A study conducted at Washington University in St. Louis suggests that an alternative way to diagnose Alzheimer’s may be around the corner. The study used patients in preclinical, early stages of Alzheimer’s along with people with a buildup of cerebrospinal fluid (this being one risk factor for the disease’s onset). The test subjects, along with a control group of people with no health issues, were given the task of navigating a virtual map on a computer, and were judged at how well they could remember a basic map of the digital environment. The preclinical Alzheimer’s patients were able to learn the route, but had some difficulty when it came to plotting a mental version of the map.
According to the study’s senior author, psychologist Denise Head: “These findings suggest that navigational tasks designed to assess a [mental] mapping strategy could represent a powerful new tool for detecting the very earliest Alzheimer’s disease-related changes in cognition.”
While the study’s sample size of less than 90 participants is considered small, the research confirmed what Head and her colleagues had long suspected: An impaired sense of direction could be the earliest symptom of the disease’s onset. Starting treatments this early could dramatically improve the quality of life not only for future generations but for their families, too.
The week after Carl’s visit, Lenny’s green Honda Civic spun through the hedge and into the living room of his next-door neighbor, shattering the wall and windows. While no one was hurt, the violent outburst escalated quickly. Lenny accused his neighbor of stealing his garbage cans, and in a rage, started up the car. Lenny’s two sons, in their late 50s, argued over whether he was capable of living on his own.
As the dementia grew worse, so did Lenny’s outbursts — with him slowly coming to realize his own powerlessness against memory loss, or against his failing eyesight. Aside from the understanding that one day his father might not recognize him, Lenny’s older son, Stephen, was torn by the possibility of having to place him in a care facility — something he finally did in 2014, as Lenny’s working memory began to fail and he was no longer able to dress himself. Today, suffering from advanced dementia, Lenny is unable to perform basic tasks, and his recollection of words has diminished greatly.
Hope For A Cure
For Stephen — whose wife, Trini, acted as Lenny’s caretaker for much of his dementia — the decision was a hard one to make, emotionally. In the United States alone, for all those suffering, treating dementia can cost between $157 and $215 billion per year — given the cost of nursing facilities, hiring personal aides, and medication. This makes Alzheimer’s easily the most expensive disease in the United States, with some families unable to bear the cost.
In addition, many may have to give up their careers to take care of loved ones with the disorder. Last year alone, 15.9 million family members and friends of people with Alzheimer’s provided 18.1 billion unpaid hours of care. The caretakers themselves may also suffer health risks on their own (depression, for instance, as their parent or grandparent cannot recognizes them), and are typically less likely to see a doctor or care about their own health and well-being.
While medical experts no longer see senile dementia as simply another part of aging, the debate about what to do continues on. While Alzheimer’s remains the mostcommon cause of dementia, there are similar disorders, like vascular dementia, which can account for 25 percent of cases. Lewy body dementia, for example — which actor Robin Williams was diagnosed with later in life — can account for up to 15 percent of dementia-related occurrences.
It is also possible for people to suffer from more than two types of dementia at the same time. Across the globe, it is estimated that 36 million people experience at least one type — and these disorders will surface in at least 10 percent of the population at some point in their lives.
According to neurologist Reisa Sperling, we may not necessarily find a cure for dementia entirely, but modifying therapy may be critical to improving the quality of life for both patients and caretakers. Even delaying the onset of Alzheimer’s by five years could reduce Medicare costs by almost 50 percent, says Sperling. “Most important, that would mean that many older people could die while out ballroom dancing rather than in nursing homes.”
For many years, Carl looked at his uncle with the hope that one day Lenny would be himself again; ready to talk about sports or his favorite home brew. Is there hope that one day he will snap out of it? Or maybe that one of the people at risk of dementia in the near future will be able to rest easily — knowing that they won’t have to plan for the worst?
Thankfully, some considerable strides have been made this year in understanding the malevolent disease. Neuroscientist Lawrence Rajendran, from the University of Zurich in Switzerland, has found that the precursor protein associated with Alzheimer’s can be effectively turned off with a targeted substance containing the enzyme beta-secretase — the same cellular interaction that protects the body from skin cancer. However, Rajendran’s team has found a way to specifically isolate and turn off the amyloids responsible for dementia.
“This opens up a promising way to treat Alzheimer’s effectively in the future, without causing the patients any serious side effects,” points out Rajendran, who is preparing to test the new medication on rodents and eventually patients with dementia. Lenny’s descendants are fortunate to live in an age when constant discoveries are being made about the brain — an age which may devise cures for disorders that have plagued humanity for millennia.
This article was first published in Brain World Magazine’s Winter 2017 issue.
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