Posted 1/14/25
My days are like a shadow that lengthens,
And I wither away like grass. But You, O LORD, shall endure forever,
And the remembrance of Your name to all generations. Psalm 102:11-12
Bob and Norm on David Letterman (Warning, beware of awesomeness explosion)
Do you like This Old House? Do you REALLY like it like I used to? If so, not unlike Dr. Who, you may find yourself a Bob Vila-era fan or a Steve Thomas/Kevin O’Connor era fan? Maybe you are just on it for Norm or Tom or just to see the evolution of the houses? I won’t judge the non-Bob Vila fans despite their wrongness. (However, my wife and I binged This Old House over a long Labor Day weekend and I don’t think Bob was host…Honey, a little help here.)
I was just thinking this week about the dreaded question “What causes Alzheimer’s?”. I am asked that early, and often. I am usually then directed to websites showing tremendous amounts of clinical research that (Insert one of more of the following: aluminum, saccharine, processed foods, a specific food dye, Donald Trump, Joe Biden, Barney the Dinosaur, McDonald’s, acid rain, global cooling, global warming, climate change, or one of 1000000 more things) causes Alzheimer’s and related dementias. They can’t be all right, but they could all be wrong. Do you wonder what I think? Oh, I am sure you do or you wouldn’t have stayed this long.
(Drum Roll Please)

(Pulling out a shoehorn from my Craftsman Toolbox)
Alzheimer’s Disease and related dementias is normally caused by a brain that looks like a house on the first episode of a season of This Old House.
(Crickets)
The brain is amazing. Heck, the whole human body is amazing. Think of the brain like a house.
Early in the season: The house is a mess. It needs work. It is falling apart. It is dated…the old is left behind instead of being refreshed. There could be some rot. Lots of issues.
OK, so your brain is a deserted house at, say, 50-60 or just younger. It is solid, it may not look great, but it is holding its own. It is water proof, its windows are intact, and the foundation is still holding its own despite wear. We are working perhaps harder than ever at the same time as having a body that, through entropy, is starting to struggle a little. What happens to the house? Things. Bad things. Things that a younger house could have withstood.

- First, the house was built by a builder who has a propensity to build less strong houses.
- A window is broken by a neighbor’s mower (who really should have called the owner!).
- Normal shift and years of freezing and thawing cause a small crack in the foundation to get worse.
- A bird or twelve flies into the house and sets up shop. A mouse, ever the climber, follows suit.
- Old pipes leak.
- Mold develops.
- Exposure causes drywall/plaster to crumble.
- The exposed wood gets weaker and weaker.
- Power surges fry the breaker box periodically and cause a small fire that goes out before causing the house to catch fire.
- A storm comes and knocks Gladys Kravitz‘ big tree over onto the edge of the house, weakening the corner and causing a partial cave in.
- The above continues.
- Those pesky teens at the end of the street break in and play Army in the house, much to the dismay of the authorities. (Do kids still play Army?) One of the kids steps on a rusty nail.
- The estate of the owner is notified of the injury. He doesn’t have money to fix it and has spent the insurance money long ago on a fast life and loose women. He stops paying taxes.
- The tax man takes over the house and decides that the house is “too far gone” and tears it down for safety. The lot is sold on the courtroom steps and the house is forgotten.
Such is the cause of Alzheimer’s.
Did the broken window cause it? It didn’t help, that’s for sure. It could have been fixed with minimal harm.
The animals? The mold? The storm? Time? Weather? Other factors? Some contributed more than others.
That is exactly(-ish) what I feel like causes Alzheimer’s and related dementias.
Here is that list:
- The builder was prone to use wood with knotholes, cut corners, focus on the outward to the detriment of the inward. Genes can factor in and set up a propensity to have the house fall down.
- Malformed Beta Amyloid plaque and Tau Neurofibrillary tangles. (Note the word malformed…Tau especially, but BA too have a function, possibly a big function, but they get messed up. Broken. Hit by the neighbor’s rock. Then what was once good becomes part of the problem.
- Modifiable risk factors (things that if we did well would reduce our risk by 40% or more) not being treated seriously (I am not throwing stones here…I am overweight and don’t sleep enough…). Here is a good current list: LINK Nobody is painting the house, caulking the windows, keeping it warm enough to keep the pipes from freezing, and addressing roof issues. Little problem not only get worse, but create a less protected environment in a dozen ways. The once stable house is unstable.
- The gut biome- Coming in and leaving the house changes and has issues. Heck, birds and possums can live there unhindered.
- Inflammation- Swelling and contracting, whether in the house or between the ears, weakens.
- Then a tree falls…we have a surgery, an illness, or similar. Or perhaps we have a very hard season in our mental health. What was already weak and what could have fared better against the tree collapses like a house of cards.
- Energy issues. Mitochondrial processes struggle. They used to produce usable power (let’s call it electricity) and now, weakened, go kerfritz and generate far too much (lightning) or too little (burned out breaker box).
- Apathy- We didn’t pay any attention to the house. It was collapsing, day-by-day and we were indifferent.
See, friends, it is an environment of collapse that caused the Old House that sits between our ears to collapse. Am I assigning blame? No, that would be cruel. I hate this disease and would never want the person with the disease to feel bad or blamed. Heck, we all…literally all, neglect our brain houses. None of our houses are as strong as they should be. However, the house was likely originally strong and houses seldom fall apart overnight.
Some friends who google a lot (and discern a little) say “Beta Amyloid plaque doesn’t cause Alzheimer’s. It is _____ that causes it. (Insert some snake oil salesman’s answer.) I can tell you this…if you remove the messed up BA from their brain, things seem to slow in getting worse. Patch the broken window with plastic or replace it and the window resumes its purpose. However, the broken window itself didn’t CAUSE the collapse.
I feel like our brain has more and more issues until it reaches a tipping point (as Lisa Genova calls it) when it ceases to be able to stop fighting the pathology. This explains why it is so dang hard to stop this disease. We need to do the following:
- Be born without APOE4 genes or, perhaps, CRISPR edit them from the bad ones (APOE4) to the protective ones (APOE2).
- Do all the modifiable risk factors right (see list above). Note: We put pictures of cancerous lungs on the side of a package of cigarettes and we still smoke them just fine, thank you…or we replace them with pot which is likely even worse.
- Remove the bad BA and Tau preferable while leaving the normal, non-mutated ones behind since they probably have several good purposes.
- Address the gut biomed issues.
- Address MItochondria failure.
- Address poor blood flow…and enhance it.
- Stop other illnesses that hurt the brain, especially the heart.
- Keep looking…more and more causes are uncovered.
- The diet needs to be micromanaged too!
- Stop falls. Perhaps Bubble Wrap our heads at birth.
OK…now that we are all depressed, remember this: We don’t have to cure the disease to “get rid of it”. All we need to do is keep living in our house and fixing things as we go (quite well)….and chances are, when combined with some of the above ideas we can delay the disease longer and longer. New drugs have been shown to slow the progression and as other causes are addressed maybe we keep bumping back that tipping point when the mice live in the house. To mix my metaphor, as I am wont to do, we deploy the 4 corners offense that basketball players used to use when a mediocre team played a better team. Stall and fight on defense in the meantime. Keep the house intact.
Will it always work? Nope. Tornadoes, floods, and other less extreme things happen. If someone promises a cure or rolling back dementia or 100% preventing it, run…they want your $. However, if we do all we can for as long as we can, our odds are much better.
Bottom line: How do we balance quantity of life with quality of life? Exercise helps both, but excessive exercise, leading to getting hurt, could shorten it.
We only get one house, friends, this side of our end. Do we want to be episode 1 or the final episode of This Old House?
#EndALZ
More Grandbaby pix:







Note: Despite the title, remember not to neglect your soul. To a Christian believer, we ultimately get a new body in heaven that can last forever with no fear of this stinkin’ disease. 🙂 What a day that’ll be!
Here is my fundraiser for my June event:
https://act.alz.org/site/TR?pg=personal&px=14575499&fr_id=18274
I will be at WashU twice this month for PET scans and a cognitive test. 🙂 That will be my last PET scan for at least 9 months. Any more and I glow from the radiation although getting a superpower might be cool.
Want info on how to help with research? Hit me up. 🙂










