MovieChat Forums > Iris (2002) Discussion > did she really have Alzheimer's

did she really have Alzheimer's


She had such a cerebral vitality. It seems odd that she would get Alzheimer's. I could see if she was sluggish mentally throughout her life, then, of course, Alzheimer's. Perhaps she had something else, like a prion caused brain deterioration from eating God knows what kind of meat during rationing in world war II. Or maybe tertiary stage of syphillis. Or something else. Another thing that puzzles me, and I am reading a biography of her right now, is that she didn't seem to suffer any consequences from her uninhibited sex life, such as pregnancy or std. Perhaps her biographers, which were male, were incognizant of what a free and easy approach to sex meant for a woman before antibiotics and reliable birth control.

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Yes she definitely did have Alzheimer's, she donated her brain to medical science and was involved in Alzheimer's research while she was alive, they used some of the tapes from that study as research for the film. Are you a medical student? It's interesting that you raise that point but I'm wondering which biography you're reading because a lot of them were written by her friends and close acquaintances and, since they knew her, they probably wouldn't think in those objective terms.

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I am still reading the biography. Maybe I have Alzheimer's. Did any of her friends really know her? Alot of her earlier life was pas de deux with her lovers, 2 of whom died and one, Canetti, who was somewhat discreet(I don't think he wrote about their sex life). So she had a lot of secretive side of her life.

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Actually Canetti did write a bit about their sex life in a book called Party in the Blitz, which is basically memoirs of people who were part of his life from about the mid 1930's onwards, he isn't very pleasant about her. No, she was quite mysterious person and most of the people who knew her will vouch for that, even her husband, but she had very long standing friendships with a lot of those people as well so they must have had some insight - then again, maybe not.

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The reason it is taking me so long to finish Conradii's biography is that I work in a coal mine(metaphorically speaking) and I only read it before I expire for the night. I read some reviews of Canetti's book that you mentioned. I doubt that our library has it, mostly because it has cut its budget dramatically. But from the reviews, I gather that he was quite ungentlemanly. What lover focuses on the undergarments? Perhaps as a novelist Iris had revealed some truths about him that he wasn't prepared to take. I also noticed he said something that Iris had not "suffered" so she could not be a good writer. I think being a second class citizen, as a woman was in those days, is suffering enough. As far as Iris being a "mechanical" lover, from personal experience, I would say a woman has to resort to being "mechanical" when the lover is older and one has to do some tricks to get the job done.

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She had such a cerebral vitality. It seems odd that she would get Alzheimer's. I could see if she was sluggish mentally throughout her life, then, of course, Alzheimer's.

Alzheimer's does not respect quality of mind, or much of anything else.

You are succumbing to the common fallacy that Alzheimer's is a disease of the mind. It's not -- it's a disease of the brain. Although we still don't know what causes it, the results are painfully apparent on autopsy, almost as much so as brain cancer. The brain is eaten away. Gone. (There are other brain disorders, such as manic depressive illness, where the disorder involves the neurotransmitter receptors or the second messenger systems, and so are not visible even on autopsy. Those however are equally disrespectful of the mind.)

An active mind does not help the brain resist Alzheimer's any more than it helps the brain resist a bullet in the head, or resist mercury poisoning, etc.

Of course this is a common mistake, and the use of the term "mental illness" helps to perpetuate the mistake. Most of the disorders referred to as "mental illness" are in fact not mental (of the mind) at all, but rather are brain disorders.

As for consequences of her sex life, I haven't read anything, but she is shown in the movie asking John if he has a condom. Perhaps he's the only one with whom she ever bypassed it.

Edward

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I read articles that seem to suggest that you can forestall the effects of Alzheimer's by self-stimulating mental activity.
But what I really meant is that for an organic neurological disorder, it seemed to have a sudden onset in the movie. Is that how the disease evolves? To me it amazing that up to the onset, she appeared to be functioning on the highest level. If I knew a person that had generally disorganized thinking or logic all their life, then I would think to myself, "yes, this person will get dementia or Alzheimer's". But I have a lack of intimate familiarity with the course of the disease, since it hasn't appeared in my family.

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I read articles that seem to suggest that you can forestall the effects of Alzheimer's by self-stimulating mental activity.

The Wikipedia article at http://en.wikipedia.org/wiki/Alzheimers has a long list of studies which have shown one factor or another -- including intellectual and social activity -- to reduce the risk of Alzheimer's disease. The problem is that, although the studies each reached statistical significance, the effects are all small. Very small compared with the inexorable devastation of the disease.

And there's huge individual variation. You can never look at one person and determine whether any particular factor raise or reduced their risk. This requires hundreds of subjects at least. It would be very useful if each subject could live two different lives, identical except for one factor, but each of us has only one life to live. Even identical twins, with exactly the same genes, differ enough in their external exposures that they are no longer identical for these purposes.

Furthermore, it's difficult to determine how much publication bias there is -- in other words, studies with a positive result are far more likely to be published than studies with a negative result. Since statistical significance usually means "a one in twenty chance that this is wrong", if twenty studies are done, it's a good bet that one will show statistical significance for something that isn't real -- and guess which one of the twenty gets published, and guess which 19 get buried? So many studies are being done for Alzheimer's that this is a real problem.

A horrifying percentage of published medical studies are poorly done, not controlling for all factors. This is due at least in part to a pressure to publish. I have not checked out all the references in the Wikipedia article, but having read other medical literature, I expect that I would judge the majority of them to be junk.

And no one has been able to show that these factors add up -- if you have 20 factors and each gives a 10% reduction in risk, you'd think we would reduce the risk enormously by following several of the recommendations. But there's no evidence at all of such a result.

IIRC, intellectual activity has been shown to have positive effects on the mind of aging people, so its effect on Alzheimer's may just be that same effect.

But what I really meant is that for an organic neurological disorder, it seemed to have a sudden onset in the movie. Is that how the disease evolves?

Oh, the movie covers several years! I'm talking about just the disease part of course. From the first signs (I forget if that was her going blank in the interview, or saying "I just said that, didn't I", or writing "puzzled" several time) to her death, was probably between five and ten years ... well, Wikipedia says only four years; she actually progressed rather quickly. Per that article, mean life expectancy at diagnosis is seven years. In one of the best known cases, Ronald Reagan lived ten years after diagnosis, and probably had symptoms for a year or two before diagnosis.

The movie gives few clues of this passage of time. In this sense it is not a good introduction to Alzheimer's, but rather assumes some knowledge of the course of the disease. Knowing that duration, it's easy to pick up a lot of clues, such the progressively messy house, John's increasing frustration, etc ... though in some ways I probably interpreted those as signs of the passage of time precisely because I knew that years had to be passing. Certainly I knew that she didn't die the day after entering a nursing home, so I knew that months or years had passed then -- but the movie doesn't really give any clue whether it was a day or a year.

The movie does seem to jump very quickly from the pre-dementia stage (and diagnosis) to the moderate dementia stage, skipping the early dementia stage almost entirely. (The Wikipedia article describes these stages.) It then spends a lot of time on the advanced dementia stage, the stage which is the most frustrating for caregivers.

I was thinking after watching the movie that one thing it could not convey is the long, inexorable progress of the disease. It did very well in the time alloted -- I was especially impressed with how it conveyed her living in her memories rather than in the present time, and in emotion rather than intellect. But it could only convey a little bit, and to show the personal interactions at various stages, it had to omit months at a time with no clue. Sure, they could have put JULY 1997 etc on the screen, but this was not intended to be a documentary.

(Note that I'm no particular authority on this. I'm done a good bit of reading on brain disorders, in large part because my wife is bipolar. My mother's father probably had Alzheimer's disease, but at the time he died -- 1971 -- the term was reserved for what is now known as early onset Alzheimer's. I don't know if he even had a specific diagnosis, though it was probably "senile dementia". I do know that his autopsy showed extensive brain atrophy, but the plaques and tangles of Alzheimer's were not commonly known at the time.)

Edward (goodness, have I forgotten when to stop?)

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This entire discussion is so educational. I sincerely appreciate your discussion. I had a brother-in-law and Aunt die of this horrible disease, and it is heartbreaking.

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Yes, horrible and heartbreaking indeed. Thanks for posting.

Edward

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If I knew a person that had generally disorganized thinking or logic all their life, then I would think to myself, "yes, this person will get dementia or Alzheimer's".

OK, I don't know when to stop.

Lou Gehrig famously died of ALS, a disease of degeneration of motor neurons, despite the fact that he clearly had exceptional motor skills. So did Huddie Ledbetter, aka Leadbelly, who though a much rougher character, was healthy and strong until he was stricken. The cause of ALS is not much better understood than Alzheimer's.

George Gershwin died of brain cancer. Being a brilliant and creative composer didn't help him.

These are not diseases which begin killing at birth and progress gradually through life. They are diseases of fairly sudden onset, even though that onset may be triggered by a congenital flaw.

There's no reason to believe that ALS, or brain cancer, or Alzheimer's disease, or a bullet in the head, is related to prior mind function any more than heart disease, or arthritis, or flu, or broken kneecaps, is related to prior mind function.

Edward

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"But what I really meant is that for an organic neurological disorder, it seemed to have a sudden onset in the movie. Is that how the disease evolves?"

If you want to know about Murdoch as a person then the movie isn't the best source to take, it's a very truncated view of a jam packed life and doesn't tell you anything much about what she was like pre-Alzheimer's. I wouldn't say it came on suddenly, if you read her novels from the early 1980's all the way up to the mid 1990's when she was diagnosed with Alzheimer's you can actually see a building awareness of things starting to slip.

Terry Pratchett also gave a lecture in honour of Richard Dimbleby quite recently and said that a lot of people show early symptoms in middle-age, possibly even earlier, they just don't make the connection and dismiss it as a "senior moment" like when you accidentally put your keys in the fridge or forget to switch the lights off before you go out.

It never just comes on suddenly is all I'm saying, they just made it seem that way in the film because they only had two hours to tell the story, her real life was obviously a lot more detailed than that as you'll know if you've read the official bio which I think is about 600-700 pages.

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In Murdoch then, I think we have the ultimate existentialist irony/reality, which is, according to Emily Dickenson, "The best vitality can not exceed decay".

You can live your life to its essence, and then be robbed of the memory of it, or else die. Though probably existentialists are not into remembering things anyway. So really, live, and if your life gets blotted out, you have lived anyway.

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I used to work in an Adult Day Care Center that was Alzheimer's Specific. I saw many bright, brilliant people in all sort of proffessions come through. Alzheimer's Disease is particularly cruel in that it doesn't care who it takes. The time length varies for each person, depending on their general health condition and the speed of the Alzheimer's. Some people have it for 20 years, others can go much shorter.

I think John and Iris' lifestyle, which had much seclusion in their studies as they worked, as well as having generally sloppy household skills might have lead to not identifying immediately her cognitive losses. As many other people have said, the movie is trying to quickly sum up a long life. So they show a quicker progression than what the illness actually probably ran.

John's journey as a caregiver was quite typical considering they had no family and had to get outside help. It is frustrating taking care of an adult whose behavior is that of a toddler and you are grieving everyday the loss of the person you once knew. Iris, one of the greatest philosopical minds of her generation, enjoyed watching Teletubbies as her illness progressed.

People are encouraged to do various puzzles and problem solving games to help stave off dementia. In doing so you are building new pathways for the brain to work. But like heart disease, when it wants to get you it will. I say keep doing those mental activities just like you are going to keep eating oatmeal for heart health. You are still doing good for you.

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It is frustrating taking care of an adult whose behavior is that of a toddler and you are grieving everyday the loss of the person you once knew

I think it's probably far more frustrating than taking care of a toddler. At least a toddler is rapidly improving -- parents often talk with joy about watching the almost day-to-day improvement. And the toddler is by and large happy about the situation. By contrast, someone with Alzheimer's steadily decays, and you know they are never coming back, and mostly they are not happy.

And not only grieving for the loss, but usually wondering how you missed the chance to say goodbye. Since you've worked in this situation, you've probably seen what I'm only guessing at: that people are so busy trying to continue their lives together as long as possible, that the one with Alzheimer's slips past the point of contact almost unnoticed until it's too late to get through.

Edward

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Alzheimer's is particularly difficult on caregivers. My grandmother has Alzheimers, and my grandfather had to take care of her, rather in the way that Bayley had to take care of Iris. It's a heavy burden for anyone, but particularly difficult for a person in his 80s to be responsible for someone with all the abilities of a toddler who thinks they can take care of themselves. This film was brutally accurate in its depiction of how Alzheimers affects a couple. The repeating things, the questions, the wandering off. Even the event that forced my grandfather to put my grandmother into care was similar. She wanted to see her father (who had been dead for 50 years) and my grandfather wouldn't let her and she took a swing at him. But, yes, the disease is very gradual. My grandmother started having trouble remembering things about 15 years ago

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Regarding the idea of prevention: I won't repeat what has already been well-explained here, but I will add that the age of onset does tend to affect how rapidly the disease progresses; i.e., the younger the person is when the disease begins to present, the faster and more devastatingly the disease progresses.

As far as who is at risk of developing this disease? Intellectual prowess really has little to nothing to do with it--as any statistical correlation does not actually imply any genuine connection to susceptibility or protection. It may be that being intellectually active provides a minor degree of protection in that they form more neural connections and are better able to compensate for any damage, thus delaying any symptoms (as there is no actual "test" for Alzheimer's), but this doesn't "prevent" Alzheimer's, just as staying mentally active does not act as any kind of treatment. In itself, being an intellectual conveys no immunity at all. However, you assumption that it DOES didn't surprise me in the least. Consider what is more likely, and the factors that lie behind such an idea:

It may be that those people who tend to pursue intellectual pursuits simply come from families that don't have a genetic connection to the risk of Alzheimer's (if in fact, there is one). It really could be that simple.

That's not to say that there is any certainty at all that if someone in your family somewhere along the line developed this disease you will definitely get it, but the risk is somewhat higher in families with this history. Just as with some other diseases: bipolar disorder, depression, alcoholism, Lupus, colon cancer--your risk may be statistically higher with a familial history but there is no certainty. Unlike other diseases where there is a known genetic link such as with SOME forms of breast cancer--to use one well-known example; even with a known genetic marker there is no guarantee the disease will manifest. With most such diseases it's not even THAT straight forward.

Until scientists find a genetic marker for Alzheimer's we don't even know if there really is any kind of genetic connection at all, because they don't have any idea as to what makes one person susceptible to the disease and what doesn't, just as they don't know what causes the disease.

Americans are particularly susceptible to the myth that we can control our bodies and our fates by force of will and action--whether it be through exercise, eating (or not) certain foods, taking mega-doses of vitamins, or meditation--or whatever the latest fad. The fact is that you can do absolutely everything right and still have a heart attack at 56 (like Jim Fixx, the guy who put jogging on the map--but then again, his own father died of a heart attack in his 40s.). Some people have a form of high cholesterol that is immune to dietary control, requiring medicinal treatment to avoid cardiovascular complications. Some people are prone to debilitating depression no matter how successful or fulfilling their lives. Some people are tall and some are short. Some have blue eyes and some have brown.

You can even see this idea manifested on the NIH website for Alzehimer's. On the one hand it states: "So far, studies have not demonstrated that, over the long term, health or lifestyle factors can prevent or slow Alzheimer’s disease or age-related cognitive decline. Similarly, clinical trial results do not support the use of any particular medication or dietary supplement to prevent these conditions." But then it turns around and suggests that "Observational studies have associated factors such as physical activity, blood pressure, and diabetes control with changes in risk."https://www.nia.nih.gov/alzheimers/publication/preventing-alzheimers-disease/search-alzheimers-prevention-strategies

That is a very weak argument scientifically. Correlation does not equal causation in no way shape or form; "Observational" studies are even weaker. But the IDEA that our actions can effect change and prevent such a devastating disease fits our prevailing mythology. It implies that somehow we can control our fates. Unfortunately the flip side of this philosophy is the underlying assumption that somehow if you DO become ill it's your own fault. It HAS to be: You didn't take care of yourself well enough--somehow what you did or didn't do brought this fate upon you. Anything that suggests otherwise--the idea that what you do or don't do isn't going to change anything is extremely frightening.

The fact is: most things concerning our bodies and our health are out of our control. We can do everything right and still develop an illness or disease that requires intervention, medication, or surgery---if we're lucky. Another reflection of this myth of control is the fact that even when everyone knows there isn't ANYTHING that will change the outcome is that people will still try just about anything in order to get that sense of control back. Even when it makes them sicker or ultimately could shorten the time they have left. Consider how people react when someone chooses to forgo chemotherapy for cancer and simply live well until they die rather than endure endless bouts of poison (and their effects) when everyone knows such treatment is useless anyway. There is rarely acceptance (in our country) for such a decision--oh they'll call it "giving up" but in reality they are reacting out of fear of what that decision represents.

The rare(r) lucky minority can abuse their bodies daily and live to be 100 in perfect health. And because the latter group tends to live in clusters it feeds into our mythos that somehow there is a magical answer just waiting for discovery (when the more likely answer is that it's "simple" genetics--hence the cluster). For the rest--you can do everything today's doctors recommended and still only add MAYBE 3 years onto your expected life span. There's still so much we don't know.

For now Alzheimer's is one of those diseases with no known cause, no prevention, no treatment and no cure.

I would not have gone into so much detail if the film wasn't dealing specifically with this disease and the fact that there are likely many others who would make the same assumptions. I hope this information has been helpful.

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