Fall 2012 Volume 7 No. 3 ‘The Nun Study’ by Reverend Myles N. Sheehan, S.J., M.D. In the first years of the 20th century, Alois Alzheimer, a German neu- In This Issue rologist, cared for a middle-aged woman with a marked personality From the Offices 5 change, characterized by bizarre behavior and memory loss. This wom- of NRRO an died about five years after he first met her, years characterized by an Calendar 5 inexorable decline to a final stage in which she was bed-bound, re- Planning for the 6 quired total care and was unable to communicate meaningfully. After Future her death, Dr. Alzheimer studied the brain of his patient and described the changes in intellect, behavior and brain structure that characterize the disease now known by his name. Alzheimer’s disease is a particular type of dementia. Dementia, when “… God is pre- used as a diagnostic term in medicine, refers to the progressive loss of sent and active cognitive function in an individual. Thus dementing illnesses affect even in those memory, language, the ability to recognize and name individuals, sense of direction, personality and other aspects of what it means for us to who are con- think and reason. There are various kinds of dementing illnesses, but fused or unable to remember. Reverend Myles N. Sheehan, S.J., M.D. Hope and love Father Myles Sheehan, Sheehan will be S.J., M.D., (pictured right) hosting a five-part can remain is Provincial for the New miniseries on graceful England Province of the aging that can be alive even when Society of Jesus. Previ- viewed on CatholicTV, cognitive func- ously, he ministered as a as well as online. professor of Medicine The book review, “The tion declines.” and senior associate Nun Study” first ap- dean at Loyola Univer- M.N. Sheehan, SJ, MD peared in America isty’s Stritch School of Magazine, October 8, Medicine. 2001, and is reprinted In September, Father here with permission. 1 Engaging Aging Fall 2012 The Nun Study, continued Photograph by Ruth Jackson The whole topic has great significance for our future, both as individuals and as a nation. Dementing illnesses are highly prevalent with increasing age. (The fastest growing age group today includes people 85 and over.) Alzheimer’s disease afflicts individuals, wears down their families and taxes the social support and health care structures of our na- Sister M. Celine Koktan, SSND, visits with Dr. David tion. It is difficult not only for the afflicted Snowdon during his visit to Mankato, MN, in 2008. individual, but also for those who love them. Sister was an original participant in The Nun Study However, in some cases patients have a gen- conducted by Dr. Snowdon. Sr. Celine died at age tle decline, become progressively more for- 98 in November, 2010. getful and, in earlier times, would probably Alzheimer’s is by far the most common. have been called “senile” before they suc- (Others include vascular dementia from mul- cumbed to a peaceful death ascribed to “old tiple strokes and very unusual dementias like age.” But for other individuals, there is no those caused by mad cow disease.) mildly amusing “Arsenic and Old Lace” kind Because there is no specific diagnostic test of batty confusion, but profound changes in for Alzheimer’s disease, diagnosis is made by the ability to think, relate to others, deal with exclusion. In other words, a physician exam- emotions and perform some of the most basic ining a person who has evidence of a cogni- functions of life like eating, bathing and us- tive problem will perform a physical exam, ing the toilet. Especially distressing are be- order laboratory tests (including neuroimag- haviors like running away, becoming violent ing studies like a CAT scan or MRI) and or wandering and yelling. make a presumptive diagnosis of Alzheimer’s But not everyone who becomes old develops after ruling out multiple strokes, vitamin de- Alzheimer’s. Some older individuals whose ficiencies (Vitamin B12 is the common one), brains look pretty bad at autopsy (lots of tan- thyroid abnormalities, depression, brain tu- gles, plaques and missing neurons) were spry mors or subdural hematomas (a collection of and active in life. Other individuals whose blood pressing on the brain). The diagnosis brains look quite well preserved spend their of Alzheimer’s disease is certain only after last few years appearing to have advanced brain tissue has been examined under the mi- Alzheimer’s. What is going on? No one is croscope. quite sure, but there are a lot of researchers 2 Engaging Aging Fall 2012 The Nun Study, continued trying to ask the right questions, figure out knowledge about Alzheimer’s. the answers and give some clues as to ways Dr. Snowdon is a very engaging writer who to prevent, cure and better help those with the clearly cares about science but cares at least disease. as much about the women who are permitting One of these researchers is the epidemiologist him to do his research, allowing him to ex- David Snowdon, who has written Aging With plore their past, their current knowledge and, Grace: What the Nun Study Teaches Us even, after death, examine their brains. Re- About Leading Longer, Healthier, and More grettably, some review accounts of Aging Meaningful Lives, a deeply moving account with Grace have been quick to giggle about of a group of women he studies as part of his studying nuns and seem to delight in trivializ- work. You may have seen some of the hoopla ing the religious commitment of a group of in the media about the “Nun Study” where women. What makes Snowdon’s book so Dr. Snowdon and his co-investigators looked wonderful is that he clearly cares for these into the lives, habits, histories and brains of women, admires their commitment, is re- women from the School Sisters of Notre spectful of their way of life and is aware that Dame. Part of that work involved the fasci- their selfless generosity, manifest across their nating comparison between essays these lifetime of work, continues after death by the women wrote as novices prior to taking their donation of their brains for painstaking study religious vows, and their subsequent develop- and analysis. ment of Alzheimer’s disease. In some cases, Photograph by Ruth Jackson these essays were written well over a half century before any clinical evidence of Alz- heimer’s disease appeared. Women with rich- er vocabularies and syntactically sophisticat- ed linguistic styles appeared to fare better than those who had a paucity of polysyllabic words or complex sentences. (I am hoping this last sentence is predictive of remaining cognitively intact in my 90’s!) Aging with Grace is not only about different aspects of Sr. Nicolette Welter, SSND, welcomed a special the nun study; it is a rich description of a guest, Dr. David Snowdon, to her 101st birthday group of women, a scientific quest and an ex- party. Sister was featured in “Aging with Grace,” cellent popular account of our current Dr. Snowdon’s popular account of the Nun Study. 3 Engaging Aging Fall 2012 The Nun Study, continued Photograph by Ruth Jackson Snowdon neatly combines a good story, some well-explained science and a nicely developed spiritual sense. The pursuit of scientific re- search provides the bare bones of the story. Snowdon has used the School Sisters of Notre Dame as research subjects for a variety of rea- sons that make them an excellent group for study. Many who study Alzheimer’s disease, or, for that matter, other conditions that afflict humans, are bedeviled by the presence of what Sr. M. Celeste Glovka, SSND, visits with Dr. David are called confounding variables, specific hab- Snowdon. The second-last living participant in its or traits of individuals that may predispose Mankato, Sister died in August, 2012, at age 98. them to a particular illness. As a group of hu- man beings, however, there is a uniformity in women: he honors their commitments and, in the lives of the School Sisters of Notre Dame telling their stories, makes clear that God is that decreases some of the most common con- present and active even in those who are con- founding variables. They did not smoke. They fused or unable to remember. Hope and love did not drink. There are good records of their can remain alive even when cognitive func- lives that explain what they did in common tion declines. Aging With Grace is a realistic, and when individuals had unusual experienc- honestly hopeful and grace-filled book about es. These characteristics make the sisters a re- a difficult illness. It combines good science markably good research group. Snowdon with wise advice and thought-provoking sto- writes about hypotheses and testing data with ries.I would recommend it to all who are at verve and full of a sense of the excitement of risk for Alzheimer’s disease—in other words, good research. He provides the best popular anyone with a brain. The book will be espe- account I have read of what we know about cially helpful for persons with early Alzhei- dementing illnesses and how to minimize or mer’s disease (yes, people with early Alzhei- avoid them, and offers excellent explanations mer’s can read, think and enjoy life fully), as of some of the basic scientific principles that well as family members and caregivers of in- could lead to cures in the future. dividuals who are in any stage of the disease. But the best thing about this book is the stories of lives spent in service to God.