Pentecostal moments in long-term care: Part 2

The first installment of “Pentecostal Moments in Long-Term Care” offered ethnographic snapshots of the wondrous effects of religion in advanced age. Researchers have examined how precisely religion affects the neurons in our brain and shapes our social behavior. The first baby-steps on this unchartered journey have led to discoveries both puzzling and enlightening.

Alzheimer’s, the disease that assaults our humanity, victimizes one out of ten by age 65; it takes a toll of one in two after age 85. In longitudinal studies almost a third of elderly who die show they had asymptomatic Alzheimer's—i.e., although their brains showed amyloid plaques and neurofibrillary tangles, typical of Alzheimer's, in life, these patients suffered no memory loss—the classic symptom of the disease. The brain-reserve hypothesis explains this phenomenon: Just as exercise helps trained athletes to resist arthrosclerosis, active and sharper minds develop enlarged neurons that resist the degeneration of the brain.

What promotes brain health? Religion surely does, in ways direct and indirect, subtle and mysterious; religion alters brain activity among the elderly, it affects emotions and changes behavior. Hard-nosed research at Harvard, Duke, Stanford and other notable centers has opened doors to the vast uncharted universe of the human brain. Early findings inspire awe, raise spiritual questions and offer practical advice.

• Satisfaction in life adds years to life. Across all faiths, elderly that attend more religious services enjoy greater life satisfaction and a longer life.
• Elderly that practice religion slow the decline of pulmonary function.
• Human brains shrink with age; different regions in the brain shrink at different rates. Religious practice retards atrophy in the hippocampus and  slows  the progression of Alzheimer's disease.
• Church attendance encourages mutual support among attendees, eases stress, boosts emotional health and confers a host of positive benefits.
• Religion encourages transcendence and altruism. Elderly who give of themselves, who serve and help others, lower their risk of mortality.

With age, our words and cognitive ability fade, but symbols of faith continue to elicit responses.  Caregivers have for long found simple ways to reach beyond the sound barriers erected by short-term memory loss, and to awaken long buried experiences. Where words fail, comforting religious prayers and the touch, feel and smell of revered, familiar objects effectively communicate the message. The thousand bedside victories of the use of evocative religious symbolism make redundant its scientific validation.

• Catholic: Crucifix, rosary, scapular, sacred heart badge, statue of Mary, prayer cards for: The Lord’s Prayer, 23rd Psalm, Ten Commandments, Apostle’s Creed, Hail Mary, Magnificat, mysteries of the Holy Rosary and prayer to the Sacred Heart.
• Protestant: Bible (New King James Version), cross, traditional picture of Jesus, prayer cards for: The Lord’s Prayer, 23rd Psalm, Ten Commandments and Numbers 6: 24-26.
• Jewish: Prayer book, yarmulkes, tallit, mezuzah, Star of David, Kiddush cup and candlesticks.

OF NUNS AND BRAINS

Alzheimer’s research made a giant leap forward in the 1990s. David Snowdon thought he was in researchers’ heaven. He found a population group more ideally suited for Alzheimer’s research than he had hoped for in his most uninhibited fantasy. The group he found was racially homogeneous and helpfully it ranged from ages 50 to well over 100; the members shared common beliefs, followed a common life style, practiced a common profession and used a common healthcare plan—a perfect group free of variations that complicate a researcher’s life.

Professor Snowdon had befriended the School Sisters of Notre Dame (SSND), Catholic nuns, in Mankato, Wis. The SSNDs had agreed to participate in a longitudinal Alzheimer’s study. He now faced a final, formidable task. He had to ask the sisters: Would they, upon death, donate their brains for the cause of science? Snowdon drew on his own Catholic experience and reverentially made the request; he addressed their religious concerns including the teary question of a young nun: If afflicted, would Alzheimer’s make her forget God?

In a consummate act of religious altruism, the SSNDs, dedicated to teaching, decided to push their mission beyond the grave and continue to be teachers. 670 of them from convents around the nation offered their brains for the study. 

The humble, unobtrusive act of transcendence was too momentous to stay hidden. The news spread out of Mankato and announced to the world on the cover of Time magazine and in headlines around the globe: “Nuns donate their brains to Alzheimer's research.”

The progress of the research proved as historic as its beginning. Its early success drew more research dollars. Rush University launched new studies which attracted many and diverse volunteers. Quite a number came from Catholic religious orders, like the Congregation of St. Joseph in La Grange Park, Ill. They agreed to annual tests to record changes in memory till death and to have their brains autopsied after death. 

The brains, more than 850 of them, along with a rich, detailed clinical history gleaned from tests and physical exams over the years have launched an army of investigators who at this very moment are busy tracking the onset and progress of the curse that threatens our personhood. Their early findings speak to us as private persons and as healthcare professionals.

• The health of body and mind of these nuns, now in the eighth decade of life, was foreshadowed in the brief autobiographies they wrote 50 or 60 years earlier. As young women joining the convent, these novices wrote a word portrait of themselves in a simple uniform template. After he analyzed these accounts, Snowdon was able to predict, with 85 percent to 90 percent accuracy, which of the young authors would show the brain damage typical of Alzheimer's disease in old age. Those young women, who had more sophisticated language skills, i.e., higher density of ideas per every 10 written words, and showed complex grammar skills, were far less likely to suffer from dementia many decades later. So too, sisters who had expressed the most positive emotions in their writing ended up living longest, and those on the road to Alzheimer's expressed fewer and fewer positive emotions as their mental functions declined. Higher education, mental activity and solving crossword puzzles are exercises that keep the brain healthy; they build up a neural reserve—the ramparts against Alzheimer’s. By cultivating mental curiosity in children and by reading books to them we start them off on the path to a healthy, brainy life. 
• A healthy heart makes for a robust brain. Alzheimer's disease has a cardiovascular component. Nuns with Alzheimer's and a history of strokes almost inevitably showed symptoms of dementia. But only half the nuns without strokes were comparably afflicted. Strokes and head trauma compound Alzheimer’s effects. So avoid tobacco, exercise and eat sensibly. Ride with a helmet and buckle up when you drive.   
• Nuns with high folate levels, (found in leafy vegetables) showed little damage to the brain wrought by Alzheimer’s. But antioxidant vitamins C and E showed no obvious benefits. Neither did mercury or aluminum stand out as culprits as they have shown up in other studies. This serves as a reminder that life is a multivariate progression. It holds unanticipated surprises at every turn.

These religiously driven women stunned Dr. Snowdon. “About half the sisters are mentally normal when they die," Snowden said. "And what is quite surprising to us is that a significant number of them have full-blown Alzheimer's disease in the brain but are acting normal."

We owe profound gratitude to these unassuming exemplars in our midst, who in life and in death teach us new things about the human spirit

V. Tellis-Nayak, PhD, a medical sociologist, is a researcher at My InnerView. He has been a university professor, has conducted research in the United States and abroad, and has authored books and articles. He can be reached at vtellisn@gmail.com.

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