FELIX J ROGERS, DO
My mother, 96, developed signs of Alzheimer’s disease in her late 80’s. She now faces the final months of her life, if not weeks, in generally good health save what this disease has done to her brain. While I’m grateful her mind was not ravaged at an earlier age, the family did not escape the pain and challenge that comes from losing a loved one, bit by bit, to this unmerciful condition.
Last weekend my wife and I left the Detroit area and drove to our cabin in northern Canada. On the way up, we remembered trips that we took with Mom when she was in the early to middle stages of her decline into Alzheimer’s. When we were an hour or so north of Detroit, Mom often got worried that we were lost. “Joe, do you think he knows where we are?” and, “How will we find our way back from here?” Dad was calm and soothing as he spoke gently and reassured her that we knew exactly where we were, and would have no trouble getting home again. As time went on, a few minutes into every car ride the driver was simply asked, “Where are we going?”
People with Alzheimer’s are famous for wandering off and getting into unusual predicaments, or just getting lost. We now have some clues from the world of neuroscience about this phenomenon. This year, the Nobel Prize in medicine went to three people who discovered the brain’s “inner GPS,” as it was called in the presentation. The first insight came in 1971, when John O’Keefe discovered the inner navigational system in rats. He identified nerve cells in the hippocampus region of the brain that were always activated when a rat was in a certain location. He called these “place cells” and showed that rats built inner maps in different environments.
The second discovery came in 2005 when husband and wife Edvard and May-Britt Moser found a component of the brain’s positioning system by identifying other nerve cells that permit coordination and positioning, calling these “grid cells.” While mapping connections to the hippocampus, they discovered a pattern of activity in the near-by entorhinal cortex. When a rat passed multiple locations, the cells formed a hexagonal grid. Together, the place and grid cells allowed the animals to determine position and to navigate.
Recent studies now show that place and grid cells exist in humans, as demonstrated in brain imaging studies and from electrode stimulations during neurosurgery. It may lead to a better understanding of the events that lead to Alzheimer disease, since the hippocampus and entorhinal cortex are often damaged in the early stages of the disease, with affected individuals losing their way and failing to recognize the environment. (Source: New York Times October 6, 2014)
Learning to Speak Alzheimer’s: A Groundbreaking Approach for Everyone Dealing with the Disease describes some of the problems of ambulation in patients with moderate stage dementia. The authors advise to stick with familiar places when traveling. And, keep vacations simple, slow paced, and consider taking several short trips rather than one long one.
These links offer helpful suggestions:
Traveling with Alzheimers in the Huffington Post
10 Tips for Traveling with Your Loved One Fisher Center for Alzheimer’s
Dr. Felix J. Rogers is a cardiologist at Henry Ford Wyandotte Downriver Cardiology Consultants. He is board certified by the American College of Osteopathic Internists and a fellow of the American College of Cardiology. Dr. Rogers has served as a scientific advisor to the NIH National Center for Complementary and Alternative Medicine as well being an Associate Editor of the Journal of the American Osteopathic Association. In his spare time, Dr. Rogers ran the nonprofit organization, Cranbrook Peace Foundation for a period of 20 years.