Reimaging brain aging: Narrative threads and environmental drivers

The history of Alzheimer's disease (AD) reveals uncertainties about the existence of a discreet, singular disease entity since its first description by Dr. Alois Alzheimer in 1906. These uncertainties are magnified by growing evidence of the clinical, neuropathological, neurochemical and genetic heterogeneity of AD. Doubts continue to grow about the validity and utility of AD as a diagnostic entity and a framework for medical treatment. It is uncertain that quality of life of those affected by age-associated cognitive challenge is improved by an Alzheimer's-oriented framework.

While doubts about the Alzheimer's framework have grown, increasing evidence demonstrates that multiple environmental factors are key drivers of neurodegeneration and related diseases. Highlights from Environmental Threats to Healthy Aging will be presented on the influence of toxicants, diet, the built environment, and other modifiable environmental influences on health. Actions and policies to reduce risks of chronic disease, while improving the health of the environment, will be discussed.

An example of a novel, community-based intervention is illustrated by the Cleveland Regional StoryBank, a transdisciplinary effort of scholars designed to collect, store, and analyze stories related to health, illness, and disease. The project intends to improve knowledge of the subjective health and illness experience, and ultimately improve individual and public health. Initial work has focused on the challenges of understanding and applying our limited knowledge of genetic susceptibility in so-called AD and the health impacts of an intergenerational public school on the education and quality of life of students and elders with cognitive challenges.