Alzheimer:
Is It Right To Call It A Disease?
What heretofore was called Senility is now called
Alzheimer’s Disease. Better to call it senility if it occurs in an elderly person.
Alzherimer’s disease was originally defined as premature senility, a mental
deterioration that occurred in people in their early forties or fifties. The
symptoms are more or less clear cut. There is a loss of recent memory, and a
quite satisfactory memory for things long past, which initially confuses the
family of the ill person. This may be followed by a forgetfulness for objects,
disorientation as to time and place, excessive restlessness, finally concern
about money, paranoia and ultimately total lack of recognition of surroundings
or identity of self.
The pathology, that which is seen under the microscope in
both Alzheimer’s and the senile patient is quite similar, so the definition of
the presenile dementia originally described by Alzheimer has been extended to
the senile state, about which Mark Twain remarked so sensitively in The
Mysterious Stranger.
The problem with calling senility “Alzheimer’s Disease” is
that by dignifying the process with a name, creating it as a disease, sort of
frightens people. After all, every organ in our bodies flag towards the end of
life. The heart gets tired and muscles certainly cannot do what they used to. Kidneys
have lost perhaps half their substance, and skin loses its elasticity. The
entire body becomes senile, why not the brain? When the entire body of a young
person becomes prematurely aged we call it progyria. That distinguishes
premature aging from the usual (normal) ageing process. In the same way the
term Alzheimer’s distinguished an abnormal pattern of premature senility of the
mind and brain from that which might be expected in a percentage of the
elderly.
It has no cure. However, there is mounting suggestive
evidence that tends to relate this to what is known as slow virus disease. That
syndrome became prominent when it was discovered that warring cannibals in New
Guinea often became prematurely psychotic and died at an early age after eating
the brains of their victims. Named Kuru, the disease was traced to a slow
growing virus (PROBABLY PRION
Initially the medical profession treated this as something
brand new, but for most of this century doctors had been well aware that
certain types of mental deterioration secondary to infection required long
latent periods before the disease became clinically apparent. Syphilis for one.
Pareses, the psychosis of syphilis hides mysteriously in the body for about 20
years before making itself known. Parkinson’s disease, another example, was
thought to be the result of encephalitis contracted during the epidemics of
1918-1920. An entire generation harbored the virus and most of its victims died
between 1940 and 1960, twenty to forty years after the primary illness.
Syphilis and Parkinson’s dementia secondary to infection are
abnormal events. Senility, however, is consonant with the ageing process,
albeit a variant. I am not sure that grouping it with true Alzheimer’s disease
is appropriate. It certainly scares people. It is more comfortable to consider
aging and its deficits as natural events, otherwise ageing itself must be
considered a disease. On the other hand if the pathology is the same one might
say that the older person is simply more resistant to the ravages of the slow
virus than the younger person.
Anyway, whatever you call it, Alzheimer’s is a loss of
recent memory – and let’s see – what was I saying?