Ordinary Forgetfulness, Or Alzheimer’s?

The Neal side of our family, unfortunately, has a history of dementia and Alzheimer’s disease that has been growing lately.  Mom and Grandma Neal had dementia, Uncle Gilbert had Alzheimer’s, and my great-aunt, who another relative described as “crazy as a bedbug” when I was a kid, had mental problems so debilitating that she was put into a care facility at about the time she reached retirement age.

When you’ve got such a history in the family, and seen what these terrible degenerative brain diseases can do to bright, kind, loving people, you can’t help but wonder if there is a gene lurking somewhere in your DNA mix that will ultimately turn you down that same dark street.  And, you also pause at every instance of forgetfulness and ask yourself whether it is a sign that the dreaded downhill slide has begun.

It’s important to remember that an infallible memory is not part of the normal human condition.  With the richness of daily experience flooding our brains with new memories during every waking moment, it’s entirely normal to not remember every incident or person from the past with perfect clarity.  And the memory failure that most frequently causes people to question whether they’re losing it — the mental block that leaves you temporarily unable to recall a name, or a word — is commonplace in healthy, average humans.  Other normal issues include the tendency to forget facts or events over time, absent-mindedness, and having a memory influenced by bias, experiences or mood.

Fortunately, too, there are tests that can be taken that can help doctors distinguish between these ordinary conditions and the onset of dementia or Alzheimer’s.  The tests range from simple screening tests of cognitive functioning that can be given by a family doctor as part of an annual exam and completed in a few minutes to intense and extensive neuropsychological examinations that involve multiple days of evaluation.

The existence of such tests raises an interesting question.  Aging Americans are routinely poked, prodded, and scanned for heart disease, cancers and other bodily ailments.  Even though, for many of us, the prospect of being diagnosed with Alzheimer’s is as dreaded as any finding of a debilitating physical disease, there seems to be less of a focus on early detection and treatment of degenerative mental diseases.  With recent studies showing that significant percentages of older Americans are afflicted with dementia, shouldn’t that approach change?  Why shouldn’t a short cognitive screening test be as much a part of the annual physical as the rubber-gloved prostate probe?

Aged Dating

Recently we were out for dinner with the Bahamians at one of the better local restaurants.  As we enjoyed our meal, a 60ish woman who knew our friends from years before stopped by our table to say hello to them.

The woman was wearing a skin-tight black mini-dress that ended about six inches above her kneecaps, with an exposed shoulder and stiletto heels.  It was the kind of skimpy, clingy outfit that demanded a supermodel’s figure, and this woman didn’t have one.  It obviously wasn’t a comfortable ensemble for her, either.  Throughout our brief interaction at the table, she was tugging the dress up toward her exposed shoulder, and tugging it down at her hem, trying to limit the overexposure of her permatanned flesh.

So why was this middle-aged woman wearing an ill-fitting garment that looked like it was hard for her to take a breath?  She explained that she had gotten divorced and was out on a date with a new guy, and made some rueful observation about how the dating world was tough for people our age.  Then her date appeared at the doorway and she went teetering unsteadily away, adjusting her dress, again, and touching up her bleached blonde hairdo.

It was an awkward moment.  Kish and I didn’t know the woman, but we immediately felt both sorry for her and . . . confused.  Sorry for her, because she looked ridiculous and miserable, and confused, because she apparently recognized that fact and elected to wear an outfit that wasn’t close to being age-appropriate, anyway.  Evidently she was  desperate for male attention, but did she really think that wearing something that left nothing to the imagination was the way to achieve that goal?  Her outfit seemed to say a lot about her confidence in her personality and other attributes and about her sense of what middle-aged men are looking for on a date — neither of which was positive.

It was a depressing encounter on a lot of levels.  It made me appreciate, once again and for countless reasons, how very lucky I am to be happily married.

When I’m 65

Last week I was walking home from work when I saw the shoe shine guy outside the Key Bank building.  In the past he’s offered a shoe shine, in a very friendly way, and this time I made the spur of the moment decision to accept his offer.  Why not take a few minutes for an old-fashioned personal service and come home with some spit and polish?

He turned out to be a good guy who did a really fine job on my shoes, and I’d definitely recommend him and use him again.  As I sat in his chair and we talked, however, the conversation turned to our ages, and the shoe shine guy guessed that I was . . . 65.

IMG_5157“65?  Wait, seriously — 65?”  I was somewhat flummoxed.  “I’m only 57!” “Sorry.  I guessed wrong,” the shoe shine guy said, and then he went back to his work, flipping his brushes and applying his polish and snapping his towel as I stewed about the fact that I evidently look almost a decade older than my actual age. I gave him a good tip when he was finished and then headed home, trying not to walk with an old guy shuffle.

Kish gets a kick out of this story, and so do I.  I’ve never been vain about my appearance because there’s absolutely nothing to be vain about:  I’m about as average-looking as you can get.  I know that as I’ve put on mileage I’ve acquired grey hairs and creases and wrinkles I didn’t have before.  I’ve always thought, however, that you’re only as old as you feel and have tried to maintain a youthful attitude.  Now I know that rationalization doesn’t apply to the exterior me — the shoe shine guy has confirmed it.  If a guy who is working for a tip overshoots by eight years on his age estimate, you’ve got no room for argument or self-deception.  You’re squarely in AARP territory.

Today, as I celebrate birthday number 58, I’ve adopted a more nuanced perspective on the shoeshiner’s comment.  Who wants to look like a kid, anyway, and fret about whether their skin is smooth and their hair has the dewy sheen of youth?  Why not embrace with the Keith Richards alternative instead?  I apparently look like I’ve packed a full 65 years of living onto my 58-year-old frame.  That’s not a bad thing in my book.

A Disturbing Sign Of Approaching Codgerdom

Yesterday morning I was at my desk at the office, innocently attending to work, when the email chime sounded.  I gave the new message a quick glance, saw that it was a sales pitch, and moved my hand to hit the delete button — when I realized that the email message had a very disturbing subtext to it.

The “re” line read:  “Walk-in Bathtub Right For You?  Free Brochure.”  The email, from “America’s Leader in Walk-In Tubs” — no doubt a highly competitive field — featured a color photo of a walk-in bathtub described as “the first walk-in bath commended by The Arthritis Foundation.”  And if that stamp of approval wasn’t enough, other bullet points in the email read “Make Bathing Safe and Easy,” “Ideal for People with Limited Mobility,” and “Hydrovescent Therapy for Gentle Massage to Help Ease Away Your Aches and Pains.”

Yikes!  How did I get on the list for this depressing email solicitation?  When “America’s Leader in Walk-in Tubs” thinks that a walk-in tub might be “right for you,” you might as well hang up the spurs and head to the old folks’ home.  You’re obviously presumed to be decrepit and incapable of attending to basic personal hygiene using standard devices.

The email gave me the option of clicking for a “free information kit” about the virtues of that walk-in tub, but I think I’ll pass on any action that would confirm my place on a codger email list.  My youthful self image won’t stand up against an inbox filled with email solicitations for Serutan, trusses, walkers, sensible shoes, retirement communities, and deals on prescription medication.

An Extra Hour

“Spring ahead, fall back.”  The shifting of hours and the changing of clocks in connection with Daylight Savings Time has been going on for as long as I can remember.

As I’ve gotten older, though, I’ve come to appreciate the “fall back” part of the process more and more.  What the heck!  It’s autumn, and it’s getting colder.  Why not stay snug in your warm bed for an extra hour?  And after staying out later than normal last night, getting home after midnight after enjoying the Buckeyes’ drubbing of Illinois at Ohio Stadium, the extra hour of shut-eye is even more welcome.  The fact that it’s a shivery 28 degrees outside just confirms the wisdom of this timekeeping sleight-of-hand.

So I’d like to thank the ever-creative Benjamin Franklin, who came up with the concept of Daylight Savings Time in 1784 as a method to save on candles.  I’d like to thank the New Zealanders, Brits, and Germans who helped to popularize the idea, and Franklin Delano Roosevelt, who implemented the idea in America as a war-time measure during World War II.  And I’d like to thank the United States Congress, which enacted the Uniform Time Act of 1966 to finally implement Daylight Savings Time as we now know it.

Ben Franklin was all of 78 years old when he came up with the idea for shifting clocks to save a candle or two.  You think the idea might have been motivated by the notion of getting an extra hour of sleep on a cold autumn morning?

Slowing The Aging Process

Mention “aging” to someone in their 50s — like me — and you’re likely to provoke a grim expression.  We feel the aging process in our muscles and bones, we get that ugly twinge after a sudden move, and we see it when we look in the mirror and notice the grey hairs, the wrinkles, and the pathetic turkey neck.

But what if aging could be slowed?  What if therapies and treatments could be developed that would decelerate the ravages of time, or stave it off altogether?

Scientists are looking into the possibility that gene therapy, hormone treatments, and other approaches might have that effect and have been using some of the new treatment concepts in experiments on animals.  Economists believe that treatments that successfully delay aging — and thereby allow people to be productive and healthy longer — could have enormous economic consequences.

Speaking as one of the aging generation, I’m all in favor of seeing whether reasonable treatments can be developed.  At the same time, however, I question whether heroic efforts should be devoted to deferring the effects of aging when there are many other public health issues that also need attention.  And a public health focus on aging makes sense only if the years that are added are healthy, sane, active, non-institutionalized years.  When you regularly visit a nursing home and see how many Americans are living their final years, you can legitimately question whether living longer is inevitably a great thing.

When Death Knocks, And Knocks, And Knocks

When you reach your 50s, as Kish and I have, part of life is dealing with death.  Whether it is more senior members of your family succumbing to age-related conditions, or colleagues who die in inexplicable, tragic accidents, or friends who finally are taken down after long battles with cancer, at some point death becomes a significant, unfortunately recurring part of the reality of your life.

IMG_1087The question is how to deal with the losses, particularly when the deaths come in bunches — as so often seems to be the case.  People find themselves grappling with complex combinations of emotions that they don’t typically experience at the same time — such as grief, and guilt, and also anger — and everyone needs to deal with them in their own way.  When multiple deaths hit in a short period of time, and strike down people who are about your age, you can’t help but think of your own mortality, and wonder. 

Kish and I try to go to calling hours or memorial services, as a kind of tangible sign to the surviving family members of the significance and impact of the departed; I’m not sure whether the family members appreciate it or not, but it makes us feel better.  Collecting your thoughts about the person, mentally composing your own personal tribute, and focusing on the good, also seems to help.  And as we’ve gotten older, and seen how people respond to such losses in different ways, I find that I’ve become a lot less judgmental and a lot more accepting about how people respond.  

Ultimately, though, you just hope that the period of bad news finally ends, and a period of good news begins.  We’ve got a family wedding coming up, and we’re looking forward to it.