Finding the positive in erosion of mind

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Elizabeth Allen, who has been diagnosed with early stage Alzheimer's, sits in her Toronto home with her husband of 20 years, Bob. (CP)

Book review

The Memory Clinic

Stories of Hope and Healing for Alzheimer's Patients and Their Families

• By Tiffany Chow, MD
• Viking, 263 pages, $32

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Alzheimer's disease and other sources of dementia give us little cause to celebrate. They are perniciously resistant to a cure, and set to affect a growing elderly population in greater numbers every year.

The Memory Clinic, by Toronto doctor/researcher Tiffany Chow, is aimed at patients and their families, but will be of interest to many others, including the "worried well" who want to understand the disease and find out what they can do to avoid it.

Dr. Chow divides her time between clinical research and a clinic for patients with early-onset dementia. (And, presumably, writing books.)

Her book balances both worlds -- it is in turn a personal memoir, a collection of stories, a guide to prevention, an update on the latest research, and inspiration to weary caregivers. The tone is personable but serious, with an occasional spot of hope or humour in spite of the subject matter.

The book clears up some common misunderstandings. For example, dementia is not synonymous with Alzheimer's disease. Dementia is a set of symptoms involving loss of cognitive function, and Alzheimer's is only the most common of many causes of dementia.

In fact, Dr. Chow's own research is focused primarily on frontotemporal dementia, another form that tends to affect people at a younger age and quickly alters the patient's behaviour and personality.

There are even multiple forms of Alzheimer's disease, including an early onset form that claimed the life of Ah Quan, the author's Hawaiian grandmother. The celebration of Ah Quan's life and desire to avoid her fate are running motifs in the narrative.

A recent Spotlight on Research exposition, organized by the Alzheimer Society of Manitoba, demonstrated the ways Winnipeg physicians and researchers are active in fighting dementia on many fronts. The event also showed, during a short period after the presentations, what sort of questions the general public wants answered.

The questions centre around a few themes, including: what can we do to avoid dementia? When and how will we find a cure? And how can we live with or beside these diseases today? The Memory Clinic addresses all these questions.

In terms of prevention, since you may be wondering: first, choose your parents and grandparents wisely. Failing that, get a good, long and diverse education, eat well and stay trim, get physical exercise, build and maintain strong social networks, and manage your stress. Happily, these recommendations are conducive to healthy living, benefits to brain longevity aside.

Less happily, despite the best efforts and intentions, dementia can strike almost anyone, and there is still no cure for Alzheimer's or most other dementias. The book ends with a look at the science behind the diseases and some of the promising avenues of research.

The difficult role of caregivers is also evident in stories from the clinic. It is usually couples who walk through the door, after one or both are "starting to lose it." The stories have, at best, bittersweet endings.

Losing a family member to a brain disorder is a slow and difficult process. While Ah Quan died quickly, many cases of Alzheimer's last well over a decade.

Dr. Chow's first advice to caretakers is to learn to take care of themselves and avoid burnout. That is more vital, as she puts it, than learning to pronounce the generic names of medications.

Drawing something positive from the slow erosion of a mind is not easy. The author's respect for Buddhist teachings certainly helps, especially those that encourage us to practise compassion and accept impermanence. Finding a way to connect, to ease pain or fear, or catch a lucid moment, can be a reminder that "to experience joy and love does not require perfect cognitive function."

Paul Klassen is a Winnipeg engineer. His wife, Mari Garcia, and her adviser, Dr. Zahra Moussavi, are among many Winnipeggers working to detect, avoid and lessen the impact of brain disorders that cause dementia.

Republished from the Winnipeg Free Press print edition February 2, 2013 J8