By Sean O’Malley
As an enthusiastic ambassador for CAMH’s PACt-MD program, Ron Singer is, quite literally, central casting. Born in Montreal, classically trained in London and New York, he also taught drama at York University for more than three decades. Well into his 60’s, Singer continued to work as an actor, and when a plum role in an American movie-of-the-week came up he auditioned, and got the part.
Later that day, while going over the script at home with his wife, he came to a heartbreaking realization.
“That was the end of my acting career,” says Singer, 79. “I said to my wife I simply can’t memorize it. It’s impossible and I’m terrified. It was a form of a panic attack. That’s when I decided to tell my agent and say I can no longer be an actor. I just can’t remember my lines anymore.”
That was the beginning of a journey that would eventually lead him to CAMH. For eight weeks recently, he came to CAMH daily to take part in the five-year PACt-MD study, the largest clinical trial on dementia prevention ever to take place in Canada. PACt-MD, led by the Geriatric team at CAMH, is a collaborative project that involves the Temerty Centre for Therapeutic Brain Intervention and the Research Imaging Centre at CAMH, as well as four major academic hospitals in Toronto.
Beginning at 9:30 a.m. every weekday, Singer received transcranial Direct Current Stimulation (tDCS), a painless brain stimulation treatment, in combination with memory and problem solving exercises, known as cognitive remediation.
“The idea with tDCS is that it primes the brain, it enhances the neuroplasticity of the brain, so that the brain itself is more likely to respond to memory training exercises,” says one of the Principal Investigators Dr. Tarek Rajji. “What happens is that the brain starts forming connections, it strengthens the synapses and builds what we call cognitive reserve. In doing that we are hoping to prevent the development of dementia.”
Just a few decades ago, the idea that a 79-year-old’s physical brain could be improved was considered a non-starter. The father of modern psychiatry Sigmund Freud famously remarked that the brains of people over 50 are so immutable that providing psychotherapy to anyone in that demographic was a waste of time.
Because of ground-breaking research into brain neuroplasticity that began in the 1970’s, 80’s and 90’s, much of it in Toronto, we now know that older brains maintain the ability to transform and adapt.
“The plasticity of the brain continues as we get older,” says Dr. Rajji, who is also CAMH’s Chief of Adult Neurodevelopment and Geriatric Psychiatry. “Actually the older we get, healthy brains, especially the frontal part of the brain, becomes more plastic. These areas of the brain kick in to compensate for memory loss.”
Dr. Rajji said the science shows that people who are highly educated, or with high-functioning careers like Singer’s, are less likely to show signs of dementia later in life than the general population, because their brains have been wired to be more resilient over the years. That premise is at the core of what the PACt-MD research is all about.
“The goal of the PACt-MD study is to develop more protection, more resiliency in the brain, so we can prevent or delay the onset of dementia. We are building the resiliency of the brain rather than targeting the disease itself.”
For Singer, after the loss of his acting career, he continued to lead a productive life as a drama professor and documentary television producer. But in recent years, he found himself struggling more with the everyday aspects of memory retrieval. He started having difficulty remembering the names of his students, something he always took pride in. He developed tricks, like insisting his wife introduce herself first to anyone he knew, so he would not have to try and remember their name.
Eventually, he started running out of tricks.
“My wife gave me a shopping list one day and I went to the supermarket to get two types of vegetables and I could not remember what they looked like. I panicked.”
With his eight weeks of tDCS + Cognitive Remediation now complete (he will return for “boosters” every 6 months), Singer says he thoroughly enjoyed the process, and came to look forward to his daily 2-hour sessions. He also came away with a renewed sense of optimism about the future.
“There have been times when I have been frightened that I would not be able to remember certain things that I had to remember. This program has made me feel less frightened in that way, more confident. I don’t know if down the line I’ll be able to beat dementia or whatever comes my way, but I’m excited about the present and hopeful about the future.”
Published on August 14, 2017