Living with Dementia

A Death of One Thousand Subtractions

Alzheimer's is the cleverest thief, because she not only steals from you, but she steals the very thing you need to remember what's been stolen - Jarod Kintz, This Book Has No Title.

It'll become an epidemic once the baby boomer generation starts getting over 65 years of age. It's the revenge of longevity. 65 to 70% of Dementia is Alzheimer's. It always begins in the hippocampus, thus the loss of short term memory at the beginning of the illness. Short term memory (STM) just gets worse and worse at first, followed by the person's analytical abilities. Frustration can lead to aggression and even violent outbursts, muscle and movement loss progressively follow and the inability to swallow, then you're more or less looking at it really beginning to kill the person.

You can't converse with Alzheimer's sufferers in the way you do with others; the dialogue tends to go round in circles - Kevin Whately.
 

The care givers are also the heroes in this disease, along with the scientists. A death of 1000 subtractions, bit by bit, day by day, week by week, month by month, year by year. A slow death sentence. However, not everyone who lives to an old age gets Alzheimer's. No one is immune to the disease. Yes there is a genetic component, but inheritance is only about 5%, so you're far more likely to be in the 95th percentile.

People think it's just forgetting your keys. Or the words for things. But there are the personality changes. The mood swings. The hostility and even violence. Even from the gentlest person in the world. You lose the person you love. And you are left with the shell... And you are expected to go on loving them even when they are no longer there. You are supposed to be loyal. It's not that other people expect it. It's that you expect it of yourself. And you long for it to be over soon - Alice LaPlante, Turn of Mind.

Alzheimer's Disease: A Death of 1000 Subtractions

Every 4 seconds someone is diagnosed with Alzheimer's Disease; a slow fatal disease of the brain affecting 1 in 10 people over the age of 65. It's the most common cause of dementia affecting over 40 million people worldwide, and yet finding a cure is something that still eludes its researchers today.

 

Doctor Aloysius Alzheimer, a German psychiatrist first described the symptoms in 1901, when he noticed that a particular hospital patient (Auguste Deter) had some peculiar problems; including difficulty sleeping, disturbed memory, drastic mood changes, and increasing confusion. When the patient passed away, Dr Alzheimer was able to do an autopsy and test his idea that perhaps the symptoms were caused by irregularities in the brain's structure. What he found beneath the microscope were visible differences in brain tissue; in the form of mis-folded proteins called plaques; and neurofibrillary tangles. Those plaques and tangles worked together to break down the brain's structure.

 

Plaques arise when another protein in the fatty membrane's surrounding nerve cells get sliced up by a particular enzyme, resulting in beta-amyloid proteins, which are 'sticky', and have a tendency to clump together. That clumping is what forms the things we know as plaques. These clumps block signalling and therefore communication between cells; and also seem to trigger immune reactions that cause the destruction of disabled nerve cells.

 

In Alzheimer's Disease (AD), neurofibrillary tangles are built from a protein known as tau. The brain's nerve cells contain a network of tubes that act like a highway for food molecules - among other substances. Usually, the tau-protein ensures that these tubes are straight, allowing molecules to pass through freely. But in AD, the protein collapses into twisted strands or tangles, making the tubes disintegrate - obstructing nutrients from reaching the nerve cell, and leading to cell death.

 

The destructive pairing of plaques and tangles starts in a region called the hippocampus - which is responsible for forming memories. This is why short-term memory loss is usually the first symptoms of Alzheimer's Disease. The proteins then progressively invade other parts of the brain, creating unique changes that signal various changes of the disease.
 



Pronounced neural atrophy in the AD brain

At the front of the brain, the proteins destroy the ability to process logical thoughts. Next, they shift to the region that controls emotions - resulting in erratic mood changes. At the top of the brain, they cause paranoia and hallucinations; and once they reach the brain's rear, the plaques and tangles work together to erase the mind's deepest memories. Eventually, the control centres governing heart rate and breathing are overpowered aswell, resulting in death.

 

The immensely destructive nature of this disease has inspired many researchers to look for a cure, but currently they're focused on slowing its progression. One temporary treatment helps reduce the breakdown of acetylcholine (ACh) - an important chemical messenger in the brain; which is decreased in Alzheimer's patients due to the death of the nerve cells that make it. Another possible solution is a vaccine that trains the bodies immune system to attack beta-amyloid plaques before they can form clumps.

 

My own personal interest around Alzheimer's Disease is a mixture of both fascination and abhorrence. It can afflict anyone, and does indeed become the most unwelcome of visitors to many. Alzheimer's disease has been termed ''a demographic time bomb'' (Shenk). Over 35 million people worldwide struggle with Alzheimer’s or some other form of dementia, according to the World Health Organization. Alzheimer's Disease was discovered more than a century ago, and yet it is still not well understood.

The progression from mild forgetting to death is slow and steady, and takes place over an average of 8 to 10 years. No one is immune. It is relentless, devastating for the sufferers and carers; and, for now, incurable.
 

 

 

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Jun, I. S. Y. (April, 2014)

Suffering is always hard to quantify - especially when the pain is caused by as cruel a disease as Alzheimer's. Most illnesses attack the body; Alzheimer's destroys the mind - and in the process, annihilates the very self  ~ Jeffrey Kluger

Hunger - The sauce for sharpness.

Research at the National Institute of Ageing in Baltimore, Maryland has examined the idea that sporadic bouts of hunger actually cause new neurons to grow.

 

In a 2003 mouse study overseen by Mark Mattson, head of the National Institute on Aging's neuroscience laboratory, mice that fasted regularly were healthier than mice subjected to continuous calorie restriction; they had lower levels of insulin and glucose in their blood, for example, which signified increased sensitivity to insulin and a reduced risk of diabetes.

 

Sunday was 'treat' day

Recently Mattson and other researchers have championed the idea that intermittent fasting probably lowers the risks of degenerative brain diseases in later life. Mattson and his colleagues have shown that periodic fasting protects neurons against various kinds of damaging stress, at least in rodents. One of his earliest studies revealed that alternate-day feeding made the rats' brains resistant to toxins that induce cellular damage akin to the kind cells endure as they age.

In follow-up rodent studies, he found that intermittent fasting protects against stroke damage, suppresses motor deficits in a mouse model of Parkinson's disease and slows cognitive decline in mice genetically engineered to mimic the symptoms of Alzheimer's.

A decidedly slender man, Mattson has long skipped breakfast and lunch except on weekends. ''It makes me more productive,'' he says. The 55-year-old researcher, who has a Ph.D. in biology but not a medical degree, has written or co-authored more than 700 articles.

 

If you think about this in evolutionary terms, if your hungry, you will better increase your cognitive ability because that will give you a survival advantage - if you can remember the locations of where the food is.

 

It seems fasting stresses your brain matter the way exercising stresses your muscles, thus ''hunger actually makes you sharper'' (Mosley, 2012). However, while this may be true in mice, human trials would need to be done to see if it is true in us.

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''An empty stomach is not a good political adviser'' ~ Albert Einstein