Bro­ken mem­o­ries

There are still no clear mark­ers for iden­ti­fy­ing those at risk of de­vel­op­ing de­men­tia

Down to Earth - - COLUMN -

WHO IS it that can tell me who I am?” So muses the tragic fig­ure of King Lear in Shake­speare’s poignant lament on the in­dig­ni­ties of old age. Se­nil­ity may be a po­lite word, but it doesn’t quite cap­ture the hor­rors brought on by a gan­grenous mind as the ca­pa­ciously graphic de­men­tia, which evokes the same kind of dread as can­cer. It’s a catchall syn­drome de­scrib­ing a clutch of symp­toms, no­tably loss of mem­ory and lan­guage skills, aris­ing from a pro­gres­sive wast­ing of the brain.

In the great bard’s time, only a few souls were un­lucky enough to bear this cross as most per­ished early due to some dis­ease or the other. But now, with more and more peo­ple liv­ing longer, de­men­tia has mush­roomed rapidly—it af­fects about 48 mil­lion peo­ple to­day, says the World Health Or­ga­ni­za­tion. There are no re­li­able fig­ures for In­dia, but one con­ser­va­tive es­ti­mate puts it at around four mil­lion, which is ex­pected to triple by 2050. Be­sides, it’s a mas­sive drain on the world econ­omy— a 2010 study put the med­i­cal and so­cial cost of car­ing for de­men­tia pa­tients at US $640 bil­lion per year.

That’s not the only bad news. Worse, there is no cure in sight de­spite phar­ma­ceu­ti­cal com­pa­nies and pub­lic re­search in­sti­tutes pump­ing bil­lions of dol­lars in the quest of a drug. Even though sci­en­tists now know a good deal about the na­ture and ori­gins of Alzheimer’s—de­men­tia’s most dreaded form ac­count­ing for 50-70 per cent of the over­all cor­rup­tion—trans­lat­ing that knowl­edge into ther­a­peu­tics is a to­tally dif­fer­ent story.

So when this Au­gust sci­en­tists from two drug com­pa­nies claimed for the first time that they had hit upon a drug that could clear the “plaques” and “tan­gles”—clumps of pro­teins gone bad that fes­ter be­tween and within nerve cells caus­ing the brain to shrink—in both mice and a few hu­mans, it caused much ex­cite­ment. How­ever, peers are cau­tious in their en­dorse­ment, as they fear it could be an­other case of déjà vu. More rig­or­ous tri­als are needed to clear the air.

Part of this skep­ti­cism arises from the fact that sci­en­tists still do not know how mis­be­hav­ing pro­teins make mem­o­ries dis­ap­pear, or turn words into gib­ber­ish. Some be­lieve we may never find the sub­lim­i­nal link, as the modus operandi is most likely hope­lessly com­plex. So most sci­en­tists say we must stop look­ing for the magic pill that will re­store bro­ken mem­o­ries, and in­stead, look for ways to in­ter­cept the cul­prit be­fore it throws, so to speak, the span­ner into the mind-works.

Some oth­ers are un­de­terred by this de­featist stance. They be­lieve the drug is still elu­sive be­cause re­searchers have been bark­ing up the wrong tree. For them, the right tree grows not in the messy tis­sues of bi­ol­ogy, but within the clear crys­tals of chem­istry. They say all they need is to find a chem­i­cal broom that gnaws away the of­fend­ing plaques, just like statins mop up ex­cess choles­terol in the blood. Re­port­edly, a few can­di­date mol­e­cules are al­ready in the pipe­line.

When and whether an ef­fec­tive drug will be found is any­body’s guess. Look­ing for the pos­si­ble trig­gers is an even more hope­less task. Early this month, a new study looked at a com­pre­hen­sive rogue gallery and found that de­men­tia can be spiked by as wildly dif­fer­ent fac­tors as air pol­lu­tion, Vi­ta­min D de­fi­ciency, and power lines. Then there are en­dur­ing enig­mas—like why Bal­lab­garh, a small town in Haryana, is prac­ti­cally de­men­tia-free, whereas al­most ev­ery­one in a Dutch vil­lage is in its thrall. Is it ge­netic, cul­tural, en­vi­ron­men­tal, gas­tro­nom­i­cal, or all of them? Your guess is as good as mine. In fact, one of the frus­tra­tions of deal­ing with de­men­tia is that there are no clear mark­ers for iden­ti­fy­ing those at risk of de­vel­op­ing it.

So while mod­ern druids take their time to de­con­struct the pulp-fictions of an ad­dled brain to even­tu­ally brew a magic po­tion, it may not harm if all of us, ei­ther in­side or near­ing the de­men­tia border­lands, take Cana­dian psy­chi­a­trist Nor­man Doidge’s ad­vice se­ri­ously by turn­ing our minds into play­grounds of cre­ativ­ity. That way, there is a good chance that the dreaded ogre might lose its way into the deep re­cesses of our Byzan­tine brain.


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