Cure ahead

The 'cure vs care' debate: "Priorities for the future", a conclusion by Prof Peter Whitehouse

Review: “The end of Alzheimer’s disease—From biochemical pharmacology to ecopsychosociology: A personal perspective.” in the journal “Biochemical pharmacology” to be published 2014.

His biography is as follows:

Prof. Peter J. Whitehouse, MD, PhD is Professor of Neurology as well as current or former Professor of Cognitive Science, Psychiatry, Neuroscience, Psychology, Nursing, Organizational Behavior, Bioethics and History. His is also a member of the faculty of the Fowler Center for Sustainable Value at the Weatherhead School of Management. He received his undergraduate degree from Brown University and MD-PhD (Psychology) from The Johns Hopkins University (with field work at Harvard and Boston Universities, followed by a Fellowship in Neuroscience and Psychiatry and a faculty appointment at Hopkins.

In 1986 he moved to Case Western Reserve University to develop the University Alzheimer Center, now a part of the University Neurological Institute at University Hospitals Case Medical Center. This center became one of the ten best funded in the world. He continued his own life-long learning with a Masters Degree in Bioethics and Fellowship in Organizational Behavior at Case

He is clinically active at University Hospitals of Cleveland in the Joseph Foley Elder Health Center caring for individuals with concerns about their cognitive abilities as they age. He is working to develop an integrative health practice focused on the healing power of storytelling. He envisioned and cofounded the Greenwall Foundation supported StoryBank, a regional resource for transdisciplinary analysis and utilization of narratives of illness and health that foster community well-being.

He is the author (with Danny George) of a provocative book entitled The Myth of Alzheimer’s: what you aren’t being told about today’s most dreaded diagnosis.

This is the conclusion entitled, “Priorities for the future”:

We must essentially reverse priorities for the treatment of AD. Care must be viewed as more important than cure rather than the current message from the Alzheimer’s Association and others that cure (ending ” Alzheimer’s”) is the answer. Even if effective drugs are developed, they might improve mortality (i.e. by keeping people out of nursing homes longer) and hence might not in the long term diminish the number of older people with cognitive impairment. If such drugs prolong life, they might actually increase health care costs and might even cause individuals to live longer with dementia rather than the hoped for goal of improving cognition but not affecting the age at which people die. Current drugs do not, and potential future drugs might not, improve quality of life. Evidence suggests psychosocial interventions, like educational and arts programs, do in fact have such a benefit [4,12]. Supportive and enriching information technology [8] may be more important than biotechnology. Providing home-like community based programs should be more of a priority. In fact in the future society should work to improve the quality of eldercare communities in general. A dementia-friendly community is likely to be more comfortable for elders in general, children and in fact all the residents. AD is a cultural lever for social change that is actually more important than even the enormous personal and social challenges age-related cognitive impairments themselves pose. Within the seeds of reconsidering the concept of AD lies the potential for deep reflection about the role of the brain in our lives, the processes of aging, the importance of science and also understanding its limitations, and the very nature of our individual human lives in community. Rethinking and revaluing so called AD can lead to social and economic benefits far beyond this unfortunate clinical label. Therein lies true hope in my view.

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