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Archive for the ‘medicine’ Category

I’ll watch the HBO series with an open heart and mind – I swear I will.

But the reviews are certainly daunting.  The whole point of Forget Memory is that there is MORE to Alzheimer’s than tragedy.  That there is HOPE in science, but there is also HOPE in human beings – in our ability to learn to be in the company of people with dementia and to find meaning in that experience.  In one section of the book, I talk about the types of stories that are told about dementia in popular culture.  By far the most dominant one is TRAGEDY with science as HERO.  And from Alessandra Stanley’s review in the NYT’s, it sounds as though the HBO project not only falls into this category, but takes it to a new extreme.

Stanley points out that in the segment on developments in research, medical researchers enthusiastically suggest that they are very near a cure. One in particular calls it the most exciting area in medical research today.  But Stanley writes:

“Neither he nor the filmmakers deliver many caveats about the long, bumpy road from clinical trial to prescription pad. At times the collective exuberance is so persuasive that viewers have to remind themselves that there is as yet no way to prevent the disease or even slow its progress.

And that’s a problem. It suggests that “The Alzheimer’s Project” comes with an implicit agenda of morale boosting — and fund-raising — that could compromise a balanced understanding of this frightening and complicated disease.”

It’s a little heartbreaking.  In Forget Memory, I profile over 10 programs that are raising the quality of life of people with dementia and reducing stigma and fear – over 10 programs where HOPE is in humanity – our ability to reach each other, care for, honor, and learn from/with even those late in the disease.   But what we’ll hear in the Alzheimer’s Project looks like it loss of self, suicide as the only option, nobility of caregivers in a losing battle, and the heroism of science.   At least, after working so hard on a book for so long, its message will still be relevant when it comes out at the end of the month…

It’s fantastic to get the country talking about Alzheimer’s.  It is.  More people need to know about the services available, and more people need to ask how they can help.  But a message so powerfully frightening about the lived experience and so powerfully positive about science risks deepening the pit of despair when cure continues to be elusive rather than X’ing out hopelessness.

Also see the NYT’s background article on the Alzheimer’s Project.

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There’s been lots of hype about cognitive fitness, with a slew of computer games and programs comign out to help older people train their brains.  They hint that cognitive fitness can delay or prevent the onset of dementia.  But this article suggests that the computer programs don’t have any more effect than doing a crossword in the newspaper.   Perhaps a glass of red wine, some friends, a little social dancing, and maybe a group game of scrabble might be the best combo!

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I would love to read a good history of pharmaceuticals in this country. Just when did we become convinced that it is cheaper to medicate than to provide actual care or change behaviors? How is it that we arrive at the numbers that tell us this is so? And why do we believe them?

There’s a great article in today’s NYT’s Science section about the over-prescribing of anti-psychotic medications for people with dementia. The article mentions a tripling of the sales of the drugs, up to $12 billion in sales from 4 billion in 2000.  Sometimes, the anti-psychotics are the only thing that can relieve tremendous suffering.  But too often, they are prescribed to control behaviors that might be changed with improvements in care.  The author points out that just paying attention to people with dementia can improve their quality of life and behaviors.  Yet the suggestion is that improving care practices is too expensive. Would it really be more than 12 billion?

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There’s a lot of electronic activity going on about “video proof” of a “miracle cure” for Alzheimer’s – the anti-arthritis medication Enbrel.  I think it’s important to listen to all the voices out there on this one. The impulse is to fly into action and proclaim a cure. But there’s a lot of science that has to wrap itself around this first.  Peter Whitehouse calls the reporting on Enbrel “premature, irresponsible hype.” Remember the “vaccine” caused some serious brain swelling (people died) and then scientists found that even with the clearing up of plaques, that function didn’t improve.  One of the headlines describes this treatment as an “awakening”, drawing an association with the film/book Awakenings – in which a pill treatment “woke up” people who were deeply withdrawn into disease.  But the treatment did not last.

I suggest using all our media literacy skills here – look at how the story is being told, who is telling it, and what information isn’t available.

Here are just a few links to the discussion on Enbrel.

YouTube video #1

YouTube video/interview with daughter

Peter Whitehouse’s blog entry on Enbrel

newspaper article from Daily Mail

article from Telegraph.co.uk

article from The Independent

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For two weeks in a row now, Jane Brody’s Personal Health column in the Science Times section of the New York Times has focused on aging-related memory loss. In the first, “Cracking the Code to the Memory Vault,” she talks about how it haunts her and her husband, who is older than she is, but who seems less haunted by ghost-names, faces, and facts that appear and disappear at will. In the second, “Mental Reserves Keep Brain Agile,” she looks at how to develop cognitive reserve and the importance of physical exercise and social networks (on and off line).

Brody’s columns echo the panic that fuels the narrative of Catherine Jakobson Ramin’s Carved in Sand, a book that tells the story of one woman’s journey to find out what is wrong with her. Along the way she undergoes brain scans, brain healthy diets, computer games to build her cognitive reserve, and her ultimate fear–someone with early on-set Alzheimer’s disease. See my review of the book in Aging Today.
Both Brody and Ramin give us careful accounts of the latest research on memory loss, and inspire us to push for new ground…to make age-related memory loss seem NORMAL. Both invoke the specter of dementia…and I think both could go further to help us soften attitudes toward people with dementia.

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Well, at least I think it’s a great book. I’m only on page 22. Stephen Hinshaw’s The Mark of Shame: Stigma of Mental Illness and an Agenda for Change is new from Oxford University Press. I just got it through interlibrary loan and am drinking up his careful distinctions between stigma, stereotype, and prejudice; and between various definitions of mental illness. I’m a little sad because one quick look in the index (I always go there first) shows “almshouses” followed by “ambivalence”. There’s no mention of dementia either. Or aging. I still think it’s going to be a great book. But I’ll just have to extrapolate…

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I came across this website/effort today– Changing Minds. The Royal College of Psychiatrists in the UK and the Republic of Ireland are tackling the problem of stigmatization of people with mental illness. The effort addresses Anxiety, Depression, Schizophrenia, Dementia, Alcohol and Drug Addiction, and Eating Disorders. Seems like a good idea for a project in this country…

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