October 14, 2009
Dementia Seen As Terminal Illness

Aging is not graceful or dignified. More parts of the body malfunction and the extent of their malfunction becomes more severe with time. When the brain decays the result is death.

(Boston)—The clinical course of advanced dementia, including uncomfortable symptoms such as pain and high mortality, is similar to that experienced by patients of other terminal conditions, according to scientists at the Institute for Aging Research of Hebrew SeniorLife, an affiliate of Harvard Medical School.

The study, published in the Oct. 15 issue of the New England Journal of Medicine, is the first to rigorously describe the clinical course of advanced dementia, a leading cause of death in the United States. Previous studies suggest that patients with advanced dementia are under-recognized as being at high risk of death and receive suboptimal palliative care, which aims to improve the comfort of terminally ill patients.

"Dementia is a terminal illness," says lead author Susan L. Mitchell, M.D., M.P.H., a senior scientist at the Institute for Aging Research. "As the end of life approaches, the pattern in which patients with advanced dementia experience distressing symptoms is similar to patients dying of more commonly recognized terminal conditions, such as cancer."

Alzheimer's Disease is one form of dementia, but not the only one. All forms of dementia are on my list of experiences I want to avoid in this life.

Dying from dementia sounds painful.

Over the course of the study, 177 patients died. The researchers found that the most common complications were pneumonia, fevers and eating problems, and that these complications were associated with high six-month mortality rates. Uncomfortable symptoms, including pain, pressure ulcers, shortness of breath, and aspiration, were also common and increased as the end of life approached.

We need gene therapies and cell therapies that will repair and replenish brain blood vessels, glial support cells, and neurons. We need the ability to do full brain rejuvenation.

Share |      Randall Parker, 2009 October 14 10:49 PM  Aging Brain Studies

random said at October 15, 2009 10:26 AM:

"All forms of dementia are on my list of experiences I want to avoid in this life."

Definitely agree with that! After watching my father suffer with PSP for over a decade, I think I will take up skydiving in my old age. All bets are off once the brain becomes too feeble to pack the chute correctly.

PacRim Jim said at October 15, 2009 11:39 AM:

Eventually, we will need to be able to "photograph" an individual's baseline healthy brain, so we will be able to restore that state. I realize the almost infinite complexity involved, but knowing what needs to be done is an important first step. Never underestimate our problem-solving ability.

Sgt. Joe Friday said at October 15, 2009 11:41 AM:

My old man had dementia, along with a lot of other problems before he kicked the bucket. His internist told me that practically everyone over the age of 65 has it to one degree or another. Explain to me again why it is we don't require older drivers to take a behind-the-wheel test every time they renew their driver license.

Anonymous said at October 15, 2009 2:24 PM:

Life is also a terminal disease if you look at it that way. These people's cause of death is never dementia but one of your listed complications (usually an infection from the impact of being in a nursing home).

Nick G said at October 15, 2009 4:51 PM:

Sgt. Joe Friday,

65 year olds are the safest drivers on the road (just as 60 year old pilots are the best). Accident rates don't start climbing until significantly over age 70.

Sgt. Joe Friday said at October 16, 2009 10:49 AM:

Nick - I didn't say 65 year olds should be subjected necessarily to the tests (I said "older"), but we should not kid ourselves that persons over a certain age are not going to start experiencing cognitive decline - as well as slower reaction times. I don't think a behind the wheel test for drivers, let's say, over the age of 70 is unreasonable, but there would be fierce political opposition to such a suggestion. And the loudest voices would not necessarily be the seniors, but the feminists, who would yammer endlessly about what an imposition it would be on working women to ask them to drive their elderly parents somewhere. The result would be an inevitable call for higher taxes and more spending on seniors and public transportation.

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