Alzheimer's: old music, new songs

Think nursery rhyme. Sing the words. How long is it since you learned that ditty?

Years ago a friend of mine named Alice suffered a stroke that left her with the ability to say only two words: “one, two.” Or she may have been saying “want to.” In the months ahead she developed a skill for packing more meaning into that phrase than most of us can manage in several paragraphs. “ONE two!,” she would fairly shout at her husband, expressing displeasure (something she did with regularity before the stroke.) “OnetwoONEtwo?” she would ask, in a “Do you really like it?” voice. Still, it was tough on friends and family, and had to have been more than frustrating for her.

Eventually Alice and her husband moved into an assisted living facility. Though she was a woman of limited education and resources, she was able to resume a minimal degree of activity within that community. I saw her about once a week there, for a period of months.

At Christmas time, a group of us went caroling in Alice’s building. Midway through one old, familiar song, as we stood facing an assembled group of residents, someone noticed that Alice was singing merrily along, word for word. There was a lot of nudging and head-nodding, and by the end of the last verse not a dry eye. As we left, Alice smiled and said, “One two, one two.”

Now comes another interesting word about music and the mind, from a Science Daily article posted on the PositScience blog. It cites results from research by the Boston University School of Medicine showing that people with Alzheimer’s retain verbal information better when it comes within the context of music. The findings appear online in Neuropsychologia, an international journal to which I admittedly do not subscribe.

To determine whether music can enhance new learning of information, AD (Alzheimer’s Disease) patients and healthy controls were presented with either the words spoken, or the lyrics sung with full musical accompaniment along with the printed lyrics on a computer screen. The participants were presented visually with the lyrics to 40 songs. Twenty of the song lyrics were accompanied by their corresponding sung recording and 20 were accompanied by their spoken recording.

After each presentation, participants were asked to indicate whether or not they were previously familiar with the song they had just heard. The BUSM researchers found accuracy was greater in the sung condition than in the spoken condition for AD patients but not for healthy older controls.

The blog elicited responses ranging roughly from “that’s very interesting” to “so what else is new?” I come down on the “that’s very interesting” side of the issue, because it is.

And the more we know about connections of this sort, the more we begin to understand about the workings of the mind and the broader the possibilities of unlocking its secrets. Those pesky memorizations of yore, set to music, still manage to survive all manner of afflictions.

I still can’t figure out where I put the keys… but I can sing you every line of “Itsy Bitsy Spider.”

Stress, sorrow and depression – – the dark side of the holidays

Win McNamee/Getty
Win McNamee/Getty

The photo on the front page of the Sunday New York Times tells the ultimate underside to holiday joy: a young woman, Sarah Walton, with her arms around the tombstone of her husband. The scene is in Arlington cemetery; the simple stone reads LTC James J. Walton and lists the parameters of his brief life, 1967-2008.

In households and hotel rooms everywhere, sadness and loss color the holidays gray. Most of the sadness is of a far lesser sort than that of the grieving widow, but just as real: relationships gone sour, bills that can’t be paid, health that can’t be restored — or the old, familiar pains of too many demands and too little time.

At my San Francisco church, a ‘Blue Christmas’ service was started four years ago by Associate Pastor Catherine Oliver, designed for those who struggle under the weight of everyone else’s festive spirits. Some of the faces she sees are familiar, but many belong to strangers seeking comfort or relief. This year, Oliver reports, attendance was not notably higher — “but there were more men.”

Acknowledging the stress and depression that so often accompany the Thanksgiving-to-New Year’s Day season, the Mayo Clinic recently posted a few tips to help bring a little peace and joy into the season. They are summarized here, in categories found to be common.

First, Mayo Clinic recommends, recognize holiday triggers so you can disarm them before meltdown occurs. Most common among these are:

Relationships. Relationships can cause turmoil, conflict or stress at any time, but tensions are often heightened during the holidays. Family misunderstandings and conflicts can intensify — especially if you’re thrust together for several days. On the other hand, facing the holidays without a loved one can be tough and leave you feeling lonely and sad.

Finances. With the added expenses of gifts, travel, food and entertainment, the holidays can put a strain on your budget — and your peace of mind. Not to mention that overspending now can mean financial worries for months to come.

Physical demands. Even die-hard holiday enthusiasts may find that the extra shopping and socializing can leave them wiped out. Being exhausted increases your stress, creating a vicious cycle. Exercise and sleep — good antidotes for stress and fatigue — may take a back seat to chores and errands. To top it off, burning the wick at both ends makes you more susceptible to colds and other unwelcome guests.

The good news is that even with the worst of causes, holiday blues can be lessened. Most effectively by following a few good recommendations such as these:

Acknowledge your feelings. If someone close to you has recently died or you can’t be with loved ones, realize that it’s normal to feel sadness and grief. It’s OK to take time to cry or express your feelings. You can’t force yourself to be happy just because it’s the holiday season.

Reach out. If you feel lonely or isolated, seek out community, religious or other social events. They can offer support and companionship. Volunteering your time to help others also is a good way to lift your spirits and broaden your friendships.

Be realistic. The holidays don’t have to be perfect or just like last year. As families change and grow, traditions and rituals often change as well. Choose a few to hold on to, and be open to creating new ones. For example, if your adult children can’t come to your house, find new ways to celebrate together, such as sharing pictures, emails or videotapes.

Set aside differences. Try to accept family members and friends as they are, even if they don’t live up to all your expectations. Set aside grievances until a more appropriate time for discussion. And be understanding if others get upset or distressed when something goes awry. Chances are they’re feeling the effects of holiday stress and depression too.

Stick to a budget. Before you go gift and food shopping, decide how much money you can afford to spend. Then stick to your budget. Don’t try to buy happiness with an avalanche of gifts. Try these alternatives: Donate to a charity in someone’s name, give homemade gifts or start a family gift exchange.

Plan ahead. Set aside specific days for shopping, baking, visiting friends and other activities. Plan your menus and then make your shopping list. That’ll help prevent last-minute scrambling to buy forgotten ingredients. And make sure to line up help for party prep and cleanup.

Learn to say no. Saying yes when you should say no can leave you feeling resentful and overwhelmed. Friends and colleagues will understand if you can’t participate in every project or activity. If it’s not possible to say no when your boss asks you to work overtime, try to remove something else from your agenda to make up for the lost time.

Don’t abandon healthy habits. Don’t let the holidays become a free-for-all. Overindulgence only adds to your stress and guilt. Have a healthy snack before holiday parties so that you don’t go overboard on sweets, cheese or drinks. Continue to get plenty of sleep and physical activity.

Take a breather. Make some time for yourself. Spending just 15 minutes alone, without distractions, may refresh you enough to handle everything you need to do. Take a walk at night and stargaze. Listen to soothing music. Find something that reduces stress by clearing your mind, slowing your breathing and restoring inner calm.

Seek professional help if you need it. Despite your best efforts, you may find yourself feeling persistently sad or anxious, plagued by physical complaints, unable to sleep, irritable and hopeless, and unable to face routine chores. If these feelings last for a while, talk to your doctor or a mental health professional.

None of the above can bring back a loved one, or make a new job appear. But perhaps they can help you through to a better and brighter New Year.

Stress, depression and the holidays: 10 tips for coping – MayoClinic.com.

The after-Thanksgiving 9-inch plate diet

At a very special holiday feast yesterday, one super-health-conscious guest chose a small plate for his buffet serving rather than the elegant-size plates of the rest of us. It was, he maintained, a matter of not having seen the table around the corner where the elegant-sizes were laid out, but he did manage to mention something about smaller portions being sufficient…

So. Now that you are, perhaps, stuffed with stuffed turkey, this space is pleased to pass along a novel idea passed along several days ago by Washington Post writer Jennifer LaRue Huget:

The holiday season brings with it an overabundance of advice on how to avoid gaining weight in the face of all those festive meals, cocktail parties and plates of cookies brought in by co-workers. Depending on whose advice you’re inclined to heed, you can cut back on carbs, mind the glycemic index of the foods before you, fill up on fat or count every calorie.

Or maybe you could just use smaller plates.

That’s the premise of “The 9-Inch ‘Diet’ ” (PowerHouse), a book published last November by a pair of advertising executives that makes a strong visual and verbal argument that much of America’s weight problem stems not from eating the wrong foods but from eating too much.

Alex Bogusky, who wrote the book with Chuck Porter, is best known for his work on the “Truth” anti-tobacco ad campaign. He starts the book with a simple tale. Having just bought a lakeside cottage built in the 1940s, he and his wife went out to stock up on dinnerware. But the plates they bought (regular ones from somewhere like Target) didn’t fit, no matter which way he tried to jam them in the cupboards. Slowly it dawned on him that those cupboards had been built with much smaller plates in mind. Further research revealed that while most dinner plates today measure 12 inches, in the middle of the past century the standard was nine inches.

And so a “diet” was born. (Bogusky notes that it’s not a diet at all — and thank goodness, as most diets don’t work in the long run, he observes.) Bogusky replaced his plates with vintage nine-inchers, and he and his family adjusted their serving sizes accordingly. “Research has proven,” Bogusky told me in an e-mail, “the mind is a much bigger trigger for how and when we feel satisfied and full than anybody had formerly realized. More so than the stomach.” As a result, he says, he’s eating considerably less food at every meal.

And you can, too.

“The 9-Inch ‘Diet’ ” is a fun read, chock-full of images that show how the continual super-sizing of American food-serving vessels has led to our consuming ever-increasing portions. Obviously, the diet is just a way of exercising portion control. But it’s an elegant and adaptable way.

Huget explains the subtleties of this system: you take smaller portions, which means you select and cook foods that will work (forget the 12-oz steaks and indivisible barbecued ribs…), and explains why, as the book in question has been around for a year, she is now bringing it up:

…I know it works, and I knew so even before reading the book. Last Thanksgiving, feeling sentimental, I dug out of my attic my Grandma LaRue’s 1950s-era dinnerware, including her nine-inch plates, in a pattern my husband and I have long referred to as “Hideousware.” They looked kind of Thanksgiving-y, so we used them at our celebration. The plates were indeed tiny. And we all ate less than usual — without really noticing.

I have to admit, I noticed what my very fit and healthy friend was consuming on his 9-inch plate.  Maybe a little bit less than I had on my elegant one. But if one were also to pass on the offering of seconds, and then not sneak extra bites when helping clean up, or pick friends whose dinners aren’t as delicious as my friend Liz’ …  There may be another diet book here.

Meanwhile, you might want to stimulate the economy by getting a new set of 9-inch plates before the next holiday season.

Jennifer LaRue Huget – Eat, Drink and Be Healthy: 9-inch plates are key to diet success – washingtonpost.com.