Another great post from The New Old Age, the blog on all things “older adult” at the New York Times.-SP
It’s been nearly 30 years since Dr. Peter Rabins, a Johns Hopkins psychiatrist, and his co-author Nancy Mace published “The 36-Hour Day,” the best known guide to caring for someone with Alzheimer’s disease. Now in its fourth edition, it remains a trusted source of information and support.
But the landscape of dementia — its diagnosis, its treatment, how much neuroscience has advanced, how much the public understands — has changed dramatically, as Gina Kolata has been reporting in The Times. As she also points out, this progress in diagnosing Alzheimer’s will mean that families are likely to face tough decisions sooner than ever.
“The book was a landmark twenty-some years ago when people were being diagnosed with what we’d call moderate to end-stage dementia,” said Dr. P. Murali Doraiswamy, a prominent researcher on the aging brain at Duke University Medical Center. “Now people are being diagnosed much earlier, when they’re still functioning well, and there’s a push to diagnose at even earlier stages.” With more medications available, with better understanding of the non-Alzheimer’s dementias, “people want to be more proactive,” Dr. Doraiswamy said. “They want to join clinical trials. They want ways to protect their brains.”
So Dr. Doraiswamy, with Lisa Gwyther, a social worker who directs Duke’s Alzheimer’s family support program, and Tina Adler, a science writer, intend for their book, “The Alzheimer’s Action Plan,” to fill a gap. “It’s essentially a book about the early stage of the disease,” Dr. Doraiswamy said.
These authors dispute the notion that since there’s no cure for Alzheimer’s, diagnosis and treatment are pointless. “Studies suggest that people who start treatment early usually remain better off than those who start treatment months later,” they write. So they’ve mapped out strategies for seeking a diagnosis and maximizing the usefulness of a doctor’s appointment. They explain conditions that can masquerade as Alzheimer’s but aren’t. They offer very specific advice on medications, not only Alzheimer’s drugs but antidepressants and antipsychotics.
An analysis of the pros and cons of participating in clinical drug trials even includes — a bonus from Dr. Doraiswamy — a sample consent form, annotated to translate its medicalese into intelligible English.