"We've been taking it for twenty or thirty years," he said in a race against Alzheimer's disease. "We threw away sleeping pills and kept our memories."
"The clock drawing test is an internationally recognized method for rapid detection of Alzheimer's disease." Tang Bin, the head of charity at Jianai, showed reporters the "Lost Clock" tattoo sticker on his arm.
This month, Degao Shentong and Jianai Charity jointly held the "Lost Clocks Exhibition" at the Xujiahui subway station, showcasing five hand drawn clocks from "chaotic time and space".
The tattoo on Tang Bin's hand is one of them. This is a critically ill patient who hesitates and cannot write. In the end, the hour hand is skewed and the numbers are scrambled. In the distorted time gap, one can see a world in the eyes of an Alzheimer's elderly person - their time logic is no longer orderly, morning and evening and year are no longer clear, family faces are gradually blurred, and memories are gradually lost in time.
"From the initial discovery of cognitive impairment to the actual diagnosis, it takes about 5 or even 20 years. The preclinical stage may not show obvious symptoms and is also very subtle, but it is precisely during this period that intervention can be made," said Tang Bin.
Since 2013, the Shanghai Jianai Public Welfare Development Center has launched the "Watchers of Memory" project in Shanghai, forming an interdisciplinary professional volunteer service team consisting of physicians, social workers, rehabilitation therapists, psychological counselors, and health managers. Rooted in the community, the team has gone deep into more than 200 communities in the city to provide volunteer services such as brain health science popularization, risk screening, and assessment for community elders aged 55 and above. It can be said that it has been a decade of hard work.
From a fresh move to mild intervention
The connection between Tang Bin and cognitive impairment originated from his grandmother.
"After my grandmother fell ill, the most obvious symptoms were becoming fearful and constantly wanting to do things. At that time, my family didn't know what to do. Later, I watched a program introducing Alzheimer's disease, and patients usually showed more than ten symptoms. My grandmother was well matched by several, and it turned out that she had Alzheimer's disease."
Tang Bin realized that he didn't understand his grandmother at all. Later, he asked his uncle and found out that his grandmother's reactions were related to her early experiences. "During the War of Resistance Against Japan, several anti Japanese soldiers hid at her home and were discovered by the enemy before being killed on the spot. The bloody scene remained in the old man's memory. As for the non-stop work, it was due to the trauma left by the early harvest of crops."
My grandmother passed away in 1999. Over a decade later, Tang Bin found that the level of nursing care in nursing homes has not improved. Perhaps due to this regret, Tang Bin plunged into the study of Alzheimer's disease. In April 2013, Tang Bin registered the Shanghai Jianai Public Welfare Development Center in Putuo District, mainly dedicated to the prevention and care support of cognitive disorders, including Alzheimer's disease.
"Love cutting" initially taught Paper Cuttings to the elderly, and it was popular in more than 200 communities, which can be described as "one recruit eats all over the sky". During a volunteer exchange activity, Teacher Zhou Kechun examined the pulse of "love cutting" and helped them sort out a three-level prevention system for cognitive disorders. They began to settle down, from Paper Cuttings activities to cognitive professional services.
In the first three years, "sex cutting" targeted the most difficult group, namely families diagnosed with COVID-19. "We can get a set of anti loss equipment by looking for 5000 confirmed elderly people in the city. However, this project has been abandoned, and many people can't even provide a diagnostic report. Some people feel puzzled because the elderly's symptoms are so obvious, and they still need to go to the hospital for testing. In the end, one-third of the equipment has not been sent out."
They began to realize that sick elderly people require the support and care of professional care institutions, and the care conditions that public welfare organizations can provide are limited. Subsequently, "Love Cutting" began to adjust its direction, targeting the group with mild cognitive impairment.
Race against Alzheimer's disease
Tang Bin drew several important nodes on the paper. Starting from the age of 40, there may be symptoms of "subjective cognitive decline", known as the "SCD" stage. By the age of 60, it is the high incidence stage of mild cognitive impairment, known as the "MCI" stage. From then on, it is diagnosed, from early, middle, to late stages. In clinical practice, it takes an average of 6-7 years for Alzheimer's to progress from mild to severe, while on average, 15% of people with mild cognitive impairment (MCI) develop cognitive impairment each year.
"Not all cognitive disorders are irreversible. Through professional intervention with a multifactorial lifestyle, mild cognitive impairment can be alleviated or even reversed. We need to grasp the golden window of prevention and treatment for mild cognitive impairment, timely diagnosis and intervention can greatly delay the progression of the disease." Tang Bin said.
Love cutting event site
There are precedents to follow internationally. One is the Finnish model. In 2009, Finland conducted an early intervention model, with an experimental group of over 4000 people who intervened in five dimensions: cognitive training, diet, exercise, emotional regulation, and daily management of chronic diseases. The results showed that over 75% of people had a reversal of their condition. One is the Japanese model. Another large-scale study conducted in Japan in 2011, which intervened and managed from the single dimension of cognitive movement, showed good results. Among the elderly diagnosed with mild cognitive impairment, 46% did not develop cognitive impairment within three years.
"The 'love cutting' model follows the Finnish model." Tang Bin believes that although the Japanese model has much lower overall costs than large sample studies, its reference value is not strong. After weighing, they chose the comprehensive intervention model.
In 2017, "Love Cutting" piloted a three-year management plan for cognitive intervention in Changshou communities. The first group selected 12 individuals with mild cognitive impairment and intervened from five dimensions: the project lasted for 12 weeks, a total of 24 days, from 8am to 4pm every day, with 2 days of all-weather courses and 5 days of exercise at home, helping them develop healthy lifestyle habits in all aspects.
As soon as the project was launched, many residents came to inquire about whether this disease can be prevented or really reversed. After seeing the promotion of "sex cutting", someone came over and told Tang Bin, "This project is really good, but it came too late. My husband was just diagnosed last night, and it would have been better if he had come earlier.".
Among the 12 major risk factors associated with cognitive impairment, alcoholism and smoking are one of the modifiable risk factors that require intervention management. In the first group, there are three "old smokers" who know that smoking is risky. A man in his 60s claims to quit smoking collectively. Whoever becomes addicted to smoking is pulled to exercise by others. The three of them supervise and encourage each other to see who changes the most and who can persist until the end. Later, all three of them quit smoking and recovered very well.
At the scene of the charity event for love cutting
There is also an elderly couple who used to be a doctor. After the old man was diagnosed with Alzheimer's disease, the old lady did not hire a nanny but took care of her husband herself. Five years later, she also developed mild cognitive impairment. When she came for sex cutting, she also dragged the gentleman over. During everyone's activity, the old man sat silently on the side. One day, someone threw a grip tool to the old man and found that his strength was greater than that of everyone present. The old man's movements in playing table tennis were also very agile. "He used to be a great athlete, no one could beat him when playing ball, did push ups, and no one had ever done him." The old lady noticed that he used to just sit there and not speak, but now he felt like his whole body was activated, playing ball and making dumplings with everyone. The changes in the old man have made the wife feel very pleased, and her own condition is also improving day by day. She has become more proactive in participating in the "Love Cutting" activity.
"We are witnessing them gradually getting better with our own eyes. Elderly people must not be confined to their homes. 'Cutting love' is to provide them with an opportunity and reason to come out of their homes, meet more people, and develop a healthier lifestyle." Tang Bin said.
Step out of the house and cultivate good exercise habits.
And this is destined to be a difficult road. Every step is a leap from 0 to 1, full of difficult bones to gnaw on, but the effect is also gradually emerging. After years of accumulation, Tang Bin has gained some insights. "Do preventive interventions, do not label them, do not isolate them from the general population, but integrate them into the community."
This can be seen from the name. At first, the project team was called the "Intervention Center", later called the "Activation Center", and now it is the "Healthy Lifestyle Center".
The first group of experiments ended in 2019, and except for one elderly person who did not show significant results, all people passed the test and returned to normal values, which is a very good result. The second group finished, and four elderly people excitedly ran over to Tang Bin and said, "We've thrown away our sleeping pills, they've been taking them for twenty or thirty years.".
In early September, "Love Cutting" launched a replica of the "Unforgettable Restaurant" public welfare activity at Global Port, calling for the care of families with cognitive impairment, and the restaurant service staff were all provided by these elderly people. Media reporters also interviewed group members. After the interview, Lao Feng ran over and smiled at Tang Bin, saying, "I worked half an hour overtime today.". "Do you understand? Lao Feng is joking. I'm particularly happy to hear that. He can understand everything," Tang Bin said.
In 2020, due to the pandemic, people were still hesitating whether to hold the New Year's Eve dinner or not. Finally, the collective decision was made to celebrate. That night, everyone celebrated with their children and grandchildren, each bringing a plate of vegetables or a bottle of wine. The 80 square meter room was crowded with 70-80 people, and the whole room was filled with laughter and joy.
Statistics show that nearly 70% of individuals with cognitive impairment fail to timely screen for the occurrence of the disease, have not undergone professional diagnosis in hospitals, and have not received scientific treatment and care, ultimately making the condition difficult to control. An elderly person with mild cognitive impairment confided in his diary, "I feel like my leaves are almost gone. The wind and rain have taken them away, and the branches can no longer catch them."
"After reading this passage, it's inevitable to feel sad, but if prevention and intervention are done well, their condition can be controlled." Tang Bin hopes that more intervention teams can enter the community. "We are rushing to retain their memories during the golden window period and running ahead of Alzheimer's disease."
