Artwork by D_Nikolaos of VGBoxartLike most people, I am subject to a regular barrage of media reports, coming from radio, television, internet news outlets, social media and daily RSS feeds. And here is what this information stream has taught me:
If I eat blueberries, I’ll lower my risk of Alzheimer’s. Or was that tomatoes? It now appears that yogurt lowers the risk as well—does that mean blueberry yogurt, or will any old flavor do? Maybe I should have coconut flavored yogurt, because apparently, if all that coconut oil doesn’t kill me with a heart attack, it may make my brain healthier.
And now it appears I may have to replace my plumbing, because a new study suggests that too much copper causes Alzheimer’s; though other medical studies have shown that a high copper intake actually lowers the risk. So which is it? And is lead involved? (I need to know because I tend to chew on my pencils when I do my daily Sudoku puzzles.)
And then there’s the glucose connection, the blood pressure connection, the inflammatory connection, the brain reserve connection, the mood disorder connection, the social connections connection.
And what kind of a teenager was I? Apparently, certain adolescent behaviors raise your risk. One of them is getting drunk; well, thank God, none of us ever did that! Also, it’s a risk if you have a history of adolescent antipsychotic use. (Tell that to the psychiatrists who are finding all kinds of new reasons to prescribe these drugs to young people, from depression to “oppositional disorders”.)
Another risk factor (cue Randy Newman) is being too short. Time to get out the gravity boots? And if that weren’t bad enough, now the folks in Manhattan say dementia can come from exposure to bacterial and viral infections. (Someone sneezed on me just the other day, and I swear my ADAS-Cog score dropped two points!)
Okay everyone, are you listening to me?? STOP! Just…stop. If there were a “Hitchhiker’s Guide to Dementia”, the first words would still be: “Don’t panic.”
Time…to…take…a…deep…breath.
What we have here is a collection of illnesses closely tied to the aging process, and a sequence of changes that may begin decades before we show any outward signs. And we are dissecting all the minutiae of the millions of things we do, eat, drink or experience in our lives—trying to find connections, however tenuous, that we can shoot to the media outlets to fuel the frenzy.
There are a lot of people making money off of our hysteria and paranoia. But it’s much worse than that.
You see, the more we fuel this kind of panic, the more we demonize the condition; and consequently, the more we demonize and dehumanize people who live with cognitive disability. Folks like Dr. Bill Thomas have long warned us that those people who do less or produce less are devalued in our society. It is also now clear that a similar fate befalls those who remember less in our hyper-cognitive, technology-obsessed world.
Here are a couple of known facts to keep in mind: We all die. Many of us who live to a ripe old age will experience changes in various organ functions and capabilities. Many of us will become forgetful as we reach our later years. Those who do are not bad people.
There is so much emphasis on “successful aging” these days—what does that mean? Are you successful if you run marathons until you are 96 and then die in your sleep, or at the completion of some incredible sexual escapade? That’s romantic, but highly subjective and unlikely. More important, this fixation on how we end our lives not only threatens to devalue who we are in our last years, but also how we have lived all of the earlier days of our lives.
And if you don’t make it to the grave with all of your organ functions intact (an oxymoron in itself), what is that called? “Failed aging”? What about people born with developmental disabilities or congenital illness? They would be “failed agers” from the very start. No need to even give them blueberries and yogurt, I guess.
You and I will always be more than the sum of what we can do and what we can remember. So here’s the advice I would put in my “Hitchhiker’s Guide”:
No matter who you are or how you live your life, you have a chance of becoming forgetful as you age. You risk is never zero, but no one knows your exact “number”. You can almost certainly lower that risk somewhat if you eat well, exercise and do things that are good for your body, mind, and spirit; your risk will probably go up if you abuse any of those. But being obsessive about every little thing you do will likely not improve your odds to a greater extent than healthy moderation.
Find that “sweet spot” that gives you a life worth living. When we stop indulging the fear mongers, we can see the value in people of all abilities. This will help us to visualize a true path to well-being for all.
I believe that if elders were truly integrated into family life and our society’s daily activities, we would not fear to the point of panic at the thought of becoming disabled and dependent while aging. Likewise, if LTC facilities where places that truly created a home-like environment and relationships for us, we would not fear the thought of living in one. It would just be a new place – not a dreaded place.
Al – as always your common sense shines through. Great post. Brian Steeves
Such a great positive post on the paranoia surrounding brain ageing.
Thanks for the great advice – and the healthy sense of humour.
One of my heroes in the “aging with purpose” movement is Dr. Bill Thomas, the founding father of the Eden Alternative and other programs that restored meaning to the lives of many institutionalized elders in nursing homes. This article is a somewhat lighthearted look at the rush to find “the answers” to how we can grow old Alzheimer’s-free. When I was a nursing home administrator in North Carolina, I had the gift of meeting Dr.Thomas and incorporating many of the ideas from his first book in our facility’s operation. There’s a special place in Heaven for men like Dr. Thomas.
we certainly do get a lot of mixed messages. the “experts” disagree and then change their minds, so who are we to believe? i can try to do my own research from what is being said and decide what makes the most sense to me from those who seem to be reasonable. then i use moderation and indulge myself within that moderation with the things that make me happy and help me enjoy life. i’m sure the anxiety all this causes will have a negative effect on our health or at least the quality of our life. i would like to leave this life at a ripe old age in fairly good physical and mental health and exit quietly and peacefully…time will tell…
Yep, it’s all about what has solid evidence as an intervention that will have a real impact on our lives. At this point, the best evidence is for good heart health, exercise, blood pressure and sugar control, not smoking and social engagement. But even then, we don’t truly know how much these will lower a given person’s risk, given the diversity of our population and our individual risks. Everything else is just hype at this point.
I see your point, Al, and there is certainly a lot of conflicting information out there, but as the daughter of a woman who developed cognitive impairment in her mid-60s, not in her 80s, I do want to know what puts me, at 48, at higher risk of dementia. I have two things in particular that put me at higher risk that are not well known: sleep apnea and high blood sugar (pre-diabetes). I’m actively treating both of these things (a CPAP machine, and changes to my diet). I don’t feel panicked. Rather, I feel grateful that I am aware of risk factors that my mother was not aware of. (She also likely had sleep apnea and high blood sugar.) I wish this information had been available to my mother in her forties and fifties. For the appendices of my book “Inside the Dementia Epidemic: A Daughter’s Memoir,” I read a lot of research and the alarming media reports you mention. I agree with you that it’s confusing to hear about this study and that study without dementia researchers agreeing on the causes or “biomarkers” of Alzheimer’s disease and other dementias. Researchers can’t even agree if amyloid beta protein (molecules or plaques) can diagnose Alzheimer’s disease or not (and thus the disagreement over whether the new PET scans for amyloid beta should be covered by Medicare. As you know, 1/3 of people with amyloid plaques will not develop Alzheimer’s disease symptoms). What we need is more funding for dementia research to find the actual “biomarker” and cause of the most common forms of dementia, so we’re not left with guess work. In the meantime, we need to concentrate on the quality of life for people with dementia, and their care partners. And I will cook with coconut oil instead of canola.
Wow! You really are my hero, Al Power! I am going out for a hamburger! Forget the coconut oil, I want french fries! I consider successful aging to be waking up every morning to age one more day!