Wednesday, October 9, 2013
Via the BBC:
The discovery of the first chemical to prevent the death of brain tissue in a neurodegenerative disease has been hailed as an exciting and historic moment in medical research. More work is needed to develop a drug that could be taken by patients. But scientists say a resulting medicine could treat Alzheimer's, Parkinson's, Huntington's and other diseases. The University of Leicester discovery showed all brain cell death from prion disease in mice could be prevented.
The research team at the university's Medical Research Council Toxicology Unit focused on the natural defence mechanisms built into brain cells. When a virus hijacks a brain cell it leads to a build-up of viral proteins. Cells respond by shutting down nearly all protein production in order to halt the virus's spread. However, many neurodegenerative diseases
involve the production of faulty or "misfolded" proteins. These activate the same defences, but with more severe consequences.
The misfolded proteins linger and the brain cells shut down protein production for so long that they eventually starve themselves to death.
It is rare to get cautious scientists keen to describe a study in mice as a turning point in treating Alzheimer's. It is early science, a lot can go wrong between a drug for mice and a drug for humans and the only published data is for prion disease, not even Alzheimer's. So why the excitement?
It is the first time that any form of neurodegeneration has been completely halted, so it is a significant landmark. It shows that the process being targeted has serious potential. If this can be successfully developed, which is not guaranteed, the prize would be huge. In Parkinson's the alpha-synuclein protein goes wrong, in Alzheimer's it's amyloid and tau, in Huntingdon's it's the Huntingtin protein. But the errant protein is irrelevant here as the researchers are targeting the way a cell deals with any misfolded protein. It means one drug could cure many diseases and that really would be something to get excited about.
Tuesday, October 8, 2013
The Center for Law, Brain and Behavior (CLBB) at Massachusetts General Hospital (MGH) has a fascinating sounding project underway: using neuroscience to develop tools to evaluate human susceptibility to undue influence. Here's a brief description from a recent MGH newsletter:
"A second CLBB project focuses on older adults with cognitive impairment who are at heightened vulnerability to coercion by opportunists hoping to control their decisions, particularly concerning financial matters. The goal of the study is to devise and test a psychometric instrument to measure susceptibility to undue influence that can be used in proceedings about guardianship, testamentary capacity and informed consent.'The development of this tool will make an immediate contribution to the protection of adults with mild to severe intellectual impairments,' says Dr. Price."
Hat tip to Ross Schmucki, Esq. of Media, Pennsylvania for sharing this news.
Monday, September 9, 2013
Recently a colleague described an estate planning dispute. After the death of the first spouse, it came out that the surviving spouse had never read the couple's estate plan, but had signed the documents in the attorney's office when they were presented. The individual failed to realize the documents were not entirely consistent with what the survivor believed to be the couple's plan. The problem may be hard to solve now that the first spouse has passed. Why would someone sign estate planning documents without reading them?
In this instance, the individual in question, a successful entrepreneur, was dyslexic; reportedly it would have taken the individual hours to read the will or trust carefully, and although the individual planned to read the documents upon returning home, that did not happen.
I suspect this happens far more often than lawyers would like to believe.
As explained by the International Dyslexia Association (IDA), dyslexia is a "language-based learning disability." According to the IDA, an estimated 15 to 20% of the population has a language-based learning disability, with some estimates suggesting one in nine individuals can be classified as having a severe disability. Dyslexia can involve a cluster of symptoms, but is most commonly associated with difficulty in reading.
According to some researchers, dyslexia may also by associated with problems in oral communication. For example, IDA advises:
"People with dyslexia can also have problems with spoken language, even after they have been exposed to good language models in their homes and good language instruction in school. They may find it difficult to express themselves clearly, or to fully comprehend what others mean when they speak. Such language problems are often difficult to recognize, but they can lead to major problems in school, in the workplace, and in relating to other people. The effects of dyslexia reach well beyond the classroom."
It is possible that by the time people get to the estate planning phase of life, they have developed or learned individual strategies for coping with dyslexia. Or, they may have become experts in hiding the fact of their dyslexia.
As lawyers, perhaps it is incumbent upon us to inquire tactfully about each client's comfort level in reading, especially in reading often-complex estate planning documents. Lawyers can offer alternatives to a formal "signing" session that puts pressure on even the strongest readers to sign without informed understanding of the documents.
Strategies may include remembering to provide all clients with quiet time to read the documents, before any signing session is planned. The lawyer can also "chart" the estate plan, to provide a pictorial image of the plan for clients. Lawyers and their staff can be patient in reviewing each aspect of the plan carefully, also involving the clients with conversation and dialogue (rather than monologues). I'm sure experienced practitioners and academics have developed a whole host of key strategies that can assist not only those with dyslexia, but those with other common barriers to understanding. Is dyslexia an understudied phenomenon in attorney-client relations? "Comments" open below.
And before anyone brushes off the topic as not relevant to "their" clients, let's remember that dyslexia can be present with highly successful people, and thus there is the potential for impact on families with significant estates.
Thursday, September 5, 2013
University of California San Francisco (UCSF) researchers published a paper, made available this week in Nature, titled Video Game Training Enhances Cognitive Control in Older Adults. We can expect our students, children and grandchildren (not to mention game manufacturers) to remind us they were "right." From the abstract for the UCSF researchers' article:
Here we show that multitasking performance, as assessed with a custom-designed three-dimensional video game (NeuroRacer), exhibits a linear age-related decline from 20 to 79 years of age. By playing an adaptive version of NeuroRacer in multitasking training mode, older adults (60 to 85 years old) reduced multitasking costs compared to both an active control group and a no-contact control group, attaining levels beyond those achieved by untrained 20-year-old participants, with gains persisting for 6 months.
I suspect we will see a lot more on this area of research in the near future. Funding should be robust. Of course, I also suspect that not every game is equally helpful to cognitive enhancement and thus caution and consumer protections may be appropriate.
Thursday, August 15, 2013
German researchers assessing clinical practice guidelines for dementia care in 12 countries, including the United States, conclude that key ethical concerns are often not addressed. The reseachers looked for 31 specific ethical issues identified as core in a previous study. USA guidelines, developed by the American Psychiatric Association, had a comparatively high score (77%) for consideration of the ethical topics. Overall the study suggested that four issues, "adequate consideration of advanced directives in decision making, usage of GPS and other monitoring techniques, covert medication, and dealing with suicidal thinking," were not addressed in at least 11 of the 12 national guidelines.
For the full study, Inclusion of Ethical Issues in Dementia Guidelines: A Thematic Text Analysis, published August 13, 2013 in a peer-reviewed, open-source publication, see here.
Tuesday, August 13, 2013
The 66th Annual Meeting for the Gerontological Society of America (GSA) takes place in New Orleans on November 20-24, 2013. As lawyers and law professors are aware, "Elder Law" is an inherently multi-disciplinary field. The GSA meeting is an opportunity to discover and share the latest in interdisciplinary research on medicine, clinical care, basic science, social science, behavioral science, and public policy for issues connected to aging. The meeting attracts an international audience, with more than 4,000 attendees, and some 400 substantive sessions.
The theme for this year's meeting is "Optimal Aging through Research," and there is a special workshop on the topic of family caregiving for persons with dementia, which should be particularly interesting for those seeking the latest in evidentiary bases for state or federal legislation to support caregivers. Further, the deadline for "late-breaking" abstracts for poster submissions is September 15.
Full details on the annual meeting are available at GSA's website.
Saturday, October 9, 2010
Check out this webinar series sponsored by the American Association on Intellectual and Developmental Disabilities
Series Title: Public Policy & Aging Report on Healthy Aging and the Environment
The American Association on Intellectual and Developmental Disabilities (AAIDD) presents a distinguished panel of guest speakers to bring you a groundbreaking series of webinars on aging, environmental health, and disability. This series, which begins October 12, is sponsored by the John Merck Fund.
The series mirrors the contents of a thematic issue on healthy aging and the environment of the Public Policy & Aging Report of the Gerontological Society of America's http://www.geron.org/ policy institute, the National Academy on an Aging Society http://www.agingsociety.org/agingsociety/ . An electronic version of this publication will be made available for free to all webinar attendees.
To access additional information and register for any of the webinars below, please go to http://aaidd.org/ehi/content_3919.cfm?navID=306 of the AAIDD web site.
Environmental Threats to Healthy Aging with Ted Schettler, Maria Valenti
Tues Oct 12th from 2-3pm Eastern Time
Built Environment with Kathy Sykes, Rodney Harrell, Regina Gray
Tues Oct 19th from 2-3pm Eastern Time
Psychosocial Environment with Danny George, Peter Whitehouse
Tues Oct 26th from 2-3pm Eastern Time
Chemical Environment with Maye Thompson, Marybeth Palmigiano
Tues Nov 2nd from 2-3pm Eastern Time
Food Environment with Michelle Gottlieb, Emma Sirois
Tues Nov 9th from 2-3pm Eastern Time