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Written by Steven Burns
From his column To Your Health

Marvin, a retired professor, shuffled into the exam room and sat in the corner. Smiling, he said, “Hey, doc, when did you grow that beard?” It was the same greeting he’s used for the last four years. His clothing showed holes and cigar ash burns, and he had not bathed in at least a week.

“Well, I’ve had the beard for a while,” I said, moving on to his chart and exam. “How much are you drinking, Marv,” I asked. “Oh, I don’t drink anymore,” he said. “Just wine.” His wife Linda grimaced from across the room.

Linda told me he had started wandering around outside their apartment. So far, he hadn’t gone far, but we discussed child locks on the door, and possibly moving him to a care center “memory unit,” something Linda didn’t want to do.

In the past, he would regale me with stories of his time as a diplomat, commenting on politicians he knew and countries he had lived in. He spoke Spanish fluently, from his time in Central America. So, what happened to this brilliant political science professor?

In his 50s, the brain’s tau protein started failing its function of maintaining nutrient pathways within nerve cells. Later, the protein started degenerating into “tangles” that blocked normal cell function, and nerves started to die. Oher than minor loss of names and a few words here and there, Marvin did not notice any problems.

Around age 60, beta-amyloid started forming sticky plaque between nerve cells. This toxic protein damages brain cells, causing loss of ability to communicate. Marvin started having trouble finding his keys, and he missed a few appointments. Friends and family didn’t notice.

At 70, about the time I met him, he went to a mall and, when he left, called the police to report his car stolen. They found it on the other side of the mall, where he had parked it. The plaques and tangles were causing brain cells to collapse and die. He could teach classes normally, but his writing and research were not as innovative, crisp, or clear as in the past. Linda mentioned he was having memory problems.

By age 80, Marvin’s brain had visibly shrunk on the CT scan. Acetylcholine, a neurotransmitter chemical in the brain, had decreased, and he would ramble, losing track of stories, and repeating questions within a conversation. He could no longer teach, and got lost when driving. He couldn’t pay bills or calculate a tip when eating out. His wife took away his keys.

Alzheimer’s disease affects 5 to 6 million Americans, and is expected to impact 15 to 18 million by 2050, as people are living longer. It increases with the use of alcohol and tobacco, as in Marvin’s case. Other diseases, such as diabetes, heart disease, obesity, and repeated head trauma, can accelerate the formation of plaques and tangles, making these people more likely to suffer memory loss.

While we tend to lose some memory with age, there is a big difference between age-related memory loss and what takes place with Alzheimer’s. Normal memory loss does not affect judgment, calculations, and analysis, known as “executive memory,” the problems that now plague Marvin.

So, how do we prevent the development of Alzheimer’s? We can’t change our DNA, but genetics only accounts for about 25 percent of cases. I had a patient whose sister died of Alzheimer’s by age 70. My patient had only minor memory problems at age 90. The sisters were identical twins, with exactly the same genes!

Avoiding tobacco and alcohol are not likely to be a problem for us Nazarenes. But habits such as overeating, sitting around too much, poor control of diabetes, and high cholesterol are problems many of us have. These all add to brain degeneration.

In short, lose weight, exercise every day for 30 minutes, cut the carbohydrates (bread, rice, pasta, potatoes, sweets), and keep your brain active. Crosswords and other puzzles, reading, getting together with other people, learning new hobbies, learning another language, all provide benefits in delaying or preventing memory loss. Newer research shows that we continue making new nerve connections throughout our lives, and these activities help the brain to make more of them, protecting the cells we have and keeping us vital and engaged.

Get on your computer (yes, that can help, too) and look up neuroplasticity. That’s the formation of new cell connections, and, like exercising a muscle, working our brains increases the brain’s effectiveness.

So, at your holiday dinners, eat lean turkey and vegetables, and skip the pecan pie. Then, get off that couch, turn off the TV, and take a long walk. Afterwards, keep working on things that matter!

Dr. Steven C. Burns is board-certified in family medicine and has been in practice for almost 30 years.

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