I was
re-organizing my files today when I came across a Wall Street Journal article
describing a woman’s predicament following a diagnosis of Alzheimer’s. The
story, “Curse of a Diagnosis,” detailed her perilous journey through brain
imaging, spinal fluid analysis, and imaging tests. Her husband commented, “There’s
no way this diagnosis benefits people who have it”, and allowing his wife to be
tested “was the biggest mistake of my life … a bomb has gone off ….” He acknowledged that his wife “sometimes gets confused
and repeats herself. But why not me; I eat right, exercise, and no one else in
my family has this."The couple owns an import saddle business in California. She had to relinquish her driver’s license by
California regulation.
This story,
though not uncommon, touches my soul. The most compelling dimension of the article
is what it doesn’t cover.
Let’s put
aside this woman’s unhappy situation for a moment and look at the subject
matter from another dimension. A healthy lifestyle that includes exercise,
strong family and social connections, and dietary changes can delay and may prevent
most chronic disease, including Alzheimer’s. A thorough medical evaluation is mandatory
before we label someone with the “A-word.” Health conditions that mimic Alzheimer’s includes chronic heart disease, endocrine problems, Vitamin
B12 deficiency, heart disease, uncontrolled diabetes, multiple sclerosis, depression,
stroke, mini-stroke (transient ischemic attack), Lyme Disease, pesticide
exposure, traumatic brain Injury, and medication side effects.
Consider a healthy
lifestyle approach. Anti-oxidants, such as pomegranates, avocado, fish,
turmeric, cinnamon, and caffeine in moderation improve memory and long term
brain function. Regular exercise, such as walking, dancing, Tai Chi, and golf, relieve
stress, improve concentration and balance, sharpen the mind, and enhance blood
flow to the brain. In other words, what’s good for the brain is good for the
heart.
Neurocognitive
rehabilitation can help with mental focus, memory recall, name recognition, and
abstract reasoning. Two excellent references on healthy brain strategies
include The Alzheimer’s Prevention Program, Keep your Brain Health for the
Rest of Your Life (Small and Vorgan,Workman Publishing), and Neuropsychological
Rehabilitation, Theory, Models, Therapy,and Outcome (Wilson, Gracey, Evans,
and Bateman).
Peripheral
issues regarding treatment and evaluation of memory impairment, include insurance
coverage and Social Security Disability.The term, “dementia,” evokes images of insanity and derangement. In my opinion, we should avoid “dementia” when
referring to memory impairment and use, “mild cognitive impairment,” and “organic
brain dysfunction of the Alzheimer’s’ type.”
It’s time to show optimism regarding Alzheimer’s
evaluation and treatment. More diagnostic treatment strategies are on the
horizon. Alzheimer’s is not a death sentence.