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THE AGING BRAIN AND THE ALZHEIMER'S DISEASE
"THE MYSTERIOUS BUTTERFLIES OF THE SOUL"
"My mother had Alzheimer's disease. I loved her so deeply, that it was destroying
to see her sinking deeper and deeper each day into a forgetfulness without a name,
into a desert where no flowers bloomed, no emotions, no days. It was terrible to
see that she didn't recognize me, the emotions that I felt were so strong,
the hope that I had when something seemed to bring her back to me: maybe a smell,
or, at times, my voice. I looked after her with tenderness and care, convinced
that love would have the capability of waking her up, to get her out of that damned fog that had paralysed her brain.
However, I wasn't able to do it.
Two years have passed since she died. Very gradually, another worry is bothering me. I've realised that my memory is going. I have difficulty in remembering names, I also have to note down the things. I'm terrorised that I'll get lost in same fog … Once, doctor, you mentioned oestrogen can help the brain stay young. Can you tell me more ? I am 58 years old, been in the menopause for six, until now have taken nothing for it. Could you tell me if there is some hope against this illness."
Cecilia
WHAT IS ALZHEIMER'S ?
- It is a degenerative disease of the
brain
- It is characterised by a progressive loss of memory, change of personality
and behavioural disturbances
HOW MANY PEOPLE DOES IT AFFECT ?
- In the USA 10%of the population
over 65 years old suffer from senile dementia
- In 70% of these cases, the cause of the problem is Alzheimer's disease
HOW CAN YOU UNDERSTAND IF YOU HAVE THIS DISEASE ?
The first "suspicious" signs are :
- The loss of memory for recent
events
- The difficulty in understanding the
sense of the situation
- The ease at which you get lost in
space and time
The later signs are :
- The loss of memory for long
distance past
- The increase in disinterest in the
well-being of other people and personal hygiene
- Incontinence
WHY IS THE LOSS OF MEMORY SO DEVASTATING FOR THE PERSONALITY ?
- The memory helps us to maintain in
the passage of time who is "Me"
- It helps us to know who we are,
where we've been, who is important to us
- It gives us sense to our existence
- Losing our memory means losing
ourselves, turning our existence into instances, with
neither one connected to the previous ones
- Losing our memory becomes like a
film in which every photograph is cut and isolated from the
others
- Memory gives us sense to the past,
present and future
DO THE PEOPLE AFFECTED REALISE THIS ?
- At the beginning "Yes"
- Later it is difficult to say what
type of awareness remains. Maybe the sensation to see the
other people at a distance
- With desperation, sometimes they
recognise something familiar - a perfume, a tone of voice, a
smile
- Unfortunately, this disease is also
terrible for the family members, especially to see that your
loved one does not recognise you anymore
- The difficult personality traits and behaviour frequently leads to the institutionalisation of these poor people - left to their destiny. This frequently accelerates the deterioration of the disease, to the point when even their own reflection in the mirror frightens them
HOW CAN WE SUPPORT THE FACT THAT OESTROGENS MAY PROTECT US FROM THIS DISEASE ?
- The number of incidences of the
disease increase much more in women after 65 years old, than
in men
- Depending on the age, women are
affected from 1.5 -3 times more than men
- Women that have had a heart attack
have a chance of suffering from dementia 5 times more than
other women : this is because both diseases are worsened due
to the lack of oestrogen
- Thin women have a higher risk. This
is because larger women produce oestrogen in the adipose
tissue thus "protecting" their brains
- A direct observation noted that oestrogen given to women after the menopause reduces the risk of Alzheimer's by 40% as demonstrated in the epidermiological study carried out by Ann Lia Paganini - Hill (USA)
WHY DO OESTROGENS HAVE A PROTECTIVE FUNCTION ?
- These hormones are powerful
nutritive factors for the nervous cells
- They aid the "neuroplasticity",
that is, the repairing capacity of our nervous system
- Ramon y Cajal, the great Spanish anatomist, nominated for a Nobel Prize at the beginning of the last century, discovered neurones with the microscope calling them the "mysterious butterflies of the soul". Oestrogen nourish these butterflies, making them fly, keeping thoughts and memories fresh and magic for as long as possible, both in normal ageing conditions and in those not at risk from Alzheimer's.
IF ALZHEIMER'S IS A GENETIC DISEASE, HOW CAN OESTROGENS HAVE A BENEFICIAL EFFECT ?
- Oestrogen cannot change genes, but
can change the way in which the "ill" genes show their
defects
- Having genes of a certain illness does not mean definitely that the illness will manifest itself. The expression of these genes depends on many factors both internal and external of the organism. In the case of Alzheimer's, oestrogen can be a protective factor in the development of the disease
ARE THERE OTHER FACTORS THAT CAN ACCELERATE THE DEVELOPMENT OF THIS ILLNESS ?
- Loneliness, i.e. the loss of
emotional and affectionate stimulants
- The loss of the "sense" of life can
accelerate the way in which a person "gives themselves up"
to the illness, and to the disappearance of every attachment
with other, and eventually with themselves
ARE THERE OTHER TYPES OF DEMENTIA THAT ARE NOT HEREDITARY LIKE ALZHEIMER'S ?
- Yes. In these situations there is
more hope : not all losses of memory lead to dementia, and
not all dementias are typical of Alzheimer's, that is,
hereditary
- There are also the so-called
"depressive pseudodementias", in which the dramatic loss of
memory and relationships with others, are due to profound
depression
- In these cases it is essential
tohave an accurate difefrential diagnosis by a competent
psychiatrist, take an antidepressant tehrapy and possibluy a
parallel pasychotherapy
- In the case of Cecilia, depressed
due to the death of her mother, the loss of memory could be
due not only to ageing but also depression
- Deep depression alters sleep
patterns, especially the "REM" phase that corresponds to
sleep with dreams. This is an essential phase in which the
memory of the days events are turned into a sort of
permanent biochemical archive that is needed as a base for
long-term memory
- For this reason a good sleep is
vital for memory and the optimal functions of the psyche
- Other causes of cerebral
deterioration not connected to Alzheimer's are
arteriosclerosis, due to an excess of cholesterol, a lack of
vitamin B12 and malfunctioning of the thyroid gland
WHICH PRACTICAL ADVICE SHOULD BE FOLLOWED, OTHER THAN AN ACCURATE ANALYSIS OF THE "TYPE" OF MEMORY LOSS AND TAKING A HORMONE REPLACEMENT THERAPY ?
- Do not listen to the so-called
"negative prophecies" which can become reality
- Do not condemn yourself to a
"forgetful" destiny
- To age mentally in the best way
possible a golden rule is to try to go back to living with
joy and enthusiasm
- Be able to say, like the great
painting of Goya : "Aùn aprendo, I learn again". To keep on
learning, on being interested on the world around, to enjoy
reading a book, improving a specific knowledge, could be a
new language, a hobby, or developing a skill we never
cultivated before, maintaing a rich web of friend and
relatives is the best way to exercise the brain, the memory
and the pleasure of living.
REFERENCES
Birge S.J. The role of oestrogens deficiency in the aging of central ner vous system in Lobo R.A. (Ed.) "Treatment of postmenopausal women: basic and clinical aspects" new York, Raven Press, 15157, 1994
Bloom, F.E., Kupfer, D. Psychopharmacology, New York: Raven Press, 1995
Graziottin A. Estrogeni, funzioni psichiche e organi di senso, Milano: Società Italiana del Pavimento Pelvico Ed,1999
Plouffe L. Simon JA Androgen Effects on the Central Nervous System in the postmenopausal woman,Seminars in Reproductive Endocrinology, 16,2, 135-143, 1998,
Rubinow, D.R., Schmidt, P.J. Androgens, brain and behaviour. Am. J. Psychiatry, 153, 8, 974-984, 1996,
Sands, R., Studd, J.. Exogenous androgens in postmenopausal women. Am. J. Med., 98 (1A), 76 - 79, Jan. 16, 1995
Copyright © Alessandra Graziottin 2002
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