group. Those in the training group played the memory game for a total of eight hours over a four-week period, while those in the control group continued their treatment as usual. At the end of the four weeks, the researchers tested all participants’ episodic memory using the Cambridge Neuropsychological Test Automated Battery (CANTAB) PAL, as well as their level of enjoyment and motivation, and their score on the Global Assessment of Functioning (GAF) scale, which doctors use to rate the social, occupational, and psychological functioning of adults. The researchers found that the patients who had played the memory game made significantly fewer errors and needed significantly fewer attempts to remember the location of different patterns in the CANTAB PAL test relative to the control group. In addition, patients in the cognitive training group saw an increase in their score on the GAF scale. Those in the training group indicated that they enjoyed the game and were motivated to continue playing across the eight hours of cognitive training. In fact, the researchers found that those who were most motivated also performed best at the game. This is important, as lack of motivation is another common facet of schizophrenia." This one sounds a lot better than the one I was doing. If they can stay motivated that is great.  That is most of the battle having someone keep playing the brain game for a long time to get results.
The article ends with: "'We need a way of treating the cognitive symptoms of schizophrenia, such as problems with episodic memory, but slow progress is being made towards developing a drug treatment,' Sahakian said. “So this proof-of-concept study is important because it demonstrates that the memory game can help where drugs have so far failed. Because the game is interesting, even those patients with a general lack of motivation are spurred on to continue the training.”
In April 2015, the researchers began a collaboration with the team behind the brain training app Peak to produce scientifically-tested cognitive training modules. The collaboration has resulted in the launch of the Cambridge University & Peak Advanced Training Plan, a memory game available within Peak’s iOS app, designed to train visual and episodic memory while promoting learning.
The training module is based on the Wizard memory game, developed by Sahakian and colleague Tom Piercy at the Department of Psychiatry at the University of Cambridge. Rights to the game were licensed to Peak by Cambridge Enterprise, the university’s commercialization company.
'This new app will allow the Wizard memory game to become widely available, inexpensively,' Sahakian said. 'State-of-the-art neuroscience at the University of Cambridge, combined with the innovative approach at Peak, will help bring the games industry to a new level and promote the benefits of cognitive enhancement.'
The game is built for four weeks of training and is priced at $14.99/£10.99."It is not bad priced if it works and it sounds like it does. Also keeps people wanting to continue that is great. Only four weeks of training that sounds even better if it helps your memory.

How learning and memory may be improved in schizophrenia

That is the title of this article I am writing about. "Institute-supported PhD student Natalie Matosin has been working on finding molecules in the brain that are altered in schizophrenia in order to identify new drug targets with the potential to improve the cognitive and negative symptoms associated with the disorder. Along with her supervisors, Dr Kelly Newell and Dr Francesca Fernandez, she has been looking specifically at a receptor in the brain, the metabotropic glutamate receptor 5, or mGluR5.
Together with NeuRA scientists, Dr Samantha Fung and Professor Cyndi Shannon Weickert, Ms Matosin and her team assessed the levels of mGluR5 in the postmortem brains of people that had schizophrenia, and found that in the frontal cortex and hippocampus there were greater numbers of the receptor mGluR5. Since these changes are in brain regions involved in learning and memory, this led our researchers to believe that these changes in mGluR5 might be contributing to the poor cognitive functioning seen in many people with schizophrenia." This sounds promising if it can help with memory and help with negative symptoms that would be great. Learning it was harder with this illness than when I did not have it even thought I feel I had symptoms of this illness growing up.
The article ends with: "In trying to understand why this receptor was expressed abnormally in schizophrenia brains, Ms Matosin, Dr Francesca Fernandez and the team worked with the Australian Schizophrenia Research Bank and Associate Professor Melissa Green to better understand whether the dysregulation of the mGluR5 receptor might originate in the mGluR5 gene. They found markers within the gene that are associated with schizophrenia in men, and a complex relationship with measures of cognitive functions such as working memory and measures of IQ, which differently affect men and women with schizophrenia. This supports the idea that mGluR5 is involved in the development of cognitive dysfunction, particularly memory and learning, in people with schizophrenia.
'mGluR5 represents a valuable new drug target to treat the cognitive deficits in people with schizophrenia,” says Ms Matosin. “It’s likely that because every schizophrenia sufferer is an individual with their own set of symptoms and causes, that it will work only in a subset of people with schizophrenia. Therefore future studies will need to find a way to identify this subset, so that they can benefit from mGluR5-based treatments.'" That it will only work with certain people of this illness I believe.  My memory of numbers is still working good. I practice working on my memory so I do not know if I lose any or not. I just know that numbers I have always been great with.

Different use of brain areas may explain memory problems in schizophrenics

That is the title of this article I am writing about.  I hear about people with schizophrenia and other mental illness that have memory problems.  It would be nice if they can figure out why and know how to fix it. “The enduring memory problems that people with schizophrenia experience may be related to differences in how their brains process information, new research has found.  We found that schizophrenic patients use different areas of their brain than healthy individuals do for working memory, which is an active form of short-term memory,” Sohee Park said.  “Both groups used their frontal cortex while remembering and forgetting.  However, while healthy subjects groups used the right side of this brain areas when asked to remember spatial locations, the schizophrenic patients used a wider network in both hemispheres.”  Schizophrenics use a different part of the brain.  Nothing infuriates me more than when I cannot do something because of my mental illness.

This is very interesting. “This suggests that while healthy people recruit a specialized and focused network of brain areas for specific memory functions, schizophrenic patients seem to rely on a more diffuse and wider network to achieve the same goal. The researchers also found a fundamental difference in the way healthy people and schizophrenic patients made errors.  When healthy people forgot, they had no confidence in their response for that trial and the brain areas that were recruited during correct memory trials remained inactive.  A more complex picture emerged for schizophrenic patients.  When healthy people are correct, there is an increased activation of the right frontal cortex.  When they forget, there is no such increase.  Their brain activation pattern is tightly coupled with their memory performance.  Not so with schizophrenic patients,” Park said. My memory for numbers is great.  For other things I just keep reminding myself that I have to do something.  Or remember something. I do not know how I would do on a test like that.
The article says: “Schizophrenic patients may encode and remember incorrect information.  The brain activation pattern during such error trials indicates that indeed they were remembering something. Albeit incorrect,” she continued “Such coupling of storing incorrect information and feeling confident of one’s response may be one way to think about how delusions get initiated,” Park said.  “Researchers have known since the early 1990s that working memory problems are a consistent symptom of schizophrenia.  The researchers sought to better understand what is occurring in the brain that may be causing these problems.  The right hemisphere is usually recruited during spatial information processing but if it is malfunctioning, as it may be in schizophrenia, the left hemisphere may also be recruited,” Park said.” The brain is not processing right.  You believe something is true and then you have a delusion.
They did tests to figure this out. “Another possible explanation is that schizophrenic patients may have more difficulty with these tasks, and as a result recruit more brain areas to assist them. In the experiment, the subjects were shown a point on a computer screen and told to concentrate upon it.  Three identical black circles were then flashed on a gray background, each in a different location.  After a short delay, the subjects were shown a probe and told to press one key if the probe matched one of the circles show earlier and another if it did not.  They then were told to press another key ranking on a scale from one to five their confidence in their answer about the probe.   The researchers captured images of brain activity during these tasks using functional magnetic resonance imaging, or MRI.  They repeated the experiment to capture data using another tool, near infrared spectroscopy, or NIRS.  NIRS is a new and promising way to study schizophrenia, the researchers believe.”  I hope this works so they can find ways to help people with schizophrenia.  We all could use our memory. It is something that worries me about growing old what problems will I also develop? Or is schizophrenia my only problem in life?

Trouble Sleeping? It May Affect Your Memory Later On

That’s the title of this article.  It has to do with the how many times you awaken during the night. “The amount and quality of sleep you get at night may affect your memory later in life, according to research that was released today and will be presented the American Academy of Neurology’s 64^th Annual Meeting in New Orleans…”  It affects your memory later in life. “Disrupted sleep appears to be associated with the build-up of amyloid plaques, a hallmark marker of Alzheimer’s disease, in the brains of people with memory problems… Further research is needed to determine why this is happening and whether sleep changes may predict cognitive decline.”  It is disrupted sleep that seems to be the problem.

My memory has never been a problem.  Especially numbers, although lately if I try to remember something I always forget one thing.  I remember it before it becomes a problem.  Although it is not too worrisome for me, I sleep and do not wake up that many times a night. It goes on to say: “Researches tested the sleep patterns of 100 people between the ages of 45 and 80 who were free of dementia.  Half of the group had a family history of Alzheimer’s disease. A device was placed on the participants for two weeks to measure sleep.  Sleep diaries and questionnaires were also analyzed by researchers.”  It is good to note they had a family history of Alzheimer’s.
The article goes on to say: “After the study, it was discovered that 25 percent of the participants had evidence of amyloid plaques, which can appear years before the symptoms of Alzheimer’s disease begin. The average time a person spent in bed during the study was about eight hours, but the average sleep time was 6.5 hours due to short awakening in the night.”  What is causing them to awaken during the night?  They do not answer that question.  I rely on my memory so that would be hard on me if I was ever to lose it.  I do make a list when I go to the store as I would forget something if I did not.
It must be different than just having insomnia. “The study found that people who woke up more than five times per hour were more likely to have amyloid plaque build-up compared to people who didn’t wake up as much. The study also found those people who slept ‘less efficiently’ were more likely to have the markers of early stage Alzheimer’s disease than those who slept more efficiently.  In other words, those who spent less than 85 percent of their time in bed actually sleeping were more likely to have the markers than those who spent more than 85 percent of their time in bed actually sleeping.”   Do they get less than 85 percent of sleep every night?
What are they going to do with this information? “The association between disrupted sleep and amyloid plaques is intriguing, but the information from this study can’t determine a cause-effect relationship or the direction of this relationship.  We need longer-term studies, following individual’s sleep over years, to determine whether disrupted sleep leads to amyloid plaques, or whether brain changes in early Alzheimer’s disease lead to changes in sleep, … Our study lays the groundwork for investigating whether manipulating sleep is possible strategy in the prevention or slowing of Alzheimer’s disease.”  Only my grandfather had dementia.  None of my other family members lived long enough to know if they would have any other diseases or stuff wrong with them.  I just have to stay exercising and do the right things and I am sure I will be alright.

Aging Brain-More Shrewd

I came across this article about the aging brain. We did an earlier blog on training the brain. I thought this might be just as interesting. They give us the bad news in the article first: “Reaction time is slower,” for middle aged people. They go on to say: “We’re quick, but we’re sloppy when we’re in middle-age. We make more errors when we’re in middle-age,” It makes coming up with the word that is on the tip of our tongue harder to say. Sometimes for me when I see someone I have not seen in a while it may take a minute to remember their name.
Here is a graphic about the aging brain that might be of interest. There is not all bad news about the brain aging though: “..Points to a continues improvement in complex reasoning skills as we enter middle age…this increase may be due to a process in the brain called “myelination” Myelin is the insulation wrapped around brain cells that increases their conductivity- the speed with which information travels from brain cell to brain cell. And the myelination doesn’t reach its peak until middle age.” We can then know when problems might come up and reason them out.
Here is the part about brain cells dying off: “is that once a brain cell dies off you can’t replace it. But many studies have now shown … that there is, in fact, brain cell growth throughout life.” You may continue learning and changing your brain like in the computerized brain games. There is also another part that helps in changing your brain and that is exercise. They gave treadmill training to “aging couch potatoes,” this is what they found: “Those who’d trained had larger hippocampi, the brain area key for memory. Other brain regions too – central for decision-making, planning and multi-tasking- were also larger in the treadmill exercisers.” More reason to make sure you work out.
The two scientists that did this research also exercise four or five days a week and do crossword and numbers puzzle every day. “… not only talk the talk, they also, quite literally walk the walk.” It would not be right if they just said do it and did not also work out and try and change their brain. The treadmill is good to work out on it helps with your body and brain.

Memory

This is a very good subject whether or not you are mentally ill. I received this article on How memory works. They say in the article that: “There are three stages to making and recalling a memory: Encoding, Storage and Retrieval of information.” It also says: “Memory only works if you are paying attention.” That is so true. When you are not paying attention or just a little attention you cannot recall everything that was said. My memory of numbers works the best for me.
All I have to do is repeat a number once and I will remember it. That has been all my life. Before cell phones and contact list on a cell phone. I did not have a phone book. All the number s of people and there were a lot. I could recall your number by just being told your phone number. I still do work on my memory though. The reason is I am very scared of getting Alzheimer’s. The reason is I want to always be independent and remember to take my medication. As I said in previous blogs, I do not like being sick from my mental illness.
My previous boss had me put a memory program on my computer to test if it worked. I work with it twenty minutes a day. It does help and my favorite part of the program is jewels hidden by fish and you have to track them. I have been able to track up to six jewels at a time. My memory is nothing compared to my grandsons though. He can remember six months back when we went to a restaurant. He can remember where everyone was sitting the last time we came to that restaurant.
The article also says: “The more you practice or remember something the stronger the connection gets, and the easier it is to remember.” That must be the reason I only have to repeat numbers once. I am going to close with a link to “10 Famous people who Battled Alzheimer’s.