earl thomas conleyEarl Thomas Conley was a country music singer-songwriter who during the 1980s and 1990s had 24 Top-10 country singles including 18 that were Number One.  Only Alabama and Ronnie Milsap had more number one hits during the decade.  
This month, at age 77, Conley died after spending many months in hospice care for cerebral atrophy, a condition that had caused progressive loss of memory over several years.  Popular performing musicians are prone to this condition because they are usually sleep deprived — they perform at night, and while on tours they sleep in a bus during the day.  They are also exposed to a lot of smoke as well as to people who use drugs and alcohol.  Cerebral atrophy is associated with anything that can damage the brain such as head trauma, infectious diseases, strokes, diabetes or arteriosclerosis, but I could find no media evidence that he had any of these conditions. 
Early Years and Music Career
Conley was born in 1941, the third of eight children, in the small country town of Portsmouth, Ohio. When he was 14, his father lost his job with the railroad, so he moved to live with one of his older sisters in Jamestown, Ohio.  After high school, he was offered a scholarship to attend art school but instead joined the Army, where he began to write songs and sing in a religious revival group.  At age 27, he left the army and worked on the railroad and in steel mills and commuted to Nashville to try to further his music career.   
At age 34, he had his first big breakthrough when the song "Smokey Mountain Memories" that he wrote for another musician made the top 40 country hit list.  At age 35, he wrote "This Time I’ve Hurt Her More Than She Loves Me” and Conway Twitty made it the number one country hit.  At age 40 he had his own first number one hit, “Fire & Smoke.”   In 1983, at age 43, he was nominated for multiple Grammy Awards for his song, "Holding Her and Loving You".  

Decline and Health Problems
In 1992 at age 52, because his records were not selling, he was dropped from his record label and did not record again for seven years. In interviews he told reporters that he had respiratory allergies.  At age 57, he recorded a few songs and at age 61, he had a top 20 recording, "All Over Me".  His last years were clouded by progressive dementia that eventually led to hospice care for several months before he died at age 77.  The cause of death was given as cerebral atrophy.  
Cerebral Atrophy Cause of Death is Usually Heart Failure
Most obituaries for people who have died from cerebral atrophy list "natural causes," but the most common cause of death is heart failure, which is never "natural."  Cerebral atrophy means that a person progressively loses brain cells and the brain looks progressively smaller on an MRI. First they have difficulty remembering recent events, then names and places, then recognizing people and eventually they don't even know their relatives or friends, or where they are.  
With progressive loss of the ability to remember anything, you eventually spend most of your time in bed.   Not using your muscles regularly progressively weakens you. Your heart is a muscle and when you lie in bed all the time, your heart weakens and eventually your heart becomes too weak to pump blood through your body and you die of heart failure. 
Causes of Cerebral Atrophy
The brain loses some size during the natural process of aging, so that by age 75 the average brain is 15 percent smaller than it was at age 25.  Greater than normal brain atrophy can be associated with many diseases and conditions, including:
• Head trauma
• Stroke (sudden interruption of blood supply in the brain)
• Certain drugs such as corticosteroids
• Environmental pollutants
• Alzheimer's disease or other forms of dementia
• Any disease that limits a person's ability to move
• Genetic disorders of the brain, nerves or muscles
• Malnutrition, from lack of or excess of various nutrients
• Diabetes 
• Bipolar disorder
• Schizophrenia
• Infections such as certain venereal diseases, or any infection in the brain
• Alcohol  

Current Diagnosis and Treatment of Cerebral Atrophy
As some known causes of dementia are treatable, everyone who suffers from failing memory needs a thorough evaluation for the causes of memory loss by a neurologist.  Furthermore, every risk factor for a heart attack is also associated with increased risk for dementia.  If you suffer from progressive loss of mental function, check with a neurologist and get: 
• an MRI of the brain
• blood tests for lack of nutrients such as B12, folic acid, methylmalonic acid
• blood tests for various infections, including venereal diseases such a syphilis and HIV
• cholesterol, triglyceride, Lp(a), homocysteine
• HBA1c and one-hour-after-eating blood sugar (which should be under 145)
• vitamin D level
• CRP, sed rate
• APOE genotype
• Thyroid tests (TSH)
• Any other tests recommended by your neurologist 
Since both dementia and heart attacks are associated with inflammation (an overactive immune system), every person with failing memory should immediately begin an anti-inflammatory lifestyle
• eat a plant-based diet with a wide variety of vegetables, whole grains, beans, nuts and fruits
• restrict red meat, processed meats, fried foods, sugar-added foods and all drinks with sugar in them
• avoid obesity
• avoid smoke and alcohol
• exercise regularly
If you are not already eating a healthful plant-based diet and engaging in regular exercise, check with your doctor and then try to start a new diet and exercise program as soon as possible.
October 17, 1941 – April 10, 2019