Baycrest doctor writes book of ‘hope and healing’ for Alzheimer’s patients and their families

Jan. 07, 2013

Draws from grandmother’s example to minimize symptoms of the disease

Dr. Tiffany ChowToronto, ON – A Toronto doctor who diagnoses Alzheimer’s disease and other dementias has a story to tell about the courageous people she’s met in her clinic and her own evidence-based plan to protect her cognitive health as she ages.

Dr. Tiffany Chow, 46, never worried about her own risk for Alzheimer’s disease. There was no history of the condition in her family – or so she thought – and she follows a fair number of healthy lifestyle choices.

A behavioural neurologist in the Sam and Ida Ross Memory Clinic at Baycrest Health Sciences, Dr. Chow has met and counseled hundreds of patients and their families through one of life’s most challenging journeys. Then came the unexpected curve ball – she realized that her own grandmother in Hawaii died of Alzheimer’s, but without the typical memory loss symptoms. With this revelation of a familial connection, Dr. Chow began to ponder the question, “Could I combat Alzheimer’s brain changes by building my cognitive reserve just like my grandmother?”

Trying to balance a busy professional career with raising a new family, regular exercise and outdoor activities that she’s always loved, she began to pay more attention to every aspect of her lifestyle to make sure she was doing everything possible to maintain and fortify her own cognitive health.


“There are many risk factors for dementia that are within your power to control, such as diet, cardiovascular exercise, maintaining a healthy weight to avoid obesity and diabetes, and, most notably, remaining socially integrated with others.” – Dr. Tiffany Chow


Dr. Tiffany Chow
Erica Ehm (left), long-time journalist, award-winning songwriter and creator and publisher of the successful YummyMummyClub.ca, interviewed Baycrest’s Dr. Tiffany Chow about her new book, The Memory Clinic (Penguin Canada) at the Terraces of Baycrest on Jan. 28. Many in attendance shared their poignant experiences of caring for a spouse or parent with dementia. Dr. Chow answered many caregiver questions during the evening and provided helpful tips and strategies for coping with what is often a long caregiving journey with a loved one who has Alzheimer’s or another type of dementia. She emphasized several times that caregivers must look after themselves first and likened it to putting on an oxygen mask in a plane that’s in trouble. “My strongest advice is for caregivers to first look after themselves. Caregivers have to feel safe, supported and loved in order to sustain their provision of kindness, patience and support to the person with Alzheimer’s disease. The course of dementia lasts many years, so pacing is an important part of caring for caregivers,” she said.

A chance meeting with a literary agent – who encouraged her to “write a book” that captures the stoic resolve and life lessons imparted by her patients and their families – started Dr. Chow on the path to penning The Memory Clinic (Penguin Canada). The book captures her patients’ and their caregivers’ inspiring stories mingled with her own unique perspective and healthy lifestyle practices that she hopes will thwart any Alzheimer’s brain changes into old age.

“I wrote this book for caregivers who are starting this difficult phase of life with dementia in a loved one and want to learn strategies for coping from those who’ve been down this road before,” says Dr. Chow, who is also a senior scientist with Baycrest’s world-renowned Rotman Research Institute.

“I also wrote the book for aging boomers who are worried about getting dementia and want to learn the best ways to reduce risk based on the latest available scientific evidence. Those of us working in the behavioural neurology field are, to a certain degree, self-interested. We want to avoid these brain diseases ourselves,” explains Dr. Chow, who faithfully adheres to regular exercise, the practice of loving kindness based on Buddhist principles, while struggling to stick to a low fat Mediterranean diet.

Buddhism offers teachings about compassion, wisdom and equanimity which all play a huge role in helping someone cope with tragedy, explains Dr. Chow. “They are very much in alignment with what works for caregivers and for healthcare professionals who are affected by their work with patients and families dealing with such difficult diagnoses on a daily basis,” she says.

Dr. Chow is matter-of-fact when talking about her own relationship to Alzheimer’s: “My grandmother had an atypical, low impact manifestation of Alzheimer’s disease, so I’m not just doing this clinical work as my job. I am scanning the latest scientific evidence to see what she did right and what I should change for myself. If what I’m learning can benefit others who want to protect their aging brains, then why not share it in a book?”

Three Do-It-Yourself appendices at the end of The Memory Clinic offer readers an evidence-based Cosmos-style quiz that calculates their risk for dementia, plus tips for reading health news headlines with a more critical eye and choosing an appropriate and safe experimental drug trial for a loved one with Alzheimer’s or other dementias.

The Memory Clinic will be available at major book retailers in January 2013.

Dr. Tiffany Chow Dr. Tiffany Chow

Dr. Tiffany Chow at her book launch at Ben McNally Books on Jan. 17.


 

About Baycrest Health Sciences
Headquartered on a 22-acre campus in Ontario and fully affiliated with the University of Toronto, Baycrest is a global leader in innovative care delivery and cutting-edge cognitive neuroscience.


Dr. Tiffany Chow Interview
Q&A interview with Dr. Tiffany Chow


 


For more information about this press release or to interview the author Dr. Tiffany Chow, please contact:
Kelly Connelly, Senior Media Officer
Baycrest Health Sciences
416-785-2432
kconnelly@baycrest.org

Dr. Tiffany Chow InterviewQ&A with Dr. Tiffany Chow, author of The Memory Clinic

Tell me about your new book?

It has wonderful stories about people who courageously face a very difficult situation. At first it’s devastating for them, yet the kindness they bring to their relationships, the enduring love, reclaims the fear and anxiety into an opportunity to embrace a different sort of outcome, which creates a compelling work ethos for me.

Who did you write this book for?

I wrote the book for two audiences – those who are caregivers for people with dementia, and those who are planning to live beyond 65 and are worried they will get dementia. There’s a lot of information in the book about how people come to dementia, and what we know so far about how to prevent dementia. The viewpoint from which I’m writing is one of solidarity with people who anticipate living a long life and hoping to avoid dementia. My grandmother had an atypical form of Alzheimer’s disease, in that she didn’t really show symptoms during life, so my reading and pondering on the subject of dementia is no mere job. I am actively scanning the latest scientific evidence to see if there is something else I should change for myself.

How did you come up with the content for book?

A lot of the content for the book is derived from what I call the Frequently Asked Questions – from my patients and their family members and from those I meet at cocktail parties who always have lots of questions for me once they find out what I do for a living. People want to know about the most promising clinical drug trials for Alzheimer’s or what I am doing to reduce my own risk of getting dementia.

You mentioned that successful caregiving doesn’t always start out that way. That’s interesting, can you elaborate?

There are a few successful principles that caregivers tend to learn as they go through their journey. The first is to pare down the list of things they feel they need to do every day to only what is absolutely necessary. I suggest there are four main principles to guide caregivers:

  1. The patient needs to be safe.
  2. The patient needs to be pain free.
  3. The patient needs to be allowed to do as much as he or she can do.
  4. The patient needs to be supported in finding enjoyment in some little slice of life every day. It can be as simple as sitting in the sun with their favorite pet.

The best person to facilitate this is the person who knows the patient best, typically a close friend or family member. I remind caregivers that these four principles are more important than spending hours upon hours scanning the internet looking for the latest drug breakthrough that might help their loved one. That part is my job. So I’m hoping that caregivers will take from the book some really feasible, stress-reducing tips from other caregivers and from our clinic in terms of what can make their time easier and more fulfilling.

There is no cure for Alzheimer’s disease and the best we can hope for are drugs that may alleviate the symptoms for a while, but ultimately the disease will progress in the brain. What inspiring message does your book offer when it seems there really is no hope with this disease?

My book helps caregivers to find meaning and some gratitude and trust that in caring for a loved one with dementia, one is embracing more of life. It takes effort for caregivers to shift their perspective and accept that dementia is part of many lives. It’s a change that we don’t want, it’s a change that we all want to avoid, but once we accept it as part of the life journey, the caregiving role can take on a new, positive meaning. It shifts from “I’m going to fight this disease” to “I’m going to help this person with dementia make the best of life as we go on.” The other piece is that for people who are still well and wondering how to avoid dementia, there are lots of lifestyle risk factors that are modifiable.

You mention that your biological grandmother likely died of Alzheimer’s. How much of a genetic risk is there for you, percentage wise?

Because she did not show obvious signs of Alzheimer’s disease, it didn’t occur to me during her life to pursue genetic testing. In general, having a 1st degree relative with dementia triples your risk, but Ah Quan was a 2nd degree relative and both of my parents (touch wood) are doing well cognitively, so I’m not necessarily looking at that tripled risk myself. However, one of the genes related to Alzheimer’s risk may have been transmitted to me, which means I have a fighting chance to offset whatever that gene has in store for me.

As a doctor who specializes in diagnosing serious memory disorders, even if you didn’t have a genetic risk factor for Alzheimer’s, would you describe yourself as hyper vigilant about your own cognitive health?

 

For those of us working in the field, to a certain degree we are self-interested. We want to avoid developing a cognitive impairment. How we think, put things together, and explain things for people, forms a large part of our own identify. The important thing that’s coming forward in the news and research these days is the different aspects of dementia risk that are modifiable, such as diet and regular exercise. In my case, I have had the happenstance of recognizing that reducing my stress, through mindfulness and a more open approach to the world, protects me from the changes of aging and helps me to help caregivers I see in my practice more effectively.

Does your book address the importance of caregivers looking after themselves?

Yes. My strongest advice is for caregivers to first look after themselves. Caregivers have to feel safe, supported and loved in order to sustain their provision of kindness, patience and support to the person with Alzheimer’s disease. The course of dementia lasts many years, so pacing is an important part of caring for caregivers.

How is your book different from all the other consumer health books on the market?

I’m sure my book has a lot of overlap in content with other books; however the one thing that is different in my book is that I’ve found that some of the tenets of Buddhism resonate so powerfully for caregivers and for healthcare professionals working in a memory clinic. Buddhism offers teachings about compassion, wisdom and equanimity, which all play a huge role in helping you cope with something that is otherwise viewed as a tragedy in your life. Also I’ve got the family connection, so I’m writing the book as someone who had a grandmother who had Alzheimer’s disease and that may be a little bit more of a personal angle than what other authors have done. The book is filled with my own editorial comments on whether I can make some of the lifestyle changes prescribed by the latest evidence. Readers can digest the information I’m providing and also get insight into how I personally am thinking about what I need to do to reduce my risk of Alzheimer’s.

Tell me about the Do-It-Yourself sections at the end of the book.

There are three sections at the back of the book that I call the DIY sections. The first one offers readers’ tips on how to read the newspaper to determine what is important health news and what is not. When you see a science story about the latest clinical drug trial breakthrough, you have to ask yourself, ‘Is this story written for the venture capitalist to attract their dollars, or is this information that might help me choose to take a new drug?’

The second DIY section instructs readers on the questions they need to ask when trying to choose a clinical drug trial that is safe and suitable for their family member. I explain the ins and outs of designing clinical drug trials and how hard it can be for family members to decide which trial is right for their loved one. There are clinical trials where you cannot be taking any other drug, which might be a deal-breaker. There are placebo trials where you may not receive the experimental drug at all. When you are desperate to find some kind of treatment that may slow or halt the disease, it can be difficult to put aside emotion and think critically (with equanimity!) about what is an appropriate drug trial. Certainly these are frequently asked questions from the patients and their family members who I see in the Sam and Ida Ross Memory Clinic at Baycrest.

The third section is for aging boomers who are concerned about getting dementia and wondering how seriously they have to take every chapter in my book. I include an evidence-based Cosmos-style quiz where readers answer multiple choice questions. Each potential answer carries a different weight toward the total score, and a person’s total score indicates his/her risk for developing dementia. I also include a separate quiz for those over age 70 because the predictors change at that point in the lifespan. Both quizzes are taken from peer-reviewed scientific literature.