Young Brains, Beware
There is an old Jewish proverb that says when the father helps the son, both smile, but when the son must help the father, both cry. How well this captures the brutality of Alzheimer's disease, a slow degeneration of the mind that's bringing many of the greatest generation to its knees and mirrors to their progeny just how difficult it might be if life breaks that way for them, too. The general belief is that such a fate would be inevitable, that there is nothing to be done to ward off a chapter in life best forgotten. Not so.
The portrait of Alzheimer's is a sad and lonely one. A fragile elder out of touch with time, place, and people, slowly surrendering will and independence to an exhausted spouse, a "lead" daughter, or a nearby nursing home. But its reach goes beyond that small circle. In searching out the secrets of this most common of degenerative brain diseases, we have discovered that risk factors for Alzheimer's smolder in people years before it displays its handiwork as memory breakdown, personality erosion, and dementia.
Do I mean in the 50-somethings or the 20-somethings? Evidence points to both. That's an unsettling thought, unless we view the long lead time as a way to preserve brain health. Here we must look to the lessons of the heart. Almost 60 years ago, in the midst of a tragic epidemic of heart attacks and sudden death in which seemingly fit middle-aged men were dropping like flies, researchers from Framingham, Mass., started combing their neighborhoods for just what made one person vulnerable and another not. Who would have imagined that personal factors brewing in them for years could have modified their fate? Smoking. High blood pressure. Cholesterol. Diabetes. Obesity. Surprises then; second nature today.
Divine inspiration. Now it's the brain's moment. We already know that many of the 4.5 million people with this disease were not predestined for that dreary fate. The risk factors compiled so far look like a virtual Framingham for the brain--even if we can't prove causality. In short, fending off Alzheimer's calls for a Framingham frame of mind.
Look at brain exercise. Alzheimer's is more apt to strike those who don't continually prod their intellects to learn and expand. Yes, use it or lose it. Brains are dynamic beings--growing nerve cells, establishing complex networks and connections, breaking down unneeded old ones. Exercising the brain builds reserves of neural networks. It's not so surprising that a low education level is a risk factor. In the Nun Study of almost 700 older School Sisters of Notre Dame begun in 1991, researcher David Snowdon and his colleagues were able to reach back in time and review the convent entrance essays of the sisters and discover that those with the lowest verbal skills back then were most apt to develop Alzheimer's. This and other studies have also shown that the telltale signs of Alzheimer's at autopsy--the waxy amyloid plaques that surround nerve cells and cut off their connections, and fibrillar clumps called tau that clog up the insides of neurons--don't always match up with the severity of symptoms. The reserves built up by a life of intellectual development appear to counter even the worst-looking damage to other cells. The message to our children: Study, study, study.