By: David H. Brown
The neurologist said three simple words and asked me to repeat them. They were “apple,” “tree” and “desk” — or something like that. Single-syllable nouns. Then he asked me to repeat them. And then he asked me to repeat them again. After five, six or maybe more times, I thought it was getting a little silly, but he continued.
He then asked me to subtract seven from a number, 100 I believe, and then subtract seven again from the difference. He had me continue subtracting sevens from the differences a few more times, but I realized I had no idea if I was giving him correct answers — and I wasn’t. This was startling because, in my careers as a nuclear engineer and high school physics teacher, the ability to do math in my head was stock in trade. He then went back and asked me to repeat the three words. I was stunned when I could only remember one of them. I recalled a few years earlier I’d been given a similar but more comprehensive test for long-term care insurance, and I’d remembered perhaps nine out of ten words after about 45 minutes.
I had come to see the neurologist because I was experiencing problems with memory and with my ability to navigate the daily challenges of life. It was 2015, and I was 65 years old. My visit left me bewildered and frightened.
The neurologist referred me to the Memory and Brain Wellness Center at Harborview Medical Center in Seattle, where they subjected me to hours of testing and a brain MRI. As it happens, I had an MRI of my brain from a couple of years previous, and the doctors could compare the new MRI with the old. A few weeks later, the Harborview neurologist, the neuropsychologist, a social worker and other staff sat down with my family and me to tell us the results. They confirmed my home neurologist’s conclusion that I had mild cognitive impairment (MCI) which he had attributed to likely Alzheimer’s disease (AD). They were very sorry. They had based their diagnosis on the cognitive test scores which were below expected for my education and career along with evidence from the MRI of atrophy of my brain, especially my hippocampus. I should expect the condition to progress. I don’t remember if anyone spoke the word “dementia,” but it hung in the air.
They said that they didn’t have any medications, but they gave me some advice: reduce stress, eat a Mediterranean diet, get regular exercise, stay connected in my job and a few other things. After returning home, a search on “mild cognitive impairment” on the internet scared the pants off of me: I was at a significantly increased risk for developing dementia. Because the MCI had sprung up so quickly on me and seemed to be progressing so rapidly, I was sure that I would be on the wrong side of that statistic, and sooner rather than later.
I did more research on the internet confirming that no drug intervention to cure AD was available, although researchers were busy working on that. I also read encouraging new research that showed physical exercise, notably aerobic exercise, had positive impacts in some cases of AD. This was worth investigating, and I did. I joined the gym and began going there every day. As time went on, I spoke with researchers and read more and more about what a powerful weapon against AD physical exercise could be.
How much exercise should I get? The research I found online at the time seemed to indicate 45 minutes to an hour, six days a week had produced promising results for some people, so that’s what I decided to do. I began walking 45-50 minutes a day on the treadmill at a 15-degree incline, seven days a week – fast enough to work up a sweat and have difficulty speaking. I’ve missed very few days since I started in December 2015.
Since 2015, I have had three more MRIs and many psychometric cognitive tests. Amazingly, the MRIs have shown that the atrophy of my brain has stopped cold, and I have had steadily improving cognitive test scores.
We think of AD as something that affects memory, but it’s really impacting the whole brain. Therefore, with AD, I’ve felt kind of lousy most of the time, and a sense of joy that I’d always experienced was being drained out of me. The good news is that as my cognition has been improving steadily, my mood has also improved and my joy has returned.
I primarily attribute my progress to exercise, but I’ve been doing other things as well. Here is what I’ve been doing:
- Eating a Mediterranean diet, a brain-healthy diet that keeps carbohydrates low and replaces red meat with fish and poultry.
- Getting at least seven hours of good quality sleep every night.
- Reducing, but not eliminating stress.
- Beginning the day with an hour of quiet time in some kind of meditation.
- Maintaining healthy social activity, including volunteer work.
The Alzheimer’s Association report “2018 Alzheimer’s Disease Facts and Figures” emphasizes the importance of early diagnosis and treatment of AD, stating that huge amounts of money can be saved. The report also emphasizes non-pharmacological treatments for AD, including physical exercise, and the benefits of a heart-healthy diet (e.g., a Mediterranean diet) and social engagement. My AD was diagnosed in the MCI stage, and I have aggressively applied all of the non-pharmacological treatments I can find recommended by credible sources. As a result, for the foreseeable future, I do not expect that my AD will be a burden on the healthcare system and I will not need dementia care.
People sometimes ask me how I’m able to be so committed to regular exercise and a proper diet. I have not been committed to these things in the past, so I understand the question. I tell them that, for me, it’s a matter of life and death. I’m not only fighting for my life, I’m fighting for my mind. I’m fighting for who I am. I’ve learned how to fight this battle, and I hope others can learn from my experience.
David H. Brown is a retired engineer and high school science teacher living in Richland, WA. He wrote and self-published a book about his experience. He is a vocal proponent of early diagnosis of Alzheimer’s disease and the benefits of a healthy lifestyle on brain health.
Disclaimer: This blog is based on personal experience and is not intended as medical advice. We recommend consulting with your healthcare provider before making changes to your diet or starting a new exercise routine.