Alzheimer’s just a normal part of ageing
ALZHEIMER’S is the second most feared disease after cancer but it should be regarded not as a tragedy, but as a normal part of the ageing process in people aged 85 and over, a mental health specialist says.
Just as other parts of the body degenerate – eyes, bones, heart and skin – so too our brain is likely to degenerate as we enter advanced age.
David Spektor, a specialist in aged persons’ mental health, will address the international conference on dementia in Sydney today. He will tell the Risky Business conference that labelling people in their 80s and 90s with Alzheimer’s disease is unfair and may serve no productive purpose.
”We bring fear to millions by telling them they have a disease; everyone’s brain ages and in different ways,” he said in an interview. ”We risk turning a normal process into a disease.”
Dr Spektor, senior clinical psychologist at Melbourne Health, a public health provider connected to the Royal Melbourne Hospital, said that the reality of ageing was that many people in their 80s and 90s would lose memory and cognitive abilities, just as they were likely to suffer hearing loss and deteriorating eyesight.
”Getting the diagnosis can lead people to overestimate what they can’t do and under-estimate what they can do,” he said. ”And the things they can do – laugh, hug, empathise, love – are arguably far more important aspects of being human.”
Dr Spektor said he did not question the existence of Alzheimer’s disease as a medical condition and for people under 85 diagnosis and medication to slow the condition, if appropriate, were useful. But the focus on Alzheimer’s as a disease meant much of the research effort was on finding a cure rather than finding better ways to care for millions of old people with Alzheimer’s and other forms of dementia as they reached the end of their lives.
”We need more research on how people can live with quality and dignity during all the worsening symptoms of the condition,” he said.
Dr Spektor said many baby boomers were obsessed with fear of Alzheimer’s disease and the fear could cloud an ability to look more positively at ageing. ”To live with less fear of old age, we have to accept certain realities,” he said. ”Death is part of life and for the majority, part of death is degeneration.”
Henry Brodaty, professor of psychogeriatrics at the University of NSW, said 25 per cent of people over 85 will get dementia but that meant 75 per cent would not.
”If you look at the brains of people who are very old there will be some vascular changes and the build-up of plaque and tangles characteristics of Alzheimer’s disease but the degree will be greater in people with dementia,” he said.
He said he was likely to be more cautious about prescribing anti-Alzheimer’s drugs to people over 85 because they were more likely to have multiple pathologies and were less likely to respond.
However, a formal diagnosis was often useful because it was the means to securing services and support.
”And it can be useful to the family to know that grandma is not just being irritable and contrary; she really cannot do things and she needs help,” he said.