Fwd: Nuns Offer Clues to Alzheimer's and Aging

From: Wade T.Smith (wade_smith@harvard.edu)
Date: Mon May 07 2001 - 14:20:53 BST

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    Subject: Fwd: Nuns Offer Clues to Alzheimer's and Aging
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    I throw this at youse here because of the mention of 'idea density'
    included, as well as the general interest of the study, and the
    specificity of the subject group for this data- all important, IMHO, for
    valid planning for memetic research.

    - Wade


    Nuns Offer Clues to Alzheimer's and Aging


    MANKATO, Minn., May 2 ‹ A spiraling road slopes gently up to Good Counsel
    Hill, where the convent of the School Sisters of Notre Dame perches
    peacefully. Within its thick red brick walls are bright paintings of nuns
    and children. Organ hymns waft from a circular chapel, and nuns attend
    Mass and murmur rosaries under a white vaulted dome.

    But this crucible of faith is also the site of an extraordinary
    scientific experiment. For 15 years, elderly Catholic nuns here have had
    their genes analyzed and balance and strength measured. They have been
    tested on how many words they can remember minutes after reading them on
    flashcards, how many animals they can name in a minute and whether they
    can count coins correctly.

    The autobiographical essays they wrote for their order in their 20's,
    when they took their vows, have been scrutinized, their words plumbed for
    meaning. And as they have died, their brains have been removed and
    shipped in plastic tubs to a laboratory where they are analyzed and
    stored in jars.

    The experiment, called the Nun Study, is considered by experts on aging
    to be one of the most innovative efforts to answer questions about who
    gets Alzheimer's disease and why. And now in a new report it is offering
    insight on a different subject ‹ whether a positive emotional outlook
    early in life can help people live longer.

    "The Nun Study has certainly been pioneering," said Dr. Richard Suzman,
    chief of demography and population epidemiology at the National Institute
    on Aging. "It's helped change the paradigm about how people think about
    aging and Alzheimer's disease."

    By studying 678 nuns ‹ at this convent and six others in the order, in
    Connecticut, Maryland, Texas, Wisconsin, Missouri and Illinois ‹ Dr.
    David A. Snowdon, an epidemiologist at the University of Kentucky, and
    colleagues have come up with tantalizing clues and provocative theories
    over the years.

    Their research has shown that folic acid may help stave off Alzheimer's
    disease; that small, barely perceptible strokes may trigger some
    dementia; and, in an especially striking finding, that early language
    ability may be linked to lower risk of Alzheimer's because nuns who
    packed more ideas into the sentences of their early autobiographies were
    less likely to get Alzheimer's disease six decades later.

    The new report, being published on Monday in The Journal of Personality
    and Social Psychology, says nuns who expressed more positive emotions in
    their autobiographies lived significantly longer ‹ in some cases 10 years
    longer ‹ than those expressing fewer positive emotions.

    "It's an important finding," Dr. Suzman said, "and I think it will lead
    to lots of additional studies."

    The nuns are ideal for scientific study because their stable, relatively
    similar lives preclude certain factors from contributing to illness. They
    do not smoke, hardly drink and do not experience physical changes related
    to pregnancy. The School Sisters are white and eat in convent cafeterias,
    and most were teachers in Catholic schools.

    The study is also considered powerful because it has information from
    several stages in its subjects' lives, including when they were too young
    to manifest Alzheimer's or other diseases related to aging.

    "I think the Nun Study is very important because it uses information
    obtained about people before the period of illness," said Dr. Robert P.
    Friedland, professor of neurology at Case Western Reserve University and
    author of a study showing that people with Alzheimer's were, as young
    adults, less mentally and physically active outside their jobs than
    people without the disease. "So we know from the Nun Study and others
    that Alzheimer's disease takes several decades to develop, and the
    disease has many important effects on all aspects of a person's life."

    All this has given Dr. Snowdon, author of a new book on the study called
    "Aging With Grace" (Bantam), a rare window through which to examine why
    some nuns thrive and others deteriorate so much they lose speech,
    mobility and much of their memory. The differences show up even in nuns
    with virtually identical backgrounds, even those who are biologically

    At 93, Sister Nicolette Welter still reads avidly, recently finishing a
    biography of Bishop James Patrick Shannon. She knits, crochets, plays
    rousing card games and, until a recent fall, was walking several miles a
    day with no cane or walker.

    But a younger sibling, Sister Mary Ursula, 92, shows clear Alzheimer's
    symptoms, Dr. Snowdon said. Several times a day, Sister Nicolette feeds
    and reads prayers to Sister Mary Ursula, who uses a wheelchair and can
    hardly lift her head or gnarled hands.

    The other day, Sister Nicolette prompted Sister Mary Ursula to remember
    her age and birth date, but when Sister Nicolette asked if she recalled
    when "Sister Julia told you to pick up the Kleenex people used after Mass
    and you didn't want to," Sister Mary Ursula's eyes glazed, showing no
    hint of recognition.

    Another Welter sister, 87-year-old Sister Claverine, is still active and
    clearheaded. A fourth sibling, Sister Mary Stella, died in 1996 at 80.

    "I wouldn't have any idea why this happened to Mary Ursula," said Sister
    Nicolette, "but I just feel like I'll keep my mental faculties."

    Some of Dr. Snowdon's research suggests she might be right. Sister
    Nicolette's autobiography, written when she was 20, was full of what Dr.
    Snowdon calls "idea density," many thoughts woven into a small number of
    words, a trait correlating closely with nuns who later escaped

    One sentence in Sister Nicolette's essay, for example, reads, "After I
    finished the eighth grade in 1921 I desired to become an aspirant at
    Mankato but I myself did not have the courage to ask the permission of my
    parents so Sister Agreda did it in my stead and they readily gave their

    Compare that to the essay of another Mankato nun, who is in her late 90's
    and has performed steadily worse on the memory tests. The nun, who sat
    quietly by a window the other day, wrote in her essay, "After I left
    school, I worked in the post-office."

    The Nun Study's latest published findings offer similarly provocative
    ideas about how positive emotional state in early life may contribute to
    living longer. Experts say linking positive emotions in the
    autobiographies to longer life echoes other studies showing that
    depression increases risk of cardiovascular disease and that people rated
    as optimists on personality tests were more likely than pessimists to be
    alive 30 years later.

    The findings also raise questions like, What underlies the positive

    "How much of this is temperament?" Dr. Suzman said. "How much of it is
    affected by life events and critical relationships with parents, friends,
    teachers, peers?"

    Overall, Dr. Snowdon says, the nuns live significantly longer than other
    women. Of the 678 in the study, 295 are alive and are all 85 or older. In
    the Mankato convent alone, there have been seven centenarians, many free
    of dementia.

    One is Sister Esther Boor, who at 106 speeds through the labyrinth of
    halls with a royal blue walker, glazes ceramic nativity scenes for the
    gift shop and pedals an exercise bike every day, her black veil flapping,
    an orange towel draped over her legs for modesty.

    "Sometimes I feel like I'm 150, but I just made up my mind I'm not going
    to give up," said Sister Esther, who gives her exercise therapists yellow
    notes with phrases from books she reads. "Think no evil, do no evil, hear
    no evil," she wrote recently, "and you will never write a best-selling

    Sister Esther's autobiographical essay, written 80 years ago, is
    similarly upbeat, speaking fondly of her family and her decision to
    become a nun.

    Dr. Snowdon's condition that nuns donate their brains was a stumbling
    block for some of the sisters.

    "I had a hard time with it," said Sister Claverine, who delayed signing
    up. "I had an image of myself being buried intact."

    But Sister Rita Schwalbe, the convent's health administrator when the
    study began, said she had told them that as nuns they had made "the
    difficult decision not to have children. This is another way of giving

    Many nuns now see brain donation through a liturgical lens ‹ or a
    humorous one.

    Sister Nicolette said: "After the resurrection, our bodies will be
    perfect. We'll be so happy we won't care what happens to our brains."

    And Sister Miriam Thissen, 89, said: "Que serα serα. After you're dead,
    so what?"

    After completing the cognitive and physical tests ‹ including identifying
    everyday objects and opening small doors with different latches ‹ the
    nuns get summaries of their results and can see if their performance has

    "Every time I get out of there I feel like an idiot," said Sister Blanche
    Becker, 88, who does crossword puzzles and reads Danielle Steel novels.
    "Here I am of sound mind and body and I sit there and open and close
    little doors and look at pictures and try to remember them all. But maybe
    it's made me more tolerant of people with Alzheimer's. I am afraid of
    what's going to happen to me, yes. How stupidly am I going to act? Will I
    know people? How long will it take me to die?"

    Dr. Snowdon, 48, has become unusually close to his subjects. He says that
    when he was in Catholic school as a child, the nuns were more rigid and
    strict than the warm, good-humored School Sisters he sees almost as
    grandmothers. That relationship has made him acutely aware of sensitive
    ethical issues, like how forthright to be with nuns who show slight signs
    of Alzheimer's.

    "Do we really want to tell these dear women who are having memory loss
    that they are in the early phases of Alzheimer's, that they should start
    taking something?" he asked.

    Dr. Snowdon is quick to agree with other experts who say his conclusions
    need to be corroborated by other studies. There are limitations to the
    autobiographies, for instance, since the nuns knew a mother superior
    would see their writing and therefore may not have been totally candid.

    "He's pointed us in some directions," said Dr. Bill Thies, vice president
    for medical and scientific affairs at the Alzheimer's Association, based
    in Chicago, "but I think it's going to take a fair amount of work before
    we start making public health recommendations about behaviors that will
    prevent Alzheimer's."

    Still, Dr. Snowdon hopes his study will encourage people to do things to
    ward off the disease, like quit smoking and other stroke-causing
    behaviors, and read to children to stimulate language development. His
    current project involves analyzing old photographs of nuns for
    personality clues in their face muscles to see if personality correlates
    to Alzheimer's or longevity.

    And, although he cannot prove it scientifically, he contends the nuns'
    spirituality and community living helps them too.

    "You don't necessarily have to join a church or join a convent," Dr.
    Snowdon said. "But that love of other people, that caring, how good they
    are to each other and patient, that's something all of us can do."

    Several nuns agree.

    "The science is important," Sister Miriam said. "But the science is
    dictated by providence anyway."

    Copyright 2001 The New York Times Company | Privacy Information

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