3-13-14
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 disease. 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. To
add to the couple’s misfortune, 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 few moments 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 through medical evaluation is mandatory
before we label someone with the “A-word.” Health conditions that act like
Alzheimer’s are lengthy -- 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.
Now consider
a healthy lifestyle approach. Anti-oxidants, such as pomegranates, avocado,
fish, turmeric, cinnamon, and alcohol/caffeine in moderation can 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).
There are
numerous peripheral issues regarding treatment and evaluation of memory
impairment, including insurance coverage and Social Security Disability. Finally the medical term, “dementia,” evokes
images of insanity, derangement, idiocy, and lunacy. In my opinion, we should
avoid the “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 and treatment strategies are on the
horizon. Alzheimer’s is not a death sentence.
Clement Hanson D.O. MPH
