Alzheimers

Each and every human being dreams of living a regular, normal life, watching their children
grow up and have families of their own. But for some people, this dream along with all their
memories can be erased by an ageless disease that affects more then four million Americans
today (Evans). Alzheimers Disease is a progressive disease that varies from person to person,
robbing its victim of their past and future. Alzheimers Disease is known as the "Great Eraser"
because it turns everyday normal people into helpless, lifeless individuals (Rice).

This horrible disease raises a very critical philosophical question: Does the loss of memory mean
the loss of personal identity? Although most individuals who have considered this dilemma
hold that forfeiture of memory equals a change or even loss of personal identity, this essay will
show that this is not necessarily true. In order to fully understand how this lesser held view is,
in fact, true one must first comprehend both the biological and psychological effects of
Alzheimers. Therefore, this paper will be divided into two parts. The first part will display the
causes, consequences, and treatments for Alzheimers. In the second section, supporting
evidence will be put forth in order to show that a partial or even complete loss of
autobiographical memory does not constitute a change in or the destruction of personal
identity.

Alzheimer's Disease (AD) is one of the most common of the dementia-inducing illnesses.
Alzheimer's is a progressive, degenerative disease that attacks the brain; causing impaired
memory, thinking and behavior. A person with Alzheimers Disease may experience personality
and behavior changes, impaired judgment, confusion and difficulty finishing thoughts, following
directions or even finding the right word to say in a conversation (Evans).

Once in the advanced stages of the disease, the sufferer may require a caretaker, as daily
chores become very difficult to accomplish.

Evidence points toward the protein amyloid as one of the main causes for the occurring
cytotoxic processes. Researchers have found that degeneration appears to be caused by

interference with intracellular calcium homeostasis via activation of calcium channels,

intracellular calcium stores, and further production of free radicals by calcium-sensitive
enzymes. The glutamatergic system, in particular, seems to be involved in mediating the toxic
processes. In the brain, the nerve cells in the area that controls memory and thinking are
damaged, this interrupts the passage of messages between communicating cells. The cells
undergo distinctive changes, these are called neuritic plaques (groups of degenerated nerve cell
ends) and neurofibrillary tangles (groups of twisted filaments that accumulate in previously
healthy nerve cells). The spaces in the center of the brain become enlarged causing a shrinking
of the cerebral cortex (used for thinking) and an overall reduction of the surface area in the
brain (Feldman).

Symptoms of AD usually occur in senior citizens, although people in their 40s and 5Os may also
be affected. The manifestations of this disease include a severe decrease in intellectual
capacity, loss of language skills that may include having trouble finding words, poor or
decreased judgment, problems with abstract thinking, time and location disorientation,
changes in mood or behavior, as well as changes in personality (Rice). AD does not
discriminate; it affects members of each and every race, socio-economic background and sex
equally.

The cause of Alzheimer's Disease is not exactly known. However, research is being conducted
on the most likely causes such as neurological damage, chemical deficiencies, viruses,
environmental toxins and malfunctions in the body's disease defense systems and genetics.
There is also evidence pointing toward a hereditary link of AD amongst children, brothers and
sisters of patients with this disease. It is also important to note that AD can only be diagnosed
100% after death through an autopsy of the affected subjects brain tissue. About a third of
autopsies turn up a different diagnosis and thus family members are encouraged to ask for an
autopsy as a contribution to the study of the disease and about the genetics of AD (Rice).

There is no single clinical test for AD. It is usually diagnosed by ruling out all other curable or
incurable causes of memory loss. As previously stated, a positive diagnosis of this disease can
only be made by microscopically studying a small piece of brain tissue after death. The cerebral
cortex of an Alzheimer sufferers brain will have certain characteristic abnormalities such as
cells marred by plaques and tangles (Feldman). A working diagnosis can be made though
through various testing procedures that include a complete physical as well as neurological and
psychological examinations.

At this time there is no definite cure or treatment for AD, although suppliers of medical
products claim to be able to help sufferers. Yet these remedies are more like over-priced
placebos, having no documented evidence of the alleviation of the illness amongst sufferers.
Despite this negative fact, glutamate receptor-selective drugs, some antioxidants, nitric oxide
synthase inhibitors, calcium channel antagonists, receptor or enzyme inhibitors, and growth
factors promise future help in curing this disease (Feldman). Combinations of drugs that act at
different levels may also prolong the sufferers life and health.

People diagnosed with Alzheimer's Disease can live anywhere from 2 to 20 years after memory
loss symptoms start to surface (Evans). It shortens the sufferers expected life span, but
through appropriate care and medical attention the patients often live for many years. Death
can't usually be predicted until the end stages where symptoms, such as total dimensia, are
nearing their worst. Some patients in the late or terminal-stage of Alzheimer's tend to lose
weight and have difficulty swallowing, difficulties with bladder control, walking and talking.
They are also known to permanently curl into a fetal position. People struck with AD most
often die as a result of a series of repeated infections such as bladder infections or pneumonia
(Evans).

Although the following estimations are from American literature, as explained earlier we know
that AD has a more or less universal effect across the world, ratio wise. Alzheimer's afflicts
approximately 4,000,000 Americans and it's estimated that one in three of us may have a
relative that will suffer from this degenerative disease. More than 100,000 die annually which
makes AD the fourth largest cause of adult death in the US (Evans). In addition to the
emotional costs of this disease, It is also a very costly monetarily wise. An estimated $80 billion
is spent annually on the care of, diagnosis, and treatment of this horrible disease of the mind
(Rice).

Now, what does AD indicate philosophically? Does the deprivation of ones memories as a
result of this disease imply a loss of personal identity? As evidence will show, it does not.
Personal identity should not be stripped from an individual just because ones biological
mechanisms fail. Personal identity exists in the mind, which is not part of the body and
therefore cannot be limited by disease or injury. The mind is not something that we can put
our finger on and locate; the mind is above and beyond our understanding. In order to show

that the previous statement is true, one must examine the mind both biologically and
philosophically.

First, let us investigate how the brain changes in dimensia causing diseases, specifically AD. A
good method of comparison is seen when examining a normal man of age 65, call him Bob, and
a man of the same age struck with Alzheimers, call him John. The normal individual will be in
the beginning stages of synaptic and dendritic degradation. What the previous statement
means is that the neurons present in the Bobs brain will be beginning to die off. As a result of
this, Bob will be unable to recall certain events that occurred in his life. Does this mean that
Bob is a completely different person each and every time a neuron dies? Obviously, everyone
can agree that Bob is not a different person after each neuronal death.

Why then must we hold that Alzheimers patients are any different? When treated with the
drug L-dopa, which is a precursor to the neurotransmitter dopamine, the neuronal death of
Alzheimers patients can be slowed down (Feldman). Therefore, the AD patient, John, might
experience only a ten-fold neuronal death rate of that of Bob rather than a one hundred or
even a one-thousand-fold increase. How then can we say that just because Johns neurons are
dying faster than Bobs neurons that Johns personal identity, his mind, is changing or even
"dying"? We cannot say this; the only proper way to explain Johns situation is to say that his
brain is merely aging more rapidly than a normal individual, such as Bob. Following this train of
thought, there is no way that science can claim that John, the man struck with AD, has lost his
personal identity and mind without making the same claim regarding Bob.

In order to provide a complete argument regarding Alzheimers and loss of personal identity,
one must take the philosophical along with the biological. Personal identity exists within and
composes what philosophers throughout the course of history have labeled the mind. How
then, can we claim that a biological disorder, such as AD, can rob an individual of something so
intangible as the mind? This cannot possibly be true, as the mind is human kinds link to a
higher power a link to God.

Perfection is the ultimate goal. Each and every human endlessly struggles to achieve
this ideal. Why one may ask? It is because we all want to exist on the same plane as God. The
only way to achieve this ideal is by improving our mind, which has nothing to do with body or

brain, to the point where all of its physical shackles are removed. The mind is above and
beyond us; it is our link to the omniscient.

God is an all-seeing, all knowing mind that has no limitations either physically or mentally.
Since humans are imperfect creatures our minds must be confined inside a living organism that
has definite physical and mental limitations. These bodily limitations are constantly being
further and further constricted in individuals struck with Alzheimers. However, the associated
bodily problems of AD cannot implicate that these people are unable to strive for perfection
and godliness. Alzheimers and other similar diseases could not possible strip an individual of
something that is intangible. Because personal identity does not have a biological basis, there
is no way that any disorder can have a negative effect upon the entity of the mind.

A supportive philosophical argument involves Alzheimers Disease and God. Visualize God, who
is but a pure mind, being struck with AD. Of course, one can already see how ridiculous this
proposal is. Since God is devoid of a body, brain, and neurons there is no possible way that AD
could have a negative effect upon Gods mind. Therefore, this proof can be applied to normal,
everyday individuals. Yes, the body and brain do fall apart as a result of Alzheimers. But the
intangible element of mind, our connection to the perfect being, is not at all damaged by this
disease. Just because one loses their memories in the physical form of the neuron, does not
constitute a deprivation of mind.

By combining both biological and philosophical arguments, one can plainly see that bodily
damage resulting in the loss of memory, such as with AD, does not rob one of either their
personal identity or their mind. Alzheimers Disease is a painful disorder, both physically and
emotionally, that has struck and destroyed millions upon millions of human beings. AD will
continue to destroy our loved ones before our very eyes until a definite cure can be found.
However, this paper should prove some solace to individuals who have had those near and dear
to them battle Alzheimers. Although the body fails, the most important part of the individual,
the personal identity the mind is beyond the injurious tendrils of AD.

Bibliography:
Evans DA. "Estimated Prevalence of Alzheimer's Disease in the United States".
The Milbank Quarterly. 68(2): 267-289, 1990.

Rice D, Fox PJ, Max W, et al. "The Economic Burden of Alzheimer's Disease
Care". Health Affairs. 12(2):164-176, 1993.

Feldman R.S., Meyer J.S., Quenzer L.F. Principles of

Neuropsychopharmacology. Sinauer Associates, 1997. ISBN 0-87893-175-9.

* This is the textbook that I studied last semester in my Neuropsychopharmacology class.

Without this book I would not understand any of the workings of the brain, neurons, or
neurotransmitters