Monday 23 January 2012

Nature v's Nurture? New Evidence regarding Intelligence

Nature vs Nurture Nature v's Nurture

For decades, scientists, educators and psychologists have debated the contribution of our genes v's our environment to our intellectual functioning.

New research has quantified the contribution of both.

In a longitudinal study of almost 2,000 people, professors at the University of Edinburgh, University of Aberdeen and University of Queensland determined that genes are responsible for 40% of our lifetime intelligence, with the other 60% being determined by the environment.

The study commenced 80 years ago when intelligence tests were administered to almost all children born in Scotland in 1921 and 1936. Professor Deary from the University of Edinburgh tracked down 2,000 of these individuals who agreed to be re-tested and to supply gene samples for DNA analysis. They were aged from 65 to 79 years at the time of re-testing. Researchers examined the test scores and more than half a million genetic markers.

They found that intelligence was remarkably stable across the lifespan, but there were also examples of people whose functioning improved or worsened over time. The study of genetic DNA Helix markers allowed Professor Deary, Professor Visscher and colleagues to create an estimate of to what extent genetic differences affect how intelligence changes across a lifetime.

While the outcomes show that both genes and environment play an important role in our intellectual functioning, genes are somewhat easier to study. Measuring detailed environmental factors is, according to Geneticist Professor Peter Visscher from the University of Queensland: "very very difficult". The researchers hope that this study will provide impetus for further research on the specific factors that are important for development of intelligence.
This research is critically important because intelligence is a predictor of many factors including lifespan, health and income. Understanding what influences our cognitive abilities may help us better manage conditions which affect the brain, such as dementia.

Friday 20 January 2012

Molly goes into rehabilitation

Ian Molly Meldrum Molly Meldrum has recently been transferred from hospital to a private rehabilitation centre, Epworth Rehabilitation Home.

Reportedly, the focus of his rehabilitation will be on improving his memory. Specifically, according to his brother, Brian, "getting things into the short term memory to the extent that they're passed onto the long term memory". There are ongoing reports that he is disoriented, has memory lapses, can only participate in limited conversation and that his recovery is likely to be gradual and prolonged.

Given his age and the likely severity of his traumatic brain injury, these outcomes are unsurprising. However, a rehabilitation program will ensure that Molly has the best possible recovery.

What is rehabilitation

Rehabilitation can be physical or cognitive, and in the case of traumatic brain injury, usually both. Our focus will be on cognitive rehabilitation.

Cognitive (thinking skills) rehabilitation has two components: restoration of functions that can be restored (remediation) and using intact skills to compensate for impaired skills (compensation). Processes that lend themselves well to restoration are things like unilateral visual inattention, where an individual does not attend properly to objects/information on one side. With practice and use of specific techniques to draw the patient's focus to the neglected side, this can often be restored.

Memory, particularly in cases of severe injury and with older patients, is often very difficult to restore. Compensation is the best option for treating memory problems. Common memory compensation techniques are using calendars, labelling objects, placing commonly used items in the same place each time, asking others to provide reminders and using techniques that optimise use of the memory process least impaired (e.g. if visual memory is better than verbal memory the use of charts/pictures can help).

The first step and the cornerstone of treatment for traumatic brain injury is a thorough neuropsychological assessment to identify level of functioning and pinpoint strengths and weaknesses. For more information about our assessment and treatment services, visit the ANTS website or contact us.

Wednesday 4 January 2012

Molly Meldrum and TBI in the elderly

Ian Molly Meldrum On 15 December 65 year-old Ian “Molly” Meldrum fell 3 metres downstairs whilst putting up Christmas decorations in his home, striking his head and fracturing his skull. He was hospitalised, sedated and placed on a ventilator to help him breathe.

From the little information released by the media on his condition and recovery since the fall it appears that:
  • Molly was unconscious for several days and possibly more than a week – although it is understood that he was in an induced coma for part of that time
  • He regained consciousness after Christmas but remains disoriented and confused
  • He is only able to respond to basic commands and is unable to carry on a conversation
  • He can recognise close family members at times but this is inconsistent
These factors suggest that Molly sustained a traumatic brain injury (TBI) that was at least in the severe and possibly extremely severe, range.

Today’s ABC news report predicts that Molly has “a very, very long haul ahead of him”.

Research supports this assertion. Older age is an important predictor of worse outcome after TBI, even with relatively minor head injuries. A study by Mosenthal and colleagues (2002) found that elderly patients had twice the in-hospital mortality of younger TBI patients, the mortality rate increasing for each decade over 50 years. Elderly survivors of TBI are more likely to have a severe disability or be in a persistent vegetative state. The incidence of complications and poorer outcome after surgery are also worse for older patients.

The best predictors of a favourable outcome following TBI are younger age and lesser severity of TBI.
While this doesn't bode well for Molly, he does appear to be making some progress and all signs are that his functioning will continue to improve. It is also likely that he is getting the best possible care, which can make all the difference in ensuring the best possible recovery.

The thoughts of the ANTS team are with Molly and his family and we wish him a speedy recovery.

If you would like more information about TBI, cognitive rehabiliation or other ANTS services, please contact us.

References
Mosenthal, A.C., Lavery, R.F., Addis, M., et al. (2002). Isolated traumatic brain injury: Age is an independent predictor of mortality and early outcome. Journal of Trauma, 52(5), 907-911.
http://www.couriermail.com.au/news/molly-still-faces-an-uphill-battle/story-e6freon6-1226236078834
http://www.theaustralian.com.au/news/nation/meldrum-remains-in-intensive-care-faces-long-haul-to-recovery/story-e6frg6nf-1226236011605
http://www.heraldsun.com.au/news/more-news/molly-meldrum-recognises-brother/story-fn7x8me2-1226233539168
http://www.clinicalgeriatrics.com/articles/Traumatic-Brain-Injury-Elderly?page=0,8