We often hear advice, ward off dementia by staying mentally active. Learn a language, pick up a new instrument, take up a puzzle routine. Having recently lost a family member to that disease, and now being much more aware of its prevalence, (seemingly more and more-so) I’ve come to question that prescription. Not that mental engagement isn’t worthwhile for many other reasons, but as deterrent to the mysterious disintegration of the mind in these diseases I have my doubts.
Off the top of my head, a quick look at some well known people who were brilliant in life and succumbed to dementia. Saul Bellow- Nobel winning novelist (and part-time Brattleboro resident), Terry Jones- Monty Python director/writer/actor, Gene Wilder- writer of books, Young Frankenstein, and actor in many classic films, Ronald Reagan, Joanne Woodward, Bruce Willis, Rosa Parks, Robin Williams…the list goes on.
Watching someone close lose their marbles is an indescribable experience. Where are they? Where do they go? And OMG what fresh hell for those still around who love and care for them. When our diagnosis first came the doctor described the condition of losing conscious touch as islands in a sea of rising water, eventually the stable ground will succumb to a submerged state. That seems accurate, but my new metaphor is more like a tablet of Airborne put in water. A once apparent solid self and identifiable form dissolves and disappears into a container that’s the Universe at large.
Hopefully progress will be made towards a cure someday. Thus far that’s been elusive. It’s tempting to wonder if the disease isn’t a symptom of society’s larger collapse, and the person who retreats into this unknown space isn’t taking some kind of refuge, perhaps in spite of their most fervent wish to remain engaged. As if rising seas are not just a global phenomena but also personal. Dementia/Alzheimer’s is a realm where all the speculation in the world does not offer much consolation. That shrouded state only shows how precious and fleeting awareness is, and how easy it is to take perception, communication, and contact for granted.
Dementia
Interesting ruminations. I have often wondered if medical science is on the wrong track trying to untangle the sticky substances in the brain. We know so little. Maybe there is a spiritual, less concrete way to ward off this disease, but “scientific research” is unlikely to follow that track.
Dark Matter
I kept my post unsentimental and impersonal on purpose, but I’d like to add a note of urgency to the search for a cure. With our growing and aging population, cases are set to explode worldwide. Often patients are kept hidden from view, so not everyone realizes how harsh and horrible the diseases is, very far from what is often depicted as some benign fog.
Dissolving
Anyone who has been through this with a family member knows exactly what you are talking about; those who haven’t should consider themselves very lucky. It’s awful to watch someone you know as a fully alert participant in the world have everything they know how to do and say slowly slip away.
It is like a dissolving tablet. It is also a bit like watching someone get younger and younger while aging rapidly at the same time. Near the end you are almost sharing space with a large, old newborn, which is very strange indeed.
It might not be such a cruel disease if it happened fast, but it is slow. I found there to be an element of Groundhog Day/Gertrude Stein to it as well – round and round repeated living repeating loving repeating. Repeating loving repeating.
A cure someday would be great; doing our best to care for people with Alzheimer’s (side note: we called it “old timers disease” when we were little and didn’t quite hear the adults correctly….) can happen now. My own strategy was to try to facilitate whatever the patient desired, as long as we avoided danger. Want to walk around and look at things? Okay by me. Just sit? We can do that.
We do tend to hide it away. It’s embarrassing that teacher/writer/poet/banker/etc everyone knows and loves is drawing on the wall or sitting under a table.
You are right that there is a lot of dissolving going on in general – weather, nature, AI-ization of all things, democracy, cost of living, and so on. Plop. Fizz. Get another tablet, honey.
One of the best medicines I’ve come across remains to be laughter. Access to it seems a bit limited at times, and it might also be fizzing away, but when you can get your hands on the good stuff, it works wonders.
Educating the Brain to Avoid Dementia: Can Mental Exercise Prevent Alzheimer Disease?
In the name of science, most physicians parrot the medical party-line as “scientific” gospel. In questioning whether what we are told could be wrong, AnneODyne’s doubt characterizes the true spirit of science.
A study published on the NHI website finds scant evidence for the oft repeated medical establishment’s conventional wisdom. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC545200/ The Abstract of this study outlines the issue:
“Physicians often recommend to older adults that they should engage in mentally stimulating activity to reduce the risk of dementia. But is this recommendation based on sound evidence?
“Physicians now commonly advise older adults to engage in mentally stimulating activity as a way of reducing their risk of dementia. Indeed, the recommendation is often followed by the acknowledgment that evidence of benefit is still lacking, but “it can’t hurt.” What could possibly be the problem with older adults spending their time doing crossword puzzles and anagrams, completing figural logic puzzles, or testing their reaction time on a computer? In certain respects, there is no problem. Patients will probably improve at the targeted skills, and may feel good—particularly if the activity is both challenging and successfully completed.
“But can it hurt? Possibly. There are two ways that encouraging mental activity programs might do more harm than good. First, they may offer false hope. Second, individuals who do develop dementia might be blamed for their condition. When heavy smokers get lung cancer, they are sometimes seen as having contributed to their own fates. People with Alzheimer disease might similarly be viewed as having brought it on themselves through failure to exercise their brains.”
After examining the evidence, the study concludes:
“So far, we have little evidence that mental practice will help prevent the development of dementia. We have better evidence that good brain health is multiply determined, that brain development early in life matters, and that genetic influences are of great importance in accounting for individual differences in cognitive reserve and in explaining who develops Alzheimer disease and who does not. At least half of the explanation for individual differences in susceptibility to Alzheimer disease is genetic, although the genes involved have not yet been completely discovered [15]. The balance of the explanation lies in environmental influences and behavioral health practices, alone or in interaction with genetic factors.
“For older adults, health practices that could influence the brain include sound nutrition, sufficient sleep, stress management, treatment of mood or anxiety disorders, good vascular health, physical exercise, and avoidance of head trauma. But there is no convincing evidence that memory practice and other cognitively stimulating activities are sufficient to prevent Alzheimer disease; it is not just a case of ‘use it or lose it.’”