Alzheimer’s - An Overview

Hardly a week goes by without Alzheimer’s being in the news – scientists discovering more about what causes it, developing a greater idea of how we can prevent or treat it, or another step being taken towards a cure.

It does seem to be an exciting time for Alzheimer’s and this becomes more apparent when you look back twenty or thirty years to what life was like for Alzheimer’s sufferers then. We have come a long way from the days when little was known about Alzheimer’s, when the attitude was taken that ‘granny’s gone a bit mad’, and knowledge of how to help and make life easier for someone with the condition was practically non-existent.

As late as the 1950s, the general consensus was that all mental illness occurring in old age was due to senility, anxiety, depression, schizophrenia, or more acute problems with cognitive functioning. It was assumed that eventually these would evolve into dementia.

Around 1980 the prevailing view of the conditions commonly known as ‘degenerative dementia’ was that they presented a hopeless picture. The care of such people was based around dealing with their most basic needs, while letting the disease take its course. There was little or no thought put into keeping the mind active, or into slowing the process of the disease.

Even the terminologies surrounding dementia have changed over the last few decades. ‘Senile dementia’ was a term often used twenty years ago and it was just seen as an accepted part of growing old.

Old age psychiatry first became recognised in the 1980s but even in 1988, a year after one of the first public talks on the subject, Alzheimer’s was still being described as the silent epidemic.

Slowly Alzheimer’s became a subject people talk about, and organisations such as the Alzheimer’s Society (founded in the late 1970s) gave people a place they could turn to for advice and support. Research has now accelerated in a number of directions, including drugs, diagnoses and how to test for the disease.

The increase in people living longer has resulted in Alzheimer’s becoming an issue which cannot be ignored. Science and medicine may have been heading this way anyway but the changes in demographics have certainly given it a helping hand.

There have been so many changes over the thirty years. For a start, people are now being diagnosed much earlier, allowing them some time to respond to drugs and to treatment. Also, as Alzheimer’s is becoming more common and more is becoming known about it, the stigma surrounding the disease is slowly disappearing. Alzheimer’s is now being talked about, instead of being hushed up.

Long gone are the days when family care or a mental hospital were the two options for sufferers. The specialist psychiogeriatric units which began to spring up in the 1970s and 1980s have now been replaced by specialist nursing homes.

Alzheimer’s is no longer viewed as an inevitable part of old age, and efforts are being made to find out more about how to prevent and treat it. While the money invested is still not enough, it does signify a big change in attitudes, and progress is being made.

Falls, the most frequent and serious type of accident in the over 65s and a common problem in people in the later stages of Alzheimer’s, are now dealt with differently, with more attention given to this area. There is even an assigned National Falls Awareness Day (run by Help the Aged) each year.

More is also known about why people with Alzheimer’s do certain things. Although their actions may look as if they have no reason to them, the reasons are actually fascinating. For example, it may look as if the person has developed an aversion to potatoes and cauliflowers but research has uncovered that there are specific reasons for this. Understanding why can help make sense of the person’s actions and can help in the care of the professional care of the person.

Attitudes from the medical profession, and in particular GPs, are also slowly but surely changing. Knowledge is greater. Twenty-five years ago some people were being misdiagnosed; GPs only really diagnosed Alzheimer’s when the patient was in the later stages and symptoms were very obvious, and the sufferer was becoming unmanageable for family and friends. They are now able to diagnose at an earlier stage, when help can be given, and plans can be made.

In December 2008 the Government announced that all NHS GPs in England would receive training on how to recognise the early symptoms of Alzheimer’s. When surveyed, only 31% said they felt that they had received adequate training to diagnose and manage the disease themselves.

This should lead to GPs being better placed to refer patients on to organisations which can help and provide support. While help is out there, it is unusual for GPs to pass details on to patients and Alzheimer’s organisations receiving requests from GPs for more information on what they can provide is still a rare occurrence.

The war against Alzheimer’s is still not over but battles are beginning to be won.

By Jackie Cosh, author of Alzheimer’s – The Essential Guide, published by Need2know, ISBN 9781861440716 (www.need2knowbooks.co.uk).