MY HUSBAND IS LEAVING ME FOR DEMENTIA

"Nowadays, it happens to me so many times," Bhaiyya said, putting a flame from his Zippo to a cigarette he had been holding between his lips for a full minute before realising he had to light it.

"What ?" I exclaimed , not quite getting him, a bit distracted also by the din of a noisy party on a Mandeville Garden rooftop.

"I dial someone's number, take the phone to my ear and then even as the phone is ringing , I am seized with a mild panic," he went on, blowing the first cloud of smoke . 

"Panic? On dialling a number?" I spat out my surprise .

" Yes, I just forget the number  I dialled  and my mind goes completely blank , " he explained.

"And you then look at your own phone screen to confirm  the number," I almost shouted back excitedly , suddenly remembering that this happens with me so many times. 

"You got it," he smiled, and then went for the finger snack of celery stick and dip sauce which suddenly floated in front of him.

I took a sip from Jacob's Creek, pursed my lips, closed my eyes for a moment and  took a quick journey to many such instances when memory has played weird games- embarrassment at forgetting a person's name while introducing her, absence of recall of the food or even the mode of return journey after the previous night's binge, searching for keys even while holding them in the hand,  and many such moments. 

The world is now seeing  a surge in the number of memory related diseases. Paradoxically, it has been the longer life expectancy owing to improvements in the health care that has also resulted in an increase in the number people affected with noncommunicable diseases, including dementia, whose most common form is Alzheimer's Disease or simply AD. 

The first  instance of AD I had heard was when it struck a former Chief Justice of Patna High Court whose son was a class tennis player in my college days. Then it was Renu Chachi, in her days one of the leading gynaecologists of Patna,  and with whom I shared a special bond in that I was her "first child" - yes, the first child she had assisted independently in childbirth. My good friend Mrityunjay 's father's life was also wasted by AD towards the end and so was one of my senior colleague's mother in law's.. Lately the father of another friend of mine has been afflicted, she watches him helplessly as a patch of Exelon is stuck in different  places on  his back every other day, and every passing day the disease thunders deafeningly in what she describes as  the  "stillness of my parents'  house". 

I had once checked up on this disease after reading my friend's article in Huffington Post.  Dementia is a syndrome, usually of a chronic or progressive nature, caused by a variety of brain illnesses that affect memory, thinking, behaviour and ability to perform everyday activities and is  one of the major causes of disability and dependency among older people worldwide.  The total number of people with dementia worldwide in 2010 was estimated at 35.6 million and was projected to nearly double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050. The total number of new cases of dementia each year worldwide is nearly 7.7 million, implying one new case every four seconds! 

Dementia is expensive as it reportedly cost the world US$ 604 billion per year in treatment and care in 2010. If dementia care were a country, it would be the world’s twenty-first largest economy, ranking between Poland and Saudi Arabia! Most European countries are spending about 1% of their gross domestic product (GDP) on dementia - Sweden spends over 2.5%.  Families and caregivers who are required to provide care and patients affected by dementia also pay a high price in terms of their quality of life - my friend confided that she could handle her father's physical ailments but what devastates her is " the void his intellectual space has become". 

So many solutions have been prescribed for treating memory disorders. Generally, modern medicine treats them as per the cause of the dementia, so if it is due to medicines, then change of medicines, if due to nutritional deficiency, then nutritional supplements , if depression then medicines to treat depression, if due to hypertension then BP medicines, if it is stroke related, then therapy, and so and so forth. But not all memory disorders are reversible, and Bhaiyya was wondering whether this could be prevented , or at least we could do something to make ourselves less vulnerable to it. It was this stage that he spotted Dr. Ram, a psychiatrist with Apollo Gleneagles, who had just entered the room and broached the topic of forgetfulness and dementia and asked him what could be done to prevent these. 

" And don't ask for giving up single malts and cigarettes," Bhaiyya spelt out his conditions for taking advice.

The Doctor smiled, told Bhaiyya he cannot take the risk of recommending something so drastic to him. He  had built  up a reputation for speaking in riddles to tease his friends, and this time it was no different.

"It may be music to your ears, but the solution could well be lying within your fingers, " he smiled and excused himself, promising to return shortly.

Both, Bhaiya and I , smiled , only to camouflage our inability to crack the riddle at the first go:Music, finger, ear- what did he mean?

A competing engagement drew Bhaiyya away from me , and I sat alone, reflecting over what the Doc had said. 

I sipped some more wine and looked at my fingers to launch an attack to crack da Ram Code. The finger is the most inquisitive and friskiest organ of the body, as it flits from one orifice to the other , sometimes of self and at times of others, in constant animation. Once, during an orificial probe, it had created a tehelka in the world of journalism.  At times the finger is dreaded, ask any  cricket batsman. It has an auto disciplining mechanism so that when you point one at someone, three are pointed back at you.

The sensation of touch in a child is the first to develop, ahead of vision, sound, taste , smell or balance. Through its  fingers,  the child experiences its first contact with the world as it feels the skin of the mother.  Fingers have enabled even the visually challenged to read , and most amazingly , as any person who has has been diagnosed by the ancient technique of naadi nidaan would admit, it is with the help of their fingers that the vaids read and listen to your pulse with a thoroughness and accuracy which are normally achieved in modern medicine after a clutch of tests.

I recalled from my school biology lessons  that our fingertips are densely packed with thousands of nerve endings, which produce complex patterns of nervous impulses that convey information about size, shape and texture of objects, and our ability to identify objects by touch and manipulate them depends upon the continuous influx of this stream of information. Recent research has revealed that since the nerve endings in our fingertips perform complex neural functions locally and not in the somatosensory cortex of the brain, the touch processing pathway of the brain has been effectively outsourced by the brain to the finger, just like it has aspects of visual processing, e.g., motion detection , to the retina. But still I could not crack Dr. Ram's riddle and I settled with the next glass to mull about music.

"Music is the most famous language," said Psy of  Gangham fame. And it is not just quite a language, it is almost life itself. Nina Kraus, a prominent brain researcher at Northwestern University said, music training does for the brain what exercise does for body fitness. Learning music has the ability to change the brain chemically and physically, it imposes a high working- memory load and thereby expands the working memory capacity which in turn improves the ability to think, as manifest in high IQ scores. I was suddenly reminded of the point made by Prof. Anil Gupta of IIM A that the highest mean IQ amongst students, as per the PISA test for many years,  was in Finland which also has the most extensive system of music instruction at school levels!

But still I could not connect all these with fingers and hit on the nail what Dr. Ram was talking, gave up and moved on to watch the launch of  a huge phanush or paper lantern when both, Dr. Ram and Bhaiyya resurfaced suddenly from just nowhere. We sat down and he asked whether I could make something of what he had said. I told him that I knew about the fingers' connectivity with the brain through the neural pathway and about the ability of music to stimulate the brain to the extent of effecting chemical changes , but was not getting the last mile connectivity to his cryptic remark.

"Well, just join your findings and you will get the answer because you are almost there," he said,

He explained that auditory learning which is implicit in music learning enhances listening, thinking, and learning abilities and that music practice enhances quicker movement of nerve impulses, grey matter growth and fibre formation of brain structures involved in the specific musical task. 

" Now let me connect this with fingers. The benefits of learning music on brain and brain memory is significantly augmented when you practise an instrument with your fingers because practising an instrument involves assembling, storing and constantly improving complex sensory and motor programs through prolonged and repeated execution of motor patterns under the controlled monitoring of the auditory system, " he added.

" So if at all I can advise anything in this matter,  I would say that all of us to should learn to play a musical instrument if not already done after we reach the age of 50," Dr. Ram signed off for the evening. Bhaiyya was happy , he was an ace percussionist, had played the guitar in his younger days and had taken to learning the keyboard recently. The problem was with me, and it set me thinking which , if you ask me,  is well begun, which itself is half done.  Not bad!