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Is Alzheimer's a disease, or just an aging brain?

By Tom Valeo, Times Correspondent
In print: Tuesday, March 25, 2008

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Over the years Dr. Peter J. Whitehouse has treated thousands of patients with failing brains. As a professor of neurology at the Case Western Reserve University School of Medicine in Cleveland, he helped create the University Alzheimer Center (now known as the University Memory and Aging Center), and he has taught countless students about the ravages of dementia.

But now Whitehouse thinks Alzheimer's isn't a disease at all. It's just normal brain aging that happens faster in some people than in others, the way hair turns gray sooner on some people than on others.

If we lived long enough, he believes, we all would experience the memory loss and other problems that afflict the millions of people now diagnosed as having Alzheimer's disease.

"Alzheimer's disease represents our culture's attempt to make sense of a natural process (what he sees as brain aging) that we cannot control," Whitehouse writes in his new book, The Myth of Alzheimer's Disease.

"Just as past civilizations posited mythical explanations for natural events they could not explain, we have created an antagonist: a terrorizing disease of the brain that our scientists are fighting against."

If Alzheimer's is just normal brain aging, then we should revise the story we tell ourselves about the process, Whitehouse says, because the version prevailing today generates tremendous fear, anguish and shame.

"An Alzheimer's disease study group found that people are more afraid of Alzheimer's than they are of death," he said in a recent telephone interview.

A better option, the doctor said, would be to redefine Alzheimer's as normal aging. That way, people with failing brains would remain part of the community and would not be stigmatized.

"In Japan, for example, there's a huge initiative to create communities that are more elder friendly, so older people with cognitive impairment can enjoy a better quality of life," Whitehouse said.

"My wife and I started an intergenerational school. Patients with what used to be called Alzheimer's disease come and read to the children. Research demonstrates that this is valuable for older adults. Ironically, if you create communities safer for older people, they're better for children as well."

Scientific evidence contradicts Whitehouse's assertion. A paper written nearly 20 years ago, for example, found that a distinct area of the hippocampus — the part of the brain essential for forming memories — degenerates in people with Alzheimer's but not in healthy older people with what is considered normal memory loss.

But Whitehouse remains unconvinced.

"Diseases are more invented than discovered," he said. "Whether we call Alzheimer's severe brain aging or a disease doesn't matter from a biological perspective. The same biological processes go on no matter what we call it.

"But the label has a huge effect on people's lives and on research. In fact, we all get Alzheimer's."

Freelancer Tom Valeo writes about medical and health issues. Write to him in care of Pulse, St. Petersburg Times, P.O. Box 1121, St. Petersburg, FL 33731, or e-mail features@sptimes.com.