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5 Truths and 5 Myths about Alzheimer's and Dementia

  • 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.

    Truth: There is no cure for AD.
    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 slowed for some meaningful period of time in many patients.

    Truth: The only certain method for diagnosing Alzheimer'sdisease is to inspect a sample of brain tissue during autopsy.
    Myth: Alzheimer's disease cannot be diagnosed with acceptable accuracy 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.

    Truth: Current treatments do not stop the progression of AD.
    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 that 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.

    Truth: Cognitive decline is a part of normal aging.
    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.

    Truth: It's best not to know if you have Alzheimer's disease.
    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.

    These narrow "truths" are presented in the media everyday and the public often mischaracterizes them, taking away a broader and more harmful message than is intended. Through the Orange County Vital Brain Aging Program and many other educational efforts, we need to divorce ourselves from these sound bites of misleading truth and begin to see the Alzheimer's picture with more clarity.