“Living with,” Julie corrected me. “Some days it’s a struggle, other days not.”
That hopeful pragmatism squares nicely with the Alzheimer Society of Canada’s philosophy. In fact, early on in Lowell’s illness, Julie was asked to apply for the organization’s vacant CEO role, but she decided it would be “too much Alzheimer’s.” Increasingly, we will all feel the deluge. The prevalence in Canada of all forms of dementia—Alzheimer’s is the most common, accounting for nearly two-thirds of all cases—is projected to double from half a million this year to 1.1 million by 2038. Meanwhile, Alzheimer’s has rocketed up the list of diseases we fear most; according to recent polls, it is second only to cancer, and it sits first for those fifty-five and up.
Although Lowell is twelve years older than the oldest baby boomer (and seventeen years older than Julie), he knows he personifies the coming wave. A critical difference is that while many people with moderate, or middle-stage, Alzheimer’s have anosognosia, or impaired insight, Lowell remains alert to his plight. Still, he had trouble understanding my designs—Were we going to write a letter together? To whom?—and Julie had to warm him to the idea of being profiled. On one of my initial visits, Lowell, with a twinkle in his eye, seemed to be rehearsing first lines for a full-blown biography: “Lowell Jenkins grew up in Faucett, Missouri. His childhood was not all blue skies… Lowell Jenkins is a natural-born helper… Lowell Jenkins woke up one night and couldn’t figure out where he was…”
In the summer of 2007, Julie and Lowell moved to another condo in the same building. Not only was the new unit a disorienting mirror image of the old, with the kitchen and bedrooms to the left rather than the right, but a full renovation was under way. Carpets were torn up, the kitchen cupboards had been knocked out, and wires hung down. Lowell sat up in bed and surveyed the rubble: “Where am I? What have we done? ”
Around the same time, he was showing uncharacteristic agitation while riding the subway, and when they started planning a trip to Russia he became strangely reticent, though he had visited there many times before on cross-cultural exchanges tied to his teaching. Julie knows now that she rationalized the more subtle changes. “Things happen as you get older,” she said. “You do get older.” But Lowell’s disquiet about the new condo was of a different scale. Such was her struggle to pacify him that in the days following they booked the appropriate tests. “He asked before we knew,” Julie said: “‘Do you think I have it?’ ”
They will knock on our doors,” Dr. Serge Gauthier says about the baby boomers. “All of them, I’m sure.” He is director of the Alzheimer’s Disease Research Unit at the McGill Centre for Studies in Aging, in Verdun, Quebec. The question, he says, is what to tell the individual keen to know his or her risk: “Does everyone who is forgetful need a PET scan? No—but who does? ”
Age is the risk factor that encompasses the other big ones: family history and genetics, gender (twice as many women as men get Alzheimer’s), cardiovascular disease, and diabetes. Evidence is gathering to support what ought to be an intuitive leap between brain health and heart health. Alzheimer’s can cause cerebral bleeding and vice versa, and aerobic activity three times a week has been shown to slow the rate of shrinkage in the hippocampus.
“If you’re preventive about heart attacks in your fifties and strokes in your sixties, you may reduce the risk of dementia in your seventies,” Gauthier says. “That’s a lot of bang for your buck.”
Further motivation is that there is no magic bullet in the offing; not a single new Alzheimer’s drug has been approved in the past nine years. Dr. Judes Poirier, the centre’s former director, says if anything positive has come from the “miserable failure” of recent drug trials, it is the new attention being paid to the idea of “simply and humbly” keeping dementia at bay. Delaying onset by two years would drop the rate of incidence by 33 percent within a generation, and a delay of five years would cut it in half. “If we delay it by ten years, something else will kill you,” Poirier says. “This is the beauty of Alzheimer’s.”
Age is the risk factor that encompasses the other big ones: family history and genetics, gender (twice as many women as men get Alzheimer’s), cardiovascular disease, and diabetes. Evidence is gathering to support what ought to be an intuitive leap between brain health and heart health. Alzheimer’s can cause cerebral bleeding and vice versa, and aerobic activity three times a week has been shown to slow the rate of shrinkage in the hippocampus.
“If you’re preventive about heart attacks in your fifties and strokes in your sixties, you may reduce the risk of dementia in your seventies,” Gauthier says. “That’s a lot of bang for your buck.”
Further motivation is that there is no magic bullet in the offing; not a single new Alzheimer’s drug has been approved in the past nine years. Dr. Judes Poirier, the centre’s former director, says if anything positive has come from the “miserable failure” of recent drug trials, it is the new attention being paid to the idea of “simply and humbly” keeping dementia at bay. Delaying onset by two years would drop the rate of incidence by 33 percent within a generation, and a delay of five years would cut it in half. “If we delay it by ten years, something else will kill you,” Poirier says. “This is the beauty of Alzheimer’s.”
by Dave Cameron, The Walrus | Read more:
Image: Amy Friend
