What don’t we know about Alzheimer’s? Or, rescuing the midwife’s hat

Keith Hudson

What don’t we know about Alzheimer’s?  An awful lot obviously, considering the vast amount of research that’s going into it — without, apparently, much progress  being made.

There’s one thing we do know about one form of AD.  That vascular deficiency can be one cause of senility — the carotid artery not delivering enough oxygen to our brain neurons.  But, apart from that, scientists seem to be in a real fog so far.

I’ve long had the prejudice that AD only occurs to people who don’t exercise their brains enough.  A reasonable corollary to that is that highly intelligent people (who presumably use their brains a lot) don’t suffer from it.  Naturally I, being a highly intelligent person, will never suffer from AD.  That comforts me a lot.

But a few minjutes ago I had my doubts.  Serious doubts.  When I was entering the previous post onto my All is Status blogsite and noting the date, 25 May, I suddenly thought that it must be my birthday.  Now, I don’t rate birthdays very highly.  I have never bothered to remember them.  I’m ashamed to say that I cannot remember the birthdate of one of my children, Max, even though as always, I was present at his birth. In fact, it was a notable birthday because, withing a few minutes of his entering the world and lying on the bed with the midwife bending over him, he urinated in a great stream that described a parabolic arc that descended into the upturned bowler rim of the midwive’s hat.  This was a home delivery, you understand, and the midwife had only arrived a few minutes previously.  And it was an old-fashioned hat of more than 50 years ago that midwives these days don’t wear (as far as I know).

The midwife looked at me in as great a state of panic as she had ever been during her whole career of supervising births.  WIthout being able to move her head one tiny fraction, her eyes conveyed to me the desperate message that I had to do something about this gynacological complication.  Well, of course, being a gentlemanly sort of man, I carefully — very carefully — came to her rescue by lifting her hat from her head — complicated during the proceedings, if I remember rightly, by a hat pin — and removed her hat which contained so much of my son’s urine that, if the situation had been reversed, then her hat would surely have been able to float on it.

I cannot remember preceisly precisely what I did then.  However, to resume my track, I could only remember the birthdate of my other two children because they happened to be born on the same date — albeit a year apart.  Forgetting that date would never do!  But there we are, to my shame, I could never remember my mother or father’s birthdays or my ex-wife’s (although I know it’s next month because that’s also her name).

But I haven’t resumed my main track.  It took me some careful consideration a few minites ago to work out that my real birthday was a few days ago when I reached a decadel age of, these days, only moderate celebration.  For anybody who’d really like to know it I will mention that it’s a number that is horizontally symmetrical (and I don’t mean 100 either!).

Like any old person, I suffer from memory lapses.  The one that really jarred me some years ago was when I had been writing about President Clinton and all the good things he’d achieved for a paragraph or two but then couldn’t remember his name!  No matter how much I wracked my brains I simply couldn’t recall it.  I actually had to get it by looking up a Wikipedia list of US Presidents.

The piece of evidence that I find to be the most relevant when thinking of AD (and who doesn’t when reaching my sort of age?) is of story related by a brain surgeon on the radio many years ago. He had a friend who was a chess master, and had been all his life.  He could think several moves ahead while playing chess.  “But what I’ve noticed lately”, his friend told him, “is that I am not thinking as many moves ahead as I used to.”  He went on: “It might be the beginning of Alzheimer’s.  Why don’t you look at my brain if I die before you?” The brain surgeon agreed.  And, indeed,  the brain surgeon did so after his friend had died — after only a fortnight of physical and mental deterioration.

The brain surgeon discovered that his friend had had as an advanced form of AD, with all its obvious symptoms of plaque formation, as he’d ever seen in any sufferer who, usually, had been declining over a much longer period, typically months, and more often, years.  How could his friend have been playing chess at all, never mind doing so right up until his last two weeks?  The brain surgeon could only conclude that his friend had such a dense network of neurons in his brain that for all normal daily circumstances he operated quite as normal until his last two weeks.  To his mind — and to mine, too — this is as powerful a piece of evidence as any about what AD is all about.  It is, however, too anecdotal — and only a single piece of evidence — to be written up in a scientific paper.

All this came to me a few minutes ago when writing about something else entirely and realising that I was easily able to recall some words (names actually) that I know in the recent past I have had great difficulty in recalling.  It so happens , however, that I have happened to be writing about these people once or twice recently when I had a newspaper in front of me and didn’t need to recall them.  Nevertheless,  by having typed their names a few times, that was sufficient to make sure that my power of recall for these particular names had been restored.  Neuronal circuits that had perhaps become too weak or had been pushed aside by others (or by plaques) had recovered to their much older prior state.

So my personal hypothesis about Alzheimer’s has been restored also.  But I rather think that it’s not simply a matter of advising someone or oneself that “one must keep one’s mind active” but it involves a conscious decision to chase down a specific piece of non-recall and then practise it immediately.  Now this is rather more than a general order.  Simply doing a daily crossword perhaps as a general panacea for all one’s possible incipient AD is not enough.  Recall recovery has to be specific and at a time when AD is so mild that it is hardly regarded as worriesome at all.  If fact, if someone naturally has a lazy mind, the AD is thus liable not be noticed  — but to become worse if it’s incipient.

This is not quite the same the same thing as saying that highly intelligent people don’t suffer from AD.  In fact, most of us know people whom we regarded as highly intelligent who still go down with it.  But who is to say that all highly intelligent people have also got to be mentally busy?  Could it be that be that there are highly intelligent people but who are also mentally lazy?  They wouldn’t know it and we, even as their friends, may not be able to discern it.  If mental busyness or laziness is just one factor in the overall suite of factors that make for high intelligence then this is why there seems to be a general correlation — but with some exceptions.  Well, that’s where I am in considering this most mysterious of diseases . . . tentatively, of course!

3 thoughts on “What don’t we know about Alzheimer’s? Or, rescuing the midwife’s hat

  1. A very interesting read, as usual. If your observation is anywhere close to what AD is then you will never have a problem with it: an intelligent and a busy mind , just like mine 🙂

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