Losing My Mind

An Intimate Look at Life With Alzheimer's

by Thomas Debaggio

Hardcover, 207 pages, Simon & Schuster, List Price: $24 | purchase

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Title
Losing My Mind
Subtitle
An Intimate Look at Life With Alzheimer's
Author
Thomas Debaggio

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Book Summary

At once an autobiography, a medical history, and a testament to the beauty of memory, a writer diagnosed with Alzheimer's disease a few months after his 57th birthday depicts the joys of life and how one can take them for granted.

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Excerpt: Losing My Mind

Excerpt


from Losing My Mind

That January, my fifty-seventh birthday, was pleasant and eventful and I beganto adjust to middle age. I no longer noticed how small facial lines becamewrinkles. I was active and happy. My son Francesco, home from California, joinedJoyce and me in the family herb-growing business in Virginia. I was equippedwith a thin body free of aches and pains. I looked forward to a life to rival myMidwestern grandmother's 104 years. I was buoyant and displayed, occasionally,the unbecoming arrogance of youth.

Then came a beautiful spring day later that year. It was the day after the testswere finished and the results reviewed. It was the day I was diagnosed withAlzheimer's. What time had hidden was now revealed. Genetic secrets, lockedinside before my birth, were now in the open. I became a new member in theparade of horror created by Alzheimer's.

At first I viewed the diagnosis as a death sentence. Tears welled up in my eyesuncontrollably; spasms of depression grabbed me by the throat. I was nearer todeath than I anticipated. A few days later I realized good might come of this.After forty years of pussyfooting with words, I finally had a story of hell totell.


*


My parents grew up in an orderly, gentle time, or so they remembered it. Theirepoch was also full of dirty secrets, enslavement, lynching, and two murderousconvulsive world wars. It was a time to need luck. They escaped the influenzaepidemic of 1918 and made it through the Great Depression of the thirties whenfood and jobs were scarce. Luck was with them in small Iowa towns named Eldoraand Colfax.

Instead of focusing on the explosive reality of their time, they created ahappier personal interval of their own imagining. This in turn created a greatoptimism in me and a gentle narrative of childhood tranquility. Soon I wasscared and uplifted, as were they, by the time of my time, a world ofconflagration, disorder, hope, ugliness, great beauty, and unnecessary death.Yet the imaginative world of kindness and promise they passed to me alwaysremained untouched by the ugliness of congested cities, immoral wars, andencompassing greed.


Here I am at the moment of truth and all I can muster are hot screams and scribbled graffiti torn from my soul. Moments of slithering memory now define my life.


After a short, mild winter, a vivid spring settled around us. The weather wastame and herbs filled a sunny patch next to the greenhouse. They were strong andvigorous now, especially the rosemaries, the thymes, the lavenders. Their scentsperfumed the air when I brushed by them.

The sun warmed the earth steadily and it was possible to spade and plant akitchen garden with early seed crops of succulent lettuce to sweeten and colorour meals. It was a spring in which you could be happy and a little carefree.There was much the earth had to say and you could hear it if you stayed quietand listened intently.

There was something else that spring and it was unnamable. As with all unknowns,it was unsettling and had nothing to do with the weather. It was not somethingthat gentle rains, bright sunny days, and an optimistic outlook would cure. Itwas an anonymous presence, yet I could feel its uneasy cadence. My memory, whichhad been a sacred touchstone, was failing long before I expected. I was losingthe ability to remember things important to me. I had difficulty recognizing thenames of many of my plants, and even friends I saw infrequently. I wasfifty-seven this year, and not eager to acknowledge that now I might be tied toa teetering mind that had begun a slow descent into silence.

A time or two I complained out loud that I could not remember things that theyear before had been brightly colored and detailed. I brushed off thoseincidents as forgetfulness due to stress, and there was stress aplenty, as therehad been always. Stress and worry were steady partners in my backyard farming,just as it was for the farmer in the great, flat Midwest with hundreds of acresof rich, black earth.

I made a living in my backyard for twenty-four years, growing and selling asmany as 100,000 herb and vegetable plants from my greenhouse each spring. Theentire operation, situated on a 5,000-square-foot lot, contained our family homeand a 1,600-square-foot greenhouse. It marked me as a new breed of urban farmerwho scorned grass and its wasteful, demanding cultivation. I made a living offthe land by selling directly to gardeners the potted plants I started from seedsand rooted cuttings and grew carefully in the greenhouse.

It had always been tough outwitting nature. It was a struggle the mind and bodyaccepted willingly by turning work into games. It was serious and enjoyable playfor me, but it was also my livelihood. My family depended on my ability to tamenature and use my guileless skills to attract customers. From the beginning, mytangle with urban farming was a test of my strength and acumen against nature'sunpredictability.

I was completing a doctor visit, a regimen that was new and uncertain to me,when my physician asked, "Is there anything you want to tell me?" He is athoughtful, no-nonsense man with a sly sense of humor, and the question may havebeen the kind of thing he often says as he winds up a session with a patient.

"Yes, there is," I said. He said nothing and waited for my words. "I am havingtrouble remembering things that are basic to my work, things I have known andnow can't remember."

There was silence while he looked at me. "I can give you a referral," he saidquickly, careful not to confuse or cheapen my predicament with some offhandremark. "And I will have the nurse take additional blood samples for the doctorI am sending you to."

I made an appointment to have the blood drawn the next day at the clinic. AfterI dressed, one of the doctor's assistants gave me a piece of paper with anotherphysician's name, address, and telephone number. I had never seen the namebefore and it meant nothing to me, but the address was a prestigious universityhospital. The first four of many vials of blood yet to be drawn were taken thenext day.


*


Alzheimer's disease was named nearly 100 years ago for Alois Alzheimer, a Germanwho first described the grisly effects of the disease. To gather his knowledge,he cut away the tops of several skulls from people who died of a mind-destroyingmalady, leaving them helpless, speechless, and as useless as a year-old carrot.He was probably the first to see inside a diseased brain and view the signaturefeatures of Alzheimer's, the sticky amyloid plaques and the twisted, hair-likethreads of the neurofibrillary tangles. Alzheimer's method of diagnosis afterdeath remains the only way to be absolutely certain of the disease even today.As a result, questions often remain about a diagnosis, a condition that eagercharlatans use to their advantage.


In a test of my memory and ability to learn new things, I came out "severelyimpaired" according to my neuropsychological evaluation. Doctors say I am at thebeginning of the disease's onslaught.

For a guy hardly sick in his life, this is a large, corrosive event. I am notalone. In a few years nearly half of those who reach eighty years old will havethe disease, according to the Alzheimer's Association. I am not so lucky inanother way. The disease is known to strike as early as thirty, but only a tinyminority falls in its clutches before the mid-sixties. At fifty-seven thedisease has been active in me for longer than I know.

Instead of bringing this disease into sunshine where we can learn about it anddo something, it has been too often hidden and misunderstood, closeted toprotect the living from its frightening consequences. Alzheimer's does not havethe drama of a heart attack or the thud of an automobile wreck.

Our understanding of the disease has been, until recently, held hostage by lackof knowledge. Now we know it was not undefined evil, profligate activity, orwitchcraft causing the strange behavior created by the disease. We are close tounderstanding mechanisms triggering this ghostly malady. The disease, or itspotential, appears to rest secretly inside us until its evil time arises and alanguid torture begins. This is a disease probably not caused by something youdid to your body. It is, most likely, a consequence of bad luck, subtle effectsactivated in the brain, and parents who carried corrupted genes.

The disease works slowly, destroying the mind, stealing life in a tedious,silent dance of death. Slowly the memory is impaired, and then you wander in aworld without certainty and names. Yesterdays disappear, except those long ago.Eventually there is a descent into silence and a dependence on caretakers. Handsother than yours feed and bathe you. A cipher takes your place amid the tubesand tragedy. By the end, Alzheimer's leaves its victims silent, quivering intheir flesh, awaiting the last rites. Some common illness often takes credit onthe death certificate.


I am alone and I can hear water running somewhere in the house. I don't remember going to the bathroom. Who else turned on the water?


This is an unfinished story of a man dying in slow motion. It is filled withgraffiti, sorrow, frustration, and short bursts of anger. While the narratorsuffers his internal spears, he tries to surround himself with memories in a wanattempt to make sense of his life and give meaning to its shallow substancebefore he expires. Although incomplete, the story is full of sadness and missedopportunity, a lonely tale of the human condition. Behind it is hope, thetortured luck of a last chance.


My Midwestern mother and father conducted a torrid romance, according to cousinPete. Every time my father returned to college after a holiday in Eldora, hesought a confessional priest, Pete remembers.

The secret transformation of my mother into a Catholic must have shocked myLutheran grandmother, but she remained loyal to her daughter. My father became alawyer, my mother a teacher.


Books set imaginations on fire in earlier times, and they continue to inspireand inform, but television and movies replaced much of the storytelling for mygeneration and left us hungry and naked, shivering for substance.


Alzheimer's disease is an irreversible, progressive brain disorder that occurs gradually and results in memory loss, unusual behavior, personality changes, and a decline in thinking abilities. These losses are related to the death of brain cells and the breakdown of the connections between them. The course of the disease varies from person to person, as does the rate of decline. On average, Alzheimer's patients live for 8 to 10 years after they are diagnosed; however, the disease can last for up to 20 years.

— "PROGRESS REPORT ON ALZHEIMER'S DISEASE,"
NATIONAL INSTITUTE ON AGING, 1999


This may be my last chance to dream.


The inspiration for this book appeared a few days after I was diagnosed withAlzheimer's. It was to be a word picture of the outside and inside, present andpast, of a man's naked struggle with the unknown on his way to trembling silenceand unexplainable torment without the torturer. It was a story of unleashedanger and beauty brought forth by an unseen illness, incurable and relativelylong-term in duration. I knew I was unable to write about all stages ofAlzheimer's because the disease causes cognitive decline and I will lapse into aworld without language and memory.

With any untreatable, disabling malady, victims become sensitized to everymovement of their body, every breath, searching for change and studying thecourse of the illness until it threatens to destroy friendships and the love ofthose around them. Writing about it may be a way to legitimize my almostcontinuous contemplation of the subject, and I hope it will allow me to leavethoughts of the disease locked up in the computer while I conduct everydayaffairs.

It is my intention to stay in the open with no secrets. I will hide nothing, noteven the inevitable self-absorption typical of such a disease. To retreat frommy lonely internal immersion with myself and the disease, I started a diary thathas become this book, as unique perhaps as the disease itself.


Sweet memory, the unreliable handmaiden of the past.


I was born in a wicked midwinter Iowa snowstorm and my father, proud and happyafter the delivery, took the news to his parents in their little restaurant afew steps from the hospital in Eldora, Iowa. I was taken home to a small whitehouse where many of my parents' friends arrived with good wishes and grand hopesfor the future.


Much news was made of the possible link between aluminum and Alzheimer's when larger than expected amounts of the metal were discovered in the brains of some people who died of Alzheimer's. Worried that aluminum might somehow promote the disease, many people began to throw away cans, cookware, cosmetics, antacids, deodorants, and other items containing the metal. However, studies of people exposed to large quantities of aluminum revealed no increased incidence of dementia. Most likely, the deposition of aluminum in brain tissue is a result — not a cause — of the factors that underlie the dementia. (Incidentally, more aluminum leaches into soft drinks from glass bottles than from aluminum cans, which are coated with a fine veneer of plastic.)

— THE JOHNS HOPKINS WHITE PAPERS, "MEMORY,"
1999


I am back from the drugstore with my packet of pills, prescription number 736631from the CVS pharmacy, four blocks up the street. The pills have in them apharmaceutical called Aricept, the trade name for donepezil HCl, the commonlyprescribed medication for Alzheimer's at the time. The doctor told me the mostcommon side effect is diarrhea. Boy, was he right.

I don't know whether to love these little round things or hate them. The pillsare tiny and buff colored and on one side a "10" is stamped into it to designateit as a 10-milligram tablet and on the opposite side is the word Aricept. Istarted taking half of one of the tablets at bedtime. After five days, I wasdirected to take an entire tablet when I go to bed (later I began taking asecond tablet before breakfast). Aricept was the second pharmaceutical developedfor Alzheimer's and is now the most widely used medicine available, but at itsbest it can slow the destruction of brain cells temporarily.

The doctor also prescribed two over-the-counter medications to take daily: twovitamin E soft gels, each 1,000 international units, about 6,666 times more thanthe normally recommended dose, and a single Ibuprofen tablet. This combinationof drug and vitamins is all medical science can do for me nearly 100 years afterAlzheimer's was scientifically described. It seems a weak armada to defendagainst eager memory destroyers working in my brain. I am a citizen of a countrythat has sent mankind to the moon. It is sadly ironic but that is all medicalscience can do, when we spend billions to send men into outer space to look atrocks.


I am happy today. I realized this was not yet a posthumous tale.


The brain does many things to ensure our survival. It integrates, regulates, initiates, and controls functions in the whole body, with the help of motor and sensory nerves outside of the brain and spinal cord. The brain governs thinking, personality, mood, and the senses. We can speak, move, and remember because of complex chemical processes that take place in our brains. The brain also regulates body functions that happen without our knowledge or directions, such as digestion of food.

— "PROGRESS REPORT ON ALZHEIMER'S DISEASE,"
NATIONAL INSTITUTE ON AGING, 1999


How do you express the true nature of tears in words? How do you define the limits of evil born of a secret disease? These thoughts lie silently on my mind and work their way through my body.


In geriatric clinics, about 5 to 10 percent of the patients seen for memory impairment have reversible dementia due to medication. Some of the medications that may cause memory impairment include the anti-inflammation drug prednisone (Deltasone, Orasone, for example); heartburn drugs such as cimetidine (Tagamet), famotidine (Pepcid), and ranitidine (Zantac); anti-anxiety/sedative drugs such as triazolam (Halcion), alprazolam (Xanax), or diazapern (Valium); or even insulin, which at too high a dose can cause hypoglycemia (abnormally low blood sugar)....Alcohol is the most prevalent intoxicant implicated in dementia. Fortunately, as is often the case with other drugs, the negative effects of alcohol on intellectual abilities can be reversed with abstinence, though chronic abuse may lead to permanent damage.

— THE JOHNS HOPKINS WHITE PAPERS, "MEMORY,"
1999

Before the end of my first year, my mother and father became immigrants and tookup residence in an apartment in Washington, DC. It was a sleepy Southern townwith a twang, and racial segregation was strictly enforced. Half a continentseparated me and my birthplace, and more than miles divided them. My father wentto work for the Bureau of Narcotics. It was half a lifetime, and many changesand surprises, before he returned to live in Eldora again.


I don't know if any of us can be prepared for what is to come. It is hard to prepare for the sly tricks and sorrows of tomorrow. Better we hug each other more often and forget the creeping sadness that we know will overcome us.

*

The lovely long spring with its silken days and sweet breezes was still upon usas I readied myself for the days ahead with their promise of quick forays intothe specialist medical community. The sun was almost ever-present and in theafternoon you could peel off the layers of clothing that were no longernecessary. The fresh, moist air of the greenhouse was filled with the fragranceof herbs and the rich, earthy aroma of wet peat moss. I learned to gauge my lifeby the seasons and their tempestuous churnings often mirrored my life.

There was always the work with its long, exhausting ninety-hour weeks, standinguntil my legs felt like stiff poles. I was in close quarters with customerspumping me for information and demanding horticultural surrender. Nature was thechief disrupter and it created the most damaging surprises and produced the mostfearful stress, especially during the early spring when sudden weather changesthreatened to quickly kill our carefully nurtured stock. Joyce and I talkedabout these things and the stress of the work and how it might cause temporarymemory loss and I thought my memory problem was of a low order and was notserious.

I always believed the less I saw of doctors, the better I would be. There was atinge of fear in me now, perhaps because I had no idea who this new doctor wasand what he might find in me. I hoped it would not be a thing that had lainsilent for so many years, the cancer that took my mother, or the bad heart of myfather.

Having avoided doctors most of my life made them special and my lack ofinteraction with them meant I did not understand how they behaved. In my worlddoctors were receptacles of knowledge that you went to when the home medicinechest didn't work. My avoidance of the medical profession may have been partchildhood fear, but the truth was that I had never needed much help fromdoctors. I rarely got sick, even with colds.

The doctors I have known are few, but memorable. I saw a doctor when I was achild and I can still remember the tall, youthful, balding Dr. Ashenbaugh, towhom my parents took me after we moved to Washington, DC, from Iowa. He was anold-time family practitioner, by choice, not age, and he was careful to explainthings even to kids. He was always available by telephone and made occasionalhouse calls. Once he gave me a thermometer.

It was Dr. Ashenbaugh who had come to my aid when, as a two-year-old, I gotunder my mother's feet in the kitchen and caused her to spill boiling spaghettiwater on my back. The sweatshirt I was wearing quickly became saturated and hadto be cut off my back. I carry the burn scars today. For years as a youngster, Iwas afraid to let any other child see me without my shirt for fear they wouldmake fun of my scars, which were prominent, ugly disfigurements.

There was another doctor I saw just after I finished high school. A girlfriendsuggested him because her mother knew him through work she did at a clinic. Hewas a splendid fellow and took time to tell great stories. As a young man, hehad been a sailor on a cargo ship that had gone around the horn of Africa and herecounted exciting events that took place during his adventure.

While staying away from doctors had worked well over thirty years, separationfrom them was quickly coming to an end. I was now on the verge of seeing moredoctors, nurses, and specialists than I had seen in all my previous years.


Once a disease is named, especially if it is Alzheimer's, you begin to understand it and that means recognizing it in everyday things. It is not long before you are under the spell of the disease. Its heartbeat is your heartbeat. There is danger here in trying to understand evil, especially when it is so close to you, gaining control of your brain. I worry I will become too conversant with this disease in me, and it will hijack my life with my permission.


Alzheimer's affects as many as four million Americans; slightly more than half of these people receive care at home, while the others are in many different health care institutions. The prevalence of Alzheimer's doubles every 5 years beyond the age of 65. Some studies indicate that nearly half of all people age 85 and older have symptoms of AD.
— "PROGRESS REPORT ON ALZHEIMER'S DISEASE,"
NATIONAL INSTITUTE ON AGING, 1999


I was not an immigrant like my grandfather who came with his father to Americafrom northeastern Italy in 1892 when he was nine years old. SteamshipWerra was slow and the food bad, he said. Going from Enrico in Italy toHarry in Iowa, he had no accent and read Shakespeare though his father took himout of sixth grade to put him to work. He and my grandmother Lottie were stuckwhen a ferris wheel stalled, leaving them high above the ground. It was aperfect place for romance and soon after they married.


The cognitive changes of dementia — impairment of memory, learning, attention,and concentration — can occur in depression and make diagnosis more difficult.In general, however, a person is most likely suffering from depression if he orshe has a history of psychiatric illness or has a sudden onset of cognitivesymptoms, difficulties with sleep, or precipitation of symptoms by an emotionalevent. Also, depressed patients often complain that they're unable toconcentrate or remember things, while those with dementia are generally unawareof any mental problems. For example, when depressed persons are asked aquestion, they are likely to say, "I don't know the answer." By contrast,someone with Alzheimer's disease might try to answer, but be unable to do socorrectly.


I start thinking about something intently and then my thoughts wander through fields of memory and I bob to the surface suddenly and wonder for a moment who I am, and whether I have truly lost my mind.
In Alzheimer's disease, communication between some nerve cells breaks down. The destruction from Alzheimer's ultimately causes these nerve cells to stop functioning, lose connections with other nerve cells, and die. Death of many neurons in key parts of the brain harms memory, thinking, and behavior.
— "PROGRESS REPORT ON ALZHEIMER'S DISEASE,"
NATIONAL INSTITUTE ON AGING, 1999


Suddenly I am surrounded by clutter. I look around my room. To the right of thecomputer is my desk. Floating on the desk are deep piles of paper, scatteredenvelopes, hastily scribbled notes. File folders full of papers almost cover thetelephone, the two answering machines, and the fax. A white straight-sidedcoffee cup with blue lettering proclaiming Lawrence Welk Resort Village isstuffed with pens and a few pencils. A wire rack designed to hold envelopesbulges with bills. A bright-red Webster's New World Dictionary, secondcollege edition, leans against the fax machine. The far corner is home for racksof file folders, my last attempt to bring order on the desktop, but they areholding piles of books and random sheets of paper. On top of the pile is one ofmy favorite books, My Summer in the Garden, by Charles Dudley Warner,published in 1874. Inside the front page is an inked inscription in clearscript, "Abby Bassy, July 1, 1875." It was a gift from one of my customers yearsago when I was smitten with Warner's garden writing.

On my left, there is better order but there are piles of books on top of booksas well. I can hardly move around the floor. I have maintained, so far, atwelve-inch-wide path in which I can see the bare, dark wooden floor.

Elsewhere there are fall garden catalogs that will eventually be mailed, fourpair of leather boots, two ready to be thrown away. There is also an assortmentof large, open paper bags, empty and awaiting duty. The tops of the filingcabinets are covered with stray papers and books. Notes hang from the calendarattached to the white cabinets on the wall above my desk.

There is more of this mess that need not be cataloged. This is a tragedy for aman who was once tidy but it is a snapshot of a room that mirrors my brain, ajumble of words awaiting order with nowhere to go. Meaning is lost in a hurriedmoment, a word lost in confusion is never recovered. So it is that Alzheimer'sbegins its conquest.


*


The dusty, flat earth next to our apartment was perfect to catch breezes on hotevenings. Men in undershirts and slacks gathered to test horseshoe skills. Myfather took me to this place of competition and camaraderie. Sweat beaded onarms and chests from exertion and heat. Heavy metal horseshoes made yellow claysmoke. A hurrah clang of metal was heard as a horseshoe slid in high for aringer.


On March 23, 1999, I went to the National Rehabilitation Hospital for aneuropsychological evaluation. On May 6, 1999, I underwent a fullneuropsychological evaluation. It was numbing and took about six hours. Testresults were as follows:


INTELLECTUAL: On the NART (National Adult Reading Test) which is used to estimate pre-morbid intellectual functioning, the patient obtained an estimate pre-morbid IQ score of 124 which is indicative of superior pre-morbid intellectual functioning.
On the WAIS-R, the patient obtained a Verbal IQ=93, a performance IQ=91 and a FSIQ=91. These scores all fall at the lower end of the range of intelligence classified as average. There was significant sub test variability in verbal sub test scores. On vocabulary, the patient obtained an above average score. Fund of general information, digit span and verbal concept information were in the average range.
Verbal numerical reasoning was mildly impaired. On a sub test of social judgment and practical knowledge, the patient obtained a mildly to moderately impaired score. When asked what to do in the movie theater if he were the first person to notice smoke and fire, the patient responded, "yell fire." He did not know why it is better to borrow money from a bank than a friend and why a marriage license is required. On performance sub tests, the patient obtained average to low average scores on all sub tests except on picture completion on which he obtained a mildly impaired score. Picture completion requires the patient to discriminate essential from nonessential details.
— NEUROPSYCHOLOGICAL EVALUATION


Within a few months of my diagnosis, I am well aware of my cognitive loss and I can track Alzheimer's disruptive work during the day, but it is minor and subtle.


Nerve cells in the brain have the capacity to last more than 100 years.

"PROGRESS REPORT ON ALZHEIMER'S DISEASE,"
NATIONAL INSTITUTE ON AGING, 1999


I began writing seriously over half a lifetime ago and when I began, as ateenager on a local daily paper, I floated above the earth with excitement. Withexperience, I no longer floated but I was rooted to a place. I was bent onuncovering life's joys and its illusions. Now writing is like walking through adark room. Sometimes I have to get down on my knees and crawl to find a paththrough the silent jungle where words are not easily picked and meaning isuntrustworthy.


There are many days of elves and magic when you are small and young in the world. It is a time without routine and rules flower with baby talk, a language without lexicon, pregnant with the breath of milk and time.


Memory and New Learning: On the WMS-R, the patient obtained the following index scores: Verbal=54, Visual=57, Attention=88, and Delayed Recall=58. These scores are all severely impaired except for attention which is low average. The patient's recall for paragraph length story material was performed at the 2nd percentile upon immediate recall and at the first percentile upon delayed recall. Immediate recall of designs was performed at the 4th percentile and delayed recall of these designs at the first percentile.

— NEUROPSYCHOLOGICAL EVALUATION


The small white house on 14th Street was the first my parents owned after movingeast. It resembled the white house left behind in Eldora but it was set at therear of the lot and grass ran to the street where a tangle of rosebushes burstinto flame in spring.


Every healthy person has 46 chromosomes in 23 pairs. Usually, people receive one chromosome in each pair from each parent. Chromosomes are rod-like structures in the cell nucleus. In each chromosome, DNA forms two long, intertwined, thread-like strands that carry inherited information in the form of genes.

— "PROGRESS REPORT ON ALZHEIMER'S DISEASE,"
NATIONAL INSTITUTE ON AGING, 1999


Getting used to the idea of dying is difficult, emotionally and physically, but what awaits me is losing the idea of dying and that is incomprehensible and at the same time it may be liberating.


Neurofibrillary tangles are abnormal collections of twisted threads found inside nerve cells. The chief component of tangles is one form of the protein, tau. In the central nervous system, tau proteins are best known for their ability to bind and help stabilize micro tubules (the cell's internal support structure skeleton).
In healthy neurons, micro tubules form structures like train tracks, which guide nutrients and molecules from the bodies of the cells down to the ends of the axons. In cells affected by Alzheimer's these structures collapse. Tau normally forms the "railroad ties" or connector pieces of the micro tubule tracks. However, in Alzheimer's tau can no longer hold the railroad ties together, causing the micro tubule tracks to fall apart. The collapse of the transport system first may result in malfunctions in communication between nerve cells and later may lead to neuron death.
In Alzheimer's, chemical altered tau twists into paired helical filaments (two threads wound around each other). These filaments are the major substance found in neurofibrillary tangles.
— "PROGRESS REPORT ON ALZHEIMER'S DISEASE,"
NATIONAL INSTITUTE ON AGING, 1999


Copyright © 2002 Thomas DeBaggio.
All rights reserved.
ISBN: 0-7432-0565-0