Fighting off dementia

DementiaAlzheimer’s – already afflicting well over 5 million Americans – is expected to claim more than 16 million of us by 2050 if a cure isn’t found. Today it is at the top of the Bad News list of potential diagnoses for almost anyone over 50. Justifiably so, since the Centers for Disease Control and Prevention reports than one in three seniors now die with Alzheimer’s or other dementia.

That’s the bad news.

The good news, explained recently by Patricia Spilman, M.S. at a sold-out Commonwealth Club event in San Francisco, is that there are things one can to do lower the risk, and perhaps slow the progress of the disease. Spilman, who is Staff Scientist at the Buck Institute’s Bredesen Lab, should know. She has spent more than two decades researching neurodegenerative disease, and has written and spoken extensively on Alzheimer’s and related diseases.

“Forgetting,” Spilman says, by way of reassurance, “is normal. You don’t need to remember where you put the car keys last week, or a doctor’s appointment last month.” And studies – including one by Buck Institute founding President and CEO Dale Bredesen M.D. that is fascinating even for a lay reader – suggest that cognitive decline can be slowed, or in some cases reversed.

Spilman’s prepared remarks consisted largely of useful, realistic advice about how to delay the cognitive decline most of us will experience at some point. The audience, ranging from 20-somethings to more than a few senior citizens, was furiously note-taking throughout (or furiously jotting down questions for the Q&A session to follow.)

Exercise – particularly activities that combine movement and navigation such as tennis or golf – is at the top of the list. “It’s easier if you have a partner,” Spilman suggests, “because this adds the important element of socialization. Walking, plus climbing, is particularly good if you try new routes.” More than a few audience members nodded knowingly when Spilman noted the increasing, widespread dependence on mindless GPS. “Take the opportunity to look at a map,” she said.

Cognitive decline can also be offset by paying attention to the critical need for plenty of sleep. To help with a good night’s sleep, Spilman advises allowing at least several hours between eating and going to bed, and having a dark room. Chronic stress is relieved by a combination of exercise and sleep, along with those other preservatives of gray matter, yoga and mindfulness meditation.

Also good for the brain: almost any sensory stimulation. Music, smells, touch. Spilman cites Oliver Sacks’ Musicophilia: Tales of Music and the Brain, and Norman Cousins’ Anatomy of an Illness, in which Cousins treated himself with comedy as useful reading.

“Do something new every week,” Spilman suggests; “every day. Have goals in later life. Take classes, volunteer, build intergenerational relationships, pursue spirituality, encourage others to change and to grow.”

Computer games can improve cognition also. Spilman did not mention any specific sites, but this writer has enjoyed BrainHQ, and other brainy items from Posit Science’s Karen Merzenich, as well as introductory games on the Lumosity site. Most fascinating of all is the University of California San Francisco (UCSF)’s Brain Health Registry, in which anyone can participate; it’s free, and your brain might wind up helping someone else’s brain one day.

The Q&A segment following Spilman’s talk was fast and full of both personal stories and pertinent questions: “What’s normal decline?” (The difference between not remembering the movie star’s name and not being able to do a job well. You might keep a diary of cognitive function.) “What about genetics – the father-daughter-son factors?” (Yet unproven.) “How about overexposure to electromagnetic fields? (Don’t have unnecessary radiation.) And enough other issues raised for two or three more hours.

No one’s brain, in any event, was idle. Which indicates that everyone in Spilman’s audience was lowering his or her risk of Alzheimer’s.

The bewildering curse of face blindness

You have trouble remembering a name? Imagine being unable even to remember a face.

Oliver Sacks, the remarkable physician/writer/author/professor of neurology — what does he do in his spare time? — wrote a long and fascinating article in a recent (August 30) New Yorker in which he details a lifelong affliction with face blindness, officially known as prosopagnosia, the inability to recognize faces. What Sacks doesn’t do in his spare time is socialize comfortably. It’s hard to be comfortable when you might walk right past your best friend. (Or greet a perfect stranger you think is your next-door neighbor.)

I had made it through seven decades (Sacks and I happen to be the same age, but that’s about where the similarities end) without ever hearing of face blindness. Then one day renowned artist Chuck Close turned up on PBS NewsHour, discussing a new biography. At some point in the program Close mentioned that he was face blind. Come on, I said to myself and the TV screen. A creative genius known worldwide for, among other things, his remarkable portraits and he doesn’t know faces? Close went on to talk of how he works from photographs, largely because once he reduces a face to two dimensions he can commit the image to memory.

Sacks theorizes that the “flattening” allows Close to memorize certain features. “Although I myself am unable to recognize a particular face,” Sacks writes, “I can recognize various things about a face: that there is a large nose, a pointed chin, tufted eyebrows, or protruding ears.” But he is better at recognizing people by the way they move, their “motor style.” He is “reasonably good at judging age and gender, though I have made a few embarrassing blunders.”

Sacks writes that he avoids parties, conferences and large gatherings as much as possible in order not to have the inevitable embarrassment it brings. Consideration of how difficult it has to be to negotiate through life with such a problem makes the common complaint of, say, blanking on an old friend’s name (and don’t we all!) so trivial as to be embarrassing itself.

Sacks cites the work of research scientist Ken Nakayama, who “is doing so much to promote the scientific understanding of prosopagnosia.” Nakayama heads the Prosopagnosia Research Center at Harvard, on whose Web site one can learn about symptoms, causes, history and where the name came from (the Greek word for face: prosopon.) You can also find, on the site, tests and questionnaires to assess your own face recognition. Sacks is particularly appreciative of a notice posted on Nakayama’s own site which reads: “Recent eye problems and mild prosopagnosia have made it harder for me to recognize people I should know. Please help by giving your name if we meet. Many thanks.”

A very small gesture, for those who take face recognition for granted.