Ask the Doctor: COP & Cognition; Head Injury & AD; Benefits of Happy Thoughts

Q: Does chronic obstructive pulmonary disease, or COPD, impair memory and cognition? If so, can cognitive decline be avoided?

A: A large study of predominantly older adults found that individuals with COPD had significantly worse performance on tests assessing information processing speed, prospective memory, and numeric and spatial skills than healthy individuals. Performance scores in these domains fell as the degree of airflow limitation increased, according to a report presented at a September 2013 meeting of the European Respiratory Society. To protect the brain from COPD-associated cognitive decline, work closely with your physician to slow the progress of lung disease and reduce its effects. Possible treatments include medications to manage COPD symptoms, and supplemental oxygen therapy that boosts the delivery of oxygen to the brain and also appears to extend life. Improvements in nutrition and moderate exercise, such as yoga, can also help, and may improve depression that often accompanies the disease and impairs mental functioning. In severe cases, surgery to remove damaged lung tissue or replace the lungs may be considered.

Q: Is it true that a serious head injury can trigger Alzheimer’s disease?

A: A number of studies conducted over the past few years have suggested that brain injury increases risk for Alzheimer’s disease (AD), although they have not proven a direct cause-and-effect relationship. Research published in the Nov. 11, 2013 online edition of JAMA Neurology revealed for the first time the development of AD-like plaque in the brains of individuals in their 30s who had suffered brain injuries severe enough to warrant treatment in a hospital intensive care unit. Researchers using positron emission tomography (PET) technology found that the accumulation of toxic beta-amyloid proteins was ob-served within hours of a severe brain trauma. The greater the blow to the head, the greater was the amyloid plaque buildup. The research highlights the importance of preventing head trauma through such measures as managing health conditions that might lead to dizziness and falls, wearing seatbelts in vehicles, using helmets to protect the head from sports injuries, and removing fall hazards around the home.

Q: Can thinking happy thoughts actually lift a depressed person’s mood?

A: Thinking happy thoughts may be one way to generate optimism and a positive attitude that can improve mood. Memory appears to play an important part in this process. Researchers have found that people who can recall in detail events in their lives that were positive or self-affirming are likely to experience improved mood. In one recent study researchers helped depressed individuals strengthen their capacity to remember the good times by teaching them a memory technique called method of loci, in which they linked positive memories with particular objects or places along a familiar route, such as the path from the front door to the back door of their home. To recall the happy memories, the participants simply mentally returned to the familiar path and recalled the memories along the way. Compared to depressed participants who simply rehearsed their memories, the method of loci participants were better able to recall happy memories over time, according to a February 2013 report in the journal Clinical Psychological Science. The research suggests that calling up happy memories through such activities as going through photo albums or sharing memories with loved ones might be an effective way of banishing the blues. However, people with major depression that lasts two weeks or longer and involves feelings such as sadness and hopelessness, and suicidal thinking may find happy memories difficult to summon. These people should seek a professional assessment.

—Dr. Maurizio Fava, MD

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