Lifestyle activities in mid-life contribute to cognitive reserve in late-life, independent of education, occupation, and late-life activities.

This study tested the hypothesis that mid-life intellectual, physical, and social activities contribute to cognitive reserve (CR). Two hundred five individuals (196 with magnetic resonance imaging) aged 66-88 years from the Cambridge Centre for Ageing and Neuroscience (www.cam-can.com) were studied, with cognitive ability and structural brain health measured as fluid IQ and total gray matter volume, respectively. Mid-life activities (MAs) were measured using the Lifetime of Experiences Questionnaire. Multivariable linear regression found that MAs made a unique contribution to late-life cognitive ability independent of education, occupation, and late-life activities. Crucially, MAs moderated the relationship between late-life cognitive ability and brain health, with the cognitive ability of people with higher MA less dependent on their brain structure, consistent with the concept of CR. In conclusion, MAs contribute uniquely to CR. The modifiability of these activities has implications for public health initiatives aimed at dementia prevention.

Evaluation of a Specialised Counselling Service for Perinatal Bereavement.

OBJECTIVES: We aimed to evaluate the outcomes of Petals: a charitable organisation in Cambridgeshire. Petals provides counselling for women and couples who have suffered perinatal bereavement, or trauma during pregnancy or birth. This paper attempts to evaluate the effect of counseling interventions at this difficult time. METHODS: Outcomes were recorded in 107 patients using the CORE (Clinical Outcomes in Routine Evaluation) system. CORE was developed to assess the effectiveness of psychological therapies. CORE-OM (CORE Outcome Measure) involves a questionnaire that assesses subjective well-being, symptoms/problems, function, and risk to self and others. The CORE-OM questionnaire was completed before and after the counselling sessions. RESULTS: The CORE-OM scores were summated into a global representation of severity. Severity decreased in all patients. Symptoms of psychological pathology were also decreased in all cases. CONCLUSION: Offering a free specialised counselling for parents suffering perinatal loss seems to be associated with an improvement in psychological outcomes. It is possible that it is more effective among a clinical population. However, we are uncertain of the natural history of the psychological problems this group of clients are experiencing. Having a control group would show how much of any natural improvement is due to the therapy; conversely, it is possible that without intervention these problems worsen with time, so a control group could actually amplify the effect.

Petals: An Assessment of the Outcomes of a Service for Bereavement during Childbirth.

OBJECTIVES: We aimed to evaluate the outcomes of Petals: a charitable organisation in Cambridgeshire. Petals provides counselling for women and couples who have suffered perinatal bereavement, or trauma during pregnancy or birth. This paper attempts to evaluate the effect of counseling interventions at this difficult time. METHODS: Outcomes were recorded in 42 patients using the CORE (Clinical Outcomes in Routine Evaluation) system. CORE was developed to assess the effectiveness of psychological therapies. CORE-OM (CORE Outcome Measure) involves a questionnaire that assesses subjective well-being, symptoms / problems, function, and risk to self and others. The CORE-OM questionnaire was completed before and after the counselling sessions. RESULTS: The CORE-OM scores were summated into a global representation of severity. Severity decreased in all patients. Symptoms of psychological pathology were also decreased in all cases. CONCLUSION: A review of the available literature indicates that little is known about the efficacy of therapy for perinatal bereavement and trauma. These original data suggest convincing efficacy and benefits, but the numbers involved are small.Further trials with greater sample sizes are required.