So read an article in today’s newspaper. I know it causes the death of neurons, but does that by itself result in death? The heart is not dependent upon the brain as it has autonomous beating. Much like other neurological diseases, many systems are affected, such as breathing, but artificial breathing machines exist. I guess it can eventually cause brain death, but reports of persons dying from Alzheimer’s does not refer to brain death.
Breathing is 100% fatal. Everyone who ever breathed, is breathing now or is going to breath is going to die.
Alzheimer’s generally kills by side effects, like most diseases do. Pneumonia is often the cause of death for many older folks but Alzheimer’s puts them into a situation where they can’t do anything to help themselves by getting up and walking around. Similarly most diabetics die of complications caused by diabetes, not the diabetic coma.
It would be quite unethical to keep a person with Alzheimer’s on a ventilator when they are so far gone that they can no longer breathe on their own. What would be the point?
Note that a lot of basic functions degrade to the extent that something bad can easily happen. Choking is common (this happened to a neighbor recently), aspirating food or vomit, inability to swallow (which makes feeding a big problem), etc. A lot of core regulatory functions are based in the brain, so maintaining homeostasis becomes progressively harder.
Plus there’s the inability to describe problems and symptoms coherently to get treatment.
“Are you having trouble breathing?”
“You look like my niece. I want chocolate…”
“Does this hurt?”
“Where’s the ow … the… um…”
Alzheimer’s generally does not kill people directly but, then again, neither does HIV so there is nothing special about that. It kills by weakening the person’s immune system and making them vulnerable to other infections. The two people with Alzheimer’s I knew best both died a few weeks after falling and breaking their hip and one wasn’t even that old.
Can you point to evidence that Alzheimer’s directly weakens a patient’s immune system?
My father died of vascular dementia before the age of 70. His death certificate lists the cause as “dementia”. However, the proximate cause of death was that he had lost the ability to swallow food and had became very weak. His death was probably hastened by the administration of morphine. I imagine his life could have been prolonged by tube-feeding, but at this stage his quality of life had already vanished.
Yeah, I think it’s usually called “inanition.”
My father, who had Alzheimer’s, died from a urinary infection, probably related to his catheterization. Normally, there are symptoms that a patient seeks treatment for, and the problem is fixed. In his state, he either didn’t notice the symptoms or he lacked the ability to communicate. Either way, the infection wasn’t noticed until it was too late. Just as well, he was already gone.
Sounds like you’re talking about complications that develop from immobility, rather than dementia itself. Alzheimer’s isn’t known to affect the immune system, but it can cause patients to become bedridden, which can then make them vulnerable to illness.
I didn’t mean that it is known to attack the immune system directly but the end result is the same. I have been doing some reading since I posted to refresh myself on the actual causes of death for someone with Alzheimer’s. I couldn’t find anything that described the exact series of events that cause death. I did find that the average time from diagnosis until death is less than 7 years. The leading cause of death is pneumonia, infections, and complications from associated injuries like broken bones. Nutrition is a huge problem in people in the later stages.
I agree that many of the problems are associated with immobility but it seems to go well beyond that. People with other conditions can be immobile for years and never suffer the same consequences. The two people closest to me that died from it never were immobile. They walked around until they broke a hip and then they died. One was a man in his early 70’s who was a strapping retired firefighter and went down very quickly because of it until a routine fall just killed him.
IANAD but I did study the disease in grad school although I have little clinical experience with it. Everything I read leads me to believe it is a syndrome that can weaken the body and immune system through many different avenues on top of the obvious brain impairment. Maybe an MD with clinical experience with it can expound on that.
You don’t think breaking a hip doesn’t help to do a old person in?
Age alone makes individuals vulnerable to infection. Throw a vulnerable person into the hospital (infection city) where they are immobile (pneumonia town) and you don’t need a lot of other factors to make them keel over. I’m not saying Alzheimer’s leaves your immune system untouched. I actually wouldn’t be surprised if they are related somehow. But you seem to be glossing over the fact that taking a bad fall ain’t no trivial thing for an elderly person.
I know. My own grandmother died through complications of hip transplant surgery and she didn’t have Alzheimer’s. I work directly in the transplant industry and that is all I see all day long for lots of different body parts. It can be a very serious thing even for supposedly routine procedures but the vast majority make it through alive if they do not have any other extreme complications. The outlook is much worse for Alzheimer’s patients even if their body appears to be relatively healthy and they are mobile.
All I am saying is that Alzheimer’s patients have a low life expectancy that goes far beyond brain impairment. I would like to know more about exactly why that happens as well but I haven’t gotten the impression that anyone truly understands why for all of them. I do know that it can become a brain-body problem that involves much more than the ‘mind’ and memory. Other brain functions that control basic body regulation start to fail and that can lead to other complications that lead to secondary problems that are the most proximate cause of death but not the ultimate one.
Part of the thing that keeps people going is staying active and having what might vaguely be described as a “will to live”. There are plenty of anecdotes of people going downhill without Alzheimer’s once they hid a speed bump - physical or mental - that incapacitates them or disrupts their routine. The ones that walk down to the corner store a mile every day are doing fine into their 90’s. The ones who get arthritis and stop moving, usually go under fairly soon, especially if they used to be active.
Alzheimer’s just aggravates that. Not only are they then incapable of the planning and arranging (and follow through) of exercise or other purposeful tasks, but they are unable to describe problems that might be fixed like infections.
A recent article published in the NY Times:
The lead sentence from the article:
I am all too close to dealing with the effects of Alzheimer’s. I observe its progression every day in an otherwise very healthy person.
To make it as succinct as possible, Alzheimer’s rots the brain. The brain is what manages the systems of the body. When any of the essential systems break down and are therefore unable to function properly, the body will die. The immediate cause of death may be attributed to the failure of an essential system but all to often what caused that failure is the effect of Alzheimer’s.
Currently, if a person contracts Alzheimer’s it is incurable and fatal.