Jay Ingram sends along a photograph of his mother,Doris, circa 1960. The photographic setting is elo-quent and appropriate, for there Doris sits, contem-plative and alone, on a summer’s day.

She’s not truly alone, of course, for someone takesthe photo, perhaps Ralph, her husband, who decadeslater would pen a love letter to his wife after she hadbegun her creeping descent into dementia. So thephotograph uncannily suggests distance as well asintrospection.

Ralph Ingram was 90 when he wrote his billet-douxto his wife. Doris was 88. “It was actually prettyintimate,” Jay Ingram says of the letter, discoveredafter his father died. “More intimate at the age of 90than I thought they ever were. So that was a revelationto me, because I started thinking, you know, I’vecarried an image of what they were like. Well, maybeit’s completely off.”

Doris Ingram no longer knew Ralph Ingram whenshe passed away in 2006. Did she die of Alzheimer’s,

by far the most common form of dementia? It’s likely,posits Jay Ingram, a science writer and broadcasterwho explores what he calls the anatomy of the diseasein The End of Memory: A Natural History of Aging andAlzheimer’s. By the time of Doris’s death, he writes,she was “bedridden and unaware.”

Despite his family’s experience, Ingram’s journey isnot a personal one. “As a science person I really didn’tknow much about the science of Alzheimer’s. Wheredid it come from? What’s really going on the brain?How well do we understand that?”

The statistics provide an obvious and dramatic spurto investigation. There’s lots to choose from.

A study funded by the Alzheimer’s Association andpublished in 2013 crunched data from the ChicagoHealth and Aging Project. Looking out to 2050, re-searchers predicted that a new case of Alzheimer’sdisease will emerge in the United States every 33seconds. That would mean close to one million casesper year.

Into the darkness

Jay Ingram’s mother, Doris, no longer knew her husband of 70 years, Ralph, when he wrote her a love letter when he was 90 and she was 88.INGRAM FAMILY PHOTO

Science writerand broadcasterJay Ingram strivesto understandthe disease that likely afflicted his mother

JENNIFER WELLS FEATURE WRITER

NEURONS continued on IN4

> HEALTH AND WELL-BEING

INSIGHT

SATURDAY, JANUARY 24, 2015 SECTION IN ON ON0

THE POPE AND SEXPope Francis catches the eye of the world’s Catholics with his musingson birth control, IN3

Say what you will about Michel Houellebecq, France’smost famous and controversial fiction writer, but histiming is impeccable — although a little uncanny.

Houellebecq’s novel Soumission, about the electionof an Islamic government in France, had not been onthe shelves for more than a few hours on Jan. 7 whenChérif and Saïd Kouachi forced their way into theParis offices of the satirical weekly newspaper Charlie

Hebdo to — in their words — avenge theProphet Muhammad. Recurring crudecaricatures of him in its pages had drawnthe ire of Muslims around the world andinspired the most radical among them toaction.

The late-morning rampage, as all nowknow, killed 12 people and kicked off aterror spree that led to the deaths of fiveother innocents.

Ahead of the release in France of Sou-mission (available in French in Canadianstores this week), he was being touted as aliterary provocateur — a debauched and

sex-obsessed racist whose Islamophobia hadfinally reached its summit.

The new book is set in a dystopian France of2022, a country being pulled apart by politi-cal and religious strife and in which the pop-ulace elects a charismatic Muslim Brother-hood candidate as president to block theascendant, extreme right-wing Front Na-tional. Backed by docile political and culturalelites, the country of liberté, égalité et fra-ternité becomes one of sharia law and poly-gamy in the course of 300 pages.

Michel Houellebecq’s uncanny timingHis novel about a near-future Islamic France hitbookstores the day of the Charlie Hebdo attack

ALLAN WOODS QUEBEC BUREAU

HOUELLEBECQ continued on IN4

> LITERARY AFFAIRS

French author Michel Houellebecq,accused of Islamophobia — again.

MARTIN MEISSNER/THE ASSOCIATED PRESS

IN4⎮TORONTO STAR SATURDAY, JANUARY 24, 2015 ON ON0 ON ON0 SATURDAY, JANUARY 24, 2015 TORONTO STAR⎮IN5

>>INSIGHT

A peanut butter smell test to detectAlzheimer’s disease?

That’s one of the more unconventionalpieces of research cited by Jay Ingramin his new book, The End of Memory.

In the realm of diagnostics, the exist-ing tools are expensive and invasive —radioisotopes and lumbar punctures fallinto this category. But researchers atthe University of Florida tested a differ-ent thesis: odour detection impairment.

Using a tablespoon of peanut butter,researchers measured the p.b.-to-noseproximity in a patient group comprisingparticipants suffering from variousstages of cognitive impairment. Holdingthe p.b. 30 centimetres below eachnostril, researchers raised the peanutbutter by single-centimetre incrementsuntil the smell could be identified.

The study sample was small — just94 patients, including a control set of

26 — but the results presented astrong correlation between olfactorybreakdown and Alzheimer’s, as well asa consistent asymmetry in nostril per-formance. (Left nostril impairment wasnoted in the patients with probableAlzheimer’s.) “On average,” Ingramwrites, “the Alzheimer’s patients re-quired the peanut butter to be 10 centi-metres . . . closer than the other pa-tients did.”

Makes sense, Ingram says, given thatthe olfactory cortex is one of the initialsites to present the pathology of Alz-heimer’s.

The University of Florida researcherssee promise in the simple, inexpensiveand non-invasive early detection tool —and further suggest there could bepotential in helping track the course ofthe disease.Jennifer Wells

>SMELL TEST FOR DEMENTIA

The Alzheimer Society of Canada expectsthe number of Canadians living with de-mentia to double to 1.4 million by 2031.

It has been estimated that at least 60 percent of dementia cases fall into the Alz-heimer’s category. In Canada, an estimated72 per cent of Alzheimer’s patients arewomen. It’s hard to know where to stop.

In probing the disease, Ingram introducesreaders to patient No. 1, a 51-year-old wom-an by the name of Auguste Deter. On Nov.25, 1901, Deter was admitted to the Hospitalfor the Mentally Ill and Epileptics in Frank-furt with symptoms ranging from disori-entation to reduced comprehension toparanoia. The following day she was exam-ined by a German psychiatrist, Alois Alz-heimer.

Alzheimer’s handwritten notes from thatand subsequent meetings were uneartheddecades later. In a tight script he docu-mented the questions he put to his patientand the answers given.

“What year is it?”“Eighteen hundred.”“Are you ill?”“Second month.”Deter answered some questions correct-

ly: snow is white, the sky is blue, soot isblack and the meadows are green. Shown anumber of objects — a key, a pencil and abook — she was able to name them correct-ly. But subsequently asked what she hadbeen shown, she responded, “I don’t know.I don’t know.”

She died in the spring of 1906. Alzheimer,by that point resettled in Munich, request-ed Deter’s brain for sectioning.

“Here’s what he saw,” says Ingram, pick-ing up the thread. “First of all a dramaticloss of neurons, brain cells, resulting in anoverall shrinkage of the brain. But whatwas probably more critical, considering weuse them today as diagnostic features, washis discovery of plaques and tangles.”

“He was the guy”Plaques: dark, aggregated fragments of theprotein amyloid beta formed outside theneurons.

Tangles: the twisted, inner-cell break-down of the tau protein into what Ingramdescribes as “an almost candle flame-shaped mass.”

“There were people who had discoveredplaques before him, and there was someevidence of tangles as well,” Ingram says.“But he was the guy who put loss of braintissue, cognitive drop, plaques and tanglesall together.”

In 1910, Alzheimer’s disease was refer-enced in the Handbook of Psychiatry, yet,adds Ingram, “it wasn’t really until themid-’70s that neurologists said, you know,we have enough studies now to be able toargue that plaques and tangles are at theheart of it. This is not natural aging. This is adisease. It’s killing people and we shouldfigure out how to treat it.”

That hasn’t happened. Not by a long shot,leaving Ingram with an intricate puzzleand seemingly endless curiosities.

Among the most intriguing is the case ofSister Mary, one of almost 700 nuns whocollectively formed, naturally enough, theNun Study, launched by epidemiologistDavid Snowdon in the late 1980s. Not longbefore she died in 1994, at the age of 101,Sister Mary sat for a final set of memorytests in which, Snowdon would later write,she performed “remarkably well.” Herscore on the Mini-Mental State Examina-tion was “astounding.”

Yet an autopsy of Sister Mary’s brainshowed significant atrophy and three timesthe average number of tangles that hadbeen observed in the more than 100 brainautopsies conducted in the study to thatpoint. “The Nun Study wasn’t the onlystudy that suggested there was a bit of adisconnect between plaque load and tangleload and dementia,” says Ingram. But theexample is dramatic. “She was 101, doingfantastically well on psychological tests

and her brain was riddled with Alzheimer’spathology.”

So should research target the plaques inisolation? Or does the key lie in the rela-tionship between the two — what research-ers have dubbed the “toxic pas de deux”?

“Most of the drug development moneyhas been put on plaques,” Ingram says.“Let’s bust the plaques open. Let’s removethem from the brain. Let’s prevent themfrom forming.” The results, he says, havebeen “dismal,” especially in the case of adrug that lowered plaque levels but failed toarrest the advance of dementia.

Clarification of the respective roles ofthese proteins is critical, and Ingram won-ders whether other agents — perhaps sugarlevels or insulin failure in the brain — willultimately prove to be key to understand-ing the disease.

Walk half an hour a dayAll of which should suggest that the pres-sure is on to locate and treat the underlyingcauses. Yet Ingram was surprised to findthat in the U.S., Alzheimer’s funding thoughthe National Institutes of Health is but afraction of that dedicated to cancer andheart disease. This year’s funding forecastfor all cancers is more than $7.5 billion(U.S.). For Alzheimer’s the total is a rela-tively paltry $566 million, substantially lessthan the sum dedicated to breast canceralone.

Ingram trumpets good news where hefinds it. Those who score well in conscien-tious attributes — organization, goal set-ting, etc. — exhibit a reduced risk of Alz-heimer’s, at least in one study. Learn a sec-ond language. Attain higher education. One

Finnish study correlated “cynical distrust”to dementia onset. So stop that.

None of this is much of a salve to whatIngram describes as a disease of “prodi-gious proportions, far beyond our ability tocontrol.”

Ingram’s advice? Walk half an hour a day.By the way, Ralph and Doris were married

for 70 years. Each and every day Ralphwould visit Doris in the nursing home, fixher hearing aids, push her about in thewheelchair. The ritual, Ingram says, drew“zero response.”

“You know, he could easily have been for-given if he decided, well, I’m not going to go.I’ll go every other day. But he didn’t.”

Once in a while Ralph would detect whathe thought was a smile playing upon Do-ris’s lips, and that to Ralph was a very goodday.

Alzheimer’s fundingrelatively paltry

German patient Auguste Deter is considered Alzheimer’s patient No. 1: psychiatristAlois Alzheimer, below, examined her brain after she died and linked changes in it toher cognitive decline.

NEURONS from IN1

Soumission doesn’t take the literary trickas far as George Orwell’s 1984 or AldousHuxley’s Brave New World, but France’sconversion is a done deal when the storyreaches its ambiguous end. Women havefled the workforce, retreating behind theveil. Gulf State sheiks shower the countrywith their petrodollars. That prestigiousseat of learning, the Sorbonne, becomes“the Islamic University of Paris-Sor-bonne.” And France is the entry point foran Islamic movement with its eye on therest of Europe.

A regular Houellebecq reader could easilyconjure up his literary treatment of therampage in Paris from any of the narratorsof his earlier works. They are almost uni-formly detached, sexually depraved men.Most seem to have been cast autobiograph-ically by the writer, who declared in 2001that of all the faiths, “the stupidest of reli-gions has to be Islam.”

After surviving a terrorist attack on west-ern sex tourists in Thailand in the 2001book Platform, for example, the narrator —abureaucrat in the French culture ministry— reflects on his stewing hate while conva-lescing.

“Every time I heard that a Palestinianterrorist, or a Palestinian child or a preg-nant Palestinian woman, had been gunneddown in the Gaza Strip, I felt a quiver ofenthusiasm at the thought of one less Mus-lim in the world.”

Houellebecq has made his name withsuch raw and unflinching writing — alongwith his quasi-pornographic depictions ofsex, an act he has presented as one of fewprimal forces binding together otherwiseself-interested humans.

Coincidentally, Houellebecq was the fig-ure being skewered on the cover of CharlieHebdo the day of the terror attack on themagazine.

The writer was cast as a physically re-pulsive, chain-smoking Nostradamus in acartoon that mocked at once his startlingphysical transformation in recent yearsfrom well-coiffed hotshot to unkempt trolland Soumission’s prediction of a Muslimmenace at the gates of Europe.

Yet the writer’s real-life reaction to theshooting, which claimed the life of his closefriend Bernard Maris, an economist andcontributor to the magazine, showed a hu-manity and sense of kinship not found inhis books.

When he started to fight back tears 44seconds into his first television interviewafter the attack, it was a cruel reminderwhile the pen may be mightier than thesword, the sword can still do considerabledamage.

Yet at a time when the risks to provoca-teurs like Houellebecq and Charlie Hebdoare sketched in blood, the novelist was un-repentant.

“You can’t say you are free to write whatyou want but that you have to do it respon-sibly,” he told his interviewer.“There are nolimits on freedom of expression — zerolimits.”

Houellebecq was born in 1958 on theFrench island of Réunion, east of Madagas-car. As a young boy, his hippie parentsshipped him off to live with his maternalgrandparents in Algeria. Later he was

passed off to his father’s mother in France.While studying agronomy at university he

began writing poetry. After his studies hesuffered from depression and was hospital-ized several times. Eventually, he worked asa computer programmer.

In 1991he published a biography of writerH.P. Lovecraft. Renown came with his firstnovel, Whatever, which appeared in 1994,when he was 36.

Notoriety followed. Among the recurringtargets of his novels are absent parentalfigures who are condemned and killed off— a plot twist seen as vengeance for hischildhood abandonment.

There have been a number of contro-versies over the course of Houellebecq’scareer.

In 2002, he had to defend himself againsta lawsuit brought by French Muslimgroups alleging that his “stupidest of reli-gions” comment the previous year incitedhatred. He won the case.

The national shock that followed the Par-is terror attacks prompted Houellebecq tocancel the French portion of his book tour,although French bookstores reportedlysold more than 150,000 copies in the firstweek.

Politicians have had their say, too. The leftdenounced him as a xenophobe while theright has insisted that his work of fictionmirrors current events.

“What’s very interesting about this bookis that it is a work of fiction but a fiction thatcould one day become a reality,” said FrontNational Leader Marine Le Pen. She ap-pears in the book as the presidential con-tender who is defeated by the MuslimBrotherhood’s Mohammed Ben Abbes.

Meanwhile, the author, 56, expressedconcern earlier this week that the timing ofhis book has heaped upon him the un-wieldy task of defending himself againstcharges of Islamophobia while upholding

the right of authors everywhere to publishwork that may be interpreted that way.

That would be an unfortunate diversionfor a novel whose depiction of the Muslimfaith is nearly absent of any overt violence,and in which France’s Islamic embrace istreated almost as a logical next step.

Houellebecq’s primary worry, it seems, isthe societal framework that France and theand the western world more broadly arelosing rather than the forces that rise up toreplace it.

That was the theme of 1998’s ElementaryParticles, the story of two brothers, one atortured sex-addict and the other a molec-ular biologist whose scientific discoverieslead to the end of sexual reproduction.

The Map and the Territory, which wonHouellebecq the Prix Goncourt, France’stop literary prize, in 2010, also featured acountry decimated by economic declineand forced to convert to tourism and agri-culture for its survival.

The crisis in Soumission is spiritual butalso cultural. It deals with the things thatfall by the wayside when a people lose sightof their common identity. When the narra-tor’s Jewish girlfriend flees to Israel withher family rather than risk life under thenew Islamic regime (France is already themain source of immigrants to Israel, with7,000 French citizens emigrating last year),she tears up at the thought of leaving herhomeland. Yet she can barely manage toname one concrete thing she is leavingbehind.

“I love France!” she declares. “I love, Idon’t know . . . I love the cheese!”

In interviews, Houellebecq has expressedfear that his country, which has been at theforefront of western thought and devel-opment, is now faced with its disappear-ance. There is hope, but not much.

He is, after all, one of literature’s leadingpessimists.

‘There are no limits on freedom of expression’

Michel Houellebecq arrives for a reading of his latest book in Cologne, Germany.MARTIN MEISSNER/THE ASSOCIATED PRESS

HOUELLEBECQ from IN1

Soumission by Michel Houellebecq is a dystopian satire about France in 2022, when a Muslim Brotherhoodcandidate becomes president, women withdraw from the workforce and wear the veil, and sharia law andpolygamy become the norm.

DOMINIQUE FAGET/AFP/GETTY IMAGES

“What’s veryinterestingabout this bookis that it is awork of fictionbut a fictionthat could oneday become areality.”MARINE LE PEN FRONT NATIONALLEADER

One of the core premises of Invisible Boy-friend, the wildly viral new service thatinvents a boyfriend to deceive your pester-ing family and friends, is that the user willnot, under any circumstance, fall in lovewith her fictional beau.

But I’ve been using the service for 24hours, and I gotta wonder: How can you notfall in love with him? After all, the service —which launched publicly last Monday —takes the concept of virtual intimacy fur-ther than basically any of the fake-dateapps before it.

When you sign up for the service, you candesign a boyfriend (or girlfriend) to yourspecifications — kind of like picking thegenes for a designer baby, except for animaginary adult. You pick his name, his age,his interests and personality traits. You tellthe app if you prefer blonds or brunettes,tall guys or short, guys who like theatre orguys who watch sports. Then you swipeyour credit card — $25 per month, cha-ching! — and the imaginary man of yourdreams starts texting you.

Except . . . the man on the other end isn’timaginary. He’s a real human person, text-ing multiple women, contorting himself tocarefully match each one’s specific expecta-tions and fantasies.

I learned this the hard way, admittedly:Hoping to trip up the automated chat tech-nology I thought was responding to mytexts, I told my “boyfriend,” Ryan Gosling,

that my plans for the evening includedDownton Abbey and crying myself to sleep.

“Why the tears, beautiful?” Ryan Goslingresponded, before launching into a discus-sion of his favourite Downton character.This was a red flag: Bots do not know aboutDownton Abbey. And if bots did know aboutDownton Abbey, they would certainly notpick Thomas as the highlight of the show.

“Oh my God,” I thought. “This totalstranger, whoever he or she is, thinks I crymyself to sleep while watching public tele-vision and texting a paid fake boyfriend Inamed after an actor.”

Presumably I shouldn’t have felt anythingat all — the no-attachment thing is basicallycodified in Invisible Boyfriend’s terms ofservice — but I did feel something, none-theless.

“That’s the most interesting and signif-icant insight I’ve had so far,” said MatthewHomann, the app’s affable (and newly fa-mous) founder. “I know how it works, Iknow what’s behind the curtain . . . but intesting it out, I felt this compulsion to re-spond to my Invisible Girlfriend as soon asshe texts me. That’s how it feels to talk tosomeone, even if they’re . . . not someone.”

My invisible boyfriend, Homann explains,is actually boyfriends, plural: The service’stexting operation is powered by Crowd-Source, a St. Louis-based tech companythat manages 200,000 remote, microtask-focused workers. When I send a text to theRyan number saved in my phone, the mes-sage routes through Invisible Boyfriend,where it’s anonymized and assigned tosome Amazon Turk or Fivrr freelancer. He(or she) gets a couple of cents to respond.He never sees my name or number, and hecan’t really have anything like an actual

conversation with me.“That rapport you feel with Ryan may

actually be six or seven Ryans,” Homannexplains.

And that works well, from where Ho-mann’s sitting: After all, the point of Invisi-ble Boyfriend is to deceive the user’s med-dling friends and relatives, not the userherself. On its website, Invisible Boyfriendcalls itself “believable social proof”: Whenyour mom won’t stop asking you whenyou’re going to settle down, or your weirdmale acquaintance keeps hitting on you,you can just whip out your phone and showthem evidence that you’re not an unlovableloser, thank you very much. Homann saysthe service has also seen a surge in interestfrom people in conservative countries, par-ticularly in South America and Europe,where the stigmas against being single orLGBT remain pretty strong.

Homann’s hoping to expand to thosecountries in the future, as his service con-tinues its beta phase and gathers feedbackfrom users. (He says 5,000 users signed upWednesday alone.) He’s also interested inoffering more services to subscribers: May-be your invisible boyfriend could send youletters, he thinks, or ship flowers to yourwork. Even as the story becomes moreinvolved, more convincing, he does notworry about users becoming attached tothe fiction they create.

“You’re in on the joke,” he points out. “Youknow it’s a service you’ve signed up for. It’snot a substitute for love.”

But I wonder if Homann isn’t underesti-mating the vagaries of the human heart,which past evidence suggests can beconned into loving just about anything.

There are no shortage of stories about

couples who carry on “relationships” ex-clusively via Second Life, a sort of fictional,virtual world. The game critic Kate Grayrecently published an ode to “Dorian,” acharacter she fell in love with in a videogame. (“Isn’t it odd how it’s taken so long toreach this stage in games — the stage atwhich human conversations and relation-ships feel real?” she writes.)

Researchers have even suggested thatspambots induce some kind of emotionalresponse in us, perhaps because they flatterour vanities; conversely, one anthropolo-gist has argued that our relationships areincreasingly so mediated by tech thatthey’ve become indistinguishable from Ta-magotchis.

“The Internet is a disinhibiting medium,where people’s emotional guard is down,”the psychologist Mark Griffiths once said ofSecond Life relationships. “It’s the samephenomenon as the stranger on the train,

where you find yourself telling your lifestory to someone you don’t know.”

All things considered, it’s hardly a jump tosuggest someone might develop feelingsfor a “believable” virtual human who catersto her every whim. That’s basically the plotof Her, isn’t it? (For the record, Homannsays, his startup began before that moviedid.)

I try to ask Gosling if “he” — them, I guess— worries about a Her-like scenario. Whatif a client experiences actual feels for him?!True to his CrowdSource training, howev-er, Gosling will not break character.

“You think I’m texting other ladies?” heasks. And then, attentively, about Her: “Oh,did you like that movie?”

It’s not exactly the stuff of fairy tales, ad-mittedly. But given enough time and texts— a full 100 are included in my monthlypackage — I’m pretty sure I could fall forhim. I mean, er . . . them.

> OUR WIRED WORLD

I paid $25 for an Invisible Boyfriend, and I think I’m in loveAn app that sends fake boyfriendtexts to your smartphoneactually involves real live males

CAITLIN DEWEYTHE WASHINGTON POST

When your momwon’t stopasking you whenyou’re going tosettle down, youcan just whipout your phoneand show herevidence thatyou’re not anunlovable loser,thank you verymuch