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Questions about Cushing’s and the Brain

An article titled Hypercortisolism and Memory Impairment appeared in the Spring, 2014 issue of the CSRF newsletter and prompted some questions from our members.

Question: The article mentions “memory exercises”. What exercises would be recommended and why would they be helpful?

Answer: Our brain is like a muscle, it needs regular exercise to stay in good shape. In fact, our brain can be easily modified with our daily activities, for instance, when we learn something new, our neural connections are changed. Even if memory issues remain after Cushing’s syndrome, the good news is that memory may be improved with daily training. This could help to remember everyday information more efficiently, to avoid being forgetful, or to learn new information more easily. Furthermore, it can help to keep our minds active and prevent memory deterioration associated with age.

It is also important to consider that attention plays an important role in memory. It is possible that we do not remember something because we are not paying enough attention to it when it happened. So attention exercises could also improve our memory.

Therefore, what kind of exercises would be helpful to improve our memory? It would be good to complete crossword puzzles, do sudokus or try to memorize information such as the shopping list, vocabulary from a new language, telephone numbers, etc. When trying to learn new information, it is sometimes helpful to use mnemonic devices. These techniques include for example:

– Associating images with words for what you want to remember. For instance, if you have to buy bread and chocolate, form an image of both in your mind.

– Dividing telephone numbers into parts when trying to memorize them.  For instance, instead of 15559994444 try to remember 1-555-999-4444.

– Dividing lists into categories. For instance, divide the shopping list into drinks, meat and vegetables.

In older age, it is also recommended to attend to memory stimulation programs regularly, as they are specific for older people and can give more motivations than home exercises alone. Finally, on the internet there are plenty of resources that can help us train our memory and even have some fun at the same time. Playing different memory games could also be helpful if it is done regularly. If you prefer, you could use websites like Lumosity (www.lumosity.com). This website provides a personalized cognitive training program for free, including different games where difficulty increases over time. Of course, there may be different ones, although we have chosen this particular example because it is supported by research studies. We have already used Lumosity and found that it works quite well.

In conclusion, there are many ways to improve your memory, the most important thing is to keep training your brain regularly.

 The above question was answered by Alicia Santos, Neuropsychologist, Winter, 2014

Question: Is there anything known as to whether Cushing’s patients have a higher risk of developing Dementia/Alzheimer’s disease later in life?

Answer: The answer to this question is still unknown. There are no data regarding a possible association between Dementia/Alzheimer’s and Cushing Syndrome. However, it is known that cardiovascular risk factors (hypertension, dyslipidemia, diabetes…) could be involved in vascular dementia.
For this reason, Cushing’s patients, before and after treatment, should be highly encouraged to reduce their cardiovascular risk factors. Cushing’s patients are known to have such risk factors prior to treatment and these factors may improve but not completely resolve after treatment.  It is also important to have healthy lifestyles and to control Cushing’s syndrome as soon as possible, because long disease duration could increase cardiovascular risk.

The above question was answered by Eugenia Resmini, MD, PhD, Winter, 2014

Editor’s note: Both Alicia Santos and Dr. Resmini are in the Endocrinology Department of Hospital Sant Pau and associated with: IIB Sant Pau, Centro de InvestigaciónBiomédica en EnfermedadesRaras (CIBER-ER Unidad 747), , Autonomus University of Barcelona; Spain. Both have a special interest in pituitary diseases in general and specifically, Cushing’s syndrome. 

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