Lesson 13: Alzheimer’s and Dementias


Attention

Two major changes are being proposed for the DSM-V related to Alzheimer's and Dementia. First, they are proposing to drop the term "Dementia" in favor of "Major Neurocognitive Disorder". This changes is being proposed, in part, because of the stigmatizing use of the word "Dementia" and "Demented".

This is very similar to when the DSM dropped the terms "Idiot", "Imbecile", and "Moron"...all of which used to be clinical terms used to describe degrees of mental retardation (by the way, the DSM is also proposing dropping the term "retardation".)

Wiki on the term "Moron"

Second, the DSM V may introduce another category of diagnosis titled "Minor Neurocognitive Disorder".

Click HERE to read about the debate!


Learning Outcomes

Upon completion of this lesson's material, students will be able to:

  • Reflect on the similarities between stigma associated with Alzheimer's and Dementia and stigma associated with other mental illnesses
  • Analyze viewpoints on the traditional medical model of Alzheimer's and alternative views
  • Locate available research on various causes of dementia aside from Alzheimer's Disease

Teaching

Reach Chapters 7 and 8 in Cohen & Eisdorfer

Alzheimer's Disease

The textbook reviews statistics from 2009, but we have statistics that are even much more up to date now. Click on the link below to visit the website of the Alzheimer's Disease International...review the "World Alzheimer's Disease Report 2012 Executive Summary" and watch the video...very good stuff.

Alzheimer's Disease International Website

One of the most challenging aspects of this disease relates to how involved we try to make individuals in their own care (note in the video when the husband relates how important it is that people talk to his wife directly instead of always assuming they need to talk to him).

Issues of competence and ability to care for self are the pressing issues of Alzheimer's Disease patients and their families.

The subjective experience of Alzheimer's can be extremely frightening. Consider the "stages" that are discussed in the textbook:

  • Recognition and concern: "Something is wrong."
  • Denial: "Not me"
  • Anger, Guilt, and Sadness: "Why me?"
  • Coping: "To go on, I must do..."
  • Maturation: "Living each day until I die"
  • Separation from self

Perhaps the one we hear about the most is the "Separation from self". Individuals whom I have encountered who have had loved ones with this disease talk about the "personality" dying way before the body does.

Similar to other "mental illnesses" Alzheimer's has a significant degree of stigma associated with it. As is discussed in the video, right at the time when these individuals need others the most, they are more likely to be alone.

There are, however, other viewpoints. I'm going to have you investigate an interesting perspective that I came across called "They Myth of Alzheimer's" Now, don't be alarmed, this is not a viewpoint that says that people are "faking it" or that the symptoms are not real, it is a critical analysis of the etiology of Alzheimer's, our reluctance to diagnose it (thus doctors are not telling the truth all the time), and findings that indicate that the physiological changes that happen in the brain (plaques) are not directly connected to the symptoms of memory loss and confusion.

You be the judge...

The Myth of Alzheimer's
Feel free to explore this website!

Check out this film: "The Diseased Other"

Other Dementias

In the second part of this lesson we see that there are a number of other conditions that can result in nonreversible dementias:

  • Vascular Cognitive Impairment
  • Dementia in Parkinson Disease
  • Dementia with Lewy Bodies
  • Frontotemporal Demential
  • Motor Neuron Disease
  • Infectious Disease with Demential
  • Tauopathies
  • Wernikie-Korsokoff Syndrome

Assessment

Possible Class Discussion

Reflect on the stigma associated with person's with Alzheimer's Disease. In what ways is this similar to the stigma that persons with other mental illnesses experience? Reflect on the video segment titled "The Diseased Other".

Lesson 13 Quiz

  1. Write a reflection paragraph contrasting the viewpoints of the current (medical model) views of Alzheimer's and those found in the "Myth of Alzheimer's". Be sure that you clearly identify the points of view in your contrast.
  2. EXTRA CREDIT QUESTION---Is there a connection between mental illness and increased risk for Alzheimer's or dementia? Answering this question will double your score on this assessment. Be sure to cite the source of your findings. You do not need to answer this question if you do not want to.

Lesson 13 Assignment

For this assignment I would like you to select ONE of the OTHER dementias (not Alzheimer's). Using EBSCO find two articles that discuss this disease. For each article you find cite the reference (APA format) and copy (yes, I said COPY) the abstract from the article. After you have done this for both articles, write a one paragraph summary of what you may have learned from these two articles.

This paper should be no longer than a page...be sure your name is at the top along with the name of the assignment.