New Insight Into Causes of Alzheimer’s: It’s Still A Mixed Bag

A recent Mayo Clinic study asked “Does Overeating Cause Memory Loss in Older People?”  This is just too simple – isn’t it?!

This study looks to be like many of the studies ongoing with new technology enabling brain scans and better targeted cognitive tests – preliminary and giving only “suggestions” about causal relationships.  It is indeed a slippery slope to identify the boundary between age related “mild cognitive impairment” and Alzheimer’s disease.  A bigger question of course is what does “healthy aging” look like for the unprecedented numbers of people over age 80 that presently reside on the planet?  There are also people (medical doctors) who question the whole categorization of Alzheimer’s and other forms of dementia.  The National Institutes of Health fact sheet on Alzheimer’s disease offers the following:

“Scientists don’t yet fully understand what causes Alzheimer’s disease, but it has become increasingly clear that it develops because of a complex series of events that take place in the brain over a long period of time. It is likely that the causes include some mix of genetic, environmental, and lifestyle factors. Because people differ in their genetic make-up and lifestyle, the importance of any one of these factors in increasing or decreasing the risk of developing Alzheimer’s may differ from person to person.”

A recent study in the United Kingdom led to a discovery that in mice, certain proteins may block the progression of Alzheimer’s, particularly the toxic effect of the amyloid-beta protein. Read it here.

One of the tricky things about Alzheimer’s is that its progression is far from uniform (except in the case of younger onset, familial Alzheimer’s, which is most likely what the patient of Dr. Alzheimer suffered from) and people suffering from dementia often die from other causes.  So don’t think that you can usually go into a neurologist’s or geriatrician’s office and get a conclusive diagnosis of Alzheimer’s or staging of Alzheimer’s, an effective treatment or a cure for Alzheimer’s or many other types of dementia anytime soon.

Here’s a rather odd twist in the field of dementia and spirituality – which hasn’t been studied much.  The original research article published by Amy Owen and colleagues at Duke University is entitled “Religious Factors and Hippocampal Atrophy in Later Life,” which is available here.  It is one of just a handful of studies about spirituality in later life.  Several previous studies had indicated positive effects for elders, especially those suffering from dementia, who were part of a religious congregation or community.  A Scientific American article by Andrew Newberg discusses the study in his article “Religious Experiences Shrink Part of the Brain,” and you can read the article posted May 31, 2011, here. It contains plenty of very interesting comments about the methodology, causality and other factors in the study and the conclusions that may be drawn from it.

Dementia and Baby Boomers – you don’t have to be old to suffer the ravages:  “Dementia’s Youngest Victims Often Defy Stereotypes,” in  USA Today online from March 23, 2012. Read it here.

Dying is Part of Life

Dying is part of life – so why is talking about it so difficult?  Many reasons for that unanswerable question, but now – more than ever is the time we can start reflecting.  Never have we had so many octogenarians and nonagenarians on the fact of the planet.  Many are living longer more productive lives than they ever dreamed possible.  Some, many of them women, are running out of money.  As the life-extending reach of medical technology continues, it forces many questions, some of which are very uncomfortable.  I just read Judith Johnson’s fourth installment in the series of posts about making peace with death.  You can read it here.

Not all of us are afraid of death (which is one thing) or afraid of the process (quite another for many of us).  The Woody Allen quip comes to mind: “I’m not afraid of dying, I just don’t want to be there when it happens.”  Why does the dying process have such a bad rap?  Is it the uncertainty of what is happening, where someone is going (or not) that makes so many of us turn away?  It is a taboo based on fear and avoidance, how odd that it is avoidance of the inevitable.  How does that turning away from dying get unpacked into steps you can try if you want to be “present” and make peace with death?  Johnson offers five practical steps:  (1) see death as normal (part of life); (2) don’t try to run away or avoid it – this is the biggest tip in my opinion because she touches on the recognition that “death is a great teacher of how to embrace and honor life more deeply;” (3) focus on being of service to those involved in the process; (4) be authentic and express yourself in loving ways; and (5) allow yourself to experience the full range of grief and sorrow that are all parts of dying, death and grief.

I ran across another article about a new course being offered on Gabriola Island in Canada called “Nothing Left Unsaid.”  It looks to be an extension of the hospice conversation and all the services it offers for those not necessarily in the end stages of an illness.  I found the article’s reference to grief perhaps being classified as a mental illness in the next DSM (Diagnostic and Statistical Manual), and that reminded me of another article about that very topic – “Should Grief Be a Mental Illness?” by Joseph Nowinski, Ph.D.  It seems this fear that grief will be classified as a mental illness originated in a January 25, 2012 article entitled “Grief Could Join List of Disorders” and announces that, based on a new report, the criteria for depression are being reviewed by the American Psychiatric Association and could be expanded to include grief in the DSM-V.  Where does this leave those of us who are challenging the death-denying traditions and practices in our own ways? I think it is life-denying, because death is part of life.

The mental health implications of removing the grief exclusion from the definition of depression in the DSM-V are controversial, to say the least. Most of old age, along with many aspects (behaviors) of childhood are now “disorders” or fall within some arguable definition of a mental illness.  What does this say about our culture and its views towards aging, the dying process and death?  It is more of the death denial in our culture.  According to many longevity seekers, death is not necessarily inevitable or the result of natural consequences, rather it is more like a disease to be overcome, a challenge to be bested.  This reminds me of Dr. Sherwin Nuland, author of “How We Die,” and several other insightful books  A recurrent theme in his books is forthright talk about aging, dying and many other life topics that tend to make us uncomfortable.  Next time I’ll write about another favorite doctor/author of mine.

Welcome to My Blog

I have a new logo, and I’m pleased to say that the day I purchased it and printed it out, I was able to ask a client what he thought about it, and he immediately recognized it as a tree and made the “tree of life” connection. Yes, that’s the tree I’m talking about! My logo is a tree that also looks like a person who is embracing a community. I think this is particularly relevant to what I do because I work to help my clients put together a holistic plan for their future – one that is consistent with the values a person has lived by and which honors the relationships with family and community members. Holistic planning can also involve peacemaking. The tree of life connection is especially meaningful to me because it symbolizes the transitory nature of our lives and the relationships, in the context of certain unchanging constants. The tree of life symbolizes a simple message of unity, that we are all part of a community and it is represented in a number of different cultures, myths, faiths and traditions across time and geography. It is an important symbol for my practice philosophy because I seek to assist my clients in identifying ways they can maximize the support and connections they need from others during their lives and so they can transmit their legacy after they are gone.

I mention the Tree of Life specifically on my blog page because my blog is the place where the diverse but related interests will converge. We have never before had so many 80 and 90 year-olds on the face of the earth. What are the implications for law, ethics, medicine, philosophy? These are all appropriate aspects of identifying a strategy for clients because a sound plan must take into account the “ripple effect” of individual actions that relate to financial, emotional, medical and physical considerations that are often relevant in the legal context.