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Experts are confronting specter of Alzheimer's

Rochester Business Journal
October 19, 2012

The torch of aging has been passed to the baby boomer generation-and with it the specter of debilitating disease. Dementia and Alzheimer's disease, in particular, are a deep concern for many boomers as they enter their 50s and 60s.
 
University of Rochester neuropsychologist Mark Mapstone is keenly aware of this widespread concern and, hence, the importance of his and other researchers' work. The generation faces what Mapstone's colleague, Frederick Marshall M.D., calls "an epidemic of Alzheimer's disease."
 
"Alzheimer's disease and dementia are one of the biggest fears of the baby boomers," Mapstone says. "Your memory is intimately tied to who you are, and people don't want to lose that."
 
The good news is that Mapstone, Marshall and other researchers are absorbed with developing strategies to thwart or reduce the risks of falling victim to Alzheimer's and other forms of dementia, as well as seeking better ways to treat people with mentally degenerative diseases.
 
For years, there was hope that the Chinese herb gingko biloba was an elixir. But studies, including one recently released by researchers in France, have shown that the herb is no wonder drug for fine-tuning memory or blocking the onset of Alzheimer's. Research also reveals there is "moderate certainty" that other drugs, such as vitamin E and cholinesterase inhibitors, also are ineffective in reducing the risk of getting Alzheimer's, says Marshall, director of the Memory Care Program at the University of Rochester Medical Center and chief of the hospital's geriatric neurology unit.
 
Most studies do not universally support the notion of brain training-through crossword puzzles and other mentally stimulating activities-to lessen the risk of Alzheimer's, Mapstone says. Puzzles and other activities that engage your mind are only beneficial in the sense that they are enjoyable; if not, they are essentially ineffective in guarding against dementia.
 
"Probably the thing you can do best is pick your parents well," Mapstone says. "Having a first-degree family member with Alzheimer's increases the risk.
 
"A number of groups, including here at the University of Rochester, are looking at whether there are things you can do to modify the risk of Alzheimer's if dealt a bad hand by Mother Nature. Most people think the risk is modifiable, but the degree to which it is is not clear yet."
 
How a person lives his life will have a big effect on how he will age and what his memory and cognitive functions will look like over time, Mapstone says. He encourages people in mid-life and earlier to remain physically and mentally active, avoid smoking and abusing alcohol, get enough sleep and exercise, and eat well. This lifestyle helps keep the cardiovascular system and brain healthy.
 
"The biggest thing is to remain mentally engaged in life and not sort of fade out with retirement," he says. "Sitting in front of the TV or on the couch is not the way to maintain a healthy engagement in life. As you go through middle age and older adulthood, it's important to remain as mentally engaged as possible in mentally stimulating activities. That could be something as simple as conversation with friends or family, going to movies, volunteering, remaining engaged in society."
 
The brain craves novelty, Mapstone adds.
 
"If you can present it with novelty and new experiences where you're actually sort of pushing yourself a little bit, that's the best way to keep your brain active and healthy as you get older," he says.
 
Marshall advocates relatively vigorous exercise; a low-fat diet based on fresh fruits and vegetables, fish, olive oil and pasta; some fish oil and an occasional glass of red wine; and cognitively engaging activities.
 
People in their 60s, 70s and 80s who start to experience memory loss should immediately talk to their doctors, because some of the changes can be modifiable, Mapstone says. The cause may be traced to an easily treated vitamin deficiency.
 
"Memory loss with aging is not a fait accompli. It's something that doesn't happen to everybody. But when it does, you have to take care of it right away if you can," he says.
 
Some patients who suffer memory loss benefit from formal cognitive rehabilitation. When appropriate, Marshall refers patients to those services at UR.
 
"I recommend that my patients keep their minds as stimulated as possible," he says. "That means socializing with folks, going out to the movies and theater, looking at art, watching the news, getting in arguments about politics, generally being interested in life."
 
There is hope even after Alzheimer's or some other form of dementia is diagnosed, Mapstone notes. There are no cures, but there are treatments.
 
"There are some who believe that once the horse is out of the barn, that's it; there's not much you can do," he says. "I don't take such a fatalistic approach. There are always things that you can do to help. It comes back to doing things that you enjoy."

Richard Zitrin is a Rochester-area freelance writer.10/19/12 (c) 2012 Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303 or email service@rbj.net.


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