A Fate Worse Than Death

It’s Tuesday and I’m sitting in my Adult Development and Aging lecture, my professor fell ill and was unable to teach. The teaching assistant came in and put on a movie: The Forgetting. A documentary really, about the incredibly debilitating disease we all know unfortunately too well, Alzheimer’s Disease (AD). A neurodegenerative disease marked by the retrospective, gradual loss of memory with no current cure. Alzheimer’s has a physiological component and a cognitive component. Physiologically, there are changes in the physical composition of the brain. The cause of AD is the creations of protein plaques and fibrous tangles that disrupt the functioning of the brain. Plaques are deposits of protein fragments called Beta-Amyloids. They cluster in large, dense numbers scattered throughout the brain, eventually becoming toxic to the brain cells if they reach excessive levels. Tangles are protein chains that tangle together to the point where they can no longer function. These tangles interfere with vital cognitive processes and eventually choke off living brain cells. In the areas of the brain in which these plaques and tangles are created, cell death occurs and the brain shrinks in these areas, notable in MRI scans. Cognitively, the brain can no longer process information the same way it used to. AD is most well known for its effect on memory. The retrieval process becomes more and more difficult, with newer memories (most recent) being affected first. Gradually, memory for older events become harder to retrieve. Not only does AD affect memories of people, in which you become unable to remember your friends, coworkers, family, also events, in which you are unable to remember the birth of your kids, your wedding night, or your sweet 16, but AD also effects your memory of everyday functions. You become unable to care for yourself, walk, talk, eat, and drink. AD doesn’t kill you directly, but it makes you unable to live.

Alzheimer’s Disease exists in two forms. There is early onset and there is late onset. Early onset refers to the emergence of AD early on in adulthood, at approximately 50 years old. Unfortunately, early onset is the most dangerous and life-threatening of the pair. Early onset AD leads to an exponential decline in cognition, giving the patient only a few more years of life. Late-onset refers to the emergence of AD later on in adulthood, at approximately 60-70 years old. Although cognitive decline is still evident in this form of AD, it occurs much more gradually and over the course of many years. With late-onset AD, medications are available that slow the progression of the memory loss, but no current cure exists.

Unfortunately, the likelihood of developing AD is 1 in 14, a number that will quickly grow with the aging of the baby boom population. AD is a genetic disorder, that can be passed down from generation to generation. This means the likelihood of developing AD increases with the diagnosis of AD among family members. However, new research proposes that AD is not as genetically determined as previously thought, suggesting there is an environmental component to the development of AD. However, this research has not yet been replicated which only means that genetics continue to play too large of a role in the development of AD.

Alzheimer’s disease. A fate worse than death. What makes this disease so terrible? Aside from the obvious loss of total memory, what is it about AD that makes it so harmful? To explain that, I have a personal story to share.

2 or maybe 3 years ago, my family and I traveled back to our home country of Argentina for the winter holidays. What we usually do is spend Christmas with our moms side of the family and new years with our dad’s side of the family. The days leading up to Christmas were warm and fun. We spent the day with my cousins, shopping, walking around the city, enjoying the beautiful summer air. Our journey through the city had a destination, however I could tell by my mother’s agitation that this destination was not necessarily one to look forward to. The beautifully glazed double doors opened to reveal a black, marbleized entrance to a modern nursing home. We waited at the security desk at the front entrance while the woman we were waiting to see made her way down to meet us. Her fragile figure emerged from around the corner and I saw my grandmother again for the first time in many years. We made our way to the common area where we could sit down with grandma and chit-chat. We talked about how we’ve been doing back home, my brother’s new hairstyle (he was rocking full dreads at this point), and the holiday plans. Of course, we talked. She sat there quietly, trying to decipher the words that flew right out of our mouths. She could only give few answers, but once she did, she forgot what she said almost instantly. It was like trying to communicate with another person through a dead telephone line. You could speak, but you couldn’t really tell if there was really someone on the other line receiving your message. We tried to get her to engage by telling us about her granddaughters (my cousins), to which she simply responded with a blank stare. A stare that said who on earth are you talking about? Should I know these people? The worst part of all is the moment we leave. She walks with us to the front door to greet us out. I take one more look back, giving my grandmother a final farewell. I looked her in the eyes and got nothing back. The light from her eyes was gone, just like her memories. Sure my grandmother was there, but she wasn’t really there. Looking back at me was only the frail body of my grandmother but her essence, her soul, they were long gone.

Many people describe Alzheimer’s Disease as the people they loved simply disappearing right in front of their eyes. To me, AD doesn’t just kill you once. First, it kills your soul and then it kills your body.

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