Friday, July 15, 2016

Resist fatalism

When I was diagnosed with Alzheimer’s in June of last year, I assumed there was nothing I could do to slow its advance. What I knew about the disease was not much more than what I’d learned from the 1981 movie On Golden Pond, which I viewed when I was in college: the Henry Fonda character getting lost in his own woods. There was no cure. And, as I soon learned, the handful of drugs to treat the disease are of limited help.
What I did learn was that certain choices—daily vigorous exercise, a good diet, good sleep hygiene, and social and intellectual engagement high among them—could alter the equation of living with the disease. But it was just last week that I grasped how consequential those choices can be. I came across Rudolph Tanzi when I was trying to land a panelist—John Zeisel, the author of I’m Still Here: A New Philosophy of Alzheimer’s—for a forum I was organizing this past spring. A Google search turned up Tanzi’s appearance on Zeisel’s “Hopeful Aging” local-cable program.
This was Tanzi’s central point: “Ninety-five percent of the time you are in control of your genes.” This came as a revelation. I’d assumed the opposite. It’s true that people who inherit the APOE4 gene are at higher risk of developing Alzheimer’s. But even those of us who have the disease can, to a significant extent, control our fates. This might sounds like magical thinking, but the research is embodied in the field of “epigenetics”—the study of how organisms drive changes in gene expression without altering the genetic code itself. The term dates back to the 1940s.
And if you have the misfortune of having Alzheimer’s, there is much compensating you can do, through exercise, modifications to diet, good sleep hygiene, intellectual and social stimulation. An overarching purpose in one’s life seems to be theraputic as well. And in contrast to the outdated assumption that brain cells are finite, Tanzi emphasizes that there are many ways to generate new brain cells. “Exercise induces them,” he said.…It clears up the area where they are going to be born.” Daily meditation is recommended. Stress, on the other hand, is to be avoided as much as possible. For me, the worst period was 2013, a year in which I made two significant mistakes overseeing publications, one of them quite costly. Had I been screened for Alzheimer’s at that time, I could have spared myself a lot of grief and embarrassment—and, more significantly, corrosive anxiety.
Tanzi elaborated on some of these points in his foreword to the book Before I Forget: Love, Hope, Help, and Acceptance in Our Fight Against Alzheimer’s, a colloboration among B. Smith, the celebrity restaurateur and lifestyle maven who disclosed she had early-onset Alzheimer’s in June 2014; her husband and manager Dan Gasby; and the professional writer Michael Shnayerson. Gasby and Shnayerson describe Tanzi as among the three most prominent figures in Alzheimer’s research. In the mid-eighties, according to the two writers, Tanzi was among researchers who discovered the first Alzheimer’s-related gene, APP, amyloid precursor protein.
After I was diagnosed, I anticipated a long day’s journey into night. But after becoming acquainted with Tanzi’s work, I don’t envision such a sharp linear descent. I’m not suggesting that this is the equivalent of a cure. But it makes me feel that in some modest yet significant way, I’m behind the driver’s wheel, not just trundling toward my execution.

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