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I really recommend that everyone do 23andMe for this precise reason.

I wonder, how much does that single bit of information (doubling the chance) matter to those decisions? Should you have been doing those things anyway, for the Alzheimer's prevention and the other benefits? Is it the motivational factor of the formal personal certification that is important or the actual information?

gwern13y00

Well, to point out the obvious, the expected value equation is 'risk times consequence', so if you double the risk and leave the consequence unchanged, by definition you double the result of expected value. (If I have a 50-50 chance of $5 with EV=$2.5, and I double the risk to 100-0, then my expected value also doubles to $5.)

A doubling could make a fair number of sacrifices or strategies now net-positive.

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12 Alzheimer's vs Cryonics

by RobertLumley

26th Aug 2011

1 min read

12

The diagnosis of a legendary women's basketball coach at my school, Pat Summit, with early onset dementia, Alzheimer's type, got me thinking about Cryonics and Alzheimer's. For the purposes of this thought experiment, we will ignore the legal implications of the fact that you can't be frozen until you are legally dead. Let us further assume (which given my knowledge of Alzheimer's, is pretty reasonable) that the damage done by Alzheimer's is complete, and that future technology will be unable to reconstruct the destroyed components.

If you were diagnosed with Alzheimer's, or really any neurodegenerative disorder, at what point in the degradation would you want to be frozen? This would fairly easily prevent further degradation, but might further damage you/all of the other risks associated with cryonics that everyone knows. Obviously, you wouldn't have the agency of mind (or perhaps you still would, depending on when you made the decision) to do it yourself, but suppose you were caring for a loved one, or writing a living will. Assume you operate healthily at the onset of your diagnosis.

Things to consider:

How would your loved ones react to your being frozen versus coping with you having Alzheimer's? Should this matter in your decision? If it does, what implications does that have for a duty to die?

How much degradation of the mind is acceptable (and the added damage potentially done by cryonics) before one should freeze onesself?

Would you avoid the risk of being frozen all together because you believe we will or may have a cure for Alzheimer's soon, and waiting for it would do less damage than cryonics?

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[-]MinibearRex14y240

Once Alzheimer's starts, the damage it does to the victim's brain appears to be permanent. The information appears to be gone. Once your memories start to get wiped away, I don't think that there is any real way to get the information back, so whenever we do invent a cure for Alzheimer's, all it is likely to do is to stop the deterioration of your brain, not bring your lost memories back. If we could start growing new neurons, you could probably get your brain functioning back to normal, but I doubt you could get much else.

Both my grandparents have Alzheimer's, and the disease is at a rather late stage. They're gone. They don't remember me; they don't remember my mother; they barely even recognize each other, and they've been married over 50 years. Even if I got my hands on a cure for Alzheimer's disease tomorrow, they would "wake up" in 80+ year old bodies, with no memories of their children and grandchildren.

Given my own experience and knowledge of the disease, if I knew someone who had been diagnosed and was starting to show signs of the disease, I would recommend that they get themselves frozen as quickly as possible.

[-]JoshuaZ14y130

Do we know that for sure? I don't know that much about Alzheimer's in particular, but for other forms of dementia people frequently have periods where they are more lucid and can access memories and other periods where they are less functional. This would suggest that for at least some forms of dementia most of the actual memories are intact but inaccessible. Alzheimer's does involve the direct destruction of synapses which suggests that the information has been completely removed in those synapses, but it is hard to tell how much information is being actually destroyed and how much is being rendered inaccessible.

[-]MinibearRex14y70

Sometimes, yes. There are good days and bad days, mostly during the early stages of the disease. Alzheimer's starts of looking just like other forms of dementia, but it gets consistently worse. At this point, there aren't any good days. And brain scans do reveal that Alzheimer's disease creates large scale destruction of synapses.

[-]RobertLumley14y40

I'm sorry to hear that. I've always said that Alzheimer's is the last disease I'd ever want. It's just... horrible.

[-]ScottMessick14y10

Upvoted for accuracy. My maternal grandmother is the same way and just the resulting politics in my mother's family for how to deal with her empty shell are unpleasant, let alone the fact that she died so slowly hardly anyone acknowledged it as it was happening.

[-][anonymous]14y100

23andMe recently showed that people of my genotype are more than twice as likely to develop Alzheimer's as others in my ethnic group. I have a 15% chance of getting Alzheimer's before I'm 80, up from 7%. See Patri's post about this.

An initial Googling has generated things like 'eat paleo', 'get caffeine', 'exercise', and 'use your brain'. I'm planning to do further research about decreasing Alzheimer's risk.

I really recommend that everyone do 23andMe for this precise reason.

[-]wedrifid14y130

I really recommend that everyone do 23andMe for this precise reason.

[-]gwern13y00

A doubling could make a fair number of sacrifices or strategies now net-positive.

[-]wedrifid13y00

Well, to point out the obvious

Yes, that was obvious. I'm not sure why you pointed it out as a response to the grandparent.

[-]Morendil14y40

My priority would be to minimize damage, so as early as possible while still allowing for the least traumatic transition for family and friends. I expect it would be the same as dying suddenly: lots of paperwork to do, translating into stress added on top of grief.

Which, of course, is a strong argument for advance preparation.

The same applies for sudden death or severe illness. At 40 it's a bit early to be thinking a lot about this, but definitely coming up as a to-do item; I've just been reminded by Steel's The Procrastination Equation that this kind of planning is something many, many people procrastinate about (sometimes until death).

Would you avoid the risk of being frozen all together because you believe we will or may have a cure for Alzheimer's soon, and waiting for it would do less damage than cryonics?

Not in the current state of knowledge about the disease. Onset-to-death times are in the range of 5 to 8 years apparently, which is just barely enough time for a new cure to make it to widely available trials, not enough for it to be more than a very long shot. But in the meantime your personality would be slowly disintegrating; by the end of that period there wouldn't be much of a "you" to benefit from the cure.

[-]Dallas14y30

If this happens, maybe a month to wrap up some affairs and then opt for live freezing to minimize brain damage. Unfortunately, I can't predict whether it would be legally simple to do so. If I am susceptible to some sort of neurodegenerative disease, the mean time of onset is probably ~02050 CE for me.

[-]RobertLumley14y40

Would you anticipate having any reservations once the month was up? Would you perhaps try to rationalize not getting it depending on how you were doing?

[-]Dallas14y30

To be honest, I hadn't really even considered that until you brought it up; I'm still far more worried about the possibility of pro-deathers ruining things for everyone, and my backup plan currently involves some form of retaliation followed by suicide. I'll make a note to make sure my friends coerce me into following through.

[-]megapolisomancy14y20

There is a growing interest of this issue in the cryonics community. For example, see this article in Cryonics magazine:

http://www.alcor.org/magazine/2011/01/14/options-for-brain-threatening-disorders/

[-]gwern14y20

Memories are very important, but they're only part of the package. Personality matters as much or more. I think the right answer would be to kill yourself once the degradation has erased most of your memories but your personality is still mostly untouched.

If you are revived, a lot of memories can be created out of all your documented evidence and buried (but nano-accessible) memories; this is especially true if you were smart enough to start lifelogging early - then you can retrieve a great many memories just by replaying the video stream and crosschecking your reactions against the videoed reactions and documentation like emails or social network updates.

This would represent a tradeoff between the 'alpha' and 'beta' simulation strategies, but that makes sense, since deciding when to kill yourself with Alzheimer's is another tradeoff between highly certain life and highly uncertain revival.

[-]lessdazed14y20

This would represent a tradeoff between the 'alpha' and 'beta' simulation strategies

What are those?

[-]gwern14y20

http://lesswrong.com/lw/2vv/lifelogging_the_recording_device/2swr

[-]Vaniver14y20

Were I to be diagnosed with Alzheimer's, I would purchase some hemlock. At that point, you might as well try to be frozen.

[-][anonymous]14y20

The thing is, suicide victims are always autopsied in the US (I saw that you attended the Houston meetup, so I'm going to assume you live in the States), which means you won't get frozen quickly enough (if at all). I suppose you could fake your suicide with something more subtle than poison, but now we're getting into questionable legal and ethical territory.

[-]gwern13y20

I thought they were only autopsied if they did not take the option of slowly starving themselves to death under medical supervision?

[-][anonymous]13y20

I've never heard of that before--do you know if doing that is actually legal?

Actually, though, my previous comment is wrong--there is no federal law mandating that all suicides be autopsied. I was misremembering what was stated in this book. Looking at it again, it actually says that suicides are almost always autopsied, but not 100% of the time. A quick Google search of some state legal codes seems to indicate that the autopsy requirement is actually determined at the state level, not at the federal level.

[-]gwern13y20

I've never heard of that before--do you know if doing that is actually legal?

Such was my understanding from previous discussions.

[-][anonymous]13y20

Hmm. It's possible, given that the handful suicide cases I've found where autopsies weren't performed were cases in which the cause of death and intent to commit suicide were so blindingly obvious that an autopsy would just be a waste. (And, in many of them, a family remember requested that an autopsy not be performed.)

The bottom line is, I don't know much about the relevant laws or how medical supervision affects things. To get a definitive answer, you'd probably need to contact a cryonics provider, a doctor, or a lawyer.

[-]Vaniver14y00

I do live in Texas, but I haven't been to the Houston meetup (yet). Like another poster, I don't expect the onset of those diseases anytime soon, and I think it likely that practices will change significantly in that time.

[-]jhuffman14y00

You think medical examiners in Texas will stop performing autopsies of suicides and suspicious deaths in your lifetime? Do you have any evidence for that at all?

[-]Vaniver14y00

Nope. It's unclear to me whether practices will change for the better or for the worse- but I can easily imagine a world where cryonics is widely accepted in ~50 years, or one where there's a jurisdiction you can quietly commit suicide in and then have your corpse flown out of, or that all cryonics organizations would have collapsed, and so the question is moot. Making a plan now is not a good use of my time because so much might change.

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