Have you ever thought which would be worse - to have a good mind and the body goes, or to have a good body and the mind goes? For most people, it’s the latter, especially as they age. When you talk to people in general about the type of death they fear most, it’s usually the Big C - cancer. But if you talk to older people, it usually centers around dementia, and more specifically Alzheimer’s disease, because people seem to lose the very characteristics that make them who and what they are - human beings. But Alzheimer’s is only a subset of the larger dementia disorder, somewhere between 50 - 60%. There are other categories of dementia other than Alzheimer’s disease, but the very word Alzheimer’s conjures up fear. It begins with a gradual loss of memory, and then progresses quickly to impact every area of your life, as well as the lives of everyone providing care for you. Much of the conflict usually centers around the appropriate level of care, and how best to transition to that level and deal with the conflicts that arise.
Dementia is usually divided into three broad categories: neurological based, general medical disorder based, and primary dementias. The first category includes Parkinson’s disease and damage from strokes. These conditions can sometimes be slowed if they can be diagnosed early and treated properly, but if allowed to progress, functional ability and personality can be severely altered. The second category contains dementias that can be traced to a general medical disorder, such as AIDS, syphilis, and thyroid deficiencies. The third category, primary dementias, are usually incurable and irreversible. The most prevalent one in the last category is Alzheimer’s disease, but also includes alcohol dementia syndrome and other rare disorders such as Pick’s disease. There are studies underway trying to determine the effectiveness of drugs in slowing the progress of Alzheimer’s disease, but trials have yielded mixed results. Aricept and other drugs have worked for some patients, but usually the effectiveness is defined in terms of slowing progression, but seldom in reversing symptoms. As the symptoms worsen and the patient loses more functional ability in areas of memory, judgement, and emotional stability, they usually become more of a burden on their care givers and eventually end up in nursing home care.
