Signs of dementia
- memory loss that affects day to day functions
- difficulty doing familiar tasks
- confusion about time and place
- communication problems
- difficulty planning or solving problems
- poor or decreased judgment
- misplacing things
- changes in mood or behaviour
- changes in personality
- withdrawal from work or social activities
Technology to reverse the effect of
Alzheimer's may be at least a decade away. But methods that protect the brain --
such as mental exercise and diet -- are here now
Morris Jeffrey is working out. But he's not
breaking a sweat. As the retired engineer hunches over a chessboard, laying a
trap with his bishop and rook, the left side of his brain is "feeling the
burn" as exercise guru Jane Fonda used to say. Tiny molecules whisk between
nerve endings in his hippocampus and frontal cortex. All the hard work is making
his neurons hungry for oxygen and nutrients. And it's keeping his brain fit.
New research using positron emission
tomography (PET) scanners, as well as long-term population studies, is showing
mental activity can strengthen the functional links between neurons and
literally change the shape of the brain. And while the technology to reverse the
effects of Alzheimer's may be at least a decade away, methods that protect the
brain from its ravages are here now. For example, a U.S. study to be published
tomorrow will link severe depression -- which is treatable -- with a future risk
of Alzheimer's.
At 68, Jeffrey knows he is at risk for
Alzheimer's disease. His father had it. So does his older brother. So when
Jeffrey had an embarrassing moment at a party two years ago -- he forgot the
name of his best friend's wife -- he sought help from a neurologist.
"He told me, it's
use-it-or-lose-it," says Jeffrey, who now plays chess or does crossword
puzzles for 60 minutes a day. "The brain is just a complicated version of
your heart. It needs exercise and good nutrition."
Indeed, scientists are finding the brain is
just as susceptible to the effects of a couch potato lifestyle of high fat foods
and TV as the rest of our bodies. And it can also be worked back into shape.
"We can think of the brain in the way we
think of the body, that if we keep it active it might protect brain cells,"
says Gary Small, director of the Center on Aging at the University of
California, Los Angeles.
"Our studies with PET scanners show
evidence of brain ageing in people in their 20s and 30s. So it's never too early
to start on a mental fitness program."
Ordinary ageing -- unrelated to Alzheimer's
disease or strokes -- may lead to as little as a 10% decline in cognitive
function. Some studies peg it as low as 2%. Genetics play a role, but a key
factor is activity. Molecular biologists and neurologists say one factor in
cognitive decline is a drop in the amount of acetylcholine, a neurotransmitter,
in the brain.
Dozens of new investigational studies are now
looking at ways to boost production of the chemical, or to prevent its
breakdown. Many new medications, such as Excelon, are managing to delay
cognitive problems in people at risk of Alzheimer's by helping to maintain
levels of acetylcholine. But some experts believe activity and good nutrition
may be just as important to maintain a healthy brain.
Animal studies show mice kept in
"interesting, vibrant environments" such as cages with a maze or fun
toys have healthier hippocampal cells -- cells involved in memory -- than mice
kept in stock issue cages.
Similarly, people who attended college or
university have a lower incidence of Alzheimer's disease than those who did not.
And longitudinal studies of groups such as nuns in the United States have found
the most mentally active people are least likely to suffer from cognitive
decline when they reach 70 years of age.
Small, author of the Memory Bible, recommends
protecting the mind with "mental aerobics." This means doing brain
teasers, crossword puzzles or math problems -- anything to stimulate the brain.
"You can also work the left side and
right side of the brain," he says.
"The left side tends to be more involved
with language, the right side tends to be visual skills. So just like you'd work
out with a physical trainer, you can cross-train your brain."
To "warm up," he suggests writing
with the hand you do not usually use.
But it is important to avoid excessive heavy
mental lifting. Too much stress can cause the production of excess cortisol, a
hormone that can damage the brain. "Let's say you have a mentally taxing
job," says Small. "Then your memory fitness program might focus more
on stress reduction. You might want to learn some of the relaxation-response
exercises."
Scientists have recently discovered that some
diseases, such as depression, can actually affect the brain's structure. For
example, depression tends to lead to shrinkage of the hippocampus, the
walnut-sized region of the brain where memories are formed.
Older people who suffer depression are at
greater risk of getting Alzheimer's disease. It is unclear whether the
depression is caused by Alzheimer's or the other way around, but either way, the
findings point to a need for immediate treatment.
Scanning with magnetic resonance imaging (MRI)
shows that when people are treated with anti-depressants their hippocampus can
grow back to its normal size. "That suggests that brain cells in the
hippocampus and elsewhere are not necessarily killed off during this time, but
they're shut down," says Gordon Winocur, medical director of the Alzheimer
Society of Canada.
In this way, the brain is like a muscle.
But it's a muscle with feelings, as a study
Winocur conducted on 120 healthy seniors a few years ago shows.
"Those people who were most active, who
scored very high on optimism, feelings of self esteem and happiness...performed
at a much higher level on tests of memory and learning than people whose
psycho-social status was much lower," he says.
"What was interesting was that over
time, when changes occurred in their lives that affected their psycho-social
status, lowering it, their cognitive performance went down. When they recovered,
say six months later, their cognitive performance went up."
Diet is also critical to brain health.
Nutritionists say a diet that is low in overall calories but rich in foods with
omega-3 fatty acids such as fish, nuts and avocados is helpful. And fruits and
vegetables with antioxidants such as broccoli, blueberries and prunes can help.
"We used to think that high fat diets
were just important in cardiovascular function ... but we're learning that high
fat diets that contribute to the level of [serum] cholesterol also contribute to
the buildup of plaques in the brain, leading to vascular dementia and
Alzheimer's disease," says Winocur.
In a recent study, Winocur and a colleague
fed rats diets high in saturated fat, high in unsaturated fat, and normal diets
and tested their mental performance.
"We were blown away by how impaired both
groups of high-fat diet rats were," he says.
"They were like demented rats."
Researchers believe the reason is the
"resting potential" of neurons is higher when the level of cholesterol
in the bloodstream is high. This means they need to be stimulated more to be
activated.
"Once that happens, the integration of
firing between groups of neurons as part of a system is also thrown off,"
says Winocur.
Not only is avoiding a fatty diet important,
but it is also important to control intake of too many carbohydrates, which can
lead to spikes in insulin production, eventually leading to Type 2 diabetes.
Diabetes, which is spreading rapidly across
North America as a result of the obesity epidemic, can have adverse effects on
the brain, because it affects glucose levels in the bloodstream. This causes
problems in the hippocampus, which is very sensitive to the effects of reduced
amounts of glucose.
Of course, it is not easy to notice an
out-of-shape brain.
"People who are impaired begin doing
less," says Winocur.
"They start challenging themselves less,
so they don't appear to be impaired. If they were doing the kinds of things they
were doing five or 20 years ago, they probably would be showing memory lapses,
absent mindedness and confusion."
The good news is the brain's condition can be
improved.
Thanks to his new regimen, Jeffrey says the
"senior moments" are becoming less frequent, and his brain performance
seems to be improving.
"I'm beating younger players [at
chess] these days," he says.
- Brad Evenson
National
Post
12 August 2002
BY ANNE LAMOTT (from O magazine)
I was at a wedding Saturday with a lot of
women in their 20s and 30s in sexy dresses, their youthful skin aglow. And even
though I was 30 or 40 years older, a little worse for wear, a little tired and
overwhelmed by the loud music, I was smiling. I smiled with a secret
Cheshire-cat smile of pleasure and relief in being older. I would not give you
back a year of life lived.
Age has given me what I was looking for my
entire life - it gave me me. It provided the time and experience and failures
and triumphs and friends who helped me step into the shape that had been waiting
for me all my life.
I fit into me now - mostly. I have an organic
life finally, not the onepeople imagined for me or tried to get me to have or
the life someone else might celebrate as a successful one - I have the life I
dreamed of.
I have become the woman I hardly dared
imagine I could be.
There are parts I don't love - until a few
years ago, I had no idea that you could get cellulite on your stomach - but I
not only get along with me most of the time now, I am militantly and maternally
on my own side.
Left to my own devices, would I trade this
for firm thighs, fewer wrinkles, a better memory? On some days. That's why it's
such a blessing.
I'm not left to my own devices. Because the
truth is I have amazing friends and a deep faith in God, to whom I can turn. I
have a cool kid, a sweet boyfriend, darling pets. I've learned to pay attention
to life, and to listen. I'd give up all this for a flatter belly? Are you crazy?
I still have terrible moments when I despair
about my body. But they are just moments - I used to have years when I believed
I would be more beautiful if I jiggled less; if all parts of my body stopped
moving when I did. But I believe two things now that I didn't at 30. When we get
to heaven, we will discover that the appearance of our butts and skin was 127th
on the list of what mattered on this earth.
And I know the truth that l am not going to
live forever, and this has set me free. Eleven years ago, when my friend Pammy
was dying at the age of 37 we went shopping at Macy's. She was in a wheelchair,
with a wig and three weeks to live. I tried on a short dress and came out to
model it for Pammy. I asked if she thought it made me look big in the thighs,and
she said, so kindly,"Annie? You just don't have that kind of time." I
live by this story.
I am thrilled-ish for every gray hair and
achy muscle, because of all the friends who didn't make it, who died too young
of AIDS and breast cancer.
And much of the stuff I used to worry about
has subsided -what other people think of me and how l am living my life. I give
these things the big shrug.
Mostly. Or at least, eventually. It's a huge
relief.
I became more successful in my mid-40s, but
this pales compared to the other gifts of this decade - how kind to myself I
have become, what a wonderful, tender wife I am to myself, what a loving
companion. I get myself tubs of hot salty water at the end of the day in which
to soak my tired feet. I run interference for myself when I am working, like the
wife of a great artist would: "No, I'm sorry, she can't come. She's working
hard these days and needs a lot of downtime." I live by the truth that
"No" is a complete sentence. I rest as a spiritual act.
I have grown up enough to develop radical
acceptance. I insist on the right to swim in warm water at every opportunity, no
matter how cold, no matter how young and gorgeous the other people on the beach
are. I don't think that if I live to be 80 I'll wish I'd spent more hours in the
gym or kept my house a lot cleaner. I think I'm going to wish I had swum more
unashamedly, made more mistakes, spaced out more, rested. On the day I die, I
want to have had dessert. So this informs how l live now.
I have survived so much loss, as all of us
have by now - my parents, dear friends, my pets. Rubble is the ground on which
our deepest friendships are built. If you haven't already, you will lose someone
you can't live without, and your heart will be badly broken; and the bad news is
that you never completely get over the loss of a beloved person.
But this is also the good news. They live
forever, in your broken heart that doesn't seal back up. And you come through.
It's like having a leg that never heals perfectly - that still hurts when the
weather is cold - but you learn to dance with the limp. You dance to the
absurdities of life; you dance to the minuet of old friendships. I danced alone
for a couple of years, and came to believe I might not ever have a passionate
romantic relationship - might end up alone! I'd been so
terrified of this my whole life. But I'd rather never be in a couple or never
get laid again than to be in a toxic relationship. I spent a few years celibate.
It was lovely,and it was sometimes lonely. I
had surrendered; I'd run out of bullets. But I learned to be the person I wished
I'd meet - at which point I found a kind, artistic, handsome man. We have been
together 20 months now.
When we get out of bed, we hold our lower
backs, like Walter Brennan, and we smile.
Younger women worry that their memories will
begin to go. And you know what?
They will. Menopause has not increased my
focus and retention as much as I'd been hoping. But a lot is better off missed.
A lot is better not gotten around to. I know many of the women at the wedding
fear getting older, and I wish I could gather them together again and give them
my word of honor that every one of my friends loves being older, loves being in
her 50s, 60s, 70s. My Aunt Gertrude is 85 and leaves us behind in the dust when
we hike.
Look, my feet hurt some mornings, and my body
is less forgiving when I exercise more than I'm used to. But I love my life
more, and me more.
I'm so much juicier. And, like that old
saying goes, it's not that I think less of myself, but that I think of myself.
- an email in circulation
