5 Truths and 5 Myths about Alzheimer's and Dementia

Contributed by: Dennis Fortier, President, Medical Care Corporation

Sometimes the truth can be very misleading. This is often the case with complex topics when an “expert” makes a narrow but accurate statement that is subsequently generalized by the lay public. This is a common phenomenon in the fields of Alzheimer’s and dementia.

Here are five examples of true statements that have been so commonly misinterpreted that they have spawned five harmful yet well-entrenched myths.

Narrow Truth: There is no cure for AD.
General Myth: Because there is no cure, nothing can be done for patients diagnosed with this disease.

Like diabetes and hypertension, we cannot yet cure Alzheimer’s disease. However, physicians can intervene and manage the symptoms with more success than most headlines would indicate. In fact, with a timely diagnosis, a physician can prescribe a treatment plan including pharmaceutical therapy, improved diet, physical exercise, mental and social activity, and certain OTC supplements. When this approach is combined with an educated caregiver, disease progression can be commonly slowed for some meaningful period of time.

Narrow Truth: The only certain method for diagnosing Alzheimer’s disease is to inspect a sample of brain tissue during autopsy.
General Myth: Alzheimer’s disease cannot be accurately diagnosed until death.

If “certain” means 100% accuracy, then there is no certain diagnostic method for many well known diseases (Lou Gehrigs disease springs immediately to mind). However, physicians following published diagnostic guidelines can get a highly accurate diagnosis of Alzheimer’s disease (90%-95), even at a fairly early stage of the disease. This diagnostic accuracy is on par with commonly accepted clinical practice.

Narrow Truth: Current treatments do not stop the progression of AD.
General Myth: Since the disease will continue to progress, there is no need to bother with treatment.

There is no doubt that reversing all memory loss would be the best treatment result and halting further memory loss would be better than ongoing decline. However, this does not mean that slowing the pace of further decline is not a worthy pursuit. We all want better treatment options in the future but until they arrive, preserving quality of life during a patient’s final years is definitely a worthwhile and attainable goal.

Narrow Truth: Cognitive decline is a part of normal aging.
General Myth: Pronounced cognitive deficits just need to be expected and tolerated

As we age, all of our organic functions tend to slow. Our ability to think, make calculations, use judgment, and store and retrieve information is not immune to this process. However, a pronounced loss of cognitive capacity severe enough to impact a person’s ability to lead an independent life is not normal. When such decline occurs, there is some underlying pathological explanation that can be identified and treated by a physician. Accepting significant loss of mental function as a normal artifact of aging is a tragedy.

Narrow Truth: It’s best not to know if you have Alzheimer’s disease
General Myth: It’s best if the problem stays undiagnosed

This final “truth” is a stretch to begin with. I can imagine that, if it were possible, an Alzheimer’s patient might enjoy life more if they could receive the highest standards of care without ever knowing they had a terrible disease. However, this does not make the case that the problem should be ignored. The published evidence in favor of managing the symptoms and prolonging a higher quality of life outweighs the presumed benefits of bliss. Additionally, patients need to know about their condition if they are to participate meaningfully in their own care and end of life decisions.

I hear and read these narrow “truths” in the media everyday. I also see first hand how the public mischaracterizes them and takes away a broader and more harmful message than is intended.

Education remains a major barrier between our current ability to care for AD patients and the higher standards that are within our immediate grasp. I hope we can begin to divorce ourselves from these sound bites of misleading truth and begin to see the Alzheimer’s picture with more clarity.

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6 comments :

  1. If you take proper care of your body, you'll never get AD. ie. a good diet, plenty of exercise and the right suppliments.

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  2. 1st comment is a myth! My dad died in September after a long battle with AD. He got plenty of exercise, ate a careful diet, and took all the recomended suppliments. YEs there is a strong family history. Granted the exercise did help the symptoms for a short time after exercise, but didn't seem to slow progression of the AD.

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  3. cannabinoids are showing GREAT promise in possibly PREVENTING the disease. great article, i am a caretaker, RN & research assistant.
    have taken care of my parent for 6 years now.
    her GP always said she showed "normal cognitive decline"
    for her age. i had to fight for a neurology consult.
    got one about 4.5 years ago & she was diagnosed on the 1st
    visit.
    she has been on all of the current drug therapies
    & now is in a research study, but i'm sure she is getting the placebo.

    anyway...
    we need researchers $$$$ & help!

    thanks

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  4. I don't agree with the first statement here. My father is 86.5 years old, has always maintained healthy weight, gets plenty of exercise, eats a very good diet, and has NEVER been sick a day in his life. Not a cold, the flu, a broken bone, NOTHING. Yet now he is in mid-stage Alzheimers, and was one of only 5 of his original Division who survived George Patton's 3rd army in WW II. He is still able to drive 400 miles each way to my home from Los Angeles to Nevada, keep his house in perfectly clean shape, do the lawn work, keep his car immaculate and in proper running order, he just can't remember to take his meds, pay his bills, or keep from getting lost when driving to places he does not go frequently. He has not had a ticket, or accident in over 40 years.

    I think that totally debunks the healthy lifestyle having anything to do with stopping or preventing Alzheimers. His mother had it, his elder (and only) brorher had it, and 2 of my cousins have it (on my father's side).

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  5. Diane has a valid point about the first comment above (from an anonymous source). We know that across a population, those with healthy lifestyles tend to have later onset and slower progression of Alzheimer's, but there are no guarantees and every patient responds differently. While I maintain that that the case in support of a healthy lifestyle is strong, I agree with Diane that it is over-stated by the commenter. However, Diane's equally forceful stance that her father's case "totally debunks" all other evidence, is also over-stated. Based on the prevalence of AD in Diane's family, her father may be dealing with an inherited form of the disease, which we know is more difficult to manage than the more common forms not currently associated with genetics.

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  6. Havint the great regular schedule of activities as cited about the gentleman 85 from California -- military training builds "maintenance of systems" into the brain. My uncle also is 85 and perectly functioning ... prompt attention to executing new projects, car in perfect condition mechanically and in appearance, personal care dutifully maintained .. duty, paTTERNS, RHYTHMS OF SCHEDULE -- THESE PUT LESS STRAIN ON THE BRAIN TO REMEMBER "WHAT AM I TO DO NEXT" -- also why older folks resist the change and adjustments associated with institutional living: They are right to want to stay in their own homes! We should have policies by employers, churches and government that encourage and enable such lifestyles.

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