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August 25, 2008

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Gail Rae Hudson

Astonishing, and promising. I beg to differ, though, with the idea that until there is a way to treat Alzheimer's it doesn't matter whether we know the cause of the dementia. I believe it matters a lot. My experience with other caregivers and with my mother tells me that when a caregiver, for instance, and, in other instances, medical personnel (including but not limited to doctors) think that someone has Alzheimer's they imagine, and treat (yes, that's right, TREAT, even though there are no really good treatments available at this time) the patient in a completely different way than if it is thought that the dementia is of another type. Recently, in the hospital, a Hospitization doctor, without my knowledge, assumed Alzheimer's in my mother, even though I was clear when she arrived that she had non-progressive vascular dementia, and began a course of Effexor (for the depression he assumes Alzheimer's patients have) and Aricept (to try to allay "further progression"). Both medications were wildly inappropriate for her for several reasons, not the least of which was her type of dementia. Several other medical professionals, having understood that my mother has dementia but not bothering to understand that vascular dementia is not Alzheimer's, made some riotously faulty judgments about her temporary dementia and other symptoms caused by her pneumonia, assuming they were indicative of Alzheimer's since "it looked like a duck and quacked like a duck", refused to listen to me until I was literally yelling that her speech difficulties were not typical of her, and delayed the pneumonia diagnosis for four days, through which my mother's pneumonia worsened.
Whether or not curative treatment for any dementia is available, there are several compelling reasons why medical personnel should be urged to consider using Dr. Duara's imaging analyses in order to determine an individual's dementia type. I believe that this will cause several outcomes, not the least of which will be:
1. Caregivers understanding better what they may and may not expect from their care recipients as time passes, which will make a difference in their ability to provide adequate and accurate care, and;
2. Medical personnel not making assumptions based on observed (and possibly temporary) behavior that allow for misjudgment of symptoms and mistreatment of patients.

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