IN PURSUIT OF MEMORY
is a journey of discovery for British neuroscientist Joseph Jebelli. Having watched his Iranian grandfather succumb to Alzheimer’s disease, this book is part of his effort to learn (and tell) the story of everything we know about the illness, from the German physician who isolated it to the latest treatments involving gene therapy.
It’s an urgent and longstanding problem. As the world’s population ages, 135 million people are expected to have Alzheimer’s by 2050, beating cancer as the second leading cause of death.
There’s a lot that might go over the head of the casual reader. Alzheimer’s involves proteins called beta-amyloids, structures called plaques, tangles that develop in the brain, and genes, prions, microglia and several other elements that have been identified and investigated, most of which only confirm how little we actually know about what causes it.
The current theory is that betaamyloids operate at the surface of cells, facilitating the entry and exit of other material. If that process goes wrong, malfunctioning beta-amyloids drift off from neurons and build up as characteristic Alzheimer’s plaques. They interfere with communication between neurons, causing them to die off further and faster. But that description is far from definitive, and even if it was then treatment would still be far from simple. Don’t believe any diet or exercise regime that claims to protect you. All we know is that exercise helps the immune system, which might fight the build-up of Alzheimer’s-related neuron damage. It also lightens mood, and depressed people are more prone to the disease, but that’s far from an empirical medical pathway.
In fact, the field is ripe for snake oil sales. Brain training videos and games might be fun, but Jebelli and the experts he interviews remind us that there’s no scientific measure of “smarter”. As one neurosurgeon says wryly, doing Sudoku puzzles will make you great at Sudoku, but that doesn’t mean they’re protecting you from cognitive decline.
Like cancer, Alzheimer’s is not even a single disease. A visual variant, the bizarre condition posterior cortical atrophy (also known as Benson’s syndrome), leaves memory and sense of self mostly intact, instead causing hallucinations and the sudden loss of the ability to read or recognise faces and environments. One sufferer even saw everything completely upside-down.
Not long after the first decoding of the human genome in the 1990s, scientists found a mutation that seemed to cause Alzheimer’s in a certain family, but competing theories about causation indicate there’s no single trigger.
More recent efforts at treatment have generated hope – plenty of it false. Some drug compounds and regimes have been shot down for apparently political reasons, with harder than usual test results imposed. Other experimental treatments almost seem to be in the realm of alchemy, like the blood plasma transfer from a healthy donor that almost wiped out symptoms in one sufferer, but then couldn’t be replicated.
There’s a lot of medical science here about beta-amyloids, but just as much about the stories and experiences of sufferers. Jebelli spins a tale a century or more long, about a battle we have no idea when we’ll win.
NON- FICTION In Pursuit of Memory: The Fight Against Alzheimer’s by JOSEPH JEBELLI Hachette Australia (2017) RRP $29.95