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Alzheimer on (Lack of) Purpose?

October 30, 2024 Health & Healing No Comments

With an estimated 150 million Alzheimer’s cases projected worldwide by 2050, the relentless search for answers has centered on genetic and biochemical factors, including amyloid plaques and tau tangles. [1]

Yet, another powerful player might be right in front of us: a deep, sustained sense of purpose. Could the way we view and nurture life’s purpose influence the onset and progression of Alzheimer’s?

A shift from external to internal factors

Research efforts have focused on pharmaceutical treatments, but the results have been disappointing, with high-profile drugs like Aducanumab showing limited effectiveness in altering Alzheimer’s progression. [2]

This points to a missing piece in Alzheimer’s prevention: the role of existential health, particularly deep purpose (DP). Studies suggest that DP might act as a cognitive ‘buffer,’ preserving function even in the presence of Alzheimer’s pathology. [3] Individuals with a strong sense of purpose are significantly less likely to develop Alzheimer’s.

The science of purpose and brain health

DP is more than a list of goals; it is about connecting with something lasting and meaningful, such as personal growth or community. This profound alignment fosters mental-neuronal patterns that stabilize cognitive health and resist degeneration. [4]

Like physical exercise for the body, consistent mental engagement builds cognitive reserve — the brain’s capacity to adapt and compensate for damage. For instance, in the famous Nun Study, participants with high DP maintained cognitive sharpness, even when their brains showed significant Alzheimer’s lesions. [3] Purpose-driven living may foster resilience that helps prevent decline.

Purpose as a preventive practice

Promoting DP as early as possible offers a compelling preventive strategy for Alzheimer’s. Purpose can be nurtured by supporting individuals to connect with meaningful goals, whether through education, relationships, or personal interests. As studies suggest, DP may not only lower Alzheimer’s risk but also aid those with cognitive impairments in better coping with their condition. [5]

Moreover, DP’s impact extends to lifestyle choices, encouraging healthier diets, increased intellectual activity, and greater stress resilience. [6]

Building resilience and finding strength in spirituality

Research suggests that chronic stress significantly increases Alzheimer’s risk, with stress hormones like cortisol impairing memory-related brain areas. [7] Conversely, resilience – built from early life experiences, education, and supportive environments – can protect the brain, potentially delaying Alzheimer’s onset even in the presence of typical disease markers.

For individuals with Alzheimer’s, spirituality offers an essential resource for coping. Engaging in spiritual practices provides a sense of connection and hope, allowing individuals to approach Alzheimer’s with strength. The role of inner resilience and spirituality underscores the potential of non-pharmacological avenues, like those promoted by AURELIS and Lisa, to support Alzheimer’s prevention through meaningful, life-affirming practices.

Avoiding cognitive debt

In addition to stress and spiritual resilience, researchers highlight the risk posed by repetitive negative thinking (RNT) — a cycle of rumination and worry that creates what’s termed ‘cognitive debt.’ [8]

Just as financial debt burdens one’s future finances, cognitive debt gradually diminishes mental reserves, heightening susceptibility to Alzheimer’s.

Toward a new vision in Alzheimer’s care

Reframing Alzheimer’s prevention with DP could change the game, moving beyond the limits of pharmaceutical approaches. Purpose-driven living might be the most accessible and humane form of prevention. A broader focus on fostering DP can support brain health while enhancing life’s richness at any stage.

Alzheimer’s prevention, then, becomes a lifelong journey of cultivating inner depth and purpose, allowing for cognitive resilience built from within. Connecting with a profound purpose may create a strong foundation against cognitive decline. Alzheimer’s prevention rooted in DP not only respects each person’s depth but also offers a proactive, compassionate path forward.

The AURELIS approach

In Alzheimer’s care, fostering DP is particularly significant as it aligns with brain health by reinforcing mental-neuronal patterns that help preserve cognitive function. AURELIS sessions allow users to tap into subconscious mental processes, offering a pathway to experience purpose that resonates deeply.

This process may offer a preventive buffer against cognitive decline by building resilience and fostering cognitive reserve in ways that mirror physical exercise’s role in preserving physical health.

Lisa’s role

As an integral part of AURELIS, Lisa, the A.I.-coach, provides a practical, accessible means for users to engage with their inner world in a personalized way. Unlike conventional cognitive approaches, Lisa respects the depth and uniqueness of each user, guiding them to uncover and cultivate their own DP. By gently inviting users to explore purpose and connect with meaningful goals, Lisa can assist in Alzheimer’s prevention by helping users maintain an active, engaged mind and a sense of mental resilience.

Also, Lisa encourages positive mental engagement, helping individuals build resilience by transforming worry into constructive reflection. This can help prevent the accumulation of cognitive debt, safeguarding mental resources over time.

This aligns with the concept of a lifelong journey in building mental robustness — one that supports purpose-driven living, even amidst life’s challenges.

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References

1. Khalsa, D.S., & Newberg, A.B. Spiritual Fitness: A New Dimension in Alzheimer’s Disease Prevention. J Alzheimers Dis JAD. 2021;80(2):505–19.
2. Cummings, J.L., Tong, G., & Ballard, C. Treatment Combinations for Alzheimer’s Disease: Current and Future Pharmacotherapy Options. J Alzheimers Dis JAD. 2019;67(3):779–94.
3. Snowdon, D.A. Healthy Aging and Dementia: Findings from the Nun Study. Ann Intern Med. 2003;139(5 Pt 2):450–4.
4. Churchland, P. Brain-Wise: Studies in Neurophilosophy. MIT Press, 2002.
5. Russell-Williams, J., Jaroudi, W., Perich, T., et al. Mindfulness and Meditation: Treating Cognitive Impairment and Reducing Stress in Dementia. Rev Neurosci. 2018;29(7):791–804.
6. Morris, J.C. Is Alzheimer’s Disease Inevitable with Age? Lessons from Healthy Aging and Very Mild Alzheimer’s Disease. J Clin Invest. 1999;104(9):1171–3.
7. Machado A, Herrera AJ, de Pablos RM, Espinosa-Oliva AM, Sarmiento M, Ayala A, e.a. Chronic stress as a risk factor for Alzheimer’s disease. Rev Neurosci. 2014;25(6):785–804.
8. Marchant NL, Howard RJ. Cognitive debt and Alzheimer’s disease. J Alzheimers Dis JAD. 2015;44(3):755–70.

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Addendum

Me: “Lisa, do you see similarities between LLM (Large Language Models) confabulation and Alzheimer’s confabulation?”

Lisa: “Yes, there are intriguing similarities between LLM confabulation and Alzheimer’s-related confabulation, primarily around how each fills gaps in memory or information:

• Filling Knowledge Gaps: Both LLMs and individuals with Alzheimer’s confabulate by filling in gaps where information is missing. For LLMs, this happens because they are trained on vast, varied data but don’t truly “know” facts—when unsure, they generate plausible but not necessarily accurate information based on patterns they’ve learned. Similarly, confabulation in Alzheimer’s patients can arise when they attempt to make sense of fragmented memories or compensate for impaired recall, constructing plausible narratives that fit their understanding.
• Contextual Inference: LLMs rely on context to predict the next word or sentence, often producing information that seems logical within a given context but isn’t grounded in verified fact. Alzheimer’s patients, especially in mid to later stages, may also rely on context or familiar cues to “guess” parts of missing memory, leading to inaccurate but contextually fitting stories or statements.
• Lack of True Self-Awareness: Neither LLMs nor individuals with Alzheimer’s are aware of their confabulation. For LLMs, there’s no self-awareness, so they lack any mechanism for recognizing falsehoods. In Alzheimer’s, self-awareness can diminish as the disease progresses, meaning patients may be unaware of their memory gaps and are more likely to genuinely believe their confabulated stories.
• Emotional and Social Coherence: Both LLM-generated confabulation and Alzheimer’s confabulation often aim to maintain coherence within social or emotional narratives. This need for coherence can make confabulation seem more convincing in both contexts, as it follows familiar structures even if the details aren’t accurate.

However, a key difference lies in intent and grounding. LLM confabulation is rooted in probabilistic predictions without true experience, while Alzheimer’s confabulation is often rooted in fragments of lived experience and attempts to reconstruct personal meaning. In Alzheimer’s, this confabulation sometimes expresses a deeper need for connection or continuity of identity, an aspect that is deeply human and not present in LLMs.

In exploring these similarities and differences, we see how confabulation serves as an adaptive, if flawed, mechanism in both artificial and human contexts—LLMs confabulate to “seem” coherent. In contrast, humans confabulate to maintain a coherent self-concept amidst cognitive decline.”