Body or mind: use it or lose it
— Photo: K.V. Srinivasan
MIND TONICS: Keeping the brain engaged may reduce the risk of Alzheimer's disease.
THE DEMOGRAPHIC transition happening in India is striking. Fifteen years ago, of the 820 million people in the country, about 8.5 per cent (or 70 million people) were over 60 years of age. Today, the proportion of these geriatrics has increased to 10 per cent, and by the year 2021, every seventh Indian will be a senior citizen.
This ageing of India poses health issues of a kind not as pronounced a generation ago. With age come problems of ageing disorders and diseases. The most challenging of these is the set of neurodegenerative diseases, notably dementia or loss of mental functions.
Increasingly prevalent
Alzheimer's disease, or senile dementia, is an increasingly prevalent form of these. The Kerala-based Alzheimer's and Related Disorders Society of India (ARDSI) has been doing praiseworthy work in recognising this growing geriatric problem and suggesting ways and means of tackling it, including starting a Respite Care Centre for Alzheimer's disease patients. The disease is named after the German physician Alois Alzheimer who described its symptoms and pathology about 100 years ago, when he was treating an elderly lady who was progressively losing memory, speech, displaying hallucinations and delusions, and finally became totally helpless. Autopsy of her brain showed strands of thick, insoluble deposits, which presumably interfered with normal brain function, by disturbing the electrical activity there. (Interesting how some diseases are named after the doctor who described them while some others are named after the patient who suffers from them, e. g., Lou Gehrig disease, after the baseball hero).
Cause not clear
What causes these Alzheimer's plaques is not clear, but a variety of factors seem to do so. Mutations or variants of the gene for the blood protein called Apolipoprotein E (ApoE) are associated with the disorder.
Life-style habits, diet and drugs are known to be involved as well. The mere process of ageing is a factor — hence the name senile dementia. How can we affect the course of human ageing? The clue stares us in the face when we ask the opposite question — what hastens ageing? Smoking, drinking, bad eating habits and impaired nutrition, abuse of the body through lack of exercise, excessive exposure to the sun and the elements and such do.
Gymnasts, health clinicians and yoga teachers show us how controlling our diet and habits, and regular physical exercise keeps the body young. Taking care of the body helps it keep young. Look at the 36-year-old Andre Agassi, who rebirthed himself in world tennis for the second time and almost won the US open this year, more than a decade later.
Or the bicycling hero Lance Armstrong, who became the champion of the Tour de France after successfully overcoming testicular cancer.
If physical exercise and proper habits can delay the course of physical ageing, why can we not do the same about mental ageing or senility? Gratifyingly, the answer seems to be in the affirmative. Mental exercise appears to affect the course of mental ageing in desirable ways.
Herein lies the hope for Alzheimer's and related conditions of dementia. There is now increasing evidence that an intellectually stimulating lifestyle may help modify late-life mental health in a positive manner.
Dr. R. Katzman asked in 1995, in an issue of the Journal of the American Geriatrics Society, whether late-life social and leisure activities delay the onset of dementia.
Testing the idea
The question was posed in order to focus attention of the increasing hints that lifestyle can delay mental ageing, and to provoke studies to test the idea. Since then, several papers have appeared, supporting the idea. In an article titled `Exercise, experience and the aging brain', in the journal Neurobiology of Ageing three years ago, J.D. Churchill and others suggest that "mental exercise provided by frequent engagement in intellectually demanding activity at work may facilitate the maintenance of inherent cognitive reserve, leading to more sophisticated cerebral networks in old age".
Latest paper
Dr. L. Fratiglioni and coworkers note in Lancet Neurology last year that an active and socially integrated life style in late life might protect against dementia.
The latest in the series of papers is a detailed population-based study of thousands of twins, all of them senior citizens, from Sweden. There is an inherent advantage in studying twins — they share the same genes, so that we can study the effect of `nurture', and not worry about factors of `nature', particularly with identical twins. Dr. Ross Andel of the University of South Florida has collaborated with colleagues in Sweden and analysed the connection between the incidence of Alzheimer's in these twins and their education, work pattern and the complexity of the work they had been involved in.
This is a classic `co-twin' study, where one of the twins has the disease while the other does not. In addition, they compared demented individuals with non-demented ones in a case-control study.
Complexity of the work involved demands on working with data, with people, and with things. Work on data involved synthesising, coordinating, analysing, compiling, computing, copying and comparing.
Work with things involved setting up, operating, precision, driving, manipulating, tending and such.
Working with people involved teaching or mentoring, negotiating, supervising, persuading, serving and such.
The results, published in the September issue of the Journal of Gerontology, suggest that greater complexity of work, and particularly complex work with people, may reduce the risk of Alzheimer's disease.
What then is the take-home message? Bend your brain so that you keep it in good order. Play with children, take up a new hobby, do crossword puzzles, solve Sudoku, learn a new language, interact with people — whatever! These are tonics for the mind and easy and enjoyable.
D. BALASUBRAMANIAN
dbala@lvpei.org
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