Nov 30, 2014 9 min read

Some retirees head to a local senior citizen center for lunch, exercise, bingo or card games, or just to chat. But some senior citizens in Washington, Greene and Fayette counties, through the Area Agency on Aging, had the opportunity a few years ago to participate in the research of a precursor of Alzheimer’s disease and a way to test for it.

One octogenarian who was part of the study had absolutely no difficulty recalling some of the details.

Elsie Pataskie of Centerville Borough was among the study participants at the Beth-Center Senior Center in Fredericktown.

“I volunteered,” she said in a recent interview. “I guess I just was interested in seeing what I could remember.”

The study, conducted from 2005 through 2009 under the direction of Dr. Judith Saxton, neuropsychologist, and Dr. Lisa Morrow, associate professor of psychiatry and psychology at the University of Pittsburgh’s Department of Psychiatry and Western Psychiatric Institute and Clinic, looked at mild impairment of “cognition,” which is defined as the act or process of knowing, including both awareness and judgment.

Saxton now has a private neuropsychology practice in Pittsburgh, and Morrow responded via email to questions about the study and why it was conducted at senior citizen centers.

“As neuropsychologists, we are interested in cognitive decline in older Americans and the development of dementia, specifically Alzheimer’s disease, as well as precursors to dementia,” she wrote. “Cognitive decline prior to diagnosis of Alzheimer’s disease, termed mild cognitive impairment, is often an unstable condition, and while many older adults may initially meet criteria for mild cognitive impairment, a large proportion will often revert to normal cognition. Therefore, mild cognitive impairment is unstable and not an absolute indicator of later onset of Alzheimer’s disease.”

The scientific method requires a rigorously controlled environment, so research is likely to be conducted in university laboratories.

“For example, if I ask someone to tell me the date and time, something we typically do as neuropsychologists, I need to make sure there are no calendars and clocks in the room,” Morrow wrote.

The university setting has its drawbacks. Participants have to be willing to drive to a university and make their way through an academic setting.

“For this reason most research participants are urban-dwelling, highly educated and Caucasian,” she continued. Also, there is a belief that some older Americans are either unable or unwilling to use computers.

The study, which included senior citizen centers in the three counties as its rural component, had three goals:

• To learn more about senior citizens’ thought patterns while maintaining a controlled environment in a community, rather than university setting, which Morrow said was achieved.

“People were already drawn to senior citizen centers,” said Elizabeth Burgwin, who, at that time, was a project leader for Southwestern Pennsylvania Area Agency on Aging, Charleroi.

• To have both black and white citizens volunteer for research studies. The researchers found people were willing to participate if the recruitment staff came from the local community and the testing is conducted at a local site. They were able to find a more diverse population with a range of education and age more typical of the general population. Mild cognitive impairment should be defined and based on data from participants typical of the general population, Morrow wrote, to prevent misdiagnosis, unnecessary treatment and a baseless fear that they may develop dementia.

• To administer a series of pencil and paper tests and compare these results to results obtained via tablet computer.

“Older Americans not only can use computers for cognitive testing but enjoy completing tests this way,” Morrow wrote. “Fewer than 2 percent of the sample failed to complete the computer test. We also found that many commented that it was ‘fun’ and ‘easy’ and something they enjoyed.”

Pataskie echoed those sentiments. “I think it was interesting, really. I didn’t mind doing it at all.”

The tablet computer prototype, known as the Computer-Based Assessment of Memory and Cognitive Impairment, was also tested in the local study.

“Using data from this study and other studies, the computer tablet prototype has now been developed into a tool designed to reliably identify individuals at risk for mild cognitive impairment. A research version of (this tablet computer) is already available, and a clinical version is currently under review by the Food and Drug Administration. The FDA is expected to make a determination regarding the utility of the test before the end of the year.”

Burgwin filled in some details about the study, “Memory and Aging in Urban and Rural Communities.”

She said the title “always seemed like a mouthful, so it became known as the MAURC.”

The research grant for detection, diagnosis and intervention in dementia lasted from June 1, 2005, through May 31, 2009, and it involved 300 individuals aged 65 or older.

There was a timed test in which participants were asked to come up with three words naming particular items. They were also asked to draw a clock face with hands. And they were asked to describe their daily activities, such as whether they were able to handle finances, shop, or follow the plot of a television program. If they gave permission, the University of Pittsburgh’s neurology department also reviewed their medical chart.

The study sought to measure participants’ ability to follow directions in a driving simulation. Using a computer, a sequence had participants “drive to a grocery store,” “pick up a few items” and “go to a bank and transfer money.” Without knowing they’d be asked later about details, those taking the test were asked if they had noticed a specific type of tree; whether a circle, star or square appeared; and whether an image of a child pedaled across the screen on a bicycle.

Elsie Pataskie still drives, so she knows she must be alert every time she gets behind the wheel.

“I’d be lost without driving,” she said. “I’m glad I can still drive.”

But she has no idea how she scored on the simulation.

“I don’t recall hearing, like, a grade or whether I got through it OK or not,” Pataskie said.

Morrow addressed this concern.

“Because this was a research study, participants did not receive direct feedback. For those who had followup questions, we responded to them on an individual basis. If they were worried about cognitive problems, we told them to contact their primary care physician. As part of the study, we did make an effort to contact all PCPs of the participants (with their permission) and received a majority of responses from PCPs on a short questionnaire.

“We had hoped that many of the participants in the urban and rural setting would come to the Alzheimer Disease Research Center for further assessment. However, the actual numbers were low and those that did come all the way to the university had a number of other disorders or illnesses that excluded them from (being) participants at the (research center). This confirmed our hypothesis that community-dwelling participants are quite different than those who come to academic research settings.

“Finally, there are no drugs that will to stop or revert the course of Alzheimer’s disease. There are symptom-modifying drugs – for example, Aricept – however, not everyone responds the same way. As of now, there is currently no treatment that will stop the course of Alzheimer’s disease.”

While people were testing the format in three rural counties, 300 people from Allegheny County comprised the urban part of the study.

“At the very end, we did a series of followup meetings with consumers and community members,” Burgwin said. “Dr. Saxton talked about preventing memory loss and how to stay active physically and mentally, getting plenty of sleep, keeping the mind active by playing bingo, cards and puzzles, watching for signs of depression and stress and maintaining a heart-healthy lifestyle with diet and exercise.

“In normal aging, we slow down, but we don’t stop. Aging is a process not an event. It’s not turning 60 or 70. How we live affects how we age.”

Pataskie has had little or no personal contact with anyone who has Alzheimer’s disease, but she and her family seem to be living their lives the way the experts would recommend.

“My dad, Steve Lesneck, lived to be 98, (almost reaching 99) and on my dad’s side, his sisters were all in their 90s and brothers in their 90s and up. My sister, she’s still going strong, too. I hope I have their genes,” said Pataskie, who lives on the family farm, although her son is now in charge of its mostly-Hereford beef operation.

The handover doesn’t mean she’s idle on the farm.

“I’m still pretty active. I still tend to my flower beds,” Pataskie said as autumn basked in its final color. “I just love ’em all, peonies, cone flowers, the ones that are long-lasting. I weed-whack around my flower beds and my son-in-law mows the grass. I have to have knee pads, that’s for sure.”