Malign Neglect
You’ve put the kids through college and then saved for decades, putting away a nest egg for those Golden Years when retirement would dictate trips to Europe, extended play on the golf course, more time for what matters most, and a new devil-may-care lease on life. Everything is rosy, and it’s good to be alive. Then it strikes you or your significant other, chipping away steadily at financial resources that were originally set aside to see you both through the rest of your journey on earth, until the Almighty beckoned. Currently, millions of people, 5.5 million in the United States, to be exact, and 35 million worldwide, and those who care for them, have been grimly awakened by a malady created by a medical science that has given us longevity. Alzheimer’s disease reigns, bringing minds to a halt immediately and hearts subsequently, within 3 to 9 years after diagnosis. To make matters worse, we should beware of what we wish for, namely, a ripe old age, as the incidence of the disease doubles every 5 years after 65 years of age. The good news is that studies on centenarians have shown that Alzheimer’s disease is not necessarily the outcome of aging. The bad news is that as the aging population increases, the prevalence of the disease will approach 13 to 16 million cases in the United States by mid-century. With medical costs continuing to spiral out of control, the bitter pill we will need to swallow is the malign neglect that will be afforded to those and their families who wander the physical world, in complete sensorineural oblivion, without the creature comforts and medical care that a life’s worth of savings was earmarked to provide but fell hastily into the red.
So, as is usually the case today, we are left with many questions and very few answers. Alzheimer’s disease is a strange one, at best, and we haven’t even scratched the surface of its causes, let alone therapies to cure, correct, or reverse its devastating effects. While ignorant bliss is perhaps the coin of the realm for those afflicted, it is the spouses and children of Alzheimer’s victims who bear the brunt of the financial and emotional pain surrounding the disease. There is no end in sight either, as unlike other chronic illnesses such as diabetes and heart disease, the biochemical and physiologic mechanisms of the malady have as yet to be elucidated. Yet, although we know neither the causes nor how to stop the devastation of dementia, we learn more each year about combating the small losses in brainpower that often occur after age 50. There are even some brain benefits of getting older.
Speed is the name of the game, when it comes to nerve impulses, which can travel as slow as a tricycle or faster than a NASCAR racecar. Reaction time often slows with age, but, with practice, the elderly can improve their mental speed by more than 50 percent. Scientists have been stunned to find full-blown Alzheimer’s disease on brain scans of people in their 70s who continue to get top scores on memory and IQ tests. In fact, in some studies, up to 20 percent of people autopsied who had no major memory problems were found to have had Alzheimer’s. So, what is going on? What dictates damnation or relative impunity to the long arm of the disease? Why does the brain continue to function efficiently in some cases, despite changes that should cause severe disability? Perhaps the answer lies in what is called “cognitive reserve,” which is the sum total of a person’s innate abilities plus the additional brainpower that comes from challenging one’s mind. No malign neglect there! Studies have shown mentally stimulating tasks increase brain cells, improve connections between those cells, and help bypass age- or disease-related trouble spots in the brain. In short, the more we work our minds, the greater our cognitive reserve; and the greater our cognitive reserve, the greater our ability to mitigate the inevitable challenges of aging.
Despite a youth-oriented culture that wants to bury us before our time, we can take comfort in a body of scientific knowledge indicating that accumulated knowledge, expert skills, wisdom, and emotional savvy all increase with age. Furthermore, higher-order decision making, such as choosing the best investments, and learned skills, such as driving, usually do not decline with age, unless, of course, one is afflicted with Alzheimer’s. Not all silver linings are 100 percent, however, and memory for events, short-term memory, and brain speed all suffer with age. The most likely explanations for such deficits are loss of neural connections, blockages of blood supply, and decreases in nerve transmission chemicals.
With no answers forthcoming on the causes and cures of Alzheimer’s, and with no stopping the march of time, what can we do to stop, or at least slow, malign neglect? The rule of ten applies here, as we make the best of what doesn’t have to be a losing hand, and, namely, boost our brain health by finding stimulating walking partners, varying our daily routines, becoming lifelong learners, playing games with several levels of difficulty, de-stressing with meditation or exercise, getting enough sleep, increasing creativity through new hobbies, socializing and making new friends, following healthy diets rich in fruit, vegetables, whole grains, and fish, and, finally, watching our blood pressure, weight, blood sugar, and cholesterol numbers.
Ignorance is bliss only for the ignorant and those too far gone to care or notice. For the rest of us, it is downright dangerous!
ã 2010, Albert M. Balesh, M.D. All rights reserved.
posted by Dr. Al at
3/08/2010 11:17:00 AM
0 Comments:
Post a Comment
<< Home