Sunday, April 24, 2005

You too have Alzheimer's Process

Entrez PubMed: Search related to stress and mild cognitive impairment

Middle-aged? Had trouble remembering the name of that troublesome Senator? Oh yes ... Frist.

Sound familiar? Of course it's worse when you're low on sleep, stressed, etc. Really, it's quite normal. Your friends and colleagues, with a few remarkable exceptions, are similarly afflicted. Exceptionally productive individuals, with great contributions ahead of them, have trouble with distraction and focus in middle-age. They'll use date books, calendars, task lists and more -- things they didn't used to need. Use Google to find missing words and to remind one of things. Avoid learning new confusing and complex software. Lose track of documents (full text search is handy). Put the umbrella on the door handle, put the car keys on the item that must not be left behind.


It doesn't help, of course, that middle-aged life can be exceedingly full. Complex family needs, complex parental obligations, complex finances, lots of stress, increasing responsibility at work as one nears the Peter Principal (what's that word, ahh, this one will do) asymptote, a brain overloaded with memory, experience, associations.

Understandable. Normal. Typical. So you can stop reading now. (The following is slightly speculative. I find it oddly reassuring, but most won't.)

You should stop reading because, when you pin an Alzheimer's specialist or researcher into a dark corner, and beat them with a rubber hose (actually, a beer works too), they'll confess that it's probably Alzheimers (omit the apostraphe, it's a pain). Not the disease really, because a disease suggests something exceptional or atypical. This process is universal and lifelong, starting probably in the teenage years. What we call Alzheimer's "Disease" is probably "normal" aging of the brain. Just as we know aging rates vary with stress (telomeres shorten with stress) and genetics, so too does brain aging likely vary with stress, injury (concussion especially) and various unidentified environmental impacts.

The timing of symptomatic manifestations (i.e. disease), from forgetfullness to dementia, is determined by a combination of fundamental reserve (how much does one start with at age 19 [1]), biological brain age, and adaptive techniques. Some people become work disabled in their fifties, a luck few will be able to carry out their routine daily life readily until they've over 100. Most of us will be substantially impaired in our late 70s, and will be work-impaired in our 60s.

So, now that you understand this, (Phew ... I won't get Alzheimer's! I already have it ...) how does should you use knowledge? (I told you not read this far.)

Well, we probably ought to talk about it. Unless we can slow the fundamental aging of the brain (there's hope, actually) we shouldn't expect to raise the retirement age much. As the boomers age, we may also want to consider environmental adaptations in the workplace, such as simpler and more reliable software, better search tools, no instant messaging (sorry young-uns), less email, fewer interruptions, schedule brainless meetings in the afternoon only (when middle-aged brains are sluggish anyway) ...

For the truly tough (life is not for wimps), it might be useful to (I suggest doing this privately) track one's decline and plot out the point when one will have to switch careers or make other accommodations. There's a business opportunity here for a web site that would provide anonymous yearly testing and maintain a projection curve. It will be a while before most of us are ready for this step. Denial is not a bad thing.

Oh, and maybe we'll finally get a useable and reliable PDA -- one made to fulfill Engelbart's dream of the cognitive extender (aka crutch).

Meanwhile, be supportive of Alzheimer's Disease research. It's not just for your parents ...

[1] If the Alzheimer's process is global, but initial reserves are assymetric, then one would expect symptomatic disease to by likewise assymetric. So if one starts with strong visual-spatial reasoning but weak categorical memory, the memory will be the first to go. One would also expect persistent strengths to compensate for focal deficits, just as they do in developing brains.

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