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The Myth of Alzheimer’s September 12, 2012

Posted by nrhatch in Books & Movies, Health & Wellness, Mindfulness.
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Our innate desire to form complete mental images encourages us to use “label makers” to categorize the world around us . . . even if doing so requires shaving off non-conforming jagged edges in order to stuff square pegs into round holes.

“It is easier to know man in general than to know one man in particular.” ~ Duc de la Rochefoucauld

Once a label is applied, accurate or not, we are placed into convenient cubby holes with others of like label.  Henceforth, instead of being seen as unique and distinct beings, we are viewed through filters, using the law of averages and stereotypical information, often out-dated. 

Over-encompassing medical diagnoses (e.g., Attention Deficit Disorder, Post Traumatic Stress Disorder, and Alzheimer’s Disease) are labels which lump  patients together, like sheep or cattle, for convenient herding, classification,  and marketing.

Yesterday, I read The Myth of Alzheimer’s ~ What You Aren’t Being Told About Today’s Most Dreaded Diagnosis.  The book substantiates what I’ve long suspected:  Alzheimer’s is not a disease . . . it is a diagnosis

Alzheimer’s is a convenient, albeit misguided, label used to categorize dementia, memory loss, and cognitive impairment:

This is not merely a semantics issue over Alzheimer’s versus senility.  Scientists still can’t agree upon what Alzheimer’s is.  As you will see, it is a disease without a clear-cut definition; there is no agreed-upon way to differentiate AD from normal aging, making every diagnosis only “possible” or “probable,” and every individual case heterogeneous and unique in its course. 

Existing treatments are not effective, and talk of a “cure” is based on faith, not measured scientific extrapolations.

One thing we do know is that Alzheimer’s is a multibillion-dollar industry, and that the label is driven in large part by the pharmaceutical industry and by some academic experts and others who use the exaggerated characterization of AD entrepreneurially to promote maximum concern for dementia and therefore maximize research support of the disorder and sustain the clinical empire that has been built around it. 

The medical story of AD generates fear, paranoia, angst, and stigmatization while evoking powerful social and emotional images.  A diagnosis of AD can act in many ways as a death sentence of the mind, which imprisons many still-functional adults to a mental death row.  By trying to de-stigmatize cognitive decline with a disease label that takes the onus off the person, we have actually made the ostracism of the sufferers worse.  The words we use to describe diseases have the potential to do emotional and societal harm.

Alzheimer’s “disease” is a multi-billion dollar industry centered around a diagnostic label which inspires fear, expands research budgets, inflates drug sales, and promotes elaborate diagnostic testing protocols.

This deceptive and crippling label allows pharmaceutical companies to sell more drugs to families desperate to slow progression of “the disease,” and allows the Alzheimer’s Association to raise money for “victims” in a race for a cure . . . selling hope through hype.

Aging is not a disease to be cured.

Instead of rushing in with label makers to diagnose “disease,” or hoping that THEY find a “cure” for brain aging, Dr. Whitehouse urges us to accept personal  responsibility for maintaining optimal levels of cognitive health  through diet, exercise, intellectual stimulation, stress reduction, social networking, and the promotion of other healthy habits.

After all, an ounce of prevention is worth a pound of cure.

Aah . . . that’s better!

* * * * *

About the Author:  Peter J. Whitehouse, M.D., Ph.D., one of the best known Alzheimer’s experts in the world, specializes in neurology with an interest in geriatrics and cognitive science and a focus on dementia.  He is the founder of the University Alzheimer Center (now the University Memory and Aging Center) at University Hospitals Case Medical Center and Case Western Reserve University where he has held professorships in neurology, neuroscience, psychiatry, psychology, organizational behavior, bioethics, cognitive science, nursing, and history.  He is also currently a practicing geriatric neurologist. With his wife, Catherine, he founded The Intergenerational School, an award winning, internationally recognized public school committed to enhancing lifelong cognitive vitality.

Comments

1. Lisa Wields Words - September 12, 2012

While I completely understand and agree to what you are saying here, there is a reality to the disease factor. Is my father being inundated with drugs that don’t seem to help much? Yes. At the same time, watching his decline and wishing that you could somehow improve or at the very least make him more comfortable is a reality that my family has to face. It’s too late to prevent. I know there is no “cure” (and perhaps there never will be), but there are ways to make life better for everyone involved. Aren’t there?

nrhatch - September 12, 2012

That’s part of the point of the book . . . that by focusing on a cure that is not apt to be found, we miss opportunities to learn how to improve the lives of loved ones, right here and right now.

And that’s why he founded the Intergenerational School.

2. nuvofelt - September 12, 2012

A recent report apparently links junk food with alzheimers. However, the elderly population here in the UK would never have consumed ‘junk food’, it just wasn’t available. Another report says that the same generation are living so long because their restricted diet during the war years was perfect for longevity. Labels are labels, and statistics can be tweaked to qualify any ‘fact’. It’s so important to maintain a sensible view of everything and to assume our own responsibility for our personal mental health. Thanks for sharing this. As a family we are living with this awful illness, and there are symptoms that are never discussed and about which no warnings are given. Ironically, the person affected had what could be termed very good mental health, and an excellent diet, so what does that mean? That’s a rhetorical question, by the way. 🙂

nrhatch - September 12, 2012

I am so glad your question was rhetorical. 😉

I expect that taking care of our brains delays the onset of age-related dementia just as physical exercise postpones the onset of some age-related diseases.

Instead of symptoms becoming manifest at X years . . . they don’t start to appear for X+3 years or X+5 years or X+15 years.

We delay the inevitable . . . but we can’t eliminate the aging process enitrely.

3. suzicate - September 12, 2012

I have relatives with Alzheimers (two of which are twins), and I’ve found it both interesting and confusing to hear them diagnosed as Alzheimers or dementia. One was said to have “surpassed the dementia stage and into full blown Alzheimer”. I wonder if the wording depends on the doctor or if they have tried to classify it in stages. At any rate, the focus should be on helping keep the patient comfortable and as functional as possible and the helping the families cope.

nrhatch - September 12, 2012

The diagnosis is incredibly subjective and depends, in large part, upon the willingness of the doctor in question to see and treat the WHOLE patient . . . rather than focusing exclusively on isolated symptoms.

The hallmarks of AD are also the hallmarks of normal brain aging which varies from individual to individual based on any number of factors.

Sadly, the diagnosis can become a self-fulfilling prophecy as patients “give up” once told they have a progressive brain disorder that destroys memory and cognitive function.

4. colonialist - September 12, 2012

Indeed, it seems to have much in common with ADD, used as a convenient label for a number of conditions some of which don’t even exist until the ‘treatment’ creates them.

nrhatch - September 12, 2012

Yup. Just as most kids have problems “paying attention” at times (especially when bored with THIS or excited about THAT), ALL people have brains that age over time. Some people lose spatial abilities and some lose verbal abilities.

Many factors contribute to aging of the brain. The process occurs in ALL human beings to one degree or another as we age ~ we lose visual acuity, hearing, sense of smell, and even basic mechanisms like temperature regulation.

But we tend to be most neurotic about memory loss no matter which type of memory is involved: Episodic (autobiographical facts), Semantic (extraneous facts), Procedural (how to tie a shoe or ride a bike), Working (short term memory ~ e.g., remembering a phone number while we dial it), and Implicit (an aversion to a food that made us sick years ago).

5. granny1947 - September 12, 2012

A thought provoking post Nancy.
How old is your Mom?
When we were growing up ADD was unheard of…what happened?
I am horrified at the number of kids who are subjected to drugs when it is probably just a bad diet.

nrhatch - September 12, 2012

My mom turns 83 this month. She has exhibited age related changes in cognitive functioning for YEARS.

Any number of factors play a part in cognitive dysfunction and/or memory loss ~ genetic, hormonal, environmental, or even the diminution of blood supply and glucose in the brain.

Lumping them all under the Alzheimer’s Umbrella does no one but the pharmaceutical companies and researchers any good.

6. Irene - September 12, 2012

Excellent post! My dad was “diagnosed” with dementia. Dad has short term memory loss. Sometimes I do too. And the majority of Americans probably as well. I mean in this day and age of SO many technologies, opportunities, choices it’s a wonder that most of us remember our names! So now he’s been labeled and it’s all over his medical records…don’t get me started. Alzheimers is it’s own issue.
I also just recently discovered that salmon and apple juice can help with good mental health.

nrhatch - September 12, 2012

The book contains “A New Model for Living with Brain Aging” . . . one that doesn’t involve “tossing in the towel.” As he notes, despite the universal process of brain aging (which starts when we are in teens), our aging brains are still quite capable of growing new cells and making connections between them.

New neuronal cells are generated in older brains . . . but are retained only by lab rats that engage in active learning to build synaptic connections.

“Use it or lose it” is a reminder to live life in a vital and active way for as long as you possibly can.

7. Richard W Scott - September 12, 2012

I don’t know enough about this to do more than speculate–and I’m not sure that the doctors who proclaim about it know all that much more–but I wonder how much of the issue is one of people getting tired, or of getting to a point where they feel helpless in their lives. I’m sure this will cause some folks to get riled up, but I cannot help but wonder.

My mother, who lives a long way away, is losing touch with reality. She keeps talking about going back north to take care of HER mother (long gone), and she repeats the same things every time I call her. Her life is considerably restricted by live-style. She lives by herself, and her day consists of feeding her dog and watching TV.

The idea that Alzheimers is more of a diagnosis than a disease rings true for me, but perhaps that’s just what I want to think.

nrhatch - September 12, 2012

“Aging is a life issue, a several decades long process, and prevention is where we must place our energy and our resources.” We cannot wait until the “fourth quarter” to come up with an effective game plan if we expect to stay sharp.

In Chapter Nine, A Prescription for Successful Aging Across Your Life Span, Dr. Whitehead identifies things we can do to slow the inevitable aging of our brains.

* A vegetarian or plant-based diet that minimizes red meat
* Foods high in omega 3 fatty acids, including fish
* Calorie restriction (less may be more)
* Breast feeding our young
* E~X~E~R~C~I~S~E!
* Protecting our brains with bike helmets, etc.
* Avoiding exposure to metals, solvents, and pesticides
* Reducing stress (meditation, yoga, music, art)
* Building up a cognitive reserve
* Learning new things (language, instrument)
* Engaging in intellectually stimulating conversation
* Reading intellectually challenging books
* Taking adult education classes
* Learning a new skill
* Maintaining a positive outlook on life

And . . .

* Keeping a notebook or starting AN ONLINE BLOG! 😉

8. Tokeloshe - September 12, 2012

Great post!

I think this post about scrapbooking details a great project.

http://www.movinginwithdementia.com/2012/05/accessible-scrapbooking-activity.html

nrhatch - September 12, 2012

Sounds like a great project for someone with cognitive issues . . . tailored to the individual in question.

9. katecrimmins - September 12, 2012

My experience with AD was different. My mother-in-law had it. It wasn’t just short-term memory loss, it was behavioral issues, lack of judgment, inappropriate responses, fearfulness, etc. For years the doctors diddled around refusing to call it dementia or Alzheimers or anything other than normal aging (she was in her early 70s) but it definitely wasn’t normal aging. Eventually there just wasn’t anything else to call it. Strategies starting coming together once it was diagnosed. We were able to find her appropriate housing (she couldn’t live alone) and the other services she needed to live without fear. My heart goes out to anyone who has a relative with cognitive issues no matter what they call it. It is heart wrenching to see someone you looked up to slowly disintegrate before your eyes.

nrhatch - September 12, 2012

Good points, Kate. Dr. Whitehead discusses each of those behaviorial issues in some detail ~ what is normal and what is not.

On p. 177, he lists the warning signs of cognitive impariment which require medical attention:

Memory loss
Difficulty performing familiar tasks
Problems with language
Disorientation to time and place
Poor or decreased judgment
Problems with abstract thinking
Misplacing things (and putting them in UNUSUAL spots)
Changes in mood or behavior
Changes in personality
Loss of initiative

And, you’re right, it is heart-braking to watch loved ones age in ways that transform them from who they were into virtual strangers.

Most of the time.

“People think it’s a terrible tragedy when somebody has Alzheimer’s. But in my mother’s case, it’s different. My mother has been unhappy all her life . . . For the first time in her life, she’s happy.” ~ Amy Tan

10. Three Well Beings - September 12, 2012

This is such an interesting way to think about Alzheimer’s as well as the proliferation of labels we are all in danger of “owning” at some point in our medical histories! I want to just digest for awhile all that you’ve said. It bears some deep critical thinking. I’m going to post it on my FB page to share with many friends I know will be challenged to think a bit differently themselves. As some of us baby boomers are advancing in our years now, there is a collective cohort who will probably encourage a whole new list of labels as in sheer numbers our health issues will affect the economy. What would the drug companies do if we all decided to take better care of ourselves! That’s something I think about a lot. Thank you, Nancy

nrhatch - September 12, 2012

That’s a great question, Debra . . . if we all took better care of ourselves, many of the “magic pills” we swallow would no longer be marketable.

I found the book quite thought provoking . . . and only in part because it confirmed some thoughts I’ve had about the self-fulfilling label applied to us by the medical community.

I’ve heard children as young as “5” abrogating responsibility for their behavior by proclaiming, “It’s not my fault . . . I have ADHD.” They hear that message from adults around them and use it to excuse things that MIGHT be more fully in their control.

11. Carl D'Agostino - September 12, 2012

My cardiologist insists aging is a disease. Coronary artery disease – arteriosclerosis. I’m 63. I’m supposed to have hardening of the arteries. I agree. Aging is not a disease to be cured. We manage it as positively as we can. That’s all. Have not been getting your post notifications.

nrhatch - September 12, 2012

We all age . . . at different rates and in different ways ~ just as children learn to walk and talk and tie their shoes at different points in time.

We don’t see childhood development as a “disease” . . . we see it as part of the normal growth and aging process. So why should we view the natural continuum of growth and aging at the other end of the spectrum as a disease to be “cured”?

Post notifications are going out to e-mail subscribers . . . not sure why they wouldn’t be landing in your in-box. Have you turned off notifications from WP?

12. Pocket Perspectives - September 12, 2012

One problem with giving a formal diagnosis (which as you write is usually very subjective) or “label” to a series of symptoms such as ADD or AD is that there can then be a tendency to over- focus on the symptoms tying in with that diagnosis…the negatives…and that type of focus can become a mental filter when viewing or interacting with that person. In addition, that self fulfilling prophecy can make things even worse. A tough situation.

nrhatch - September 12, 2012

I agree, Kathy. instead of looking at the WHOLE person, both abilities and symptoms, the focus becomes more myopic. We no longer see their glass as “half full” . . . we see it as “half empty.”

13. Booksphotographsandartwork - September 12, 2012

AD sounds like being diagnosed with Fibromyalgia. A road to no where. No cure, no hope, no fixes, nothing. Just move along the best you can. If you can. Some people can’t.

As for labeling you are so right. As I was handing out flyers for the missing dog that I rescued last week I would have never thought to hand one to a particular person. Their look was so odd and confusing, I wasn’t ever sure if they were female or male. And they looked as they might belong to a gang. But they read that flyer and offered to take one and asked questions about the dog. I could have read that one of two ways. Inspite of how they looked they were nice and wanted to help find the dog or they wanted to help find it for bad reasons. I’m trying to think positive.

nrhatch - September 13, 2012

Good plan . . . think positive! Doing so improves cognitive functioning later in life! 😆

14. Booksphotographsandartwork - September 12, 2012

As for my ADD hmmm one of the phone number I put on the flyer was wrong!!!! That person pointed it out to me. Good going Linda.

nrhatch - September 13, 2012

That’s perfect! Yesterday, BFF had a senior moment which I would tell you about so you could have a good laugh . . . but I’m having a senior moment and can’t remember what his senior moment was all about. 😛

15. jannatwrites - September 13, 2012

This is a different way of looking at it. In general I think we label too much. I’m a bit disturbed by how many boys are on medication for ADD/ADHD. Sometimes I wonder if it’s just a pill to keep them manageable (boys are quite active and can be unfocused, too.)

I can see how this can be the case for Alzheimer’s. But I think it’s still a disease. It’s more than just plain old aging. My Grandma had it, but the family didn’t tell her because it would’ve confirmed her worst fear.

No matter what it’s labeled, it’s still difficult for everyone involved.

nrhatch - September 13, 2012

I think his point is that it is not “A” disease . . . it is many different forms of brain aging of varying degrees and trajectories.

We hear, “You have Alzheimer’s,” and we immediately conjure up images of “worst case scenarios” . . . which is why your family chose NOT to use the label when talking with your Grandmother.

That’s the point . . .

What good does a label do if everyone under that label has a different path or trajectory to follow? Especially when the label itself inspires fear and resignation rather than a motivation to beat the odds?

16. spilledinkguy - September 13, 2012

My great grandmother had Alzheimer’s…
I was very young at the time, but I can still remember how very difficult and sad it was…

nrhatch - September 13, 2012

Watching our loved ones “fading away” is sad, and scary, and frustrating . . . no matter what we call it ~ senility, senile dementia, Alzheimer’s, brain aging, brain atrophy, cognitive impairment, cognitive dysfunction, old age, neurological disease, etc..

17. Piglet in Portugal - September 13, 2012

How true Nancy! We all become (~well most of us) become forgetful with age. The one thing I think we all dread aprrt from the dreaded C word is the A word diagnosis!

nrhatch - September 13, 2012

It used to be that Alzheimer’s was only used to describe senile dementia in non-geriatric patients. Those who made it into their 70’s and beyond before exhibiting significant symptoms of brain aging were “senile” and diagnosed with senile dementia. To get additional funding, researchers changed the nomenclature to incorporate the label “disease.” 😦

Here’s to aging gracefully . . . and minimizing our loss of cognitive functioning through lifestyle changes.

18. sufilight - September 14, 2012

Yes, taking care of our brains with mental exercises and a healthy life style is worth the investment. Posit Science is offering brain training exercises for $10.00 a month. Haven’t looked into it, but will as they are the best in the field.

nrhatch - September 14, 2012

Thanks, Marie. Brain training exercises that land in your In-Box (?) might be a good idea for busy bees (those stretched for time). I enjoy the “thrill of the hunt” ~ scouting out interesting seminars, doing puzzles, pondering philosophical questions, reading books, etc..

Dr. Whitehouse even lists “Starting an On Line Blog” as a way to keep our brains healthy and happy! Yay! 😀

19. Team Oyeniyi - September 14, 2012

I sent this link to a Twitter acquaintance. He is devastated at his mother’s treament.

nrhatch - September 14, 2012

Some clinicians lack the inclination to see past the symptoms to the person . . . as a result, they have no “bedside manner.”

It’s a bit of a tightrope ~ the balance between recognizing the diminution in cognitive functioning while celebrating the abilities that remain. Best of luck to your friend and his mother.

20. kateshrewsday - September 14, 2012

Oh, Nancy, you remind me of Jaques’ seven ages of man: though his is such a fearful portrait. Let us hope we can improve on the Elizabethan version: “Last scene of all,
That ends this strange eventful history,
Is second childishness and mere oblivion,
Sans teeth, sans eyes, sans taste, sans everything.”

nrhatch - September 14, 2012

My great aunt lived into her 90’s . . . a bit forgetful, but otherwise of sound mind. Her eyesight, hearing, and mobility failed . . . but her sense of taste remained as did the ability to “wag her tongue” and talk up a blue streak. 😀

21. On Being A Hermit « Spirit Lights The Way - September 19, 2012

[…] your own life domain and make the decisions that you feel will best promote your wellness.   ~ The Myth of Alzheimer’s, p. […]

22. Christine Grote - September 30, 2012

It’s interesting that having a family member who has a diagnosis of Alzheimer’s, all I can say is that nobody we interact with is thinking about curing it. We are all of us, trying to focus on making Dad’s life as good as it can be. However, as the child of someone who has what may be a genetic disease, I really hope people are working on a cure. Everybody has to die, but doing it this way is hideous and horrible. I really hope my spouse and children won’t have to be dragged through something like this with me.

nrhatch - September 30, 2012

Same here. It is heart-braking to watch loved ones age in ways that transform them from who they were into virtual strangers.

So much more exciting to watch development and aging at the other end of the spectrum . . . in newborns and toddlers.

It would be nice if we could slow the aging process in elders.


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