The Maintenance Cascade: Neurodegeneration as Tool Degradation and Its Reversal

This paper proposes that neurodegeneration is not a disease of consciousness but progressive degradation of the tools consciousness depends on. The initiating event is cellular aging — telomere shortening producing senescent neurons with degraded maintenance capacity — not protein accumulation, which is the consequence. A self-reinforcing loop between slow wave sleep disruption and glymphatic clearance failure accelerates protein accumulation years before clinical symptoms appear. Three non-invasive slow wave sleep restoration interventions are confirmed effective at breaking the loop in existing patients. Telomerase reactivation addresses the root cellular aging mechanism through TERT localization to mitochondria, reducing oxidative damage and preventing mitochondrial DNA damage through antioxidant defence enhancement. The chooser remains intact until late stage disease. The tools can be maintained. Neurodegeneration is a maintenance failure with a known mechanism and an increasingly tractable solution.