Four years ago I attended the 40th anniversary of my "almost" graduating class, almost because we moved from Idaho to Eureka, Nev., before graduation. Of my 200 classmates over half joined the visit. While years had changed faces, I found that demeanors remained and that if I had known a fellow student's mother, I could easily recognize the son or daughter. Updates filled the air, some sad because of death or divorce, others happy because of the apparent perfectness of life. One dear friend entwined in early dementia came with her devoted husband.
Annette smiled as she moved cautiously through the crowd, her husband always nearby to act as her protector. She demonstrated many similarities of my mom and sister in early Alzheimer's: vacuous smiles, empty stares, and miscued conversations. Heartbreaking, this ground felt far too familiar to me.
A couple of weeks ago I rejoined some high school friends and we decided to visit Annette who now lives in a group home. With children in high school and college, she had remained home until it became dangerous and frightening to leave her alone. As her husband works and the tussle between adult daycare then home and back to adult daycare became too confusing, full-time residency became the wisest option. The diagnosis delivered: dementia, however not Alzheimer's disease.
The friends who accompanied me had never witnessed the terrifying loss of severe dementia. While Annette semi-greeted us in the hallway, she then continued her daily circuitous route: up the hall, down the hall, a peak in the kitchen and common area, a mutter, an echo, and then a replication of the course. The differences I noticed included a glint in her eyes that frequently disappears in later stages of Alzheimer's and an odd echo in her voice. Labeled echolalia, Annette would start a simple sentence and then drift off into an echo: Glad so see-see-see-see... and then an exit into a new thought. Sadness pervaded us although we held a wisp of hope that our visit, smiles, and conversation had somehow brightened her day. Now weighing less than 80 pounds, I wonder how many more steps my friend will be able to take. All dementia is not Alzheimer's, but all Alzheimer's is dementia.
On an uptick, "60 Minutes" disclosed a study of the "oldest of the old", those over 90 who live for the most part with good health and sound minds. The research hopes to determine what it takes to keep everything in good order. Yes, genes play an important role, but so do other lifestyle choices. The most valuable appear to be having a strong social network, eating well, carrying a little extra weight (not obesity), having relatively low blood pressure (again these individuals are in their 90s), consuming one or two alcoholic beverages per day (including choices other than red wine), and maintaining physical and mental activity. The hardest part of longevity for many was outliving spouses, family, and friends rather than the thought of their own mortality.
Researchers originally operated under the premise that high blood pressure at 50 was also worrisome at 90, but as I mentioned, this proved wrong. The same was true with weight. Extremely thin individuals did not fair as well as those who carried a few spare pounds. They were, correct , however, on the importance of friendship and activity. Exercising mind and body, especially with others, added to the joy and wellbeing of the volunteers.
Science has long held the plaques and tangles of the brain as key signs of Alzheimer's disease. Since true, absolute proof of the disease exists only after death and brain autopsy, the disease is frequently misidentified or confused in the living. The members of the 90+ study all agreed to donate their brains to research after death. Some volunteers died while maintaining high mental functioning but their brains revealed the plaques that indicate Alzheimer's disease. Others had slipped into varying stages of dementia but were found to have few plaques and tangles. This exacerbates the continued mystery of what actually leads to this horrible disease.
To me, the show reiterated that having the Alzheimer's gene or the tangles and knowing that dementia risk doubles every five years after age 65, it is not necessarily a death knell. Happy, healthy, engaged living strongly affect good mental health. So dance, sing, volunteer, imagine, and celebrate. I do not intend to minimize Alzheimer's but rather to offer glimmers of hope.[[In-content Ad]]
