demented

Dr. Gary Small’s The Naked Lady Who Stood on Her Head: Brain Fog

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(Edi­tor’s Note: what fol­lows is an excerpt from Dr. Gary Small and Gigi Vor­gan’s new book, The Naked Lady Who Stood on Her Head: A Psy­chi­a­trist’s Sto­ries of His Most Bizarre Cas­es)

CHAPTER TEN

Brain Fog

Sum­mer 1990

Gigi and I had moved to Stu­dio City, about a forty-minute com­mute to UCLA. On week­ends, we often went to the movies at Uni­ver­sal City­Walk, a repli­ca­tion of Los Ange­les with­in Los Ange­les. Why peo­ple couldn’t just walk down the real streets of Los Ange­les made no sense to me, yet there we were, on a Fri­day evening, eat­ing ice cream and strolling down a sim­u­lat­ed street.

We had just seen Total Recall, Arnold Schwarzenegger’s new sci­encefic­tion film about a con­struc­tion work­er who under­goes a false mem­o­ry trans­plant that takes him on an imag­i­nary trip to Mars. But things go wrong, and when he comes out of it, he can’t tell what’s real and what’s imagined.

“When he first got back from Mars, there were so many signs that he was from the future that I believed it,” I said.
“But hon­ey, before he had that mem­o­ry implant done, he was per­fect­ly hap­py liv­ing in the present—on Earth. Then he got all paranoid.”
“Of course he did. How do you know what’s real­i­ty if you can’t trust your mem­o­ry?” I asked.
“I don’t know; you’re the mem­o­ry expert. I want to go into this shop for a minute.” Gigi dis­ap­peared into a record store.

As I ate my ice cream and watched the crowds, I kept think­ing about those ques­tions. If two real­i­ties seem equal­ly true, how would you know which ver­sion to believe? Many of my patients strug­gled with sim­i­lar issues, whether they were psy­chot­ic, dement­ed, or sim­ply hav­ing mem­o­ry problems.

Over the past few years, I had begun to con­cen­trate a large part of my prac­tice on mem­o­ry issues—not just in old­er patients with Alzheimer’s dis­ease but in mid­dle-aged peo­ple who were wor­ried about their increas­ing for­get­ful­ness. My research was also focus­ing on ear­ly detec­tion of demen­tia and age-relat­ed mem­o­ry decline, and I was devel­op­ing brain imag­ing as a diag­nos­tic tool.

Gigi came back with a bag of CDs and said [Read more…] about Dr. Gary Small’s The Naked Lady Who Stood on Her Head: Brain Fog

Education builds Cognitive Reserve for Alzheimers Disease Protection

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Giv­en the grow­ing media cov­er­age men­tion­ing the terms Cog­ni­tive Reserve and Brain Reserve, you may be ask­ing your­self, “What exact­ly is my Cog­ni­tive (or Brain) Reserve?”

The cog­ni­tive reserve hypoth­e­sis, test­ed in mul­ti­ple stud­ies, states that indi­vid­u­als with more cog­ni­tive reserve can expe­ri­ence more Alzheimer’s dis­ease pathol­o­gy in the brain (more plaques and tan­gles) with­out devel­op­ing Alzheimer’s dis­ease symptoms.

How does that work? Sci­en­tists are not sure but two pos­si­bil­i­ties are considered.
1. One is that more cog­ni­tive reserve means more brain reserve, that is more neu­rons and con­nec­tions (synaps­es) between neu­rons. Indi­vid­u­als with more synaps­es would then have more synaps­es to lose before the crit­i­cal thresh­old for Alzheimer’s Dis­ease is reached.
2. Anoth­er pos­si­bil­i­ty is that more cog­ni­tive reserve means more com­pen­sato­ry process­es. The brain of indi­vid­u­als with more cog­ni­tive reserve would use more alter­na­tive net­works to com­pen­sate for the dam­ages caused by the pathol­o­gy in pre­vi­ous­ly used networks.

In a new­ly pub­lished study, Roe and col­leagues brain fitness event from Wash­ing­ton Uni­ver­si­ty in St. Louis, used the num­ber of years of edu­ca­tion as a mea­sure of cog­ni­tive reserve. Why years of edu­ca­tion? Because pre­vi­ous stud­ies have shown that peo­ple who have more edu­ca­tion also exhib­it a greater resis­tance to Alzheimer’s symp­toms, even while patho­log­i­cal changes are occur­ring in the brain (see Ben­nett el al., 2003 or Roe, Xiong, et al., 2008).

Roe and her col­leagues stud­ied 198 indi­vid­u­als whose mean age was 67. Out of these 198 indi­vid­u­als, 161 were non­de­ment­ed and 37 were diag­nosed with Alzheimer’s Disease.

All the par­tic­i­pants in the study took a [Read more…] about Edu­ca­tion builds Cog­ni­tive Reserve for Alzheimers Dis­ease Protection