I recently saw a bumper sticker that read, “Of All the Things I Have Lost, I Miss my Mind the Most.” After the brief smile that brought, the grim reality of it settled like a damp mist. All of us have had experience with the failing of intellectual competence in an aging friend, in a parent, or a public figure. In the latter category none was so painful to watch as the long good-bye, as Nancy Reagan called her husbands’ decline into darkness. If you have had a family member who traveled the same road, then you know of the terrible sense of hopelessness one feels.
Like every other system of the body, the brain falls prey to the ravages of time; it happens to everyone if they live long enough. In the last decades we have become much more aware of it. When Alois Alzheimer, a German psychiatrist and neuropathologist, first described it in 1906, he felt it was a different disease from the dementia of old age, hence it was called pre-senile dementia. Now his name has been generalized into encompassing dementia in all age groups.
Unlike the primitive tools Alzheimer had at his disposal, we have many techniques to study what is happening to this remarkable, soft, pink mass inside the skull. When the human heart is examined anyone can see how the complicated anatomy works together in such a synchronized fashion. Holding a brain, by far a more mysterious organ, there is a sense of disappointment; there is no hint of the power it once held, not a clue as to how it directed a life.
We are beginning to learn more about it with functional magnetic resonance imaging (fMRI), which can display changes in the brain as they are occurring with emotion, with thought, with stimuli delivered to a conscious subject.
The Virginia Tech Carilion Research Institute is a recognized leader in fMRI coordinating their studies with others around the world. As amazing as this is, I suspect in a few short decades we will look on the current technology as primitive as the Wright brothers’ adventure in Kill Devil Hills. Just like flight a century ago, neuroscience is on the cusp of great discovery. They can’t come too quickly for the millions who are in the midst of their personal long good-bye.
With the heightened awareness of dementia has come an increase in anxiety. I suspect that is particularly true in those in their 70s and beyond. Misplacing keys, not recalling names, forgetting why you entered a room are commonplace experiences for all but now, the lingering doubt voices the question, “Is it happening to me?”
Probably not. There are countless reasons for those simple but irritating lapses. Multitasking, simple distraction, lack of attention to detail, stress, fatigue and a dozen other daily problems are more than enough explanation for those things. I once heard losing you keys is not a sign of Alzheimer’s disease; not knowing what to do with them when you find them, now that is a problem.
Much has been written about the pathology of dementia and it is extremely complicated. An equal body of work has been produced about how caregivers can cope with the stress of caring for a loved one who suffers from AD. Support groups available for patient and caregivers alike are a blessing, but little can be done with current medications other than slow the decline.
I recently read (for the second time) a book I would highly recommend to anyone who is seeking a better understanding of Alzheimer’s. Still Alice was written by Lisa Genova, a neuroscientist whose credentials are beyond impeccable; and she writes as well as she thinks.
Still Alice is a work of fiction but it is filled with facts. Written from the point of view of one who discovers she has early onset Alzheimer’s, it touches every facet of the disease. One cannot come away from a thoughtful reading without a sense of empathy for those already suffering, a hope that the thousands of trials underway, the advancing technology, and the understanding of the public will unravel this tragic problem.
– Hayden Hollingsworth
