[lit-ideas] Re: Superman Returns
- From: Carol Kirschenbaum <carolkir@xxxxxxxx>
- To: lit-ideas@xxxxxxxxxxxxx
- Date: Mon, 03 Jul 2006 18:44:00 -0700
Julie,
So *I* know this because recently I took a yearlong graduate college course in
major illnesses and their longterm physical (and psychosocial) consequences.
Read a lot. Very depressing, sobering course. It crushed my denial mechanism.
A full swallow of this information probably wouldn't help your family cope with
the distress, however. It's scary, as you say, for it describes inexorable,
universal decay leading to stoppage--hardly the stuff of optimism or hope.
I'll toss in my .02 here:
Dementia is a feature of Alzheimer's, yes, but other organic changes occur in
Alzheimer's disease. Many people who exhibit "dementia" (which is a
nonspecific, generally descriptive term, btw) do not have Alzheimer's, even if
they're old. Their brains do not undergo the same type of degeneration as with
Alzheimer's; indeed, dementia--mental confusion and memory loss--may be
symptomatic of a host of comorbid (co-existing) conditions that are common in
old age. But I'm reiterating Robert's more cogent explanation.
The problem is, we've been used to referring to Alzheimer's, dementia, and
"senility" interchangeably. Speaking with my 90 year-old mother yesterday, she
talked about her mother having been "senile" but not having had Alzheimer's,
back when. In other words, her mother was confused, apparently, and not all
there, towards the end, in her 70s or 80s (keeping track of people's ages
wasn't big with the Lower East Side group). But it's impossible to know, now,
why the woman was "fajudgied"--a Yiddish descriptive word that covers the gamut
of confusion, and thankfully lightens the impact, for a moment.
So did my grandmother develop Alzheimer's in her 70s or so? Or earlier? No
telling. Did she have "senile dementia"? (It's not exactly normal to suddenly
start talking in Russian, walk around in your nightgown, and call every man
"Sam.") But living alone for a long, long time, in old age, certainly can
affect cognition. Did she have mini-strokes? No telling.
My mother then pulled back and changed her story. Her mother was "sharp as a
tack" when she died of heart disease. (First I've heard of this cause of
death.) But hey, my mother's 90 years old. Let's give her minimal dementia
some slack--those are a lot of years to remember. Besides, she was more
confused in her fifties.
Best,
Carol
----- Original Message -----
From: JimKandJulieB@xxxxxxx
To: lit-ideas@xxxxxxxxxxxxx
Sent: Monday, July 03, 2006 6:15 PM
Subject: [lit-ideas] Re: Superman Returns
So if YOU know this, why in the bloody blue blazes can't the Doc's tell my
Aunt if my Grandmother has dementia or Altzheimers?? And would it make a
difference? Treatment?
Julie Krueger
currently thoroughly pissed w/ all MD's.
========Original Message========
Subj: [lit-ideas] Re: Superman Returns
Date: 7/3/06 3:28:56 P.M. Central Daylight Time
From: rpaul@xxxxxxxx
To: lit-ideas@xxxxxxxxxxxxx
Sent on:
Judith Evans wrote:
> I think, Robert, I read you as meaning that dementia
> could never be a cause of death. But some (including
> some doctors) appear to believe Alzheimer's, which
> is one form of dementia, can be.
Well, perhaps from here on it's just semantics all the way, but strictly
speaking it is not the dementia which causes death.
Alzheimer's causes dementia. It does so by changing, inhibiting, and
destroying, brain cells, altering brain chemistry, and in other ways
destroying brain functioning.
Dementia is a loss of cognitive functions. These cognitive functions are
lost because of the loss of the brain activity which makes them
possible. (Mind-body problem here ignored.)
The loss of brain functions caused by Alzheimer's (or by whatever causes
Alzheimer's) can lead to death, just as the loss of brain functions
caused by what causes vascular dementia can lead to death. Loss of
oxygen to the brain in the latter case causes loss of brain functioning
which causes dementia; but starving the brain of oxygen in some
irreversible way can eventually lead to death.
Loosely speaking, Alzheimer's is one form of dementia. But it's clearer
to say that the brain changes of Alzheimer's cause dementia. (As I've
said, it's possible to have Alzheimer's without any loss of cognitive
function at all, although as the disease progresses sooner or later
there will be a loss.
It is the actual destruction of the brain (to put it simply) which
causes death, not the concomitant dementia.
It would be clearer, then, to say that Alzheimer's is one _cause_ of
dementia, not one form of it, even though one knows perfectly well, I
think, what's meant by saying it.
Robert Paul
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