Country music legend Glen Campbell is dying of Alzheimer’s disease. In an effort to raise awareness of the illness he and his family made the brave decision to bare their lives by creating a documentary of Glen’s farewell tour. I highly recommend that you watch this film with your loved ones… and a box of Kleenex.
One of the most remarkable aspects of Glen’s disease was the preservation of his musical abilities despite severe cognitive impairment. Although he rarely knew where he was or even how to tie his shoes, he was able to perform songs in front of live audiences. With redirection and prompting, he managed to participate in 151 concerts across the United States within the span of ~18 months. Accompanied by his gifted guitarist son and daughter, and his doting fourth wife Kim, Campbell was able to maintain his musical self for longer than his physicians ever anticipated.
The documentary held nothing back – from violent outbursts brought on by paranoid delusions of golf club theft, to inappropriate table manners, to hypersexuality triggered by too high a dose of Aricept – the trials and tribulations of being a caregiver for someone with dementia were painfully acute. In brief moments of insight, Glen himself would manage to stammer a “Thank you. For being so nice to me. I have been an ass.”
One of the saddest moments of the movie was a brief clip of his daughter testifying before congress. She explains that memories are what lives are made of – and that although she is holding fast to the memories made with her dad, she knows that soon he will not even know who she is, and that their time together will be meaningless to him. Campbell listens silently next to her with a pained expression and misty eyes.
The movie’s final song, artfully strung together from clips of Glen singing repeat phrases into a studio mic, is haunting:
“I’m Not Going To Miss You”
I’m still here, but yet I’m gone
I don’t play guitar or sing my songs
They never defined who I am
The man that loves you ’til the end
You’re the last person I will love
You’re the last face I will recall
And best of all, I’m not gonna miss you.
Not gonna miss you.
I’m never gonna hold you like I did
Or say I love you to the kids
You’re never gonna see it in my eyes
It’s not gonna hurt me when you cry
I’m never gonna know what you go through
All the things I say or do
All the hurt and all the pain
One thing selfishly remains
I’m not gonna miss you
I’m not gonna miss you
Alzheimer’s is a terrible, cruel disease. I share the frustration of the Mayo Clinic neurologists who treated Glen Campbell – unable to do much more than simply document his decline and mentally prepare his family for the next stages of the disease. To all those who are taking care of people with Alzheimer’s I offer my sincere admiration and respect. To those who face a genetically higher-than-average chance of contracting the illness (such as myself), I tremble and hope for a cure.
Dr. Oz is a powerful guy, blessed with a name that conjures up wizardry. He just unveils his latest “miracle,” which seems to happen on an almost daily basis, and people scamper off to the nearest the health food. Recently the great Oz anointed the oil extracted from the fruit of the palm tree that grows in Indonesia and Malaysia as a wonder product that can aid weight loss and reduce the risk of Alzheimer’s and heart disease. Introduced to this marvel by his a guest, a homeopath, Dr. Oz excitedly gushed about the beta carotene and “special form of vitamin E” found in “red palm oil.” A curious business. Tell me, does a Professor of Surgery at Columbia University with over 400 research publications under his belt really need advice on nutrition from a homeopath?
As is usually the case with Oz’s miracles, there is a seed of truth that then gets fertilized with lots of verbal manure until it grows into a tree that bears fruit dripping with unsubstantiated hype. For example, one study did show a reduction in the severity of cholesterol-induced atherosclerosis in rabbits fed high doses of red palm oil. This has little relevance for humans but magicians who pull rabbits out of hats may consider adding red palm oil to the diet of their little assistant. The red colour of the oil comes from beta-carotene, the same substance that contributes to the hue of carrots and many other fruits and vegetables. It is the body’s precursor for vitamin A, which makes it an important nutrient.
Unfortunately, in many areas of the developing world there is a shortage of both beta carotene and vitamin A in the diet leading to a high incidence of blindness, skin problems and even death. In such cases red palm oil would be useful, but of course there are numerous other ways to introduce beta-carotene into the diet including “golden rice” that has been genetically modified to provide the nutrient. Aside from remedying a vitamin A deficiency, there is not much evidence for increased intake of beta carotene outside of that contained in a balanced diet. There are suggestions that higher blood levels of beta carotene reduce the risk of breast cancer in high-risk women, but the beta-carotene levels may just be a marker for a better diet.
As far as the Alzheimer’s connection goes, Oz may have been referring to a study in which 74 seniors with mild dementia were compared with 158 healthy seniors. People with dementia had lower levels of beta-carotene and vitamin C in their blood. Again, this does not prove that the lower levels are responsible for the condition, they may just signal a diet that is poorer in fruits and vegetables. Tocotrienols, the “special form of vitamin E” Oz talked about, have shown some borderline effects in Alzheimer’s patients at doses way higher than found in red palm oil. There is no evidence for preventing the disease.
What about the claim that red palm oil causes loss of belly fat? That seems to come from a rat study in which a tocotrienol-rich fraction extracted from palm oil caused a reduction in fat deposits in the omentum, the tissue that surrounds organs. There was no evidence of abdominal fat reduction, and furthermore, the study involved putting the animals on an unnatural and unhealthy diet. But these are not the facts that the audience was treated to on the Dr. Oz Show.
What the eager viewers witnessed were three visually captivating but totally irrelevant demonstrations of the purported health benefits of red palm oil. First in line was a piece of apple that had turned brown because of “oxidation.” This could be prevented with a squirt of lemon juice, Oz explained. Then came the claim that red palm oil protects our brain the same way that lemon juice protects the apple. This is absurd. Vitamin C inactivates polyphenol oxidase, the enzyme that allows oxygen to react with polyphenols in the apple resulting in the browning. The human brain, however, bears no resemblance to an apple, except perhaps for the brains of those who think it does. Yes, oxidation is a process that goes on in the human body all the time and has been linked with aging but suggesting that beta-carotene because of its antioxidant effects protects the brain like lemon juice protects the apple is inane.
Just as zany was the next demo in which two pieces of plastic half-pipe representing arteries were shown with clumps of some white guck, supposedly deposits that lead to heart disease. Oz poured a gooey liquid, representing “bad fats” down one of the tubes, highlighting that it stuck to the goo. Then he proceeded to pour red palm oil down the other pipe and lo and behold, the deposits washed away. Totally meaningless and physiological nonsense. The homeopath then explained that saturated fats behave like thick molasses cruising through the cardiovascular system, but palm oil does not, despite being high in saturated fats. While saturated fats may lead to deposits, they do not do this by “thickening” the blood. Arterial deposits are the result of some very complex biochemistry and are not caused by “sludge” in the blood. Oz even exclaimed that this demo was indicative of how red palm oil reduces cholesterol in a month by 40%, better than drugs. A search of Pubmed reveals no such study.
The final demonstration involved Dr. Oz lighting a candle and a flare, without wearing safety glasses mind you. The message seemed to be that the body burns most fats slowly, but it burns red palm oil with great efficiency, preventing weight gain. Where does this come from? Possibly some confusion about medium chain triglycerides which are somewhat faster metabolized than other fats. But these are not found in palm oil. They are found in coconut oil and palm kernel oil. Oz and his homeopath expert were as confused about this as about the rest of red palm oil info they belched out.
Aside from scientists who took issue with the misleading information, animal rights groups also attacked Oz’ exhortations about the benefits of the oil claiming that it will lead to destroying larger stretches of the jungle, home to many wild creatures including the orangutan. They maintain that when the jungle is cleared every living creature is either captured or killed and adult orangutans are often shot on sight. A tragedy. Another tragedy is that Dr. Oz could be doing so much good if he just focused on real science, as he sometimes does, instead of drooling over the latest “miracle” as presented by some pseudo expert.
Joe Schwarcz, Ph.D., is the Director of McGill University’s Office for Science and Society and teaches a variety of courses in McGill’s Chemistry Department and in the Faculty of Medicine with emphasis on health issues, including aspects of “Alternative Medicine”. He is well known for his informative and entertaining public lectures on topics ranging from the chemistry of love to the science of aging. Using stage magic to make scientific points is one of his specialties.
Can we “train” our brains to be brighter, sharper, faster?
A while back I wrote a post about a big study looking at “brain training”. The researchers wanted to know whether training programs that look like video games (like Brain Age andLumosity) could significantly improve brain performance on various tests. The results, in a nutshell, showed that while participants improved on the tasks they trained on (e.g., if the game involved ranking balls from smallest to biggest, the participants got *really* good at ranking balls from smallest to biggest), the improvement didn’t carry over to general brain function.Turns out ranking ball sizes doesn’t help you remember where you left your keys this morning.
Two years later, what’s the word?
I’m going to shift a little from how I normally do things (review a single article) and tell you about findings I learned about at the recent Aging and Society conference. At the conference, several researchers talked about brain training in the context of aging. We know that as we get older our cognitive abilities decline – we forget names and words, misplace our shopping lists, and process information a little bit more slowly. Wouldn’t it be fantastic if we could just spend ten minutes a day playing games on our iPad and successfully counter this decline? Of course it would be fantastic. Not just for us, but also for the companies who are trying very hard to convince us to buy their products to improve our cognition.
The problem is that skills are specific. If you want to become a fabulous jazz pianist, you have to play the piano (preferably jazz songs, too). If you want to become a star ballet dancer, you have to practice ballet. If you want to become a better mountain biker, you have to mountain bike – road biking will improve your leg strength and fitness, but ultimately it won’t make you a better mountain biker. So why should things be any different for brain skills?
As it turns out, they aren’t. Two years later, nearly all the research conducted in the field of brain training is turning up the same results: people only get better at the tasks they trained on – the improvement doesn’t cross over to more general skills, different skills, or everyday life. In one study, a researcher compared a commercially available brain training program with what she called an “active control” – a group that simply played regular video games like Tetris. She found that the group who spent time on the commercially available brain training program actually saw some aspects of their cognition decline compared with the control group. Bummer.
Now don’t throw out your Brain Age game yet – everyone at the conference agreed that engaging your brain in training programs is better than not doing anything. And most of the researchers felt that while the programs don’t work now, it’s not to say they’ll never work. We are increasingly more knowledgeable about how the brain works, what happens when we get old, and what different training tasks do. So it’s quite possible that sometime in the near-ish future (don’t ask me when) we could see the advent of brain training programs that do have a significant and lasting impact on cognition.
Until then, there is one thing you can do to have a significant and lasting impact on your brain health… And I’ll tell you in the next post.
Dr. Julie Robillard is a neuroscientist, neuroethicist and science writer. You can find her blog at scientificchick.com.
The Boerewors Emergency Medicine Chronicles has a great post which I think is worth your time: On alzheimer’s
……..…I think it is beautifully written and provides a real window into the difficulty of loving someone who has this disease.
“The thing with this sentence, this arrest of dementia, is that its greatest victims aren’t those who have it. That’s not to say that the diagnosis isn’t dreadful for the recipient, but there is a peculiar and particular hammering sadness for those that love and care for an Alzheimer’s spouse or parent.
It is a wearying and lonely obligation, but with the added cruelty that the person you’re looking after vanishes, escapes before your eyes. In the end, you’re caring for the case that someone came in………”
Check out this post from @JordanGrumet who blogs at In My Humble Opinion: From Birth To Death Read more »
*This blog post was originally published at Suture for a Living*
Intranasal insulin stabilized or improved cognition and function and preserved cerebral metabolic rate of glucose in brain regions affected by Alzheimer’s disease, concluded researchers from a phase II trial. But more and larger trials are needed before any conclusions can be drawn, they also cautioned.
Insulin is important to normal brain function, and reduced insulin levels may contribute to Alzheimer’s disease, researchers noted. To examine the effects of intranasal insulin in adults with amnestic mild cognitive impairment or Alzheimer’s disease, researchers conducted a randomized, double-blind, placebo-controlled trial in a VA medical center.
The intent-to-treat sample consisted of 104 adults with amnestic mild cognitive impairment (n=64) or mild to moderate Alzheimer’s disease (n=40) defined as Clinical Dementia Rating scores of 0.5-1 and Mini-Mental State Examination scores greater than 15.
Participants received Read more »
*This blog post was originally published at ACP Internist*