So I self-prescribed the lifestyle changes I would have suggested to my patients in the same position. I adopted a strategic regime of more exercise, with more of it aerobic, a modified Mediterranean diet called the MIND diet, with special emphasis on brain-healthy foods, and everyday activities that kept me socially active and mentally stimulated: daily crossword puzzles, reading six to ten books per month. I became my own longitudinal study of one.
Over the past five years I’ve been accepted into four clinical trials. I recognize that the chance of me personally benefiting, in terms of prolonging my life or slowing progression of my Alzheimer’s is very small. What I hope is that my participation will benefit the next generation, so that Alzheimer’s becomes a controllable disease within my children’s lifetime, if not mine.
Because early-stage Alzheimer’s like mine ranges from no symptoms to relatively mild ones, I generally don’t dwell on the darker aspects of the late-stage disease. But I know them well.
I am a neurologist, not a psychiatrist or psychologist. But in my experience, someone’s fear of the future as they come to terms with a diagnosis can often be debilitating beyond the burden of the physical illness itself. This is especially true for Alzheimer’s disease because it attacks the brain, and that alone is terrifying for most people.
Fear of that projected future hijacks any thinking about the present and its realistic possibilities. Fear has kept countless others from exploring available options at the earliest sign of impairment, or kept them from sharing their diagnosis with family, which leaves them alone to manage their growing fear and symptoms as their cognitive impairment progresses. And most devastatingly, fear has driven individuals to end their lives prematurely.
My hope is that as we discover and communicate more about the earliest stages of Alzheimer’s, long before symptoms begin to emerge, we can normalise the conversation and help more people seek out the professional guidance and sometimes the medication that might help them the most.
The seemingly quirky olfactory issues that came up for me are a good example. As research now confirms, almost all people with Alzheimer’s disease have at least some impairment of the ability to smell, but over 90 percent of them are unaware of this until tested. Since they tend to be tested only when other symptoms of cognitive decline or changes in behavior have begun to emerge, they are typically in the later stages of the disease. By then it’s too late.
The Covid-19 pandemic has forced us all to confront our mortality, to grieve losses and, for many, to live in dread of an uncertain future. What I realised in the past year was that the conversation about Alzheimer’s has long been stuck on fast-forward to the late-stage loss, the fear and stigma of the disease, not recognizing the years, even decades of meaningful time that can be maximized with early diagnosis and treatment.
There now is overwhelming evidence that, during the ten to 20 years before the onset of cognitive impairment, the simple lifestyle changes I mention above and will detail in the *Telegraph* tomorrow can markedly slow the progression of Alzheimer’s. I believe that a cure will eventually be found, but until that happens we need to focus on these early stages, before memory and a fundamental sense of self disappears. There is no time to lose.
- Monday: Dr Daniel Gibbs’s five anti-Alzheimer’s strategies
Extracted from A Tattoo on my Brain by Daniel Gibbs and Teresa H. Barker (£18.99, Cambridge University Press). Buy now for £16.99 at books.telegraph.co.uk or call 0844 871 1514