Healthy Thinking

Two years ago, almost to the day, I lost my mother to Alzheimer’s disease, which took us both through six trying years. With a close-up view, I thought I was familiar with the lay of the land.

After my fascinating conversation with Dr. Nicole Absar, I realized how much the landscape of the disease and dementia has changed in just a short time. The great news is that many new resources are available on the Vineyard.

In her conversation “Healthy Aging and Prevention of Alzheimer’s Disease and Dementia” at the Vineyard Haven library on Tuesday, Sept. 24 at 6 pm, Absar will speak about the different stages of Alzheimer’s disease and other dementias and various cognitive health interventions that can help prevent and slow down the disease process, maintain brain health, and assist in healthy aging.

With her specialty in Behavioral Neurology and Neuropsychiatry, Absar recently opened

the Neurocognitive Clinic at the MV Hospital. She moved here full-time last December after some 20 years as a summer resident who loves the Island. “I thought, what can I do because there is so much need here? We started in January, bringing everything we can to identify and diagnose fairly sophisticatedly with the most up-to-date biomarker. We don’t have to have people go to Boston.”

Early diagnosis makes so much difference, Absar stresses. “It used to be so pessimistic. The disease was so misunderstood in the past. If you get an early-stage diagnosis, you can do a lot. And you can make people understand what they are struggling with, making them feel better and what they can do about it.”

Absar emphasizes there are many misunderstandings about dementia, which is a general term, not a disease, and it’s not uniform. “It is a syndrome, a collection of certain symptoms and signs. If someone has trouble with their memory, thinking, problem-solving, word finding, or navigation — these are all different kinds of domains in the brain. There are two criteria. You must have two or three symptoms and some kind of interference with your daily activities. Say, you can’t take your medication anymore, or have problems with driving or making an appointment by yourself.”

Therefore, Alzheimer’s disease is the cause of one kind of dementia. Vascular disease, such as a stroke, is another. Parkinson’s disease, low thyroid function, vitamin deficiency, sleep apnea, and head injury can also trigger it. “We have to treat the cause, not the symptoms,” Absar stresses. Half of them are reversible. You have to have an optimistic view. The stigma and fear factor should be removed.”

In terms of medications, FDA has recently approved lecanemab (Leqembi) and donanemab (Kisunla). Both are intended for people with mild Alzheimer’s disease or mild cognitive impairment. They are believed to neutralize or clear the amyloid accumulation in the brain, helping to slow cognitive decline. “We also have symptomatic medication, which doesn’t cure the disease, but it can keep you where you are as long as possible,” Absar says.

She also encourages any loved one who observes subtle changes to immediately have the relative or friend see their primary care doctor for an early diagnosis referral. “If you miss it in the early stage, treatment at later stages doesn’t work as well. We have so many tests now on the Island.”

There are simple things anyone can do to help slow down cognitive decline. “Maybe you read one book before; now it’s time to read three. Reading is one of the best ways to slow the disease progression. There’s the Mediterranean MIND diet, and walking 7,000 to 10,000 steps a day can slow down dementia’s progression,” Absar says.

At the library, Absar will focus on how we can live graciously and prevent dementia, as well as ways to screen for memory issues, including dealing with fear and removing the stigma. In the meantime, if you or someone you know has any concerns about memory, cognitive issues, new changes in personality, behavior, or day-to-day functioning, a patient’s primary care or other specialist can make a referral to the Neurocognitive Services at Martha’s Vineyard Hospital.

For information about the MV Hospital’s Neurocognitive Clinic, call 508-957-9552. For more information about the event, call 508-696-4211 or email vhpl_programs@clamsnet.org.