A Country Doctor Writes:

Happiness is widely thought of as being present in and enjoying every moment of our lives. The whole mindfulness and meditation movement is built on this premise, as are some of the major religions of the world.

But how possible is it to enjoy every ordinary day if our thoughts are elsewhere, ruminating about a future that may not even happen?

Let’s be honest and admit that there are no good treatments for Alzheimer’s disease. Let’s also admit that the things we know can delay its onset are the same things that to some degree can ward off diabetes, heart disease and many other chronic diseases that afflict us westerners.

So, I don’t buy into the strategy of using genetic or other predictors in singling out individuals for scare tactics in promoting healthy lifestyles that we should all be adopting anyway.

It doesn’t work very well with diabetes, now does it? We can and do talk about blindness, kidney failure and toe amputations, but people still get those things, even though diabetes is a whole lot more reversible than Alzheimer’s.

If scare tactics can delay the inevitable outcome of this terrible disease only to a small degree, what impact can an early diagnosis have on people? Depression? Suicide? Self-neglect? Risk taking? I think those negatives are a whole lot more frightening than poor estate planning, which is one argument for early diagnosis I have heard again and again.

Would you tell a school child they’ll never get the life or career they hope for? Would you tell a pregnant woman that her baby will die from SIDS a few months after birth? Would you tell a bride that ten years from now she’ll be a widow or divorcee? Would you tell a grandmother that her first grandchild will die from an overdose before age 15?

All we have is today. We should live it to the fullest, not in a hedonistic way, but with respect for our bodies, our fellow humans and our planet. And we should lead healthy lives because it is the right thing to do, and because that can help us enjoy the future more – if we should happen to get there.

I watched my father die at 86 from Alzheimer’s, which is how his mother had died. He seemed puzzled sometimes, but he didn’t seem aware or concerned about his declining cognition or his ultimate diagnosis by the time it had become obvious to the rest of us.

Curiously, the common word for it in Sweden when my grandmother died was åderförkalkning, hardening of the arteries, which actually better approximates the pathophysiology than the mumbo jumbo amyloid theory that made this disease seem quite random. When it was called hardening of the arteries, the commonsense implication was that unhealthy eating habits accelerated the disease in predisposed individuals, which is where we have now ended up again.

We should promote healthy lifestyles with the carrot – as a way to feel better in the short term and possibly into the future, but spare us from the stick. Reward is a better motivator than punishment.