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   Decline in daily functioning related to decreased brain activity in Alzheimer's   
      
      
   Date:   
   August 12, 2014   
   Source:   
   Brigham and Women's Hospital   
      
   Summary:   
   Decline in daily functioning associated with Alzheimer's disease is related to   
   alterations in activity in certain regions of the brain, according to a study.   
   Impairment in instrumental activities of daily living -- or an inability to   
   perform high-level    
   daily activities such as calculating finances, remembering appointments and   
   medications, and driving -- is first seen when a person has mild cognitive   
   impairment, which can later progress to dementia due to Alzheimer's disease,   
   experts warn.   
      
      
   Decline in daily functioning associated with Alzheimer's disease is related to   
   alterations in activity in certain regions of the brain, according to a study   
   published in the August 2014 issue of the Journal of Alzheimer's Disease.   
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   Impairment in instrumental activities of daily living -- or an inability to   
   perform high-level daily activities such as calculating finances, remembering   
   appointments and medications, and driving -- is first seen when a person has   
   mild cognitive    
   impairment, which can later progress to dementia due to Alzheimer's disease.   
   Deterioration in the ability to carry out daily activities has been associated   
   with changes in brain activity measured as use of energy (or metabolism of   
   sugar) with a nuclear    
   medicine scan called 18F-Flourodeoxy glucose (FDG) positron emission   
   tomography (PET).   
   To further investigate the relationship between instrumental activities of   
   daily living and brain activity (FDG metabolism), a team led by researchers   
   from Brigham and Women's Hospital (BWH) analyzed data from the Alzheimer's   
   Disease Neuroimaging    
   Initiative database, a multi-center study that BWH has been a part of for   
   nearly 10 years.   
   They looked at data from 104 clinically normal elderly participants, 203   
   participants with mild cognitive impairment, and 95 participants with mild   
   dementia due to Alzheimer's disease. The participants had a baseline PET scan   
   to determine brain activity    
   and underwent clinical assessments every 6 to 12 months for up to three years.   
   The participants' study partners (family members or friends who knew them   
   well) also completed questionnaires about the participants' daily living   
   activities.   
   The researchers found that decreased activity in frontal areas of the brain,   
   which are responsible for cognitive processing and decision making, and deep   
   temporal and parietal (back) areas of the brain, which are associated with   
   memory, were associated    
   with greater impairment of instrumental activities of daily living initially   
   and over time.   
   "Impairment in activities of daily living is a major source of burden for   
   Alzheimer's disease patients and caregivers alike," said Gad Marshall, MD, BWH   
   Center for Alzheimer Research and Treatment, assistant professor of Neurology   
   at Harvard Medical    
   School, senior study author. "Therefore, detecting these important deficits   
   early on prior to the dementia stage, along with a better understanding of how   
   they relate to changes in the brain, can lead to more effective design of   
   clinical trials that    
   focus on vital patient-centered outcomes. This in turn will ultimately lead to   
   better treatments prescribed to patients at the early stages of Alzheimer's   
   disease before they are robbed of their faculties and autonomy."   
   According to the National Institute on Aging, National Institutes of Health,   
   as many as five million people age 65 and older in the United States have   
   dementia due to Alzheimer's disease. As the rapid growth of the aging   
   population continues, the number    
   of those developing the disease is expected to increase significantly, with   
   the number of people with dementia due to Alzheimer's disease doubling for   
   every five-year interval beyond age 65.   
   Story Source:   
   The above story is based on materials provided by Brigham and Women's   
   Hospital. Note: Materials may be edited for content and length.   
   Journal Reference:   
   Gad Marshall et al. Regional Fluorodeoxyglucose Metabolism and Instrumental   
   Activities of Daily Living across the Alzheimer's Disease Spectrum. Journal of   
   Alzheimer's Disease, August 2014 DOI: 10.3233/JAD-131796   
   Cite This Page:   
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   Brigham and Women's Hospital. "Decline in daily functioning related to   
   decreased brain activity in Alzheimer's." ScienceDaily. ScienceDaily, 12   
   August 2014. .   
      
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