Can you really prepare for Alzheimer’s?

I think so.

Last night, I watched a really good TED talk my brother, Karl, sent to me.  The talk is about Alzheimers disease and Karl is my older brother—the only one of the four of us to have cracked 80 so far.  Alzheimers is something Karl and I care about, so when he recommended this lecture, I paid attention.

You can see it here and I hope you do.

But if you don’t—and most of you are a lot younger than I am—let me tell you what it says and let me start at another place.  Here is Dylan Thomas’s well-known prescription:

Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.

He had death in mind, of course, not dementia.  But the you—the person you are—is what is lost in dementia.  Dementia shows that “who I am” is a shorthand expression referring to who I have been.  I am proud of who I have been, but as that self slips away, I do not become no one at all.  I become the person I am then.  I may be shifting, frail,  and confused.  A disordered self, but a self, still.

As I look at the poem, I am struck that submission or acceptance are seen as one pole: the bad one.  And rage is seen as the other pole: the good one.  Really?  Are those the options?  Whatever a self is, it is associated with “agency,” that is, with the ability to intend an outcome and to act so as to achieve it.  Is it worth spending the last penny of agency on rage?  Maybe that’s a good use for some people.  I don’t think it is for me.

Alanna Shaikh calls her talk “Preparing to get Alzheimers,” which is a little catchier than the title I would choose.  She pictures herself as predisposed to get Alzheimers because her father had it—as my father did—but I still think I would want to say that I was preparing for the possibility of Alzheimers.  There are three things you can do, she says, and I like all of them.

Alz 1First, learn to do some activities that are not principally cognitive.  She chose knitting.  The idea is that you want to do things you take pleasure in and if the New York Times crossword is the kind of thing you take pleasure in, you are going to lose it quickly.  You aren’t going to lose knitting quickly.  You hands will know how to knit and you will  be able to take pleasure in what they do.

That idea caught me because my favorite activities, apart from running on Portland’s famous Wildwood Trail, are cognitively demanding.  I read a lot, I write a lot, I have discussions that require and that celebrate careful thought and careful use of words.  Maybe I could make a regular routine out of shooting baskets.  I used to be a pretty good shot.  Maybe weeding garden beds is my kind of thing. Something.  Alanna’s idea is that now is the time to start getting good at it and that, at least, makes sense.

Second, she proposes that becoming physically stronger and better balanced are worth doing.  If Alzheimers offers a straight decline from whatever level of fitness you had whenAlz 2 the decline started, then the higher the level, the more of the decline is at the good end of the scale.  She wants to maintain her mobility for as long as she can, and who wouldn’t?

I have had a quibble for a long time now with the notion of “getting fit.”  “Fit for what?” I always wonder.  Here, at last, is a good answer.  Fit for moving around safely under your own power.  Fit as in not falling down and hurting yourself.  Fit as in standing up and sitting down when you want to.  Those all seem to me to be things worth doing and retaining the ability to do them longer doesn’t have, for me, any of that burring sulphur smell of “rage against the dying of the light.”

Alz 3Shaikh’s third project is “becoming a nicer person.”  I have my doubts about that one.  I think becoming a nicer person is worth doing, but my sense of what Alzheimers does to you is that it takes you way back to your most natural and least processed self.  I don’t think I am going to “regress” in my 80s to the person I started trying to become in my 50s.  If it really works like that, I’m going to move toward the person I was as a little boy.  That’s a mixed bag, I’m sure, but I was a pretty happy little boy, so maybe it will work out.

Apart from the specifics of Shaikh’s proposals, I’d have to say that I really like the idea of doing what I can now to give me more good time then.  And if “then” never comes, how bad is that?  I’m stuck with some new skills and a heightened level of fitness and some surplus niceness?  Is that bad?

And then too, I just like being plan-full.  It feels good to me.

About hessd

Here is all you need to know to follow this blog. I am an old man and I love to think about why we say the things we do. I've taught at the elementary, secondary, collegiate, and doctoral levels. I don't think one is easier than another. They are hard in different ways. I have taught political science for a long time and have practiced politics in and around the Oregon Legislature. I don't think one is easier than another. They are hard in different ways. You'll be seeing a lot about my favorite topics here. There will be religious reflections (I'm a Christian) and political reflections (I'm a Democrat) and a good deal of whimsy. I'm a dilettante.
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