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The Price of Living Long Confronted by the fearful prevalence of Alzheimer’s By Lakshmi Mani

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s we celebrate more birthdays, and the number of people living to be ninety or even hundred is no longer uncommon, behind the celebration lurks the painful reminder that longevity comes at a price. The golden years may not be so golden when we realize that brain cells can deteriorate with advancing age and rob people of a good deal of their lives by wiping out much of the past, and disabling the capacity to function in the present or plan the future. The culprit behind this tragic deterioration is the Alzheimer’s Disease (AD). In her blog in the Times Union, Elizabeth Floyd calls AD “the long goodbye.” It is a form of dementia, resulting in loss of memory and cognitive functions, and in worsening conditions, behavioral changes and an inability to perform even simple daily tasks. The connection between neurological damage in the brain and clinical dementia was first presented by a German doctor named Alois Alzheimer at a medical conference in 1906. Hence the eponymous name of the disease.

Touched by Alzheimer’s

When I met one of my friends here in Schenectady after a long time at a social function, I noticed a significant absence. Her husband, a prominent cardiologist, and a pillar of the Indian society, a sort of Renaissance man whose hospitality I had enjoyed often whenever I visited Schenectady, was not with her. I remembered attending many birthday parties and wedding anniversary celebrations hosted by this couple just a few years back. Answering the puzzled look on my face, my friend said with sadness: “Fifty plus years of our life together have been wiped out completely. He does not remember me or his children.” He lives now in a facility for AD, away from his loved ones, since he needs professional care. Love is not enough. Another friend who regularly sat with me at meal times at Ingersoll Place, an Assisted Living facility in Niskayuna, New York, where I have been living for the past 18 months, has now gone to the Memory Room, a space allotted for residents with memory problems, and separate from where 14 | INDIA CURRENTS | Dec ‘13—Jan ‘14

Once, a vibrant person, who sat at my table along with her husband, today she is forgetful, and cannot perform even simple daily tasks like bathing and dressing herself. She seems to go in and out of her present life and cannot connect with her past. regular residents live. There are 11 residents that currently live in the Memory Room. Roughly half of them have dementia, and the other half AD. Once a vibrant person, who sat at my table along with her husband, today she is forgetful, and cannot perform even simple daily tasks like bathing and dressing herself. She seems to go in and out of her present life and cannot connect with her past. While medicine has wrought miracles in curing diseases that seemed incurable in the past, and prolonged our lives, the price that some of us pay for longevity is loss of memory and weakening of motor and cognitive functions that can result in AD. The essence of a person is taken away with this disease. Their life experiences, which make up their personhood, vanish through the decline of brain functioning, and who they were remains only in memory for those who love them, like photographs in sepia. The best that can be done for Alzheimer’s patients when they are unable to carry out daily tasks like bathing, dressing, and walking which ends up in frequent falls, is to have one on one caregivers. When Alzheimer’s patients show behavioral changes like agitation, hallucinations, paranoid distrust, depression and wandering, it becomes necessary to have structured living areas where psycho-social services can be provided. Over 8 million people have AD, and it is expected that by 2050, there will be a million new cases every year. AD strikes about ten

percent of people in the United States aged 65 and up. Fifty percent of people over 85 and up have this old-age scourge. Healthcare costs for dementia and AD in 2010 were over $172 billion dollars, three times higher than money spent for the healthcare of other seniors over 65. Businesses lose over 58 billion dollars a year because some of their employees are caregivers to loved ones with dementia/AD and need time off. Why do these dreadful diseases happen? The word “dementia” literally means “the loss of the ability to think.” Scientists have made significant progress in understanding the possible causes of Alzheimer’s but have found no cure. The brain is a complex structure which has over a hundred billion nerve cells or neurons. Connecting these neurons and helping them communicate with each other are synapses that send out electrical and chemical signals to the body for motor as well as cognitive activities. In its pathological state, the brain is hindered from carrying out its important function of sending out these signals because of the formation of plaques and the tangles of the neurons. A protein called “beta amyloid” causes the buildup of plaques in the spaces between the neurons. The plaques prevent communication between the neurons. The protein “tau,” which normally promotes communication in the brain cells, breaks them up into tangles in its pathological state, and blocks effective communication between the brain cells. This brain disorder causes Alzheimer’s. The causes of AD can be genetic as well as non-genetic. Some non-genetic factors include head injuries in childhood, lower levels of formal education, and lower socioeconomic status. Though not proven conclusively, environment and childhood experiences can be a risk factor in getting this mind-robbing disease.

The South Asian Diet

1n 2006, a study titled, “Curry Consumption and Cognitive Function in the Elderly” conducted by Ng TP, Chiam PC, Lee T, Chua HC, Lim L, Kua EH indicated that those “who occasionally ate curry (less than once a month) and often (more than once a

December 2013 - January 2014 India Currents  
December 2013 - January 2014 India Currents  

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