Longevity Nuances
Diet and exercise are important components of living a long and healthy life, but I feel the article on the blue zones (February/March 2024) overlooked genetics and hereditary factors. Okinawa, Sardinia, and Ikaria are islands. Nicoya is a peninsula, and Loma Linda might well be an “island population” with intermarriage and social isolation. Isolated populations tend to demonstrate or be spared certain hereditary entities. I wonder what the incidence of genetic predilection in these island demographics might show. Diabetes mellitus, lipid disorders, atherosclerosis, and small vessel disease may not be part of the genetic footprint of islands and other isolated populations. Alzheimer's disease also can be hereditary. Other than these omissions, it's a good article. —Marcus Miller, MD, Pleasant Hill, OH
THE EDITOR RESPONDS: The residents of these islands may have been spared certain genetic disorders. We hope the article's focus on positive lifestyle habits will inspire our readers to do what they can to improve their health.
Diet and Epilepsy
In your article summarizing current and possible future epilepsy treatments (February/March 2024), I was surprised that there was no mention of dietary treatments such as the ketogenic diet or the modified Atkins diet. —Mark Wallace, Boynton Beach, FL
The ketogenic diet has been used successfully in many patients with epilepsy for over a century to reduce and in some cases even eliminate seizures. When appropriate, implementing it as adjunct therapy can improve the efficacy of the patient's treatment as a whole. This diet was initially developed specifically as a medical treatment for epilepsy. Studies suggest that it may benefit a variety of conditions, and I personally have kept several of my autoimmune diseases in remission this way for years. —Lauren Slattery, Cleveland
THE EDITOR RESPONDS: We have written several stories about the ketogenic diet and hope to continue to provide a range of options for anyone managing epilepsy or other neurologic diseases.
Skill Set
In response to the recent editor's letter (“The Keys to Longevity,” February/March 2024, I want to share my story about acquiring a new skill. My passion for learning Italian began in middle school and continued through high school, where I took AP Italian and received a small scholarship for my language skills. As an early graduation gift, my father took me to Italy during my senior-year spring break in 2007. We saw all the sights, and I didn't want to come home. My Italian was good enough that people thought I was a native speaker. My dream was to return to Italy for study and eventually become an English teacher. Shortly after my graduation, however, I began experiencing health problems and was eventually diagnosed with dystonia and a parkinsonian syndrome. Once I was well enough, I began taking classes in Italian at a community college. During the pandemic, I downloaded a free app on my phone that helps me develop my vocabulary and improve my grammar. I hope to return to Italy one day. Until then, I live by the motto tattooed on my forearm: “fuoco nelle vene.” It translates to “fire in the veins.” To me, that means having the determination and passion to be successful. —Emilie Mascoli, Levittown, NY
In response to Dr. Avitzur's call for new skills, I would like to say that at 84, I work out at the gym four days a week and am studying Italian in preparation for a 10-day cooking course in Lucca, Italy. After five days of sightseeing, I'll start a similar course in Taormina in Sicily. —Lance Fogan, MD, FAAN, Los Angeles
I'm a professor of music at the University of Colorado, where I teach the history of rock. In the spring of 2019, I was diagnosed with Parkinson's disease and was unable to play classical guitar, the instrument to which I had devoted my life. For a while I grieved. Then I decided to learn to play again, no matter how long it took or how slow the process. Over the course of several months, with many hours of positive mental visualization, meditation, and physical practice, I was able to build back some facility. In the fall of 2019, I played for my students for the first time. Playing “Blackbird” by the Beatles was more fulfilling than performing my own guitar and flute arrangements of Bach's music at Carnegie Hall in 2006. —Leo Welch, Greeley, CO
Other Lethal Weapons
I appreciated the calm and balanced discussion of caregivers' responsibilities regarding firearms in the home (February/March 2024). I am 87 and the primary caregiver for my wife, who is cognitively impaired. Even though I've never felt threatened, I now keep all potentially lethal items such as knives under lock and key. Within the past five years, our local police force has had two tragic incidents involving knives. In one case, an elderly woman threatening others with a butcher knife was fatally shot by a young officer. In another, an officer was killed by a mentally impaired man with a knife. Both incidents involved people who should not have had access to deadly instruments of any kind. —Harley Shaw, Hillsboro, NM
Dementia Burden
Reading the responses to the article about Hector Elizondo and his family's experience with Alzheimer's disease (Letters, February/March 2024) was a reminder of the toll the condition takes on families. My father, who was diagnosed with Alzheimer's disease, died last October. To preserve his activities of daily living for as long as possible, we had him wear the Exelon patch. I believe that it bought him some time. How much, we don't know, and eventually we discontinued it. It was hard to watch a once vibrant problem solver waste away. —Bob Gutentag, Austin, TX
Gone Too Soon
I was devastated by the news that Richard Lewis had died. Reading about him in Brain & Life (October/November 2023), I felt that he and I had much in common, including a diagnosis of Parkinson's disease. Just a few weeks ago, I spoke with the chair of the department of neurology at the VA Medical Center in East Orange, NJ, and we agreed to invite Lewis to help us with some projects. Now that Lewis is gone, I will dedicate some of the things I'm working on to him. I know that Lewis' wife and other family members will carry on his legacy. —Lance Morton, New Egypt, NJ
Taste Loss
I wish your publication would write about the loss of taste. I experienced this gradually over time, not as a result of COVID-19, and my sense of taste shows no sign of returning. I have heard every remedy imaginable, but the only thing I can do is eat from memory, and that is not satisfactory. I worked until my seventies and looked forward to traveling and eating during my retirement. I grew up on a farm in Iowa surrounded by people who loved to cook, bake, and eat. I appreciate all types of cuisine and enjoy eating out. To have this happen now, at age 85, is a gigantic loss. —Ricky Lacina, Oakland, CA
THE EDITOR RESPONDS: Thank you for your wonderful suggestion. Although we have written about this in the past, we agree that it is time for an update. Stay tuned!
