Memory interventions are training programs that provide a variety of cognitive and psychological strategies meant to improve memory. These interventions have been shown to yield significant benefits to normal aged persons and small-size studies have shown that they are suitable and beneficial for persons with mild cognitive impairment. The goal of this proposal is to assess with a well-controlled design the efficiency and specificity of cognitive training in persons with mild cognitive impairment. The hypothesis is that cognitive training can improve the cognition of persons with mild cognitive impairment and that this improvement can be enduring.

Autres collaborateurs : Geneviève Létourneau MD, MSc,  Ovidiu Lungu PhD, Christian Bocti MD, Serge Gauthier MD, Panteleimon Giannakopoulos MD MSc.

Alzheimer's disease is the most common form of dementia. However, there is increasing evidence of a relationship between vascular dementia, which is characterized by the presence of cognitive deficits due to cerebrovascular lesions, and Alzheimer's disease. This raises questions regarding the distinction between Alzheimer's disease and vascular dementia, and the need for a better understanding of their similarities and differences. Importantly, a large proportion of persons diagnosed with Alzheimer's disease actually have mixed dementia; that is, they have vascular abnormalities in addition to Alzheimer's disease. It is important to identify these individuals, because clinicians don't use the same management approach for patients with only vascular dementia, patients with only Alzheimer's disease or those with mixed dementia. Unfortunately, it is difficult to diagnose these individuals with current clinical tools.

The goal of this study is to assess whether magnetic resonance imaging, a brain imaging technique, can help identify individuals with Alzheimer's disease, vascular dementia or mixed dementia. We will also focus on a group of patients with very mild cognitive deficits. The brain of these participants will first be analyzed to identify brain anomalies. Patients will then be evaluated using neuropsychological tasks (of episodic memory, executive functions, psychomotor speed), and through neuropsychiatric examination. Participants will be followed repeatedly over a long period of time to assess the nature and progression of their deficits. This will allow a clearer understanding of whether the clinical outcome of those patients was primarily determined by brain abnormalities.

Urinary incontinence is a common and devastating geriatric condition with important physical, psychological and economic consequences. Among individuals older than 50 years living in the community, incontinence affects almost 20 percent of men and 50 percent of women. Drug therapy, consisting of a growing number of acetylcholine-blocking agents, is currently prescribed to approximately one third of incontinent individuals to help relax their bladder. However, the same acetylcholine-blocking mechanism that controls unwanted contractions in the bladder forms the basis of many of the theories underlying memory loss in Alzheimer's disease patients. A number of patients on incontinence medication have experienced sudden memory problems. Surprisingly, few large studies have investigated whether bladder relaxant medications indeed affect memory and function in older individuals.

The goal of this project is to systematically evaluate whether medications used to treat incontinence affect memory and function in older adults, by asking them to undergo detailed neuropsychological testing before and after they begin their therapy. We also intend to discover the most sensitive screening test for physicians to use to detect if any of their patients are at risk for having memory side effects from their incontinence treatment.

In this way proper screening and prevention can be done in the future to allow patients to continue reaping the benefits of treatment for their incontinence without suffering undue harm.