Two excellent questions for consideration. The first question, what constitutes a cure can be easily answered, that is the administration of operations or medications that would eliminate the affliction. Currently, the only medications for Alzheimer’s do not cure the disease, but rather slow the progression. One can question whether this prolongs meaningful or enjoyable life, or merely prolongs suffering. This is a question for individuals to decide.
With respect to Alzheimer’s, there are many individuals who died with the defining features of the disease—neurofibrillary tangles and amyloid plaque, but who never exhibited any of the behavioral or cognitive characteristics of the disease. Apparently there were many people who died not knowing that they had the disease. So for these individuals, at least, the debilitating features of the disease had been prevented. The only explanation that has been provided for this prevention is that they had built up a cognitive reserve during their lifetimes, by using their brains. This is the justification for advocating growth mindsets. But there are other factors such as being socially active, which also requires the use of one’s mind.
The only way of trying to determine the factors fostering prevention is through longitudinal studies. There are two longitudinal investigation—the Religious Orders Study and the Rush Memory and Aging Project, which have enrolled more than 3200 older adults across the United States. This studies are being led by David A. Bennet at the Rush Alzheimer’s Disease Center in Chicago. The volunteers enter these studies dementia-free, anywhere from their mid-50s to their 100’s and agree to hours of testing each year. They all have agreed to undergo autopsies once they have died. Here are the two primary findings that have emerged from these investigations.
Virtually all brains in old age contain some pathological signs of Alzheimer’s disease, but only some people suffer any symptoms as a result. Those who do not develop dementia appear to have greater cognitive reserve to fall back on.
Choices we make throughout life, from learning a second language or studying music in childhood to finding purpose and remaining physical, intellectually, an socially active in retirement can build cognitive reserve and dramatically reduce the risk of dementia.
It is hoped that growth mindsets capture the general nature of intellectual activity. Mindfulness and meditation foster greater control over one’s cognitive activity and lead to better control over one’s emotions and enhance personal interactions. The healthy memory blog certainly endorses physical activity and a healthy lifestyle which includes, obviously, a healthy diet.
Regarding the defining characteristics of Alzheimer’s, the neurofibrillary tangles and amyloid plaque, seem to have little or no effect on individuals who have built up this cognitive reserve. And there has been little success in the development of drugs to treat these physical symptoms. One of the foremost experts in this area, Peter J. Whitehouse, M.D., Ph.D, who is the senior author of “The Myth of Alzheimer’s” does not think that successful medications will ever be developed.
Perhaps one of the best resources on the extensive research that has been done in the area can be found in the book, “Nurturing the Older Brain and Mind” by Pamela M. Greenwood and Raja Parasuraman.
Dr. Michael Merzenich has been called “the father of brain plasticity,” and the co-founder of Scientific Learning and Posit Science. You can go to brainhq.com
and find brain training exercises. These exercises can be helpful, but by themselves cannot be regarded as providing a cognitive reserve. Building a cognitive reserve requires a lifestyle devoted to cognitive and physical health. Dr. Merzenich also has an interesting book, “Soft-Wired: How the New Science of Brain Plasticity Can Change Your Life.”
Research reviewed by Norman Doidge, M.D. has documented the extreme plasticity of the brain. It is truly plastic in its ability to recover from severe injury. His research is documented in two books,”The Brain that Changes Itself” and The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity.”
HM would like to see extensive research done on individuals suffering from Alzheimer’s who apparently failed to build up this cognitive reserve. What level of recovery might be achieved through exercises designed to recover lost capacity? And at what level of dementia might individuals still be recoverable? HM believes that money spent on this research would be more valuable that the extensive work that is being done on drug treatments that are likely to be doomed to failure. Unfortunately, the money is in potential drug sales.
There have been many previous HM posts on these topics. Enter “Bennet,” “Whitehouse,” “Parasuraman,” “Merzenich,” “Doidge,” “The Relaxation Response Update,’ and “Mindfulness” to find them.
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