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Graphic novel depicts one family's experience with the ravages of Alzheimer's disease

Robin Wulffson MD's picture
Alzheimer's disease, Tangles, Sarah Leavitt, graphic novel, chronicle

November is Alzheimer’s Awareness Month. Approximately 14 million Americans suffer from Alzheimer’s disease. For each of those individuals, one or more family member or friend is involved with the struggle of a loved one.

Many of them assume the role of a caregiver. Vancouver, Canada author Sarah Leavitt confronted the impact of Alzheimer’s disease on her mother. Symptoms began when she was only 52 years old. Sarah chronicles her mother’s transition from an outspoken, passionate, and quick-witted woman to a forgetful, fearful childlike shell of her former self in her graphic novel “Tangles.”

A graphic novel is a narrative work in which the story is conveyed to the reader via sequential art, either in an experimental design or in a traditional comics format. Leavitt’s novel is in the traditional comic format; however, it is by no means comical. Her mother, Midge, was diagnosed with Alzheimer’s disease in 1998; for the next six years, Sarah’s father and other family members. She eventually required the services of a professional caregiver. As her mother’s illness progressed, Sarah made numerous notes and sketches. After her mother passed away, Sarah wrote the novel to remember Midge as she was before she was stricken; she also wrote it to chronicle the progress of her mother’s illness and its impact on family members. To date, “Tangles,” represents the only published Alzheimer’s-related graphic novel. Library Journal describes it as “A glowing, heart-wrenching memorial.” The novel should connect with anyone who has been involved with a loved one facing this tragic decline in function.

Sarah shares her family’s journey through a harrowing range of emotions—shock, denial, hope, anger, frustration—with poignant detail, all the while learning to cope, and managing to find moments of happiness. Her mother, a Harvard-educated intellectual, struggles to comprehend the simplest words; Sarah’s father Rob slowly adapts to his new role as full-time caretaker; Sarah and her sister Hannah argue, laugh, and grieve together as they join forces to help Midge get to sleep, rage about friends who have abandoned her, or collapse in tears at the end of a heartbreaking day.

About Alzheimer's disease:
Dementia is a loss of brain function that occurs with certain diseases. Alzheimer's disease (AD) is one form of dementia that gradually worsens over time. It affects memory, thinking, and behavior. Memory impairment, as well as problems with language, decision-making ability, judgment, and personality, are necessary features for the diagnosis. Age and family history are risk factors for Alzheimer’s disease. The risk rises with age; however, developing Alzheimer's disease is not a part of normal aging. Having a close blood relative, such as a brother, sister, or parent who developed the disease increases one’s risk. Having certain combination of genes for proteins that appear to be abnormal in Alzheimer's disease also increases your risk.

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Other risk factors that are not as well proven include:

  • Longstanding high blood pressure
  • History of head trauma
  • Female gender

There are two types of AD: early onset and late onset. In early onset AD, symptoms first appear before age 60. Early onset Alzheimer’s is much less common than late onset. However, it tends to progress rapidly. Early onset disease can run in families. Several genes have been identified. Late onset Alzheimer’s, the most common form of the disease, develops in individuals age 60 and older. Late onset Alzheimer’s may run in some families, but the role of genes is less clear.

The cause of AD is not entirely known; however, it is thought to include both genetic and environmental factors. A diagnosis of AD is made when certain symptoms are present, and by making sure other causes of dementia are not present. The only way to know for certain that someone has Alzheimer’s is to examine a sample of their brain tissue after death. The following changes are more common in the brain tissue of individuals with the disease: