An Article And A Book

A provocative article about Alzheimer’s and other dementias showed up last Sunday on the Huffington Post, written by Scott Mendelson. After reading it I checked out his book at Amazon: Beyond Alzheimer’s: How to Avoid the Modern Epidemic of Dementia. I haven’t read the book, mind you—but the Product Description let me know that “the author asserts dementia is primarily the result of bad diet, stress, lack of mental and physical exercise, and other poor lifestyle choices,” and that he recommends “scientifically tested herbs, vitamins and nutraceuticals” as a way to help mitigate or delay the effects of the disease.

Against the freight-train advance of dementia, I wouldn’t want to depend on lemon balm, vitamin E and Omega-3 fatty acids. Then again, Aricept and Namenda haven’t had the best results, either. In the end, good diet, physical exercise and other lifestyle choices may well be more important than anything currently on the market.

What I perked up to in Mendelson’s article, however, was his fearless explanation of how much money we are spending on diagnosing and treating Alzheimer’s, and how little we’re getting in return. The changes that Alzheimer’s disease causes in the brain, he writes, “usually begin 15 years or more before any changes in memory and behavior are noted. Thus, by the time Alzheimer’s disease is diagnosed, the damage is done and the expensive treatments do little more than slow the pathological processes down a little.”

Even more dire is his summary of the current Alzheimer’s epidemic, coming at a time of severe economic downturn. “The country is deeply in debt,” Mendelson writes, “and government expenditures, including those for health care, must be trimmed back…. In 2005, Medicare spent $91 billion on the care and treatment of Alzheimer’s patients. By 2015, the expenditures are expected to be close to $200 billion.”

This is the kind of direct talk that few politicians will engage in. What Mendelson claims is that new medical technologies are expensive, and “we might not be able to afford them.” Though it isn’t his phrasing, we could easily be looking not at death panels, but dementia panels. In short, how much will the country be able to spend on elderly (and occasionally middle-aged) Alzheimer’s patients? Not enough, surely.

His conclusion? That “the most reasonable stance to take is not to develop evermore technically advanced and expensive means to diagnose and treat Alzheimer’s disease, but rather to assume that we are all at risk for developing Alzheimer’s disease, and that we must do what we can right now to minimize our risks for developing it.”

That’s pretty much how I look at it myself: healthy food, exercise, a good night’s sleep and so on. For now, I can’t see anything else to do in the face of what looks like an ever-increasing disaster.

The other side of the coin with Alzheimer’s is always caregiving—and let me cite a compelling memoir on the subject. It’s Come Back Early Today by Marie Marley, recently out in paperback. It is, as I’ve written before, “not an easy story—but like a gathering storm, you can’t look away from it. Marley has written a compelling, detailed, often powerful book about love, and where it takes us.”

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