Laughter Is The Test Medicine

To an Alzheimer's patient, there's nothing funny about forgetting to turn off the oven, losing a telephone number or misplacing books from the library. But turning those mishaps into punch lines might turn out to be therapeutic. The idea that improvisational comedy might help those in the early to middle stages of Alzheimer's cope with their disease is being tested by the Cognitive Neurology and Alzheimer's Disease Center of Northwestern University's Feinberg School of Medicine and Chicago's Lookingglass Theatre Company.

Not having to memorize lines or remember a story narrative might spur confidence by freeing patients from worry over lost words or thoughts, and actually stimulate their brain chemistry to forge new protections against further onslaught of the disease, researchers say. A possible role for creative arts in improving life for those with memory loss is being studied nationwide.

At a recent improv session, skits progressed unexpectedly: A pair of lovers morphed into a mushroom hunting expedition; an ice skating adventure became a camping trip. "I don't know what I'm doing," one of the performers confided, "but it's freeing."

Mary Beth Roth, whose husband, Wolfgang Roth, 80, participated, said he couldn't tell her 10 minutes later what he'd done, but, "Every day after class, there was a lightness in his spirit. There was a buoyancy about him, a more positive attitude."

Wolfgang Roth, a former dean of Garrett-Evangelical Theological Seminary in Evanston and a retired Hebrew scripture scholar, was diagnosed with Alzheimer's in 2007. His wife said the class "opened an avenue of new experience for him." She recalled that during a skit about a student and teacher, her husband accidentally used the wrong word, but everyone laughed, because it was funny, and the skit just went in another direction.

The work is based on research showing that people with dementia who participate in cognitively stimulating activities and are socially engaged have a better quality of life and suffer less depression. At the same time, patients build up what is called "cognitive reserve," a resilience in the brain that seems to slow down or stop the disease's onset. So, for instance, people with large amounts of cognitive reserve might begin showing symptoms of Alzheimer's at 75, instead of at 70, he said.

The most common form of dementia, Alzheimer's is believed to be caused by abnormal deposits of proteins, called plaques and tangles, that may damage and destroy cells and nerves inside the brain. These deposits usually start in the part of the brain that plays an important role in memory and then affect the lobe responsible for planning, ordering and thinking. Eventually, they spread to the parts of the brain that regulate bodily functions.

Patients in the early and middle stages of the disease probably still have the brain plasticity to create new neurons and synaptic connections that might provide something of a bulwark against the disease or might shift functioning to areas of the brain that are unaffected or less affected. Participants in Northwestern's eight-week project reported feeling more confident and able to cope with their diagnoses, as well as less isolated and depressed.

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