Alzheimer’s and the great brain robbery

As the Alzheimer's epidemic rages worldwide without the hope of a cure, the best we can do is change the way we live to halt it in its tracks. In the 2001 biopic on Iris Murdoch, the much-acclaimed British philosopher and novelist, a mesmerising Judi Dench plays the older Murdoch in the throes of losing her mind. The agony of losing one’s self in the ruins of a crumbling decrepit mind is not peculiar to Murdoch alone.

By the reckoning of the 2016 World Alzheimer’s Report, over 47 million people globally are in the grip of this merciless and elusive burgler of memories. And with large numbers of people living longer across the world, Alzheimer’s is expected to strike three times as many by 2050, surpassing cancer as the second leading cause of death after heart disease.

For all the boast about India being a young nation, with every two out of three people under the age of 35, it still has over 80 million people over 65, of which, according to one estimate, more than 4 million are affected by Alzheimer’s and other kinds of dementia. This makes India the third highest bearer of this dreaded burden, after China and the US. Taking care of such a legion of Alzheimer’s patients could take an extraordinary emotional, let alone economic, toll on the caregivers.

The disease itself remains an enigma with no treatment, let alone a cure, in sight as yet. However, as wicked a problem as Alzheimer’s is, science has managed to decipher some aspects of its complex persona. One knows about its many inexplicable quirks. For instance, it afflicts women more than men; or that some communities, such as the Icelanders, have a natural defence against it, while some others, like 5,000 people in a particular clan of Colombians, are unusually vulnerable to it

Though often described as the “plague of the 21st century,” Alzheimer’s has an ancient vintage. In fact, it wasn’t until the beginning of the 19th century, when the French physician Phillipe Pinel coined the word dementia to describe mental illnesses, that such patients were seen as suffering from a disease.

But it was almost a century later, in 1906, that a German psychiatrist called Alois Alzheimer described for the first time the characteristic symptoms—plaques, tangles and reduced brain-size—of what was called Alzheimer’s.

However, his ideas were reaffirmed in the 1970s when more advanced imaging techniques exposed in finer detail plaques and tangles of a brain wasted by Alzheimer’s. In 1991, British geneticist John Hardy proposed plaques of a renegade protein called beta amyloid as Alzheimer’s smoking gun. Lured by the amyloid hypothesis, many researchers and pharma companies rushed to develop molecules that could kill the plaques, and hence prevent, or at least stave off, Alzheimer’s.

With the amyloid hypothesis in doubt, new competing theories have sprung up. However, as hypotheses go, they might have some substance, or they could be pure flights of a desperate mind. As things stand, scientists concede that a treatment for Alzheimer’s is at least a decade away. Some scientists argue that in the meantime, as Alzheimer’s expands its empire, altering our lifestyles might be our best bet against the great brain robbery even though there is no solid evidence of whether and which environmental factors, good or bad, might do the trick.

Of the notable candidates, there is turmeric, the sine qua non of most Indian diets, which some scientists believe might explain the alleged resistance of Indians to Alzheimer’s; or sugar, which many suspect of being complcit in the elaborate brain heist; or solving puzzles and learning new skills, all of which might keep the brain from sliding into the dark abyss.

Amidst this pain and despair surrounding Alzheimer’s, it’s sobering to look at the ravages of an ageing mind from an evolutionary vantage. As the Icelandic neurologist Kari Stefansson muses in Joseph Jebelli’s absorbing A Pursuit of Memory, “is it a design flaw when a disease terminates a life when we are relatively old, or is it a masterpiece in the design?...We’re born to have offspring and die. What our roles are beyond that is beyond me. I don’t know why we last this long.”

By: Rakesh Kalshian
(Courtesy: Down To Earth)