“It’s scary to have Alzheimer’s, and doctors are not exempted from it,” Dr. Taddy Gonzales, a classmate of mine in medical school at UST, told me on the phone. The ever-witty Taddy gave amusing ripostes on our piece on Alzheimer’s disease (AD) last week in this column. Obviously, Taddy is least likely to develop it; he still knows the complete names of every batchmate we have and recalls incidents and anecdotes about them like they happened just yesterday.
Let me just clarify the prevalence we wrote last week, since Renato Santos of Naga City, now 79 years old, presumed in his e-mail that his risk of acquiring the disease is relatively small. We stated a projected prevalence of 1 in 85 in the future, but this refers to the general population—from the newborn to the very old. If you look at the elderly, the risk increases markedly. Between the ages of 65 and 74, about one in 20 people have AD. And the risk doubles every five years after 65. Over the age of 85, as high as 50 percent or every other octogenarian older than 85 are likely to have AD.
Factors
Although one out of 10 cases of AD may occur in young individuals (as early as those in their 30s), nine out of 10 cases occur in people aged 65 or older. Those with early-onset AD usually have strong genetic abnormalities predisposing them to the disease. Late-onset AD (in those 65 years old and older) usually have a combination of genetic and environmental factors causing the development of AD.
Since it could be genetic in cause, AD may run in the family. One’s risk of developing it tends to increase if a first-degree relative like a parent, brother or sister has the disease, especially if it’s early-onset. Rare changes (mutations) in three genes have been identified by scientists which will predict that one will most likely develop AD. But these mutations account for less than 5 percent of AD cases.
It’s true that AD cases register more women than men, but it doesn’t really mean that the female sex is more at risk. It’s simply that women live longer than men; hence, by sheer number there are more older women than men who could develop AD.
Mr. Santos further asked if memory lapses, which he frequently experiences, is already a symptom of AD. Not necessarily. AD affects not only memory but also one’s ability to learn, make judgments, analyze information and do ordinary tasks of daily living.
How to avoid
Dr. Taddy asked me also how one can avoid developing this progressive dementia as one ages. Difficult question, but the general advice is—if you don’t want to lose anything, keep on using it. The same thing is true for brain or mental functions. One reason the elderly is more prone to AD is that when one retires, one tends to read less, write less, think less, analyze less and unwittingly make the brain hibernate. This makes it more prone to develop plaques and tangles, which are the hallmarks of AD.
So just as eager as we are in jogging or exercising to maintain our physical vitality, we must also “jog” and “exercise” our brains daily, especially when one nears retirement age. If you have a mindset which dictates that “old dogs can’t learn mental tricks anymore,” then you’re setting yourself up for AD.
One can do all sorts of mental activities—sudoku, crossword puzzles, chess, mahjong, scrabble; recalling what one ate the last three days, or the names of the people one met recently; memorizing a poem, a song, phone numbers, Biblical verses, a short shopping list; adding and subtracting mentally and so many other mental exercises. The thing is to keep challenging oneself with new tasks.
Experts also say that using the nondominant hand regularly can help stimulate synapses—the connections between nerve cells, and the interaction of the right and left sides of the brain. So, it might be a good idea to try to learn writing with the left hand if one is right-handed. You can do the same with other activities like brushing, combing, or eating.
Learning to play a musical instrument may also help prevent AD. One doesn’t have to aim for concert-level performance. Simply being able to play the instrument and enjoy it can be stimulating enough for one’s aging brain cells.
Loners may also have a higher tendency to develop AD. So regular interactions with relatives and friends could not only earn one more social graces and closer relationships, but more “closely knit” brain cells.
Now that modern Medicine is enabling us to live longer lives, one shouldn’t spoil it by developing AD in one’s golden years. So, let’s not fail to do our mental “jog” daily.