I'll be me: Understanding Alzheimer’s Disease Through the Music of Glen Campbell

| 10 November 2015

The Arts reveal the impact of disease with clarity that no medical paper or scientific presentation can achieve

When I was 14 years old I started playing guitar. I had guitar heroes, Andres Segovia, Chet Atkins and Glen Campbell. I loved Glen’s finger picking style and bought the same Ovation guitar he played on the Glen Campbell Goodtime Hour (1969-1972) (in fact I still have that guitar). The Goodtime Hour featured Glenn’s songs (By the Time I Get to Phoenix, Wichita Lineman, Gentle on My Mind), his fluid guitar playing, and lots of humour. Glenn Campbell had the entire package: handsome, talented, funny and, not surprisingly, he sold tens of millions of albums. He had a tumultuous life with 3 marriages and a destructive addiction to alcohol and cocaine. In his third marriage he finally achieved sobriety. However, his friends and family began to notice changes in his speech and behaviour that suggested something was seriously wrong with Glen. He could still sing and play-but he was forgetting-forgetting almost everything but his music. Glen Campbell was in the clutches of Alzheimer’s disease. With that diagnosis he and his family could have retreated but instead courageously chose to do a final national tour to say goodbye to his fans. Fortunately for us James Keach and Trevor Albert also made a documentary of this tour. This powerful film shows the heartbreaking roller coaster that is life when Alzheimer’s disease touches your family. You can stop reading here and let Keach’s powerful documentary “I’ll be me” speak for itself.

The video of Campbell’s Goodbye Tour begins with tender moments at home and on the tour bus as Glen’s family works to keep him on task. As the tour progresses so does Campbell’s dementia and there are painful scenes of frustration. The Campbell family’s joy and pain is compelling and at times is hard to watch. The documentary is more instructive about the impact of Alzheimer’s disease than any dry medical dissertation. I’ll be me gives us the privilege of being with the Campbell family in clinic and in public and then following them home for a house call. It’s at home and in private that the real challenges emerge.

Through 425 days and 151 shows his wife, sons, daughter and friends help this remarkable man say goodbye to his fans. There are moments that will make you laugh (when he covers for a mistake on stage joking, “that’s the problem…if you do it perfect they expect it to be perfect all the time”. There are moments when you will cry (when the teleprompter stops during the show he stops singing immediately-the words are gone). But all in all, the film is instructive and should inspire us all to get involved in supporting research to cure this scourge.

What is Alzheimer’s disease: There are few consequences of disease worse than loss of memory for in memory lies our very identity. As the population ages we are increasingly affected by diseases that impair memory (dementia). The most common cause of dementia is Alzheimer’s disease, named after the physician who first described the syndrome in 1906. Dr. Alois Alzheimer reported the case of a woman with impaired memory, unpredictable behaviour and difficulties with language. When she died he examined her brain and noted abnormal material infiltrating the bran, including amyloid plaques and tangled fibre bundles, which are called neurofibrillary tangles (or tau tangles). According to the National Institute of Aging Alzheimer’s disease is the 6^th most common cause of death. However, since it affects older people more commonly it is the 3^rd most common cause of death in older people. Starting in the hippocampus, the home of memory formation, neurons progressively die in Alzheimer’s Diseases and ultimately the brain shrinks.

Early in the disease the symptoms vary substantially amongst affected people. The first signs of illness may be when family and friends note impaired memory but many people present with other manifestations of impaired cognition (e.g. difficulties with word-finding, vision and spatial issues, impaired reasoning and/or poor judgment). For some the disease is detected when the day-to-day activities of life, such as bill paying, can no longer be performed; other patients wander off without reason. The one commonality in Alzheimer’s diseases is the pain it causes the family. The inexorable, progressive deterioration of fathers, mothers, friends, or colleagues is heartrending. Unlike a heart attack, which is brutally fast, but if treated leaves the essence of the person unchanged, Alzheimer’s attacks our identity and steals our memories. We don’t know the cause of Alzheimer’s disease, although mitochondrial dysfunction and increased production of destructive oxygen radicals in the brain is implicated. We also know that variants in the sequence of the apolipoprotein E (APOE) gene predicts an increased likelihood developing late-onset Alzheimer’s. While we are far from a cure there are some useful drugs that modulate neurotransmitter levels, including Donepezil (Aricept^®).

I encourage you to watch the Campbell family’s heroic journey. “I’ll be me” should be required viewing for students of medicine of all ages.

Footnote: I’ll be me is available on Netflix®.