Sorry to say, you are massively over-estimating the impact of these drugs. The NHS decided not to fund donanemab back in October. That’s because, despite being best in class, it produces a six month slowing in progression of memory deterioration. What does this mean? If you start on the drug at, say, age 75, then by age 80, you’ll have the memory loss you’d otherwise have had at age 79.5. It has zero effect on every other symptom, including those that can be more distressing for everyone than the memory loss, such as apathy.
Alzheimer’s is a shitty disease. The progression is what it is. It’s not modifiable, by exercise, good living, drugs, using your brain or anything else.
And the attention these drugs get is a massive distraction from having to confront the actually hard work of both population-level prevention and providing compassionate well-funded services for those in need. Arse-wiping is a lot less glamorous than drugs, but it’s very much needed.
My background in all this is that my m-i-l also had AD (although she died of mouth cancer), and I am lucky enough to have one of the UK’s most senior dementia doctors as a good friend, so I asked him to tell me the blunt truth, and he did.
Some people are so terrified of death, that they think that extending the horrors of Alzheimers are a good tradeoff. I mean, living 20 years with it is great - or perhaps not.
The decomposing brain doesn't just make people forget who they are, they slowly stop the very processes of staying alive. Organs slowly shut down, Bowels stop working correctly and muscles atrophy. You end up not being able to walk or speak, and end up on antipsychotics to try to level you. Some people become happy demented, but a majority are quite unhappy.
And it is absolute hell on the family.
I have absolutely no intention of inflicting that on my family.
When I was a child, my grandmother had "hardening of the arteries" as they called it. She became demented. But such a difference. At that time, she was at home until things got bad, then when it wasn't possible to keep her at home, she went to nursing, and didn't last much longer. So rather than the 10 to 15 year dying process it was less than 4.
It was obvious what was going to happen. But it was over in a much shorter time. That to me is a blessing both for the patient and their families.
If I were to make a guess, the opportunistic causes of death in Alzheimer's patients will just have more time to strike when they spend longer in the final stages.
If a cure or an actual prevention is found, then the healthcare system can give me a call. Otherwise, thanks, but no thanks. No one gets out of here alive, and extending the amount of time a patient spends in nursing care to live a little longer without a mind only helps the pharmaceutical companies and Nursing homes. Miss me with that shit, life!
