The two words we fear the most

‘Alzheimer’s disease’. According to a recent survey, over 85% of people fear this neurodegenerative disease – the name of which sounds like that of a deranged scientist - more than any other. And the reality is that it has reached unprecedented, epidemic proportions in the West: 225,000 new cases are diagnosed each year and it’s estimated that in France, a quarter of over-65s will be affected by 2020.
Sixty-five can hardly be said to be elderly, especially when you consider it’s the legal age for retirement in many European countries… At this age, like most people, you probably see yourself as a wise, respected and charismatic figure, a seasoned veteran with a ready supply of anecdotes, attracting admiration and goodwill in equal measure. Unfortunately, for many individuals, the reality is somewhat more disturbing. Degeneration, dependence, incontinence, soiling … the words that spring to mind at the mention of Alzheimer’s disease are truly awful. Almost all of us would agree that it’s one of the most frightening ways to grow old, and to die: dementia wrecks the mind and robs you of control of both your own destiny and your final wishes. But that’s not the only reason it’s overtaken cancer in the fear and dread stakes.

You’re no longer the same person

What’s most frightening about Alzheimer’s is the loss of identity. It’s also referred to as ‘losing your mind’. In actual fact, Alzheimer’s patients maintain their own identity but it changes insidiously and irretrievably. Identity is not immutable: it develops throughout life, with the passage of time and memories¹. What makes you feel as if you’re the same person as yesterday, last month or 20 years ago, are the memories you have of these times as past events. It is the combination and interpretation of these memories in the light of your current situation that forges your identity.

In Alzheimer’s victims, the gradual disappearance of certain memories and the inability to form new ones leads to the construction of identities that are out of synch with their actual past selves. Indeed, Alzheimer’s sufferers are often described by their loved ones as ‘not the same anymore’. It’s not that they’ve completely lost the sense of who they were but the process of identity becomes limited to what are sometimes patchy memories from the more distant past. Normally, updating the identity process happens in a forward direction, in such a way as to integrate new, accumulated memories, but in the case of Alzheimer’s disease, the updating occurs in reverse with the progressive loss of memories².

Alzheimer’s sufferers are often unable to recognise their children as they’ve lost the memories that correspond to this stage of their lives. For the same reason, they sometimes think they’re much younger than they are, as in the case of a patient of Marie-Christine Nizzi’s², who was convinced she was 17 and needed to go home to her parents.

You no longer have the same interests

The gradual change in identity also means that your tastes, interests and affinities are no longer the same. People who were previously passionate about literature or the arts, for example, suddenly cease to have any interest in them at all. The film Die Auslöschung, follows the story of art history teacher and Alzheimer’s sufferer Ernst Lemden. It shows how a picture which he had previously found superb and profoundly meaningful to the point of devoting an entire book to it, struck him just a few years later as ridiculous and grotesque. Sometimes, the opposite happens where an individual starts to keenly pursue an activity in which they had previously shown no interest.

You’re cast aside

This is one of the worst consequences of the disease: a terrible chasm opens up between victims and those around them. As the Alzheimer’s patient loses the ability to meet the expectations of their loved ones (because they can’t remember a particular event, can’t recognise a particular face or are no longer interested in things they would previously have shared with them), these friends and relatives cease to expect anything of them. So little by little, Alzheimer’s sufferers become outsiders. And we tend to be less empathetic and attentive towards outsiders...

Don’t just hope for the best – take action to cut your risk

Why me? Why now? What on earth did I do to deserve this? Alzheimer’s disease is often seen as a bolt from the blue, an undeserved punishment that strikes without warning. But while the mechanisms that lead to its development remain mostly unclear, it is possible to reduce individual risk as long as the necessary steps are taken in advance. Once the rot’s set in, it’s too late.

1) Calorie restriction
In examining the outcome of people genetically-predisposed to Alzheimer’s (carriers of the ApoE4 gene), scientists observed a higher rate of the disease among individuals who ate a high-calorie diet compared with those consuming fewer calories^3-4. The researchers believe that calorie restriction may help increase the resistance of neurons to Alzheimer’s, as well as to stroke and the normal ageing process⁵. There is thus a real benefit to be gained from reducing food intake, apart from losing weight and looking slimmer. And to do that, it’s no secret that you need to adopt good dietary habits and develop an iron will, though there are natural aids that can help curb your appetite such as Appetite Control Formula, Hoodia gordonii (obtained from the spiny succulent plant) and Zero Craving (a soluble fibre formulation for increasing the feeling of satiety).

2) A diet rich in antioxidants
A number of studies ^6-7 have shown the benefits of antioxidants for reducing the harmful effects on neurons of reactive oxygen species. While all antioxidants appear to be beneficial, scientists have marked out three for special attention: folic acid (found predominantly in offal, pulses and dark green vegetables, as well as in supplements such as SuperFolate 200 mcg), vitamin B6 (found in offal, fish, wholegrains and supplements such as Pyridoxamine 100 mg) and vitamin B12 (see: Is everyone lacking in vitamin B12? Why is there such widespread deficiency and what are the consequences?).

3) Mental training
Recent studies ⁸ show that people who engage in mentally-stimulating activities (reading, puzzles, memory games, studying) are less likely to suffer from dementia at an advanced age. Keeping an active, alert mind throughout life seems to help maintain neuronal connections and ward off cognitive decline and dementia. So if you’re not already participating in such pastimes, you know what you need to do.
There is currently no cure for Alzheimer’s disease and other related forms of dementia. It’s therefore logical to be scared of developing it. But fear can be an effective weapon if used wisely: don’t allow it to paralyse you and instead take action now.

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References
1. Mollard-Palacios Judith, Lechenet Valéry, « Les peurs suscitées par la maladie d’Alzheimer », Gérontologie et société, 2016/2 (vol. 38 / n° 150), p. 31-41. DOI : 10.3917/gs1.150.0031.
2. Nizzi Marie-Christine, « La maladie d'Alzheimer et son impact sur l'identité de la personne », dans Alzheimer, éthique et société. Toulouse, ERES, « Poche - Espace éthique », 2012, p. 49-59. DOI : 10.3917/eres.hirsh.2012.01.0049
3. Luchsinger JA, Tang MX, Shea S, Mayeux R. Caloric intake and the risk of Alzheimer disease. Arch Neurol. 2002 Aug;59(8):1258-63.
4. Pasinetti GM, Wang J, Porter S, Ho L. Caloric intake, dietary lifestyles, macronutrient composition, and alzheimer' disease dementia. Int J Alzheimers Dis. 2011;2011:806293. doi: 10.4061/2011/806293. Epub 2011 Jun 19.
5. Mattson MP. Neuroprotective signaling and the aging brain: take away my food and let me run. Brain Res. 2000 Dec 15;886(1-2):47-53. Review.
6. Esposito E, Rotilio D, et al. A review of specific dietary antioxidants and the effects on biochemical mechanisms related to neurodegenerative processes. Neurobiol Aging. 2002 Sep-Oct;23(5):719-35. Review.
7. Salerno-Kennedy R, Cashman KD. Relationship between dementia and nutrition-related factors and disorders: an overview. Int J Vitam Nutr Res. 2005 Mar;75(2):83-95. Review.
8. Middleton LE, Yaffe K. Promising strategies for the prevention of dementia. Arch Neurol. 2009 Oct;66(10):1210-5. Review.