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Is Alzheimer’s Disease a Myth? When is Disease a Disease?

Posted Apr 26 2009 12:33am 1 Comment
I received this abstract from Mark Smith. Mark is Editor-in-Chief, Journal of Alzheimer’s Disease and a Professor of Pathology at Case Western Reserve University.

This is thought provoking. I am going to take a look at the book and write more on this issue down the road.

In a recent book [1], Dr. Peter Whitehouse describes Alzheimer’s disease as a myth that cannot be separated from aging and, as such, the “disease” is simply an accelerated brain aging. While it is factually true that the aging brain and Alzheimer’s disease are on a pathological continuum, this is true only in the most general sense – that is, the quantities of plaques and tangles in the brain [2]. It is well known that standard pathological criteria do not address such factors as the nature and onset of clinical signs, kinetics of disease progression, and presence or absence of age-related comorbiditiessuch as hypertensive cerebrovascular disease and diabetes mellitus. Clearly, a 68 year old patient who dies of pneumonia while in a vegetative state after a four year history of progressive dementia, and who is found later to have met Alzheimer’s disease criteria at autopsy, has a “disease.” Further, it would be an offense to the patient’s family and to the condition itself to suggest that this mind-destroying process, occurring at an age where many individuals of the same age are vacationing and/or working New York Times crossword puzzles, is simply a manifestation of advanced age.

Moving Alzheimer’s disease to an aging disorder may take some of the stigma and fear from the disease, and for this, Dr. Whitehouse is commended; however, such well intentioned motives should not lead us down the path of minimizing Alzheimer’s disease and “lumping” a condition into a category before that condition is adequately understood. It might also be noted that the term “Alzheimer’s disease,” suggested first by Emil Kraepelin, was justified because of early age at onset, and clinical signs that differed from “dementia senilis.” So perhaps Dr. Whitehouse is confusing Alzheimer’s disease as it was originally intended, with senile dementia in the very old – a term and an age group that is more in line with the idea that “Alzheimer’s disease” is a manifestation purely of advanced age.

Rudy J. Castellani1, George Perry2,3 and Mark A. Smith3,*
1Department of Pathology, University of Maryland, Baltimore, Maryland, USA; 2College of Sciences, University of
Texas at San Antonio, San Antonio, Texas, USA; 3Depatment of Pathology, Case Western Reserve University, 2103
Cornell, Cleveland, Ohio 44106, USA; Tel: 216-368-3670; Fax: 216-368-8964; E-mail: mark.smith@case.edu


REFERENCES
[1] Whitehouse PJ and George D. The myth of Alzheimer's: What you
aren’t being told about today's most dreaded diagnosis
. St. Martin's
Press, New York, pp. 319, (2008).

[2] Castellani RJ, Lee HG, Zhu X, Nunomura A, Perry G and Smith
MA. Neuropathology of Alzheimer disease: pathognomonic but not
pathogenic. Acta Neuropathol 111: 503-509 (2006).

Mark A. Smith, Ph.D., Professor of Pathology
Wolstein Research Building, Room 5125, Department of Pathology
Case Western Reserve University
2103 Cornell Road, Cleveland, Ohio 44106
Tel: 216-368-3670; Fax: 216-368-8964;
mark.smith@case.edu
http://path-www.path.cwru.edu/ information6.php?info_id=44

Executive Director, American Aging Association
http://www.americanaging.org/

Editor-in-Chief, Journal of Alzheimer’s Disease
http://www.j-alz.com




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Bob DeMarco is a citizen journalist, blogger, and Caregiver. In addition to being an experienced writer he taught at the University of Georgia , was an Associate Director and Limited Partner at Bear Stearns, the CEO of IP Group, and a mentor. Bob currently resides in Delray Beach, FL where he cares for his mother, Dorothy, who suffers from Alzheimer's disease. He has written more than 500 articles with more than 11,000 links to his work on the Internet. His content has been syndicated on Reuters, the Wall Street Journal, Fox News, Pluck, Blog Critics, and a growing list of newspaper websites. Bob is actively seeking syndication and writing assignments.

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Here is some additional information about the "genetics" of this condition that was written by our Genetic Counselor and other genetic professionals: http://www.accessdna.com/condition/Unverricht-Lundborg_disease/700. I hope it helps. Thanks, AccessDNA
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