February 20, 2019

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Alzheimer's, dementia studies offer more questions than answers

Hey there, time traveller!
This article was published 21/2/2015 (1460 days ago), so information in it may no longer be current.

We who are alive in Canada now will live, on aggregate, longer than any of the generations that have gone before.

Moreover, the human lifespan is still rising -- by some counts as much as one more year of life expectancy for every four years of real time.

Who wouldn't want to exceed expectations and live to see 90, 100, and beyond?

Well... it depends. Most people are inclined to add an important caveat: those years would have to be good years, and that means, among other things, years without Alzheimer's disease or any other form of dementia.

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Hey there, time traveller!
This article was published 21/2/2015 (1460 days ago), so information in it may no longer be current.

We who are alive in Canada now will live, on aggregate, longer than any of the generations that have gone before.

Moreover, the human lifespan is still rising — by some counts as much as one more year of life expectancy for every four years of real time.

CP

Who wouldn't want to exceed expectations and live to see 90, 100, and beyond?

Well... it depends. Most people are inclined to add an important caveat: those years would have to be good years, and that means, among other things, years without Alzheimer's disease or any other form of dementia.

In this, his 14th book, science writer Jay Ingram looks at the science of aging and longevity, and then turns his focus to the age-associated disease that is feared above all others.

Ingram may have a familiar voice, as the host of Quirks and Quarks on CBC Radio before the days of Bob MacDonald. He may also have a familiar face, from his 16 years hosting Discovery Channel Canada's Daily Planet.

His decades of experience presenting science to a general audience are evident in this book. It is accessible and quickly paced, covering the history of Alzheimer's disease, some notable cases, and several promising avenues of research being explored today.

The End of Memory is less than 300 pages, and yet includes impressive scientific detail, including a layperson-friendly description of Alzheimer's pathology, with an introduction to several concepts in molecular neurobiology.

Although many forms of dementia are labelled as Alzheimer's disease, a sure diagnosis is only possible by cutting the patient's brain apart, preferably after death. The disease first described in 1906 by Dr. Alois Alzheimer takes the form of two types of abnormal growths in the brain — dark, round plaques around the nerve cells, and twisted, matted tangles inside the cells.

Jay Ingram

COLIN CORNEAU/BRANDON SUN

Jay Ingram

Plaques and tangles together in the brain are the distinguishing features of Alzheimer's. However, as Ingram shows again and again, the microscopic reality in the brain and the impact on the mind and life of the person are not easy to understand or predict.

Some people have only plaques or only tangles, or other growths named after famous doctors, or burst blood vessels in the brain. Moreover, some people can have some or all of these symptoms and yet remain perfectly lucid.

A whole chapter deals with the "Nun Study," which followed a group of nuns into senescence, monitoring their cognitive abilities through the years and examining their brains after death. One plucky centenarian, Sister Mary, was alert, happy and sharp almost to the end. Yet, her brain was small and full of Alzheimer's plaques and tangles.

Cases such as Sister Mary's are a cause for hope, even as researchers try to better understand what actually causes Alzheimer's, and why some people are more resilient than others. The End of Memory includes much of the latest research in this field, which is still in its infancy.

Much of the research today in the fight against Alzheimer's is directed towards finding a way to prevent plaques from forming in the brain. Many others in the scientific community, however, would prefer to take the fight to the tangles instead.

Yet others doubt that either plaques or the tangles cause the disease — those might simply be what is left over after some other process wreaks havoc at a smaller scale much earlier in life. One theory ties Alzheimer's to excessive sugar and insulin deficiency, calling the disease "type 3 diabetes."

Meanwhile, research is also focused on finding ways to detect and diagnose Alzheimer's earlier. Genetic testing can uncover certain precursor genes that indicate a much higher risk, and new tests can identify more subtle forms of cognitive decline long before obvious signs of dementia appear. But without a cure, would you want to know?

This is a book with many difficult questions, the answer to most being: we still don't know. Is it the plaques or is it the tangles or is it something else? Is there a link between aluminium and Alzheimer's? Why is sugar such a risk factor? Where should we direct the millions of dollars available for new trials and studies? The research, Ingram admits, is frustratingly inconclusive.

We do know of certain things that help: an education, a job that engages the mind, exercise and vegetables. These are good measures, to be sure, but hardly enough to satisfy those who, like the author, are approaching the age when dementia threatens to settle in.

A cure, or even a better understanding, will be slow in coming, for it is a disease that progresses over years and decades, and the science is complicated. However, anyone who is not already an expert can increase their own understanding of Alzheimer's quite quickly — it's a topic marketing types would say is "trending," and this book is a solid addition to that library.

 

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

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