Tatuaż na mózgu. Moje życie z chorobą Alzheimera

by Daniel Gibbs, Teresa H. Barker, Dariusz Rossowski (Translator)

Neurolog Daniel Gibbs pisze refleksyjną, pouczającą, miejscami humorystyczną i wzruszającą relację z pierwszej ręki na temat życia we wczesnej fazie choroby Alzheimera. Splata wiedzę kliniczną, nabytą dzięki dekadom opieki nad pacjentami, z własnym przeżywaniem choroby. Widoczne na wynikach badań zmiany na swoim mózgu porównuje do tatuażu. A ten był w wielu społecznościach uważany za oznakę realizacji konkretnej misji.



Tak jest i w moim przypadku, podkreśla Gibbs. Dlatego powstała ta książka. Mam nadzieję, że zawarte w niej optymistyczne przesłanie da ludziom poczucie sprawczości w sytuacjach, w których ogarnia ich bezradność w obliczu choroby.



Tatuaż na mózgu jest ucieleśnieniem determinacji Gibbsa, aby pracować jak najdłużej, przynieść pomoc jak największej grupie ludzi i działać na rzecz jak najwcześniejszego rozpoznawania choroby Alzheimera wśród pacjentów.

Genres: Nonfiction, Memoir, Science, Medical, Neuroscience, Health, Psychology

256 pages, Paperback

First published May 6, 2021

Reviews

[Jamie · Rating 5 out of 5]

The reason I purchased this book, was because my dad was diagnosed with Alzheimer's in 2017 and passed away in 2019 after some rapid decline in the last 6 months of his life. I wanted to better understand my risks and what someone might be experiencing during early stages.

Dr. Daniel Gibbs has such a different perspective having been a neurologist treating patients diagnosed with Alzheimer's. He knows what a diagnosis means. He's walked so many patients and families through this. In this book he takes us through his journey prior to his official diagnosis. He also goes through the challenges of getting diagnosed and being part of clinical trials. Even being chosen for clinical trials was tough.

One of my favorite parts was learning about the early signs that were initially overlooked, like changes to his sense of smell. He also provides insights into lifestyle changes that can be made to slow progression. I found myself taking notes and wanting to make changes now, while in my 40s.

I don't ever want to go through this or put my family through it. I appreciate Dr. Gibbs for being vulnerable and giving us a rare view of decline through the eyes of the person experiencing it.

[Sue · Rating 5 out of 5]

Both my parents had dementia of some type - was it Alzheimer's, frontal temporal dementia, vascular or a combination of both? I found this book very informative, from recognizing the early symptoms of Alzheimer's, to diagnosis, tests, current drugs/beneficial lifestyle changes and investigational studies. Dr. Gibbs provides good resources and links to other articles for further reading. Coming from a medical background and having worked Neuro as a nurse practitioner, along with being personally affected by my parent's dementia, I think this book will be a good resource for medical and lay people alike.

[Verne · Rating 5 out of 5]

Great book. Insight on a scary topic from a professional dealing with it first hand. Good information about both the disease as well as how to slow its progression. I found it very interesting.

[Yoy · Rating 5 out of 5]

Table of contents
This is a long review that's why I give you all the items you can find here. It is important that you find all the information you need. In order of appearance:
- introduction
- the book: scientific explanations
- the book: so warm-hearted
- how to get a better and hopefully longer life:
= medication
= change your lifestyle
= take part in scientific research, maybe there'll be something good!
- Alzheimer starts very early. How can you know it, in -order to do something about it asap?
- What else can you do? Personal addendum on what we do, in addition to what the doctor has written
= food supplements, phytotherapy
= good advice: a bit of philosophy

Introduction
This book is very valuable, a must-read when you have Alzheimer and can still read, or when you live with the person who has the disease or when someone from your family or a good friend has Alzheimer.
The book is written by a neurologist, but the doctor writes in a very abordable language. It is not only intersting, but also very kind and warm-hearted. You find not only important information, but also consolation and even some hope. Nice also, the doctor talks about his wife, how they live the disease together. And of course, he is sometimes restless or sad. But generally, he is an optimist, and happy to be able to do something about the disease.

Scientific answers to all your questions, easily explained
First of all, I found here all the anwswers to everything that the doctors had not told me because these doctors only see me for twenty minutes every three months. In fact, they suppose that you inform yourself. I read so much about this disease, but got many fragments that didn't always say the same things. I was so eager to get structured and scientific information, and here I got all the answers and much more, on a scientific basis and explained easily (for me... and ok, not all the chapters were as easy, but one could understand).

Warm-hearted book
Second, the book is warm-hearted. It is written by a doctor who has seen so many patients in his life that he very well knows what his readers are going through. Besides, he has the disease himself. There is so much empathy in his book, and there lies so much quietness in simply knowing the truth, without the usual horrified or ultra-sad reactions from people who write about it. This doctor is a scientist, AND a patient. He shows us that it is possible not to be horrified or ultra sad, and that it is possible to have a pleasant life with beginning and mild Alzheimer.
What is more, Alzheimer patients who are not yet advanced patients, can have the hope to make the good times longer.

How to get a longer and a better life
Daniel Gibbs shows us how this is possible. If you set your mind to it, change your life, the effects needn't be so limited. At least, you can try it out. The good thing about it is: living the way you need to live, is very pleasant! So from now on, you will have a nice life AND care for your health at the same time. It is a win-win, you cannot lose.
Medication
At first, there is of course the medication, but whether it will work for you is not sure. You can try, of course, that is the doctors' advice.
Then the lifestyle
(I am mixing up here what we do and what Daniel Gibbs says, not everything is in the book): move, walk, sport a lot, follow the MIND-diet (personnaly I would say WITHOUT wine, change that by drinking grapefruit, black or blue grapes, which is healthy), avoid stress (meditation, relaxation, yoga, whatever you like) and if it pops up in your life, get rid of it, it is important, stress deteriorates the brain. Rest a lot, go for a siesta everyday e.g. And see your friends, family, go to social activities even if it is difficult because you cannot follow what is said, and be creative the way you like it. Painting, reading etc. Listening to music is very important as it will last even in the later phases of Alzheimer. Let the family know what songs you like, sing them together. Later on, they will manage to make you quiet if you hear them.
According to the doctor and research that has been done, if Alzheimers' disease is beginning or mild, you still have time to work on these things, so that you will gain time, and more important: good time before the degeneration.

Take part in scientific research
For people who have beginning/mild Alzheimer, you can follow what science is doing and start as a candidate for research programs for therapies. Perhaps you'll be lucky and get a good therapy very early that way.
Personally I don't know whether I would do it: I was once proposed to take pills for epilepsy. They said it had no side-effects and was safe. I refused. Years after that, the therapy was not available anymore because it was too dangerous and had many bad side-effects. But Daniel Gibbs is very much in favor of these experiments. He thinks that if he participates for science to progress, his children will possibly have therapy. Not necessarily himself, but his children. And as Alzheimer is going so fast, many people will need to be helped in future. He wants to contribute to that. It gives him hope, what I understand.
And also, donate, of course.

Be alert. Alzheimer begins very soon and you can know it.
For Daniel Gibbs however, something else is very important. I have not talked about it yet, still it was the reason why he wrote the book. Daniel Gibbs thinks that Alzheimer is already in the body ten to twenty years before we notice it. If we could know it so soon, we could change our lives very soon (everybody should, as a matter of fact). But how can we know whether we are one of them? There are genetic tests, so you can see whether you have chances to get it, or are rather protected. You can do such a genetich test but never forget that even if you have all the bad genes, THIS DOES NOT MEAN THAT YOU WILL NECESSARILY get the disease. Inversely, if you have good genes, chances are better but still you might get it.
Second indication is smell. As soon as you do not smell anymore, or you smell less, or you smell unexisting smells (phantom smells), you should go to the doctor and talk about the link between Alzheimer and smell even if you have no symptoms. You should change your life as mentioned above. And as there are more and more medicines, you might have access to medicines that slow down the illness from the very beginning.
Possibly there will be blood tests to know how your alzheimer-proteins are in a nearby future.

What else can you do? Personal addendum - what we do:
My wife has Alzheimer. We live in France and our doctor refuses to prescribe the medicines Dr. Daniel Gibbs writes about. We still have to see our neurologist, I don't know whether she will prescribe the medication. In France, the government doesn't pay for this medication and says it does not work (but they say that for a lot of pills that do work... )
So while we are waiting to see the neurologist (which takes a very long time in France), we already did the following:

Disclaimer: if you experiment with the supplements I mention, look up about the possible side-effects, I can only tell you what it did for us, this is no scientific article.
- CBD oil 5% 2 times a day 4 drops. It immediately helped to get a better mood, works against mild depression and anxiety. It appeased emotions, reduced stress very well, which was good against the disease. There was a slight improvement of cognition, nice to have this, but slight. One can take more though not real heavy dosage, which is bad for Alzheimer. Less is more. When someone is aggressive, I would also try it.
- Citicoline 2 times 250 mg a day (= 500 mg). I was astonished by the real impact on cognition. It depends on how sensitive one is to it, but we were lucky, with this supplement she won months, a year or more. The good thing is there are no side-effects (somnolence in the beginning but it withered away), and where normal medicines have no effect anymore after six months to a few years, this supplement will always have an effect. If you react well on it, you can continue to take it.
- That is why we also think we'll try phosphatidylserine (please ask ChatGPT about it, but when we have tried it I'll give an update here to say what it did).
- Alpha-lipoic acid (ALA): Dr. Gibbs wrote in his book how important the tau protein is for Alzheimer, so I thought maybe we can work on it with phytotherapy. This antioxidant is known to improve insulin sensitivity and protect against oxidative stress. It may also be beneficial for neuronal metabolism. Insulin plays a key role in the brain, influencing neuronal health and cognitive processes. In Alzheimer's disease, a dysfunction in insulin signalling is observed, which may contribute to changes in tau proteins and neurofibrillary tangles, a phenomenon associated with cognitive decline.
We did not yet try ALA but we will do it. I'll update though even if we have no effects, she would continue to take it because it can prevent a lot of damage, even if it doesn't restore it - or perhaps very slowly in time.
What else she already takes:
Centella asiastica (Gotu kola by Solgar), 3 caps of 100 mg a day. It improves the blood supply to the brain cells. She has taken it in the beginning of her problems. We have seen such good results that she hasn't been to the doctor for a cognition test. But the disease is degenarative and has progressed nevertheless, though much slower, and finally the test has been done. She still takes it though, the effects are established (at least in our household).
Green lipped mussel3 times 500 mg a day. It contains omega 3-6-9 in ideal proprtions. It is anti inflammatory. It is known for osteoarthritis, but also works for inflammation on the intestines and brain, which is particularly important for Alzheimer. We have seen no effect on cognition, nor a significant slowing down of the disease. Perhaps it prevents inflammations and is beneficial in ways we don't know. And it is good for osteoarthritis and she suffers from that as well, so she still takes it.
- She drinks grapefruit (dark grapes) every day to replace wine, and there is reservatrol in it, which helps regenerate the brain cells. And the brain DOES regenarate. But not fast enough. It deteriorates quicker than it regenarates. Perhaps some good grapefruit helps a bit. Anyway, it's delicious to drink out of wine glasses, and one must have fun while having alzheimer.

Good advice - a bit of philosophy
Good advice: do not read too many things on how it will be later on. If the ill person wants to live in denial, let her. I wonder what is more terrible, the disease or the tears people shed and the fears they have. We remain in life in the now. We have to know everything for later, I am informed, but that is enough. Not talk about it constantly. Living in the present is good. Don't be possissive towards the person who has the disease. There must be space, one must be independent. Don't let your brain get full of worries. Don't take them with you, not one single minute.
Eradicate sorrow. Sorrow is terrible. Sorrow is an evasion. Where there is sorrow there cannot be passion nor love. There is no compassion but pitying. It is possible not to have sorrow. End all attachments, be independent, and sorrow ends. Then there is passion and love and com-passion. That love has its own intelligence and will know what to do.
Try to look at death differently. We always talk about it as if it is terrible and are horrified. Why shouldn't there be death? It is natural. Look at your dog, he doesn't know he's going to die, he enjoys every moment, and when he gets ill he is helped, and when he dies, he is completely calm. When you know what life is, without carrying your worries with you, with space in your head, you won't have questions about death. You might discover creation.
Always leave space in your brain, space where there is nothing, simply space or nothing. Whatever you do, whether it be technical or friendship or whatever, let there always be some empty space in your head. That empty space in nothingness. That space is the source of love and is tremendous energy. That space is eternal, not the consciousness of the brain.
You may even discover this space in your entire brain and body. Sometimes, it can be in your person completely. These are tremendous moments and they go. Don't cherish them. They come or they don't. Be happy to always have some empty space with nothing whatsoever in the brain, no attachments, no relations, no wishes, no sadness because you can't do things, a space with nothing. As I said, this space is nothing, it is love, it is intelligence, it is tremendous energy and it is eternal, not the working of the brain. Try it. Play with it. Try to have that space in your head.
(If you want to read more about this philosophy you can look for books by Jiddu Krishnamurti, or watch them on the Youtube Channel, Krishnamurti, and watch whatever subject that you are interested in.)

[The Reading Bibliophile · Rating 3 out of 5]

3.5
I admire the resilience of this man and I wish him and his family all the best.
This book stresses on the importance of brain health and the sooner you take care of your brain, the better.
Alzheimer's manifests itself very subtly a decade, even up to 20 years before mild cognitive impairment can be diagnosed. It is essential to be aware of this. The medical community should listen to patients who complain that something feels wrong in their brain even if the various tests and MRI don't show any sign of the disease, yet. When these tests come back positive, it is already too late to slow down the condition. Significant cognitive impairment has already settled in and no health measures nor medication will stop the progression to full dementia. The only way to fight Alzheimer's back in order to push the first frank signs of the disease it at its very early beginnings. Hopefully the blood tests for amyloid-beta plaques and tau protein will be easily accessible and be able to detect Alzheimer's at the earliest as to be able to significantly hinder its evolution and maybe find a cure some day soon.

[Shirley Porterfield · Rating 4 out of 5]

This book was recommended to me by two different people I talked with during the Gerontological Society of America (GSA) meetings earlier this month. For me, the scariest part of aging is the possible cognitive decline into dementia. This book is by a neurologist who through happenstance discovered he had Alzheimer's. He is documenting his experience and takes the reader through all we know and don't know about how to stave off the worst of the inevitable cognitive decline until late in the progression of this disease. It actually make me feel more hopeful! Four stars as I think it goes on a bit long (I listened to the audio version) and I can't give 4.5 stars on Goodreads.

[Sunny · Rating 5 out of 5]

Interesting book about a neurologist who documents his on mental decline. Here are the best Bits:

Under the microscope, he saw dark particles between the nerve cells in the outer layers of the brain. He also saw a different type of smaller dark particles within the nerve cells, which were twisted in appearance. These were the plaques and tangles in the brain that we recognize today as the signature of Alzheimer's disease,

The goal of the trial is to see whether fluctuations in cognition can be linked to activity level. The cognitive data from the smartphone app is correlated with measures of exercise obtained through a fitness tracker. Lately, although I've started to notice some decline in cognition, more forgetfulness and befuddlement, I still think more clearly during and after exercise.

These false odors are called phantosmias - a kind of olfactory hallucination. In the medical literature, phantosmias are usually associated with decreased ability to smell. It's as though the brain is inventing a smell to replace the one it can no longer detect.

Another theory suggested that lifetime habits of study and stretching to learn, and other stimulating cognitive activity, contribute to so-called cognitive reserve, a kind of brain bank of neural cells or networks that provided backup, or created resilience, that might be keeping my
cognitive functioning high despite the presence of brain atrophy and accumulations of plaques and tangles normally seen in mild to moderate Alzheimer's disease.

A recent study reported in JAMA Neurology showed that high cognitive reserve, as measured by education and high baseline intelligence, does not protect from tau-associated brain atrophy, but it does leave to a delay in cognitive impairment, postponing the onset of the symptoms of Alzheimer's disease 2]. In other words, cognitive reserve does not reduce the tau-mediated brain damage of Alzheimer's, but it seems to provide cognitive resilience to the effects of this damage. And, in a study reported in JAMANetwork, researchers found that better cognition measured during high school was associated with decreased odds of dementia later in life

Once people with high reserve start to get cognitive impairment, the trajectory toward the late stage of the disease is much more rapid. Put simply, everyone who is going to get Alzheimer's disease gets pathology in the brain at about the same time, and they probably will die of the disease at about the same time, but those with high cognitive reserve will have better cognitive function longer - a delay in the start of the first cognitive symptoms before the loss then progresses more rapidly. Cognitive reserve can buy you more quality time.


Greater education: Those with less than eight years of schooling have twice the risk of developing dementia compared to those with more education. Occupational achievement: Those with so-called lower occupational achievement (unskilled/semiskilled, skilled trade or craft, and clerical/office worker) also had a two-fold increase in risk of developing dementia compared to those with high occupational achievement (manager business/government and professional/technical).
Leisure activity: Subjects were asked about their participation in thirteen leisure activities in the previous month. These might include knitting or music or other hobby, walking for pleasure or on an excursion, visiting friends or relatives, being visited by relatives or friends, physical conditioning, going to movies or restaurants or sporting events, reading magazines or newspapers or books, watching television or listening to the radio, doing unpaid community volunteer work, playing cards or games or bingo, going to a club or center, going to classes, and going to religious services. Those who participated in more than six of these leisure activities had about one-third less chance of developing dementia going forward.

the five main anti-Alzheimer's strategies are: (1) aerobic exercise; (2) a Mediterranean-style, or the MIND, diet; (3) mentally stimulating activity; (4) social engagement; and (5) good sleep,

Intellectual activities (reading, playing games or going to classes) and social activities (visiting or being visited by friends or relatives, going out to movies or restaurants or clubs or centers, doing voluntary community work, and attending religious services) all significantly delayed the onset of dementia.

it is becoming increasingly clear that adequate sleep may be very important in fighting the accumulation of amyloid in the brain, at least in the early stages of the disease. There is evidence from both mouse and human studies that amyloid is scavenged from the brain during sleep.

Dr. Tanzi has described how the expression of these risk genes - the epigenetics - can be altered by our lifestyle. "Every choice we make leads to experiences that change the expression of our genes," Tanzi told the US Senate Special Committee on Aging in 2019[15]. Gene expression is actually controlled by our habits. A healthy lifestyle of good habits leads to beneficial gene programs and good health. The opposite is also true. You may currently have bad habits, like a little too much junk food, which induce gene expression programs that promote risk for age-related disease. But, with repetition, the establishment of new, "good habits" like a plant-rich diet, will change gene expression programs that promote health .. At the end of the day, by altering our gene expression programs through our daily conscious choices. we have the power to slow the aging process, improve mod, staving off anxiety and depression, reduce persistent aches and pains, improve quality of sleep, and even decrease risk of age related chronic diseases including cancer and neurodegenerative diseases

Musing from his sickbed, Marcel Proust in his 1913 semi-autobiographical novel Remembrances of Things Past (Ala recherche du temps perdu) famously described the vivid retrieval of a long-lost memory evoked by the smell and taste of a tea-soaked Madeleine cake. His childhood memory of cherished Sunday mornings in the country, his aunt Léonie, and now the rush of memory itself was an exquisite pleasure, he wrote. "And all from my cup of tea." The Proust effect,
as it has come to be called, refers to the phenomenon most of us have experienced, in which sensory cues instantly take us back to a long-ago memory.!

If a song I haven't heard for fifty years or more comes on the radio, it immediately tags a memory from the time I used to listen to it. It seems 1 always have a song going in my head. Not the annoying kind that sticks when you wish it wouldn't, but one you welcome. I take the time to give these reveries their due. Music turns nostalgia into a kind of neurological resistance to a disease that takes no prisoners.

Climbing the steep trail up the face of Beacon Rock, it's easy enough to look straight ahead into the scenic surroundings and avoid the rail-side view looking down the sheer drop to the river below. I don't have a particular fear of heights, but I can appreciate that sometimes in life our view can take a precipitous drop down a scary slope. Sometimes a disturbing dream, a mood, a moment of forgetfulness or a depressive dip draws me in, takes my mind's eye to the trail's edge of this Alzheimer's path and I can't help but look down. It's an unsettling glimpse into the abyss.

In humans most mammals if you shine a light dancing dancing stranger in one eye both pupils will constrict to the same degree. This is called the consensual pupillary response and it’s something that neurologist checks for because the lack of it can indicate where lesion may be in the brain.

My brain recalls my col-league, Dr. Lisa Silbert, by name only after starting with the thought of a hazelnut (the state nut of Oregon), then filbert (the other name for hazelnuts) - then Silbert. Many people use mnemonics to enhance their memory skills, and it's interesting to think how a seemingly convoluted neural processing sequence could be considered an advantage - until you imagine how that circuitry enables a brain like mine to skirt the plaques and tangles to make the needed connection.

For someone with Alzheimer's, apathy is biological, intrinsic to the disease as it affects the brain's executive function and diminishes motivation and the capacity to make plans and follow through.

the pathological changes of Alzheimer's disease begin in the brain up to twenty years before the onset of cognitive impairment. There continues to be overwhelming evidence that simple lifestyle changes started during this period can markedly slow the progression of Alzheimer's.
I believe that a cure will eventually be found, but until that happens, we need to focus on these early stages, before memory is lost, and start fighting the battle before it is too late.

[Mary · Rating 4 out of 5]

A difficult read due to the subject matter: a neurologist makes his own diagnosis of early Alzheimer's. But this book also presents hope that, if diagnosed and treated early, this evil disease might prove curable or at least manageable. He also presents proven measures to prevent/forestall the development of symptomatic Alzheimer's: the MIND diet (a variation on the Mediterranean diet); regular aerobic exercise; brain stimulation via new learning and alternate pathways; meaningful interaction with other humans.

[Marysia]

Bardzo dużo się dowiedziałam na temat choroby Alzheimera. Na pewno najcenniejszym aspektem tej książki jest to, że autor sam na nią choruje i opisuje to z perspektywy pacjenta (ale również z perspektywy lekarza)

[zbookami · Rating 2 out of 5]

2,5
Trochę za mało wiedzy/informacji, a za dużo prywatnego życia autora. Wiem, że dokładnie o tym miała być książka, ale jego historie z wolnego czasu były dla mnie najmniej interesujące. Jeśli chodzi o całą resztę (czyli temat choroby) był interesujący i dający jakąkolwiek nadzieję.

[Anna · Rating 4 out of 5]

Very honest description of the attempt of saving the personslity while fighting with Alzheimer progress.

[Quinn · Rating 3 out of 5]

From the book:

My interest now lies in navigating the progression of this disease in its early stages to find ways to slow it down. I want to buy myself more time on this end of the Alzheimer's continuum. Time with my family and friends. Time to study, read and write, for professional purposes as well as pleasure. Time to enjoy walks in the woods and time on the river. The good news is, I've discovered that all of these pursuits intersect. Each informs the others, advancing some aspect of the larger inquiry around science or life satisfaction, or setting up for the step of insight that will. How that all fits together neurologically - how a brisk walk affects the way your brain functions, for instance - is really pretty amazing in the landscape of the brain.

---

Soon enough though, my abstract what-if worry about Parkinson's was eclipsed by my work with patients, expanding administrative and faculty roles at the university medical school, volunteer commitments at home and abroad, and immersion in my own family life. This now included a full family itinerary of sports, Scouts, music, drama, homework, school volunteering, summer camp, canoe and other field trips, and all the duties and delights of being parents of three growing kids. Years passed. Five years, to be exact. If I felt the clock ticking, it was the same one everyone feels when the passage of time occasionally registers with a sudden awareness. Births, deaths, milestone moments, Kodak moments or sometimes just a glance at the mirror and the surprising sight of an older self peering back.

---

Then, just about 100 yards away, a pod of orcas appeared - soaring out of the water in a brilliant flash and disappearing as quickly in clean dives, resurfacing again, and repeating the choreography until they were out of sight. There were eight or ten of them, and it was a spectacular sight. We were ecstatic, dumbstruck by our good luck.

After twenty years of these trips, I have found that the times you see the orcas are when you least expect them, not when you are trying to find them. You just stumble on them. We would have completely missed them that year if our engine had been working and we had headed out farther as planned.

When I think back to the years after I first retired, I'm reminded of that day on the water, stalled out and adrift for all practical purposes, our plans upended, but the day full of the memorably ordinary things of life. The gift of the orcas. The gift of time.

---

But I knew the day for that diagnosis would come, and this was no time to take a wait-and-see approach. There was too much at stake. I had already decided some months back that even if my cognitive scores continued to be high - too high for me to qualify for the research studies - I could still take steps on my own to start an aggressive regimen of diet, exercise and other activities that have been shown to build cognitive resilience and slow the progression of Alzheimer's. That research is extensive and the findings clear. Always, as a doctor, one's aim is not only to treat or to manage illness, but to do everything possible to prevent it. For now, there were definite preventive steps I could move ahead with on my own. Actual prevention might not be possible, but if preventive steps could provide a protective effect - slow the speed or spread of the neurodegeneration - that was the point.

So I self-prescribed what I would have suggested to my patients in the same position. I adopted a strategic regimen of more exercise, with more of it aerobic; a modified Mediterranean diet called the MIND diet, with special emphasis on brain-healthy foods; and everyday activities that kept me socially active and mentally stimulated: crossword puzzles once or twice daily, reading six to ten books per month. I had a little trouble remembering what I'd read a few days later, but it helped to tell Lois about what I was reading - it firmed up my memory. Fortunately, she's a voracious reader herself, and she was a good sport about it.

---

As close to a prescription as you can get, the five main anti-Alzheimer's strategies are: (1) aerobic exercise; (2) a Mediterranean-style, or the MIND, diet; (3) mentally stimulating activity; (4) social engagement; and (5) good sleep, along with good control of diabetes and high blood pressure, if present. Admittedly, these have become such familiar recommendations for a generally healthy lifestyle that they are practically a cliché. It would be easy to shrug them off and put them off for a later time. But for someone with Alzheimer's, or with a strong genetic risk for it, "later" is a gamble. Sooner is the better bet. These strategies have been shown to be most effective in slowing the disease process in the early stages of cell-level changes - the ten to twenty years before significant cognitive impairment. Especially for someone with early-stage Alzheimer's or a significant risk of developing Alzheimer's, this is vital time in your favor. It has been for me.
...
Consider exercise, for example. If there were a drug for Alzheimer's disease that would slow progression by 50 percent, we'd hail it as a miracle, and it would be worth billions of dollars to the pharmaceutical industry. We already have it, and it is free: exercise. Aerobic exercise has been shown, without a doubt, to have a positive, protective effect, at least in the early stages of the disease. A number of research studies have shown up to 50 percent decline in the rate of developing Alzheimer's among those who start the study with no clinical evidence of dementia. In virtually all studies on people with early-stage disease including mild cognitive impairment, there appears to be unequivocal benefit, not only in slowing cognitive decline, but specifically in reducing the rate of brain shrinkage related to amyloid.
...
The data for a beneficial effect of diet is strong, if not quite as robust yet as that for exercise. Most studies have shown that a Mediterranean-style diet promotes brain health, as well as cardiovascular health. A modification of the Mediterranean diet called the DASH diet (Dietary Approaches to Stop Hypertension) was designed with the goal of lowering high blood pressure, and it too had a modest effect on slowing cognitive decline with aging. In 2015, the MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) was introduced to specifically target slowing of cognitive deterioration, both in normal aging and in Alzheimer's disease. The MIND diet combines most elements of the Mediterranean and DASH diets, but specifically focuses on foods that have the most evidence for benefits to brain health, such as whole grains, green-leafy vegetables, beans, nuts and berries.
...
Moving from meals to the mind, participating in mentally stimulating activity has long been shown to postpone the onset of cognitive impairment caused by Alzheimer's disease. As early as 2001, a group from Rush Medical School began looking at the effects of various types of leisure activity on the chance of later developing dementia. Intellectual activities (reading, playing games or going to classes) and social activities (visiting or being visited by friends or relatives, going out to movies or restaurants or clubs or centers, doing voluntary community work, and attending religious services) all significantly delayed the onset of dementia. The authors proposed that "maintaining intellectual and social engagement through participation in everyday activities seems to buffer healthy individuals against cognitive decline in later life". More recent studies have generally confirmed this. Activities pursued in late life - such as reading books five to seven days a week, using a computer three to seven days a week, participating in social activities two to four days a week, and doing craft activities - all lead to about a 30 percent reduction in the rate of developing cognitive impairment. Those who do these activities in both middle and late life have even greater benefit, and the benefit increases with the number of these activities done, to a maximum of about a 50 percent reduction in the rate of developing cognitive impairment.
...
Social engagement is also important, and it can be hard in Alzheimer's disease. Apathy is almost universal, especially in the later stages. I've never been especially social. I don't particularly like to go to parties - now more than ever. Part of this is the trouble I have understanding language when several people are talking at once. It's really difficult for me to follow the conversations in a group, so I tend to stop trying. I also continue to have some trouble recognizing faces, even of people I know fairly well. This prosopagnosia, or face blindness, is usually due to damage to the fusiform gyrus of the temporal lobe or to portions of the occipital lobes. It is relatively common in Alzheimer's, and it is just one more thing that makes social interaction somewhat fraught. Having said that, I realize that one way to fight the apathy is to stay socially engaged and not withdraw into a protective shell, so I do make an effort.
...
Sleep research brings insights literally from bench to bedside. Sleep apnea can cause cognitive impairment that may mimic or worsen impairment due to Alzheimer's, and it should be ruled out or treated if present. Other sleep disturbances are common in Alzheimer's disease, especially in the moderate and late stages. It often is difficult for the patient with Alzheimer's to get adequate sleep. However, it is becoming increasingly clear that adequate sleep may be very important in fighting the accumulation of amyloid in the brain, at least in the early stages of the disease. There is evidence from both mouse and human studies that amyloid is scavenged from the brain during sleep. This is thought to occur through the so-called glymphatic circulation in the brain, a network of passages that surround brain blood vessels and bathe the brain in fluid. The glymphatic system gets its name because of the similarity to the lymphatic vessels that are seen throughout the rest of the body. During the non-REM, slow-wave stage of sleep in humans, waves of fluid pulse through the glymphatic passages in the brain, and these fluid waves are driven by both arterial pulsations and changes in the electrical activity of the brain. This washing of the brain during slow-wave sleep appears to remove toxins, including beta-amyloid. Reports of this research in the popular press have led to the inevitable headlines about "brainwashing." This is still a new, but very exciting, field of study. There are hopes that methods might be found for manipulating this system to enhance amyloid removal. This is years off, but, in the meantime, I make a point of getting at least seven and a half hours of sleep per night.
...
All of these lifestyle changes that appear to be beneficial in slowing the progression of amyloid accumulation and onset of cognitive impairment share one important caveat: they work best in the earliest stages of the disease, probably in the period when amyloid has started to accumulate but before significant cognitive impairment has started. The pre-symptomatic period of Alzheimer's disease that can last ten or even twenty years is a critical time, then, for meaningful intervention. By the time Alzheimer's has reached the moderate and late stages, many nerve cells have been destroyed, and we don't have a clue yet how to make them regenerate. No lifestyle modification is likely to have much of an effect at this stage, above increasing comfort and well-being.
...
In the years since, the link between lifestyle choices and genetic predisposition has become only more compelling. Rudoph Tanzi is a pioneering researcher in the genetics of Alzheimer's disease who is recognized for his discovery of three rare genes that result in autosomal-dominant, hereditary Alzheimer's disease, as well as many other genes that appear to increase risk without always causing the disease. Dr. Tanzi has described how the expression of these risk genes - the epigenetics can be altered by our lifestyle.

"Every choice we make leads to experiences that change the expression of our genes," Tanzi told the US Senate Special Committee on Aging in 2019.

Gene expression is actually controlled by our habits. A healthy lifestyle of good habits leads to beneficial gene programs and good health. The opposite is also true. You may currently have bad habits, like a little too much junk food, which induce gene expression programs that promote risk for age-related disease. But, with repetition, the establishment of new, "good habits," like a plant-rich diet, will change gene expression programs that promote health ... At the end of the day, by altering our gene expression programs through our daily conscious choices, we have the power to slow the aging process, improve mood, staving off anxiety and depression, reduce persistent aches and pains, improve quality of sleep, and even decrease risk of age-related chronic diseases including cancer and neurodegenerative diseases.

---

APPENDIX: THE MIND DIET BASICS

In 2015, the MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) was introduced specifically to target slowing of cognitive deterioration, both in normal aging and in Alzheimer's disease. The MIND diet combines most elements of the Mediterranean and DASH diets while adding greater emphasis on green-leafy vegetables, beans, nuts and berries. The components of the MIND diet are shown below, along with recommended servings for both the brain-healthy and brain-unhealthy food groups.

Ten brain-healthy food groups are:
- Green leafy vegetables (kale, collard, spinach, salad): 6 or more servings/week
- Other vegetables: 1 or more servings/day
- Nuts: 5 or more servings/week
- Berries: 2 or more servings/week
- Beans: 4 or more servings/week
- Whole grains: 3 or more servings/day
- Fish (not fried): 1 or more servings/week
- Poultry (not fried): 2 or more servings/week
- Olive oil: Primary oil used
- Wine (optional): 1 glass/day

Five brain-unhealthy food groups are:
- Red meats (includes beef, lamb, pork and ham): Less than 4 servings/week
- Butter and stick margarine: Less than 1 tablespoon/day
- Cheese: Less than one serving/week
- Pastries and sweets: Less than 5 servings/week
- Fast fried food: Less than once per week

[The_J · Rating 3 out of 5]

A neurologist deals with his personal descent into madness, or at least a stroll towards absentmindedness.

[Healthypedia · Rating 4 out of 5]

‘A Tattoo On My Brain’ — a first-hand experience of identifying and preventing Alzheimer's in the early stages from a renowned neurologist.

Alzheimer’s disease affects 50 million people worldwide. The biggest issue about this disease is that it can be developing unrecognisable for 10-15 years.

Dr. Daniel Gibbs is one of the 50 million Alzheimer’s patients. The difference between his situation and those of many Alzheimer’s patients is that he used to be a neurologist, caring for individuals who now suffer from the very disease that is afflicting him. In this review we will look at the memoir ’A Tattoo On My Brain’, the story of a neurologist who suspected he had Alzheimer’s several years before receiving an official diagnosis and shares his methods of detecting and managing the disease.


Author’s background

Daniel Gibbs, the author of ‘A Tattoo on My Brain’, is a retired neurologist based in Portland, Oregon. With twenty-five years of experience in the field, he has dedicated his career to caring for patients, including those with dementia.

His firsthand knowledge and expertise in neurology provide him with a unique perspective on Alzheimer’s disease. Dr. Gibbs’s credibility as an author stems from his extensive experience as a neurologist, particularly in treating patients with dementia.

Dr. Gibbs references other published works such as ‘This Is Your Brain on Music’ by Levitin and sources like JAMA Neurology, Practical Neurology, and The Neurology of Olfaction. These references indicate that he has drawn upon relevant and reliable sources to inform his writing and strengthen the credibility of his book.


What is the book about?

‘A Tattoo On My Brain’ is a compelling and unique book written by Dr. Daniel Gibbs who is sharing his personal journey with early-stage Alzheimer’s disease. Unlike most patients, Dr. Gibbs suspected he had Alzheimer’s for years before receiving an official diagnosis through genetic testing. This memoir and scientific journal blend clinical knowledge gained from years of caring for dementia patients with his own firsthand experience of the disease.

The book delves into the moment Dr. Gibbs discovers his genetic predisposition for Alzheimer’s and follows his journey as he notices early symptoms and eventually receives an official diagnosis. It explores his experiences, the science behind lifestyle changes and drug trials he participates in, and his advocacy for improved early recognition and diagnosis of Alzheimer’s.

Dr. Gibbs’ perspective as both a medical professional and a patient provides a unique insight into the challenges of living with Alzheimer’s.

Readers will be captivated by Dr. Gibbs’ storytelling, find inspiration in his resilience, and gain valuable knowledge about Alzheimer’s disease and the importance of early recognition and management. ‘A Tattoo On My Brain’ prompts reflection on our own lives, encouraging us to make positive changes and take proactive steps to safeguard our cognitive health.


Key takeaways from the book ‘A Tattoo On My Brain’

1. Early detection is not only crucial but possible

According to the book ‘A Tattoo on My Brain’, early detection of Alzheimer’s is crucial as the disease process starts ten to twenty years before there are any cognitive symptoms or signs of dementia.

The author presents the research using biomarkers that have revealed that the first signs of Alzheimer’s disease, such as the formation of plaques in the brain, can begin up to twenty years before any cognitive symptoms or signs of dementia appear. This understanding has prompted the idea that effective treatments targeting the disease should ideally be initiated in the early stages, possibly even before symptoms manifest.

Dr. Gibbs suggests that anyone with a family history or any suspicion of the disease undergo tests that detect the progression of the disease. These tests include analyzing spinal fluid for the presence of amyloid and abnormal tau proteins, which are associated with plaques and tangles, respectively. Additionally, PET scans can visualize the location of these proteins in the brain, and there may soon be blood tests for amyloid and tau as well.

2. The more exercises – the better

Exercise plays a significant role in preventing and treating Alzheimer’s. Exercise has long-term benefits in slowing cognitive decline, reducing the rate of brain shrinkage related to amyloid, and has a modest and transitory acute effect on cognitive function. Even modest levels of exercise are helpful, but there does seem to be a dose-response effect: more activity is more effective than less activity.

The sooner the exercise regimen is started, the more positive effect it will likely have. In the later stages of dementia, exercise may improve mobility, but it doesn’t seem to improve cognition. For those with early-stage disease, those with a family history or those with known positive APOE-4 carrier status, it is especially important to start a regular exercise program. Starting it at earlier ages, in the forties if possible, is better than waiting until the sixties or seventies.

3. Saying socially and intellectually engaged is one of the keys to Alzheimer’s prevention

Evidence-based science has found that simple lifestyle choices about social and intellectual activity are beneficial for brain health and resilience. The book suggests that lifestyle and behavioural interventions can stave off Alzheimer’s disease. Some of the recommended social and intellectual activities include volunteering, leisure activities, writing, journal keeping, and language testing.


Strengths and weaknesses according to readers’ reviews

Strengths:
• Feels personal and relatable as it is backed by the author’s experience and not only scientific research and studies.
• Provides tried and tested pieces of advice on Alzheimer’s management, such as daily exercise, a healthy sleep schedule and a Mediterranean or modified Mediterranean diet.
• Addresses the problem of lack of methods for early-stage detection.

Weaknesses:
• As the book delves into personal experiences and the challenges faced by individuals with Alzheimer’s, it can evoke emotions of sadness, especially for those who have personal connections or experiences with the disease.


Best quotes from ‘A Tattoo on My Brain’

“Most Alzheimer's patients are diagnosed when symptoms of the disease show up in their behavior or cognitive functioning – they may seem noticeably off to those who know them or to themselves. That's typically around the time that the damage to brain cells has become moderate to severe. I found mine much earlier because I went looking for it.“

“I've made some simple lifestyle choices about diet, exercise and social and intellectual activity that evidence-based science has found beneficial for brain health and resilience.“

“If I couldn't read, I couldn't safely navigate these ordinary activities alone.“


Final takeaway

‘A Tattoo On My Brain’ is a powerful and informative book that not only educates but also prompts readers to reflect on their own lives and make positive changes.

It is highly recommended for anyone with a family history of neurodegenerative disease or individuals who have loved ones currently battling Alzheimer’s. By sharing his personal journey and advocating for change, Dr. Gibbs offers hope and guidance in the face of a growing global health crisis.

[K · Rating 5 out of 5]

I wasn’t sure how much I would be captured by Daniel’s book, but I really wanted to be. I started off slowly and in the past day and a bit finished the last 3/4 of the book finding it difficult to put down.
Academics (I was one myself) aren’t necessarily the best narrators when it comes to their own topic of interest, what I mean is that they can get bogged down in the detail that most laypersons may not get. Daniel however has proved me wrong and instead kept me wanting to read more and turn each page.
I found it was a great balance of the science and the personal experience this book had me there on every page.
Having had personal experience of a family member having a neurodegenarative disease I just wish this book had been on the shelf when we were living through our own family’s experience.

My main take homes from the book are that:

1. The book is essential reading not only for families living with an AlzD diagnosis but also an essential read for all neurologists on the frontline, researchers, caregivers, governments and its politicians, NGO’s/charity employees, grant giving bodies and most importantly the pharmaceutical industry leaders if we are going to make any advancement in the area of neurodegenarative disease.

2. It’s imperative that research needs to be more
active in seeking methods and support to detect, treat and cure these diseases in their “early stages” as Daniel puts it “when a patient’s lifestyle choices have the greatest chance to alter the neurodegeneative course of the disease - a chance to slow cognitive impairment and extend the largely pre-symptomatic stage by 10 to 20 years” the ultimate outcome that any advancement is accessible by all!

3.The social stigma to be obliterated for those associated with a positive diagnosis. The private battle to be made public. There is still a need to heighten awareness, take steps to counter apathy and stir conversation and action for those who are experiencing these diseases

4. Importantly we should all be taking these diseases personally, particularly those who may be at increased risk. Maybe we in fact should all embrace the lifestyle choices that have been shown to slow the progression of these diseases
a) Daily exercise
b) Follow a heart healthy diet- Med or MIND diets
c) Stay intellectually and socially engaged
d) Ensure one gets adequate/restorative sleep
Just don’t wait to switch to these choices the earlier the better.

5. Finally Society as a whole needs to take responsibility for a larger share of the cost of research, instead of relying on Big Pharma. Substantial funding must come from government agencies and private foundations, with a change in the research model i.e. there needs to be a common coordinated battle sharing information and promising leads. Indeed the response to COVID-19 has shown this. I agree with Daniel AlzD is the next growing pandemic.

Daniel what a legacy your book has left us with. I think you still have more to stir conversation with though! What a read.

[Valérie · Rating 3 out of 5]

As the title suggests, this memoir is about a neurologist who is diagnosed with Alzheimer's disease. A disease he studied and saw in many of his patients. His story begins with the first symptom, loss of smell, which he does not initially associate with Alzheimer's. A genetic test reveals that he is a carrier of APOE-4 alleles. This is known to increase the risk of developing Alzheimer's dementia. Thus, he began to suspect he had Alzheimer's several years before an official diagnosis could be made. Partly because he has a high cognitive reserve. Which makes cognitive decline less easily detected through cognitive testing and screening. Being a scientist and neurologist, he begins to document the effects and symptoms he experiences and participates in clinical trials.

The book is a good combination of theoretical knowledge about Alzheimer's dementia, the proven methods to delay the onset of cognitive decline and his personal story. It includes some private photos that make it a little bit more personal. In essence, Dr. Gibbs emphasizes the importance of early diagnosis so that cognitive decline can be delayed. He is also trying to increase awareness of early-stage Alzheimer's disease.

Given that this is my field of study, I had long wanted to read this book. I finished it within a week, which is pretty fast for me! It did not disappoint me and was interesting, but I would give it a 3.5 out of 5. The book seems to be aimed primarily at professionals and individuals who themselves suspect early Alzheimer's due to genetic risk. Most of the book is a surface discussion of dr. Gibss’ life. I hoped to get to know him better through this book, but this was not the case. I missed his emotions and feelings around being diagnosed. I would have liked to have heard his wife's side as well. Nevertheless, his optism was palpable in all lines of the book. This is inspiring for anyone going through the same. Lastly, there were a lot of repetitions, presumably to make his point that creating awareness is very important. The social importance etc is also highlighted.

[Reid · Rating 4 out of 5]

The book of a neurologist's early self-diagnoisis of Alzheimers disease. He is in his early 60's at the time. He journals his experience of cognitive decline, missing the right word's, misplacing objects, loss of olfactary sense, and experiements and reflections in prevention of further degradation and correlating lifestyle management. He credits his upbringing to yielding a further layer of protection. His mother played complex classical Piano, which he himself also learnt from 10 years and through college. He attended weekly science lectures, and conducted experiments with his father growing up. His father was a Harvard university student who tinkered in photography. Meanwhile he is longtime married to a supportive Librarian and had 3 children. Given this environment Dr Dan Gibbs had led a life of supportive community, meaning and intellectual support that brings an lifestyle ideal for an above middle-class family living in social, intellectual and material comfort that has offered an extra protective buffer against decline. He credits similar high quality extraneous factors to buffer his familial predesessors that he attributes as having Alzheimers albeiet admittedly some of which didn't have or had little symptoms. Dr Dan said he uses organisation to manage his life and memory caused executive plnning difficulties. He uses Goodreads to remember books otherwise he'd forget them in two weeks. He also writes lists to plan his day otherwise he wouldn't get tasks done that day. He enjoys travel, hiking, boating, puzzles, reading, friends, piano, his dog etc. He is retired which he said was important as the accuracy of small details was immensely crucial for his job title. He did say he gets depressed but it was brief and unworrying as two sentence among many that are celebratory of his good life. People with Alzheimers have paranoia, loss of smell, lack of vocab, depression, trouble gettibg tasjs done.

[Marion Sheppard · Rating 4 out of 5]

4.5 stars
“My hope, both as a neurologist and as a person with Alzheimer’s disease is that, if we neurologists can learn to slow the progression of the disease even more, increase the years of relatively mild cognitive impairment, and postpone the awful end-stage, we patients may have a chance to die of other natural causes first.”

Dr. Gibbs was a neurologist by trade, dealing first-hand with the progression of Alzheimer’s in his patient population. However, when he notes some cognitive quirks in himself, he submits a DNA test that identifies the gene that is a possible link to the development of this disease. Choosing retirement allowed him to pursue how this link would play out in his life and to conduct research in hopes of finding new ways to treat the disease earlier in its life. He provides suggestions about how to combat Alzheimer's in order to prolong your cognitive functions, championing multiple leisure activities, plenty of sleep, and eating a healthy Mediterranean diet. We see how this process affects both the physician and his family, and how Dr. Gibbs works to carve out the best life for himself. His story, while sad, is actually one of hope and fortitude.

“However personal my medical battle against Alzheimer’s, more than anything now I’ve committed to the larger one. I am battling its power to avert our gaze, to muzzle the potential of sciences and medicine to make more dramatic strides, to intimidate and silence us and, in doing so, have us fail to address the challenges and promise that early diagnosis and treatment may hold.”

[Kelsey Sheridan · Rating 4 out of 5]

I came across this book as recommended reading from the Alzheimer's Association when someone I knew was diagnosed with early-onset Alzheimer's, and I am so glad I read this.

This is part memoir, part scientific journal, but entirely fascinating. The author is a former neurologist who worked with Alzheimer's patients. Because of his work and knowledge, he suspected he had Alzheimer's years before an official diagnosis could be made. It's a compelling account, starting when he finds out he has a genetic predisposition for Alzheimer's and following him as he notices these early symptoms and then gets officially diagnosed. He also talks about his personal experience of the disease, the science behind the lifestyle changes and drug trials he becomes a part of, and his advocacy for improving early recognition/ diagnosis.

I learned so much about the history and the science of Alzheimer's from this book. While certain points were a bit too medical and sometimes hard to understand, as someone who's not a doctor, I could comprehend most of it. The thought of having Alzheimer's is so terrifying, and it's only becoming more prevalent, but having the knowledge of early warning signs and the lifestyle changes you can make to help potentially reduce the risk of developing this makes it less scary.

Do yourself a favor and read this; it's quick (only 230 pages!), super interesting, and even if you don't like it, you'll learn so much.

[Ann · Rating 3 out of 5]

p.187
"Over the past six months, I've noticed increasing problems with my short-term memory. I just couldn't rmember whether something had happened earlier in the day, yesterday, or even last week. I couldn't seem to place events onto the time scale of my recent history, and time seemed to be passing much more rapidly. I think that, because I don't remember the details of what I have done earlier in the day or earlier in the week, my sense of the passage of time has been altered."

p.211
"Memory loss is the familiar headliner, but one of the most insidious symptoms of Alzheimer's disease is apathy. Not as in a casual indifference or uncaring attitude that might change if you understood more about a thing at hand. For someone with Alzheimer's, apathy is biological, intrinsic to the disease as it affects the brain's executive function and diminishes motivation and the capacity to make plans and follow through.... Apathy is consisered the most common neuropsychiatric symptom of those with Alzheimer's. A recent meta-analysis covering twenty-five studies showed a prevalence of apathy in Alzheimer's ranging from 19 percent to 88 percent -- quite a range but with an overall mean or mid-point prevalence of 49 percent, meaning that apathy was a clinical issue for at least half othose in the overal participant population.

[Mati 'Matimajczyta' · Rating 4 out of 5]

I’m becoming increasingly interested in books on neurological topics. This time, I picked up the story of another doctor who describes the progression of his own illness. Interestingly, he was a specialist working with people suffering from the same condition, yet that didn’t protect him from the disease or help him notice its first symptoms in himself.
The book is written like a narrative, without an excess of specialized or analytical terms. I noted down two quotes for the future—to know what to pay attention to in my older loved ones and to be more alert to memory-related diseases.
I really liked how the author shows how much effort needs to be put into relationships so it’s easier to support each other in old age. His wife also experiences the changes described in the book, and their joint efforts are aimed at slowing the progression of the illness. The author regularly underwent check-ups and engaged in various activities to maintain his mental fitness.
I believe that reading books, traveling, walking, and any kind of mental activity at any age helps strengthen our neurons—and this book is a great example of that. It’s worth reading to see that it is possible to fight the disease, but it requires determination and commitment, because nothing will happen on its own.

[Susan Belperio · Rating 5 out of 5]

I've read a lot of books about dementia (having a strong family history for it). This would have to be one of the very best and most highly informative, no doubt due to the fact that the author is both a sufferer of early Alzheimers disease, but also a neurologist who spent a substantial part of his career diagnosing patients, and providing whatever symptomatic treatment he could. Daniel Gibbs hammered several critically important points home, hence the occasional repetitions in relation to these were forgivable. It is now thought that the ability to identify those who are in the one or two decades preceding the development of cognitive decline, is of great urgency since interventions at that time might be very useful. Another important take home message is that there can only be benefit involved in incorporating various brain health measures into one's daily life, as these are shown to either delay the development of the disease or to slow its progress. Only one issue perplexed me greatly. I didn't find any mention of the now well recognised fact that correction of hearing loss is an important modifiable risk factor for dementia. Perhaps I'll find this when I read his sequel.

[Patricia Rudolph · Rating 5 out of 5]

My LO has been diagnosed with Alzheimer's officially for 5 years. Memory was lost, didn't remember his mother, or past life, acted like a 12 yr old. he was 75, He had some terrible night as he kept asking to go to the bathroom and get up at night. The doctor prescribed a sleeping pill (zolpidem), but it had a very bad side effect on him (delusions and hallucinations) and we decided not to give it any more and went for the Neuro X program that was introduced to us by his primary care doctor, he was on the Neuro X program for Alzheimer’s disease from Uine Health Centre for 6 months. The treatment relieved symptoms significantly, After the treatment he’s all of a sudden back active again, almost all his symptoms are gone, no signs of agitations, his sleeps pattern are back to normal. His memory loss has greatly improved and he tells stories about his past life, we got the Neuro X program from uinehealthcentre. com. I want to clarify that my comment is not a paid promotion or any form of advertisement. I am absolutely confident that this program offers a viable solution and hope someone find it helpful.

[Bernice · Rating 4 out of 5]

Fascinating account of Daniel Gibbs very brave account of his journey / personal battle against alzheimers. What would be viewed by most as a cruel act of fate, Daniel sees his situation as an opportunity to provide feedback to his fellow neurologists in the hope that a breakthrough in treatment or in the provision of support for those who share his predicament results. He highlights that his journey also affects those around him who must also come to the understanding that this journey is not going to end well and encourages everyone to plan ahead in order to simplify future events. This book is not just for the medically minded, it also tries to highlight signs for those who may be questioning their own brain functions by recognising indicative signs of things to come and encourages those who have doubts about their own status to seek help earlier rather than later.

[Lois · Rating 5 out of 5]

Geared for the general reader, as well as informative for professionals who may be caring for dementia patients, this book is a rare inside look into early-stage Alzheimer's disease from the perspective of a neurologist challenged with his own diagnosis of Alzheimer's. Self-diagnosed in the earliest stage before his symptoms were significant enough to register on any cognitive testing method commonly used for assessing impairment, the author has pursued options for contributing to Alzheimer's research and education as well as strategies for slowing the progression of his disease, which will be inspiring and helpful in a practical way for anyone who is affected or knows someone with Alzheimer's.

[Kasia Czytanka · Rating 3 out of 5]

Autor sam choruje, więc ciekawy punkt widzenia do takiej akurat książki.

Neurolog Daniel Gibbs pisze refleksyjną, pouczającą, miejscami humorystyczną i wzruszającą relację z pierwszej ręki na temat życia we wczesnej fazie choroby Alzheimera. Splata wiedzę kliniczną, nabytą dzięki dekadom opieki nad pacjentami, z własnym przeżywaniem choroby. Widoczne na wynikach badań zmiany na swoim mózgu porównuje do tatuażu. A ten był w wielu społecznościach uważany za oznakę realizacji konkretnej misji. "Tatuaż na mózgu" jest ucieleśnieniem determinacji Gibbsa, aby pracować jak naj­dłużej, przynieść pomoc jak największej grupie ludzi i działać na rzecz jak najwcześniejszego rozpoznawania choroby Alzheimera wśród pacjentów.

[Daisy · Rating 5 out of 5]

• doctor was diagnosed
• I started reading this book due to 23andme results
• he made a bucket list and even though he couldn't climb a big mountain he did a 400 foot long one
• people have severe symptoms and then they go to the doctors, and die in 8-10 years usually
• started loosing smell at 54, got diagnozed at 64 with AD
• got a dna test and found he had variants if APOE just like I do
• was diagnosed, started experimental treatment but lost the ability to read temporaryly. his family was very concerned as he was flying from Portland, Oregon to San Fransisco, California
• it is hard for him to recognize faces and follow conversation when there's many people talking, no more multitasking

[Natalia · Rating 5 out of 5]

Doskonała książka, opisująca perspektywę na wczesne stadia choroby Alzheimera przez osobę niesamowicie świadomą wszelkich, nawet najdrobniejszych, zmian. Czyta się ją szybko, a techniczny, naukowy język przeplata się z anegdotami z życia autora. Wszystko ma swoje uzasadnienie, nie wyłapałam treści zbędnych. Z zachwytem dostrzegałam naukowe podejście autora, który starał się podawać bibliograficzne uzasadnienia dla tego, co opisuje.
Mimo ogromnego brzemienia, które wiąże się ze świadomością nieuniknionego pogłębiania się objawów chorobowych, w narracji autora wybrzmiewa nadzieja i duma - swoją chorobę stara się wykorzystać do tego, aby wspomóc naukę.

[Pamela · Rating 4 out of 5]

A réally interesting enlightening book. A neurologist who devoted his career to treating dementia patients writes of his own experience with Alzheimer’s, which he diagnosed in himself at a very early stage. A lot of science, but also a lot of personal anecdotes and observations about what he experienced, changes he notes, and what he learned about life-style changes that can slow the progression of the cognitive decline if the disease is discovered in its early stages before cognitive decline has advanced. Very instructive about signs to be alert to and how to live a lifestyle that preserves brain health.

[Linda Bahe · Rating 5 out of 5]

I greatly recommend reading or listening to this book. Alzheimer’s is a very complex and harsh disease. That does not care what your profession is what your race is what your thoughts on life are, and it is so subtle with how it sneaks in to take over someone’s life and those that love them. This book also showed me that genetic testing as we all want to do to look at our heritage. Also can bring some things that we don’t want to see even when we should so it just gives us all caution,do you look to see what your genetic markers are ?or do you go about your life.