Tom Magliozzi died at age 77 on November 3, 2014 from complications of Alzheimer’s disease. This horrible dementia prevents you from remembering almost anything. For 35 years he was the star of the nationally-syndicated radio show “Car Talk” with his brother Ray, hosting calls from would-be mechanics, puzzled car owners and entertained listeners.

This is another sad reminder that anyone can suffer dementia. Alzheimer’s disease can affect rich or poor, brilliant or dull, educated or illiterate. Magliozzi had an undergraduate degree from the Massachusetts Institute of Technology, one of the most prestigious and difficult-to-get-into colleges in the country, and had also been accepted at Harvard. He earned an MBA and a PhD and was a college professor.

A Boston Success Story
Tom was born and raised in a poor and tough Italian neighborhood in East Cambridge, Massachusetts. He went to Cambridge High and Latin School, which sent several of their graduates to MIT each year. (I went to a similar public school, Boston Latin School, that sent many of its poor kids from mostly immigrant families to Harvard and MIT). At MIT he was a commuter student, which means that he lived at home while almost all of the other undergraduate students lived and socialized in dormitories. (I was also a commuter student who spent three hours a day traveling on the streetcar from Roxbury to Harvard.) Tom hated MIT, had to study very hard just to stay in school and was graduated “Magna Difficultate”. Many years later, in 1999, he and his brother were the commencement speakers at MIT. He ended his speech with “Don’t drive like my brother.”

After a brief stint in the army, he went to work for Sylvania and the Foxboro Company and appeared to be working his way up the corporate ladder. After a near-fatal auto accident, he quit his job with no plans and spent the next year hanging out in Harvard Square and drinking coffee. He became a handyman and house painter, and taught a business course in Saudi Arabia. Then his brother quit his job teaching high school and together they started a do-it-yourself auto repair shop. They called it Hacker’s Haven. They supplied the tools and people would come in and repair their own cars. The brothers didn’t make much money, so they changed the name to “Good News Garage”.

WBUR-FM, the Boston National Public Radio affiliate, asked several auto mechanics to be in a panel on repairing cars. Magliozzi was the only one who showed up, and as a result of this appearance, he and his brother were offered the chance to host a radio show called “Car Talk” that began in 1977. It did so well in Boston that in October 1987, NPR offered to syndicate the show nationally. The radio show audience eventually grew to four million listeners on 700 radio stations and in 1992, Tom and Ray won a Peabody Award for their show. An example of the uniqueness of the show was that they would ask callers to reproduce the noises that their cars made, and then they would make a diagnosis from the sounds supplied by their callers.

Tom spent nine years getting a business PhD at Boston University and taught there. After eight years of hosting his radio show, he quit teaching and spent the rest of his life doing his once-a-week radio show. As Tom Magliozzi’s dementia became more obvious, the Magliozzi brothers stopped hosting the show on September 2012, but NPR continues airing reruns.

Death from Complications of Dementia
When you read that a person has died from complications of Alzheimer’s disease, the most likely causes are pneumonia, a heart attack, a clot in the lungs, starvation or dehydration (Medicine and Health Rhode Island, December 2010;93(12):379-81). More than 90 percent of dementia patients need nursing home care in the end because they lose control of their muscles and just lie in bed. They cannot swallow properly, so they often vomit food and acid from the stomach into the lungs and die from a lung infection. They cannot walk, so they develop bedsores that spread infection into the bloodstream. They lose control of their bladders so they develop urinary tract infections. They fall and break bones and develop clots that cause strokes. They lie down most of the time which kills their kidneys and they die of kidney failure.

What Is Dementia?
Alzheimer’s disease is the most common type of dementia and is marked by a devastating loss of memory, comprehension and speech. One in eight North Americans over 65, one in two over 85 and half of nursing home residents suffer from dementia.

First people forget what has just happened. Then they are unable to focus on what they are talking about and can’t even add up short lists of numbers or remember where they live. This causes them to become confused and frustrated, and they often become very angry for no apparent reason. They can also lose interest in what used to be their favorite occupations, such as playing chess, watching television, reading or riding a bicycle. When they wander off and can’t find their way home, they are usually institutionalized. In later stages, they lose coordination and walk with an uncoordinated gait, have trouble using a telephone or a TV remote control, lose control of their bowels and bladder, can’t communicate with other people and can’t even feed themselves. They may die from one to 20 years after they are diagnosed, with an average time from diagnosis to death of nine years.

What Causes Alzheimer’s Disease?
Nobody really knows what causes dementia. People are at increased risk if they have a history of head trauma, a family history of dementia, or any of the factors associated with increased risk for heart attacks, including high blood pressure, high cholesterol, high blood sugar levels, lack of exercise, obesity, smoking and so forth.

Dementia is more common in people who take drugs that affect the mind and in those who have chronic infections such as Lyme disease, chlamydia or syphilis. Risk increases with aging. Examination of the brains of dementia patients after death have shown plaques made of beta-amyloid, loss of brain cells, and tangled threads of tau proteins, but we do not know if these are causes or results of dementia.

Steps to Protect You from Dementia
From the many studies on older people, both those who have dementia and those who do not, the behaviors that appear to protect your brain include:
• Using your brain: computer games, crossword puzzles, counting steps when you walk or cycle, reading, learning new subjects or tasks such as dancing, and so forth
• Having lots of friends and being active in groups and clubs
• Following the same healthful diet that helps to prevent heart attacks: high in vegetables, fruits, nuts and seeds and low in sugared drinks, sugar added foods, fried foods and red meat
• Keeping hydroxy Vitamin D levels above 75 nmol/L
• Exercising every day
• Avoiding smoking
• Limiting or avoiding alcohol
• Treating all heart-attack-risk factors such as high blood pressure, cholesterol and blood sugar levels
• Avoiding any unnecessary drugs that affect the mind
• Treating any chronic infection
Check with your doctor for an evaluation if you have persistent headaches.

Tom Magliozzi
June 28, 1937 – November 3, 2014