Talk:Alzheimer's disease/Archive 7

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Corrections to prevalence estimates for U.S.

Alzheimer's disease #Epidemiology said "In the United States, Alzheimer prevalence was estimated to be 1.6% in the year 2000. In the 65–74 age group, approximately 5% of the U.S. population has AD, with the rate increasing to nearly 20% in the 75–84 group and to 50% in the greater than 84 group." But the cited source (Hebert et al. 2003, PMID 12925369) doesn't give percentage figures; it gives absolute numbers of 0.3, 2.4, 1.8, and 4.5 million for people aged 65–74, 75–84, 85–, and total, respectively. The Census Bureau gives counts of 18,390,986, 12,361,180, 4,239,587, and 281,421,906, respectively, for these groups, and these work out to 1.6%, 19%, 42%, and 1.6% respectively, not the 5%, nearly 20%, 50%, 1.6% reported in Alzheimer's disease #Epidemiology. I guess somebody's calculator messed up? I made this edit to cite the Census Bureau for the totals, so that the reader can see where these numbers are coming from, and to correct the numbers. Eubulides (talk) 22:25, 27 August 2008 (UTC)

Alzheimer's disease for main page

The article has reached the FA status after very hard work. Right now it has been nominated to appear in the main page of wikipedia the 21 of september (Alzheimer's international day). Anybody which thinks it is the best date for the article can vote here. That day many media do specials on the disease and being in the main wikipedia page can attract a lot of attention to the article and wikipedia, and also provide reliable information to all those searching for it that day. --Garrondo (talk) 14:29, 26 August 2008 (UTC)

Seems like a fine idea to me. Congratulations to all contributors. It has been a long trek to a little gold star.LeadSongDog (talk) 16:09, 26 August 2008 (UTC)

Great job, editors! --Chrispounds (talk) 19:23, 26 August 2008 (UTC)

On my computer, it always looks like a brown star. Either I'm going color blind, or I need a new monitor. Humph. OrangeMarlin ^{Talk• Contributions} 06:04, 28 August 2008 (UTC)

As usual, you're (mostly) right. It's bronze.19:45, 28 August 2008 (UTC)

Social cost of AD due to wandering

In this edit with edit summary Social costs: Eliminated SAR: Not peer-review reference and only a minor cost for society when compared with others named", Garrondo deleted this text:

People with Alzheimer's disease are prone to "wandering", leaving home and becoming disoriented and lost, and often requiring expensive public emergency response services such as search and rescue.

Garrondo's edit summary gives two reasons: quality of reference and notability of cost. The ref is not peer-reviewed but it is by an authority and it is free full text. There may be a peer-reviewed article available, in the public safety literature. Rather than summarily delete the reference, it may be more appropriate to tag it. The social cost of wandering by AD patients is not minor. A SAR mission lasting more than a few hours is likely to expend many hundreds to thousands to tens of thousands of skilled man hours. So, rather than dismiss this contribution, how about looking into it farther and expanding the article to mention non-custodial social costs? --Una Smith (talk) 21:35, 27 August 2008 (UTC)

The quality of reference was poor, and the rest of your edit, therefore, seemed like WP:SYNTH. And wandering is not a major social cost, although when it does occur to the family, it may have one. OrangeMarlin ^{Talk• Contributions} 22:02, 27 August 2008 (UTC)

OM, what do you have in mind when you write "major social cost"? --Una Smith (talk) 04:08, 28 August 2008 (UTC)

e/c I haven't looked at this section for a while and I won't read it this minute (I'm busy elsewhere and I've been afraid of what I'll find!), but I'm afraid this is probably part of the Featured Article process. I'm not fan of FA's myself - they lead to controlled information if you ask me. I know very well what wandering is all about. Regarding the deleted line, it only doesn't need to clarify "such as search and rescue" (sounds like a US term, and it's obvious without it). Garondo's done a great amount of work on this article, but sometimes he doesn't fully see AD as all-round bad news as it actually is. People are often found dead if they have been out too long - hypothermia, traffic (eg when the pavements one side only, and corners are tight) - tunnel vision is particular symptom of AD. Sometimes they can't see something inches from their line of vision. I've seen a score of normal working and retired people looking for one person - police excluded! Sometimes complete strangers give the crucial lift home. The section might need to specify that the costs/burden etc to society can be varied. AD is cheap when the governments won't spend on it (the UK is almost ignoring AD in some respects - especially over the right to not tell the sufferer, which clearly doesn't fit into their 'risk assessment' rules) - but somewhere down the line AD simply has to be dealt with. It's hard to factor in police time too. Our 'mountain rescue' is a volunteer service, but it's still a cost. --Matt Lewis (talk) 22:13, 27 August 2008 (UTC)

SAR is mountain rescue, volunteer fire department, etc. In much of the world searches for missing persons are either a police function, or informal. In much of the US, they are an organized volunteer function. Volunteer or paid, the costs of searching for an eloping AD patient can be very high. As in, the monetary value of the manhours spent (in terms of pay not received) frequently exceeds the direct cost of a nursing home for one year. --Una Smith (talk) 04:18, 28 August 2008 (UTC)

Matt Lewis: What has this disccussion to do with FA? Taking AD to FA has done nothing but taking what was a really innacurate and messy article to something that anybody can understand, and the first people who get benefits of it are AD patients families. As for your accusations of not seeing it as "all-around": Do not think that you are the only one that has worked as a carer of people with dementia: I have for four years, so I now the burden it is, which has nothing to do with the search of reliable sources, accuracy and balance in an Encyclopedia.--Garrondo (talk) 07:23, 28 August 2008 (UTC)

Una Smith: Of course the cost of a rescue mission is high, but how common they are? Even a search in a city is costly, but what is the prevalence of AD people going out of their home and a search being organized? Once a year per patient? Probably much less. the cost of that seems VERY LOW, when compared to the lost productivity of a family caring for a person for a whole year or the cost of taking him to a hospital. Lets put it other way: If you were talking about children caring costs it would seem rather simplistic to say that searching for lost children is one major cost for society, when compared to the cost of public education. I believe that for the SAR fact to be included you would have to find a peer-review reference which clearly states the median cost of rescues and searches per person with the disease and year to see if it is really as high as your not-very-reliable reference says. If there is none it may probably be because it is not so important. --Garrondo (talk) 07:23, 28 August 2008 (UTC)

This might be helpful: Volcher Ladislav, Nelson Audrey(ed), Algase Donna L(ed) (2007). Evidence-based protocols for managing wandering behaviors. Springer Publishing. pp. 53–64, 181–191. ISBN 0826163653. {{cite book}}: |author= has generic name (help)CS1 maint: multiple names: authors list (link)LeadSongDog (talk) 15:48, 28 August 2008 (UTC)

The cost of wondering has 2 parts. Above, we discuss the cost after the person elopes. Consider also the cost of keeping the person from eloping or otherwise coming to harm due to unattended wandering. That includes 24hr surveillance, and physical security measures. --Una Smith (talk) 16:24, 31 August 2008 (UTC)

Any work in this area is much appreciated by me. I'll certainly find some time soon to focus solely on this subject (certainly before September 21st, when this becomes an 'article of the day'). I personally find it hard to dip in sometimes as I see AD almost every day, and I have a number other involved interests on Wikpiedia too. Certainly we have more work to do in the 'social' area before the 21st, current FA status or no. --Matt Lewis (talk) 23:13, 31 August 2008 (UTC)

But this second cost is alredy included in the article: The cost of living at home is also very high,[17] specially when informal costs for the family, such as caregiving time and caregiver's lost earnings, are taken into account. When it is calculated how much money costs caring for an AD person and how much money is lost is already taken into account that a person with dementia and specifically with AD has to be closely followed. The thing is that it is not only because of wandering. It is also because he may endanger himself in the kitchen or bathroom, he is not able to take his meds adequately, etc. So I do not really see the point of specifically talking about wandering when the costs wandering brings can not be separated from the costs brought by other symptoms of dementia. --Garrondo (talk) 08:34, 1 September 2008 (UTC)

The point I'm trying to make, that seems not to be getting across, is that the financial cost to society of wandering out of bounds (elopement) is not already taken into account. Concerning those costs, the state of the art, albeit a rough state, is in the web page I cited. --Una Smith (talk) 19:38, 1 September 2008 (UTC)

I now see I gave this section a misleading title; a better one would be Additional costs to society due to elopement. --Una Smith (talk) 19:38, 1 September 2008 (UTC)

That annoying 'caregiving burden' again

This section once had a couple of lines that explained that the 'family carer' sees their loved-one lose any idea who their once-loved carer is. Consequently, the carer has virtually none of the traditional caring 'rewards' (such as thanks, or a feeling of progress, as caring for an AD sufferer can be like babysitting someone with hyperactivity - yet it is day after day for so many carers). Tempers fray from both sides. All this is AD related, very specifically - it can't be pushed onto 'general dementia' (and it hasn't even been moved over, either). Where is it all? It's pure deletionism - which is against the rules without good reason.

The section now almost verbatim repeats the sentence from the lead ("Alzheimer's disease is known for placing a great burden on caregivers which includes social, psychological, physical or economic aspects."). Surely that's not even great by MOS is it? I expect it 'passed' their current structure (which all they want to do as MEDMOS) but it's not exactly impressive is it?

Now the sections says "Caregiving can also have positive benefits such as lessened postloss depression and grief in some cases". Sorry, but is this talking the piss or what? I mean FFS? FFS? I nearly hit the hit the roof when I saw what was missing and then read that. Is it sadism, a phonecall from the UK gov, was is it? I've seen someone turn into a shell of himself after his wife finally died - he had nothing left. He visited her every day until the final hour too. Shall I tell him he should be feeling less grief? Wikipedia says it so it must be true. Something in him has died after his endless ordeal. He may never have bawled in tears as soon as she died (I don't know), but I wish you could see the set of his face - and the wet gloss over his eyes from time to time. He was lucky she died in hospital and not by an accident - but he was always there for her, wasn't he? Do you people think AD suffers would ever make it to a hospital death if it wasn't for the constant care that they've had? Really - think about it. And she was once a senoir in the health service too - he told me he has all this money and nothing to do with it. I hope no one here is feeling too smug. One thing MEDMOS don't give a damn about is inner-article balance and WP:WEIGHT. That is up to us - where is it here? They are rubbish references too.--Matt Lewis (talk) 00:52, 31 August 2008 (UTC)

It is true that some people feel praise of their job as carers and this can have positive psychological effects, and it was well referenced, but it may also be unbalanced, no problem with the elimination (But relax PLEASE).--Garrondo (talk) 07:38, 1 September 2008 (UTC)

Spoken version added

I have added a spoken version of this article; see the links above and on the article itself. Hassocks5489 (tickets please!) 23:00, 12 September 2008 (UTC)

Who does this? Is it part of WMF?OrangeMarlin ^{Talk• Contributions} 23:12, 12 September 2008 (UTC)

WP:SPOKEN is a Wikipedia project. Sound files are uploaded to either Wikipedia itself or Wikimedia Commons. Hassocks5489 (tickets please!) 10:07, 13 September 2008 (UTC)

Couple of ideas

An expanded lead and some more images in the first section or two may help improve this article further? SGGH ^speak! 10:52, 21 September 2008 (UTC)

This article has had a thorough review to get to FA status. Why is necessary to expand the lead? What images? And in what way would this improve the article? OrangeMarlin ^{Talk• Contributions} 14:47, 21 September 2008 (UTC)

I agree that the lead needs to be improved. See Talk:Alzheimer's disease#Alzheimers and senility (below). --Una Smith (talk) 15:54, 21 September 2008 (UTC)

Prevention

Yesterday I added Bridge (contract bridge) to the prevention activities. Someone ignorant to what bridge is erased it. Please put it back, here's a link: http://www.redorbit.com/news/science/37035/the_useitorloseit_defense/index.html where you'll find that bridge also helps prevent Alzheimer. —Preceding unsigned comment added by Hanoi5 (talk • contribs) 09:14, 22 September 2008 (UTC)

Intellectual activities such as reading, playing board games, completing crossword puzzles, playing musical instruments, or regular social interaction. Such as is a non exhustive enumerator: the activities commented are only examples of intellectual activities, (as it is bridge), so there is no need to comment all the infinite possibilities of intellectual activities. On the other hand bridge does not appear in the refs proposed in the article but the commented activities do. --Garrondo (talk) 10:59, 22 September 2008 (UTC)

There is no need but chess is mentioned as are crossword puzzles. What's the problem with mentioning bridge? I linked to an article that can be used as a reference. Besides bridge combines regular social interaction and intellectual activities, so in a way it should have a priority. —Preceding unsigned comment added by Hanoi5 (talk • contribs) 13:07, 22 September 2008 (UTC)

Alzheimers linked to copper and other metals.

My attempt to add copper (and other metals) as a cause of Alzheimers was deleted. Perhaps someone with more time can find an appropriate way of adding this important bit of information.

(copper from water pipes, and or aluminum would be logical conclusions)

• Research as recent as 2007, conducted by Dr R. Squitti, Head of the Laboratory of Biology of AFaR and of the Laboratory of Neurobiology in the University "Campus Biomedico" added, "'Free' copper may be intrinsically toxic to older persons due to its oxidative activity, small size and ability to cross the blood brain barrier and enter the central nervous system in an unregulated fashion, similar to elevated 'free' copper's effects in other diseases of copper metabolism, such as Wilson's disease."Pipex Pharmaceuticals Initiates Phase II Clinical Trial of Anti-Copper COPREXA for Alzheimer's Disease

--Caesar J.B. Squitti: Son of Maryann Rosso and Arthur Natale Squitti (talk) 17:09, 20 September 2008 (UTC)

Please see WP:MEDRS; a peer-reviewed, non primary source review article would be helpful. Primary sources are often incomplete and give WP:UNDUE to recent events. A press release with commercial possibilities is not a good source for this information, and unless it has been mentioned by secondary sources, it would not likely be included here. Also, please have a look at our WP:COI policy. Regards, SandyGeorgia (Talk) 17:18, 20 September 2008 (UTC)

The source cited, suggests other primary sites to present this information. Excuse me but I have to finish my book, or else I would do the research myself and post it...

--Caesar J.B. Squitti: Son of Maryann Rosso and Arthur Natale Squitti (talk) 21:08, 20 September 2008 (UTC)

I could not find one published article in PubMed that dealt with the chemical compound and Alzheimer's. Not one. To get to even Phase I studies, there should be dozens of publications. I wouldn't give any weight to this posting. OrangeMarlin ^{Talk• Contributions} 04:05, 21 September 2008 (UTC)

What about this? Not that I think it justifies a mention: this is just one of the zillion remote possibilities that fall below the radar for a Wikipedia article like this. Looie496 (talk) 04:26, 21 September 2008 (UTC)

Ongoing; WP:RECENTISM. SandyGeorgia (Talk) 04:29, 21 September 2008 (UTC)

Except my search was for tetrathiomolybdate and alzheimer's. Even so, Looie496 is right. And you too SG. OrangeMarlin ^{Talk• Contributions} 04:30, 21 September 2008 (UTC)

I wrote this section for another article, please feel free to take any part of it if you think it is important enough to be mentioned. Tim Vickers (talk) 05:30, 21 September 2008 (UTC)

There has been considerable scientific interest in the hypothesis that Alzheimer's disease may involve reductions in the levels of copper in the brain. These results have led to initial clinical trials of copper supplements as a possible treatment for Alzheimer's disease. The use of the copper chelator clioquinol to treat changes in copper levels has also been proposed. This compound showed promise in initial studies, but a recent meta-analysis stated that firm conclusions cannot be made from these small-scale trials. However, if this effect is genuine, the mechanism of action of this drug is unclear. One scientist investigating clioquinol theorizes that the cause of Alzheimer's is a build-up of copper and zinc in the brain, and believes clioquinol will be useful in absorbing the metals and dissolving the amyloid plaques associated with the disease, but others suggest that clioquinol may be an ionophore that transports copper into the brain.

Tim, a couple of thoughts. Is this giving undue weight to a potential, but unproven theory? If the best source for the theory is USA Today, then how much should we talk about it? Like aluminum, maybe one or two sentences would be sufficient. OrangeMarlin ^{Talk• Contributions} 14:41, 21 September 2008 (UTC)

Did you miss the first reference provided, the review in Current Opinion in Chemical Biology? II | (t - c) 14:50, 21 September 2008 (UTC)

Unconvinced. But I don't think this qualifies as a fringe theory, so I'm not opposed to its being included, but maybe just a sentence or two. The problem with a disease like AD, where it's not fully understood, is that there are dozens of theories, and it will eventually narrow down to one or two. Every time I read anything about micronutrients, specifically metals, I'm suspicious. OrangeMarlin ^{Talk• Contributions} 14:57, 21 September 2008 (UTC)

I don't think many of us care that much about your idiosyncratic opinions when it comes to Alzheimer's any more than we care about your skepticism of global warming. When you make false or misleading statements (or "questions"), however, it becomes a problem. There are a fair amount of theories as to what causes Alzheimer's, but to say that a few dozen are on the radar, especially at the level of say, this one, is similarly misleading. Metals are the most highly-researched environmental risk factor, and interest remains significant. II | (t - c) 15:20, 21 September 2008 (UTC)

This is a notably uncivil and unnecessary response to what was a productive discussion; please stay on track and avoid personalizing discussions. SandyGeorgia (Talk) 15:43, 21 September 2008 (UTC)

I've got to say that if you think metals are the most highly-researched risk factor then you must not be reading the same literature as I am, in the scientific and medical literature the best understood and researched risk factors are the genetic risk factors, followed by hypertension and blood lipids. Smoking and diet are the major foci of research on environmental risk (see PMID 18088206). A sentence or two summarising the risk factors would suffice, PMID 18299540 is a up-to-date free access review and would be a good source to summarise. Tim Vickers (talk) 15:38, 21 September 2008 (UTC)

I certainly wouldn't call genetic risk factors environmental. Hypertension is not really environmental either, but might classify it as that I suppose. I don't know that I would classify blood lipids as environmental either. Certainly "nutrition" is environmental, and I suppose that general topic is more heavily-studied than metals -- but of course, copper is a nutritional metal. Aluminum is not. So there's crossover. Regardless, metals are a major, heavily-studied risk factor. And the research is not nearly as ambivalent as this article misleading implies. The good 2008 review article in Journal of Alzheimer's Disease is given the same weight as the "criticizing" study in Occupational and Environmental Medicine. The abstract exposes the bias of latter article immediately: it looks at all environmental risk factors together (non-specificity). Thus it only has space to look at 3 epidemiological studies for aluminum when the JAD article observes that 20 have been done on Alzheimer's and aluminum in water alone, with 15 of these showing a statistically significant positive relationship. II | (t - c) 15:58, 21 September 2008 (UTC)

Could your paragraph above be shortened for this article? SandyGeorgia (Talk) 15:41, 21 September 2008 (UTC)

I don't think so, metals don't seem to be regarded as particularly significant in the reliable sources reviewing the topic, do dealing with them in such depth would be giving the topic undue weight. The reviews that deal with metals specifically, rather than covering the entire area of Alzheimer's risk, state that this is still an unproven hypothesis (eg PMID 17522444 and PMID 17119287), Best to give a list of what are regarded as the clearest risk factors and mention metals as a possibility that are still under investigation. Tim Vickers (talk) 15:47, 21 September 2008 (UTC)

Looking at the section on Prevention, I see this is exactly what the article does, it even cites several of the sources I mentioned above. That seems a perfectly balanced approach to me. Tim Vickers (talk) 16:04, 21 September 2008 (UTC)

It's too bad we don't have instalinks to previous discussions. While building this article we had significant discussions about metals, and I think the compromise is what was written--I believe the old aluminum issue was the prompt. OrangeMarlin ^{Talk• Contributions} 23:03, 21 September 2008 (UTC)

So there is a political agenda to hide the simple fact that copper in excess tied with fat cells can lead to alzheimers, as was the 'belief' that aluminum would also cause it.

The again when you see that Alcan Aluminum is one of the greatest 'donators' or contributors to Alzheimers Research I can see the reluctance to 'publish' an article that these 'metals' cause alzheimers...

Another point to research. That old betraying Truth for a handful of silver idea....

The link may not be found in pubmed, but look up Dr. R. Squitti and Alzheimers, and hopefully you can find a link that you can feel comfortable enough to quote. People are suffering !

--Caesar J.B. Squitti: Son of Maryann Rosso and Arthur Natale Squitti (talk) 19:36, 21 September 2008 (UTC)

Please see WP:NPOV, WP:WEIGHT, WP:RS, WP:VERIFY and WP:NOTAFORUM. OrangeMarlin ^{Talk• Contributions} 22:59, 21 September 2008 (UTC)

Searching Pubmed for R. Squitti and Alzheimer's finds PMID 17641816 and PMID 16832081. If I understand correctly, these articles support the copper imbalance/AB marker correlation hypothesis, but do not indicate causality.LeadSongDog (talk) 03:43, 22 September 2008 (UTC)

The literature on Alzheimer's is stunningly vast, and if this article tries to give balanced coverage to primary sources on the level of those, it will end up being literally thousands of pages long. We need to restrict ourselves to things that get serious attention in high-quality review papers (as Wikipedia policy asks us to). Looie496 (talk) 03:54, 22 September 2008 (UTC)

Thanks for the link...seems there may be a 'liver' connection to this as well. IE the liver does not filter the blood properly..

--Caesar J.B. Squitti: Son of Maryann Rosso and Arthur Natale Squitti (talk) 13:52, 22 September 2008 (UTC)

"Old timers"

Shouldn't there be a mention in this article about a common colloquialism for alzheimers is "old timers" and that alzheimers is often wrongly translated as "old timers". Jabso (talk) 06:50, 21 September 2008 (UTC)

Discussed dozens of times, most recently during the FAR, and it is not that common. Maybe it's used amongst some socioeconomic groups, but not widely. OrangeMarlin ^{Talk• Contributions} 14:38, 21 September 2008 (UTC)

Jabso, it is very common, and evocative too. It is so common that it is the lead example of an eggcorn. But here alas majority rule has prevailed. --Una Smith (talk) 15:40, 21 September 2008 (UTC)

Una get off your high horse. It was not a majority, it was that hardly anyone educated in this field uses the term. OrangeMarlin ^{Talk• Contributions} 22:57, 21 September 2008 (UTC)

Wikipedia is not a medical encyclopedia. --Una Smith (talk) 01:38, 22 September 2008 (UTC)

The real problem is that it would be tricky to introduce the term in a way that wouldn't make readers think we were joking/cavalier about the disease, and that's an impression we really don't want to give. Looie496 (talk) 23:08, 21 September 2008 (UTC)

Since this has come up again, I will again offer this: "also known as oldtimer's disease, an evocative eggcorn". --Una Smith (talk) 01:38, 22 September 2008 (UTC)

It shoudl be in an introduction to the Culture section, so it comes up on search engines. Clearly people use it, and WP is for the 'genreal reader' (per MEDMOS). --Matt Lewis (talk) 01:52, 22 September 2008 (UTC)

Wikipedia is not a joke; we aim to be a serious encyclopedia. I just spent a long time searching scholarly sources, and introducing this colloquial language to the article would lower the prestige of the article. SandyGeorgia (Talk) 02:08, 22 September 2008 (UTC)

PMID 1984525 uses "oldtimer's disease" in the article title. --Una Smith (talk) 02:55, 22 September 2008 (UTC)

Instead of "Yes" and "No", how about we try to come up with a way to mention this name for the disease, in a way that is not jocular? --Una Smith (talk) 02:55, 22 September 2008 (UTC)

Do you know SG, Wikipedia is a joke to a great many people. This is twice you have snubbed me on this page alone - but who actually are you? Are you a special person? I've no idea who you are, or anyone in this place. I've put countless hours into this article, I've just not had the energy lately to fight on this front too (I've had it with WIkipedia to be honest - it is 'care in the community' if ever I've seen it) - despite my intital intentions for getting some of the lost carer stuff back in for the 'big day' yesterday. When I first edited on Alzhiemer's almost exactly 2 years ago I noticed that this 'old timers' question was asked, and I've seen it asked periodically ever since. It's clearly not Introduction stuff, but it clearly is a phrase/term/whatever-it-is that is used by people, and people are often asking for its inclusion. Maybe they are just stupid 'common' folk not worthy to even look at something as important and prestigious as a 'Wikipedia Featured Article', but it's pretty damn obvious that some people, I imagine all in the USA, use the term, is it not? Or maybe it's just the idea of having an Intro to the Culture section that iritates you, I don't know. The 'Culture and Society' section I had to fight at MEDMOS to get in here, by the way. Looking at Google, there is actually 7,000 hits for that term searched in quotes. Whether here or at MEDMOS, you (and others too) just seem to have no comprehension of the 'general reader' element of Wikipedia. I daren't even look to see if MEDMOS still has that line, as I can honestly imagine it being quietly removed. Coming from a country with an NHS, maybe I have a little more love for the 'common man'? I'm deadly serious about that too. You might thing this is silly over a such a line but I dispair about Wikipedia I really do. I'm glad I chose not to put myself through this.

And as for this "prestige" - that kind of comment is why I've been moaning about FA status since it was first proposed. Alzheimer's is a better article now for sure (although at least half the work seemed to be MOS presentation), but why the silly need for prestige? And the article's growth is clearly going to be forcibly stunted from now on due to whatever this 'prestige' is. It's a more solid and presentable article, that is all - it should still be allowed to breath.--Matt Lewis (talk) 03:56, 22 September 2008 (UTC)

Please avoid personalizing content issues, but I'll answer, as requested: see here. And MEDMOS has accomodated Cultural and societal factors for as long as I've been involved (at least); you didn't have to "fight to get in there" (as I recall, you failed to notice it was already there and provided for). I haven't snubbed you; I have rejected the notion that we need to include an obscure colloquialism that I had never heard of (until reading of it here) and that is essentially never used in high quality sources in what tries to be a serious encyclopedia. SandyGeorgia (Talk) 16:24, 22 September 2008 (UTC)

MEDMOS had "Prognosis (social impact may also be discussed)" so at AD we had something awkward under Prognosis. A new "Society and culture" section was included after some awkward and confused debate at MEDMOS, as 'Cultural References' clearly meant something else. We were all confused by what was previously there. I then came back to AD and included the new section - but it was initially a push at MEDMOS to get change to happen, and another improvement I saw was completely blown out as irrelevant (probably my bad memory). I suggested MEDMOS needed more work and was told in no uncertain terms that it didn't. Looking at MEDMOS now it is a lot better I will admit. And it does still have this, which I'm very happy to see:

Wikipedia is written for the general reader. It is an encyclopaedia, not a comprehensive medical or pharmaceutical resource, nor a first-aid (how-to) manual. Although healthcare professionals and patients may find much of interest, they are not the target audience.

I couldn't say the number of times I protected the intro we still have today by quoting that. It's essential.--Matt Lewis (talk) 21:13, 22 September 2008 (UTC)

I think your misunderstanding then was the same as your misunderstanding now, but I'm not going to re-debate a moot point here. Suffice it to say that autism, Asperger's and Tourette's always had sociological and cultural daughter articles and sections (well before your confusion), and we had no issues about where to incorporate all necessary content. The long discussion you initiated merely shuffled the chairs. SandyGeorgia (Talk) 21:36, 22 September 2008 (UTC)

If you were wondering at my angry response to you above - I think that attitude you still have now is what stuck with me! You basically refused to accept that there was anything wrong with MEDMOS, when clearly is was misleading people, and eventually improved itself to fit in with people after I stuck at it! Autism etc may have got it right - but people at AD insisted on going by MEDMOS alone, hence my excursion into the MEDMOS Talk. I was wondering myself why I reacted to you so strongly - this must be mostly why. I was going to apologise too (in fact I still will - there is never an excuse to be personal).

But you or anyone else here are not the only ones who have put a large amount of their hours into this article, specifically - and you did bring up all the work you do v's my eggcorn suggestion. All I wanted to do was support someone I thought looked like becoming overwhelmed by a rather measured 'no change' vote, and for me this is simply a plausible issue for that very Society and culture section in question! I don't understand the negativilty - it's nothing, just a bit of colourful copy I've even drafted into the culture secion at one point. This kind of relevant curiosity is never a bad thing for a prose writer, and it humanises the article, not demeans it.). Although admittedly we don't strictly have the 'human' section - but that is also my point.--Matt Lewis (talk) 22:27, 22 September 2008 (UTC)

Matt, you've been around long enough to know that like any editor, the only relevant answer to your "...who actually are you?" can be read at Special:Contributions/SandyGeorgia. We all stand on our records. SG's compares very well to anyone's. LeadSongDog (talk) 05:36, 22 September 2008 (UTC)

In what capacity? Tweaking style issues and constantly grumbling about it in the edit notes? I'm not saying it's without merit (in fact she probably works her socks off), but people's actual comments (whether here, medmos or wherever) are something else entirely.--Matt Lewis (talk) 08:21, 22 September 2008 (UTC)

Stop doing personal attacks. From my point of view this article has changed more in a year than in all its history. This changes have not been minor style issues but very important content changes (and surely not half of them have been MOS). The fact that it now has an star is important for some such as me, since it gives people a clue that is a feasible article. This does not mean it can not change. (it will surely will), but those changes will have to be according to reliable refences and not personal feelings on what is important to appear. Regarding this specific issue my opinion is that the eggcorn thing is too much specific, as are many pathophisiological facts on how cells react when the disease appears. This does not mean that they are not true, but simply that it may not be the best place to appear since precisely go against what you try to create: a balanced article for anybody. However I might be mistaken (In Spain such issue has no sense). Do you believe that some people don not know the correct spelling and really think that it is oldtimers? If the answer is yes maybe the best practice would be to create a redirect to the article form oldtimers: doing it we will make sure that anybody looking for info on the disease finds the article but also we make clear the correct spelling.--Garrondo (talk) 08:59, 22 September 2008 (UTC)

Why are we spending this amount of time discussing a word. Oh that's right, one of the most disruptive editors to medical articles thinks it belongs here. SG, Colin, Garrondo, and others are correct. Time to move on. OrangeMarlin ^{Talk• Contributions} 14:02, 22 September 2008 (UTC)

I don't know who you mean but I'm not aware of any disruption - I've just seen a valid enough point. And have made a few valid points. The eggcorn example itself may seem a bit low on the Richter scale but the points beneath it are sound: you have to be open to a place for cultural stuff, or people aren't ever going to be able to bring it in. But they will certainly keep asking. Credit to Una for not being scared off.--Matt Lewis (talk) 17:17, 22 September 2008 (UTC)

This "old timers disease" is a complete non-issue and most certainly does not belong in the lead. The Google search Matt links to above gives back (in the first page or so) mostly joke collections, forums and other low-grade web sites. There's one newspaper article from 2002. No charity links, which I'd expect if this was a common confusion that AD charities would like to clear up. Nobody is searching for the term on Wikipedia either. There's a redirect, Old timers disease, which goes to the Eggcorn article. Redirects show up on stats.grok.se and that site shows that it is getting less than one hit a day. This article gets over 2k a day. Time to move on... Colin°^Talk 09:11, 22 September 2008 (UTC)

Nobody said to put it in the lead Colin did they? Please. It’s the first time I've mentioned it after seeing it keeping popping up the past year at least - if not the two I said earlier. People come here asking for things and they get shot down. I've consistently been the only person on their level as far as the article is concerned, although others (who deal more with talk) can be polite if they want to. This term is used in humour, as a genuine mistake, and ironically by copy writers too. It probably even passes as a WP:COMMONNAME, and yes, is an eggcorn as well. It is probably prevalent in certain areas that have little health insurance. But these people still have some value though don't they? Calling it "Not relevant" etc (which has always stuck in my mind since I first saw it here) is just indicative of the bizarre machismo that can occasionally be seen around this and other medical articles. Frankly, I just don't always like the bedside manner in here - the entire attitude can at times be hugely aloof. The term is less important, although would normally deserve a place somewhere in a less controlled Wikipedia article I would say - after seeing enough interest in it and looking at the sources that I've seen. If someone types (or even mistypes) it in Google they would instantly get the Wikipedia page, which is not bad thing, surely. But the real issue underneath all of this is actually that there is nowhere to put it, as the Culture and Society section has no intro. It's carpet sweeping again in the grand MEDMOS style. As for Alzheimer's awareness in Alzheimer's Day? All some of you people really cared about yesterday was your own sense of "prestige". Too few people in the world understand this disease - and that is not irrelevant. And if you want to hear a good few more eggcorns, try spending time with someone with Alzheimer’s disease. The term is almost guaranteed to have originated from a sufferer - probably even someone from uptown perhaps? There's a thought. The atmosphere in this talk is just so unreal to me, and clearly is to many people who pass through here too. We are not the Lancet circa 1860, we are the encyclopedia for everyone. --Matt Lewis (talk) 11:36, 22 September 2008 (UTC)

I interpreted Una's "also known as oldtimer's disease, an evocative eggcorn" suggestion as a request for this to be appended to the lead definition. This, as she says, is a repeat request from her earlier discussion regarding inserting it into the lead. The mention of "Old timer's disease" in the Eggcorn article seems the proper encyclopaedic way to discuss a language feature. Colin°^Talk 12:00, 22 September 2008 (UTC)

Colin, you overinterpreted my suggestion. --Una Smith (talk) 06:58, 26 September 2008 (UTC)

PS: I changed the redirect; other variants (Oldtimer's disease etc.) already redirect to Alzheimer's disease. --Una Smith (talk) 07:18, 26 September 2008 (UTC)

How can you write in your edit note "It's a language feature, nothing to do with the disease." after my above comment? This article is not just about the plaques and tangles! How about the swings and arrows? To say the eggcorn has nothing to do with the disease when it is a name for the disease is extraordinary. The desire is to make this article only about certain areas of the experience commonly known as Alzheimer's disease - and that is uncommon on Wikipedia. Wikipedia is a naturally inclusive place (for good or bad), and you will never fend off the requests for stuff like this, however abrupt you are with people. People come here for the AD experience - to learn and understand what AD is in the full sense of the word. People who needed the really technical stuff would never rely on Wikipedia anyway. Editors here go on about 'cruft' (though I'm not sure what could be 'cruft' with AD, apart from some alternative health), but the sweeping brush covers a lot more than that. My worry was always that the blanket attitude would get worse after it got the FA. I know its just a minor inclusion, but the attitude here is clearly more of a protective one, than a progressive one. tThe underlying fact is that i won't be approaching a proper appraisal of the subject until a paragraph on general society and culture is finally tackled.--Matt Lewis (talk) 12:33, 22 September 2008 (UTC)

Then do not talk so much and simply write it. Look for high-quality references that exactly support any claim you make, and bring it here so everybody can disscuss it and improve. I am not against an introduction for the society section and I doubt that if it is of high quality others are. You proposed a social section, and right now is the longest section in the article after treatment, so do no feel you are censored, you simply have a view which is not followed by the majority of the article editors, and as wikipedia for the moment works on consensus between editors and not visitors you will have to live with the fact that many times your views would be minoritarian. Regarding the eggcorn: it may be a name, but is clearly VERY minoritarian name and as such many of us think that has no place in the Alzheimer main article. If we had to include anything related it would be absolutely endless. That does not mean that it is out of the scope of wikipedia, since it is already explained in the eggcorn article. (Where some of us think is the proper place to appear).--Garrondo (talk) 13:14, 22 September 2008 (UTC)

If anyone places that phrase into the article without significant sourcing, it's going to be reverted. Moreover, WP:CONSENSUS does not come into play here. WP:VERIFY and WP:RS are the critical points. Garrondo, you are not required to continue to give AGF to these editors, since Matt and Una have exceeded the pointiness of this argument. OrangeMarlin ^{Talk• Contributions} 14:05, 22 September 2008 (UTC)

Come on, Orangemarlin - it's rude to point. It looked to me like a group in here was ganging up on someone - that is kind of not really right where I come from. And why? It's true - there is no space for this stuff, you will have to stay in a gang being rude to people (wahtever turns you on one might say). And have you ever seen me put in a point anywhere without either reliable sources or the clear knowledge that they are there - so what kind of point was that? You wouldn't demand Pubmed for a cultural section would you? That was a rhetorical question. Weight and NPOV, by the way, are policy too. Looking at your talk page I have merely interupted a conversation on American football with you buddies - hardly the 'flow of Wikipedia' unless you've cracked something open! --Matt Lewis (talk) 17:01, 22 September 2008 (UTC)

Well, not sure what my talk page has to do with this discussion, but I note in your edit summary that you think that NPOV trumps RS and VERIFY. Well, in fact, RS and VERIFY are the very foundation of NPOV. Just saying. And BTW, for future reference, we do not discuss American football on my user talk page. It's prohibited by statute. OrangeMarlin ^{Talk• Contributions} 17:12, 22 September 2008 (UTC)

Apologies about the football gaff - I meant American Catch of course. There is only one football (unless you’re Irish). I did not say "NPOV trumps RS and VERIFY" - who would say that? I actually said "RS and verifiabilty? Of course. But NPOV and Weight are far more exciting."! Reliable sources are not necessarily usable – it’s quite easy to find reliable sources for the eggcorn. As you would point out, a reliable source doesn't in itself warrant inclusion - things like WP:REDFLAG matter, which you could bring up for eggcorn if it was put in incongruously. You would probably also have to argue that is provides undue weight. It all depends how its done. If someone puts it in the intro, I'll take it out myself.--Matt Lewis (talk) 21:13, 22 September 2008 (UTC)

Editors for this article have found sources for material in the article, and I do not believe Jabso has provided a source where "old timers" and "alzheimer's" are brought together. Once sources are identified, we can then judge them as a community and decide if they belong in the article. At the Alzheimer's conference held in Chicago this past July, there are no mentions of "old timers" in the abstracts and presentations. --Chrispounds (talk) 14:11, 22 September 2008 (UTC)

Why would they need to be mentioned together? It would hardly be in an abstract - its an eggcorn! Is that the community that lives in a caveat? --Matt Lewis (talk) 17:08, 22 September 2008 (UTC)

Chris, the eggcorn article supplies a source:

• Staff (2006-08-26). "The word: Eggcorns". New Scientist. p. 52. Retrieved 2008-09-22.

For the benefit of those without a subscrition, it says "Eggcorns often involve replacing an unfamiliar or archaic word with a more common one, such as "old-timer's" disease for Alzheimer's." The NS article was on eggcorns, not Alzheimer's, and was part of a regular lightweight series on words. That should be a clue as to where in Wikipedia this should be mentioned. Colin°^Talk 16:43, 22 September 2008 (UTC)

Digressing in this article into cute semantics and eggcorns would be the equivalent of digressing into discussing clinomorphisms about coprolalia on Tourette syndrome; perhaps of semantic interest in the coprolalia article, not in the TS article. We don't need to be semantically "cute" in scientific or medical articles about obscure colloquialisms. The content could be added to eggcorns or, if a comprehensive article on Sociological and cultural aspects of Alzheimer's disease were written (modeled after other medical FAs), this kind of cruft and trivia can probably find a place there. 17:56, 22 September 2008 (UTC)

If I can make a suggestion, it seems to me that a subsection on attitudes toward Alzheimer's might make a nice addition to the "Society and Culture" section, and that the phrase "old-timer's disease" could be introduced there in an inoffensive way, using the JAMA commentary that Una cited as a source. Looie496 (talk) 16:12, 22 September 2008 (UTC)

Hey that's a genuinely nice surprise! A positive suggestion, and a good idea. --Matt Lewis (talk) 17:08, 22 September 2008 (UTC)

Why would we do this? It isn't that important, notable, interesting, or cultural. We discussed this previously, dismissed Una Smith's suggestion, and moved on. OrangeMarlin ^{Talk• Contributions} 17:13, 22 September 2008 (UTC)

The fact that some contributors here dismiss my suggestion does not dispense with it. If we cannot resolve this to the satisfaction of all among us, the next step is dispute resolution. Better sooner than later, I think. Do you prefer informal or formal mediation? --Una Smith (talk) 06:58, 26 September 2008 (UTC)

As formal as possible, Una. I insist that no less a figure than the Queen ask me to spend more time discussing these two words. Colin°^Talk 08:18, 26 September 2008 (UTC)

• Comment - The eggcorn is worthy of inclusion in the article, along with the etymology of the surname "Alzheimer"; does it mean "old timer" in German? If not, what is the etymology of the name? That would do with a sentence, and we'd be done with it, and any user looking for this information would find it (though it doesn't seem to belong in the lead). Badagnani (talk) 18:14, 22 September 2008 (UTC)

• Etymology of a surname in an article about a condition named after someone with the surname? That is getting really far afield. Should we do that on every eponymous medical condition (explore the meaning behind the name of the person who named the condition)? So we should explore the etymology of Hans Asperger's surname on Asperger syndrome? Do you have some reason to believe the name "Alzheimer" means "old timers"? I'm having a hard time connecting this logic to good article writing. SandyGeorgia (Talk) 18:25, 22 September 2008 (UTC)

Of course it doesn't belong in the article, but just for the fun of it: "Alzheimer" means "person from Alzheim", which is a town in Germany. "Heim" means "home", but "alz" is not like any modern German word I know. Probably it is a kind f tree or some other nature-thing. It could be a corruption of "altes", though, which means "old". Looie496 (talk) 18:32, 22 September 2008 (UTC)

Didn't mean to start a big war about it. I'm nonplussed either way. If someone wants to know if it does translate to old timers the first para will sort it out for them. Although some people may open this article up expecting it to be cleared up properly. I don't think it would be insensitive to put it in, but if you all think it's unnecessary then that's fine. Jabso (talk) 17:10, 23 September 2008 (UTC)

I don't care where the term is explained, only (1) that it be explained and (2) that, if not explained in this article, this article has clear wikilink to the relevant other article. The term has two angles: linguistics, and coping with AD. It is a euphemism used by people coping with AD to obtain a measure of much needed distance from their distress. I have good sources for both angles. --Una Smith (talk) 07:18, 26 September 2008 (UTC)

The linguistic angle has no place here and is adequately covered elsewhere. For the second, you need sources to indicate it is in widespread usage and also that such usage has been discussed at a significantly serious level to warrant encyclopaedic inclusion (WP:WEIGHT). Colin°^Talk 08:18, 26 September 2008 (UTC)

I agree that the linguistic angle should not be explained here, but a wikilink to eggcorn is appropriate so that readers who are interested can find the linguistic angle. Re the AD angle there is Caring for America's Alzheimer's Victims: Hearing Before the Select Committee on Aging, House of Representatives, Ninety-ninth Congress, First Session, May 21, 1985 (snippet on Google Books) also Long-Term Care Assistance Act of 1988: Hearings Before the Subcommittee on Health of the Committee on Finance, United States Senate, One Hundredth Congress, Second Session, on S. 2305, May 27, and June 17, 1988. Judging by Google Books hit results, "Oldtimer's disease" does not appear in widespread use before 1985, the date of the first congressional testimony, but since then it has become widely used in fiction. One linguistic article refers to it as an Americanism of recent origin. Much of this information could go on Wiktionary, with a link from this article there. --Una Smith (talk) 08:40, 26 September 2008 (UTC)

Discussed is not the same thing as mentioned in passing. Can you quote some text to back up your euphemism angle. Colin°^Talk 09:07, 26 September 2008 (UTC)

Alzheimers and senility

Alzheimers has always struck me as a pc way to refer to senility. It's always annoyed me that the man put his name to something which has been known for thousands of years. He studied it, rather than discovered it.

What precisely is the difference, if any? --MacRusgail (talk) 14:33, 21 September 2008 (UTC)

I think you're not using the proper definitions here. Dementia is the general disease, of which there are 10-20 unrelated pathologies with different causes. Some could be caused by physical head trauma, prions, alcoholism, etc. So, Alzheimers is a form of dementia, but not all dementia is Alzheimers. Also, there are literally hundreds of diseases that have been named by the primary researcher. I hope this helps. OrangeMarlin ^{Talk• Contributions} 14:46, 21 September 2008 (UTC)

Yes: Alzheimer's is not the same thing as "senility". It is a specific brain disease, characterized by plaques and tangles in the brain. It is the most common cause of senility, but there are many others. Looie496 (talk) 15:42, 21 September 2008 (UTC)

I like to explain it this way: Dementia has many causes. Alzheimer's disease is one cause of dementia. Dementia has been known forever. Alzheimer's disease (the formation of characteristic plaques in the brain) was described by a man named Alzheimer. This brain disease was named after the man by others. Such naming often is more a matter of convenience than of honor. The article misleads the reader by its lead sentence, which at this moment says Alzheimer's disease (AD), also called Alzheimer disease or simply Alzheimer's, is the most common form of dementia. --Una Smith (talk) 15:53, 21 September 2008 (UTC)

AD is not a cause of dementia. It is a presentation of dementia which (apparently :) is associated with plaques and tangles etc. The article lead does a fine job of explaining this. Fvasconcellos (t·c) 15:56, 21 September 2008 (UTC)

Except AD can be diagnosed in the absence of dementia, eg via characteristic early defects in short term memory. --Una Smith (talk) 20:01, 21 September 2008 (UTC)

Una what are you talking about? Defects in short-term memory is a symptom for so many pathologies, that I would waste everyone's time trying to describe it. OrangeMarlin ^{Talk• Contributions} 14:08, 22 September 2008 (UTC)

Okay, for starters, if AD is a "presentation of dementia" then it is also a presentation of psychosis. The lead is tidy but at the price of omissions that I think are important. --Una Smith (talk) 07:28, 26 September 2008 (UTC)

Next, see the lead second paragraph. It is logically inconsistent with the first paragraph. If AD is a form of dementia, how can it be diagnosed (as this article says it often is) in people who are not demented? --Una Smith (talk) 07:32, 26 September 2008 (UTC)

So, why is it wrong to speak of senility, but alright to call someone "demented"? The latter word has nastier overtones, like "spastic", "retard[ed]" and "mongo[loid]", but seems to be the one used.--MacRusgail (talk) 16:00, 21 September 2008 (UTC)

It isn't wrong to speak of senility. In the Diagnostic and Statistical Manual (DSM IV, the "bible" of psychiatry), Alzheimer's disease is called "Senile Dementia/Alzheimer's Type", and abbreviated SDAT. We need to distinguish between "people-speak", in which "senile" and "demented" are derogatory terms, and "scientist-speak", in which they have a precise clinical definition. Looie496 (talk) 16:14, 21 September 2008 (UTC)

In actual fact, it was a doctor who first complained to me that Alzheimer had appropriated the idea! Also, there are many, many cases, in which the names of disorders have been changed to protect people's feelings or to avoid unpleasant associations. Mongoloid -> Down's Syndrome being one example.--MacRusgail (talk) 16:38, 21 September 2008 (UTC)

WP:NOTAFORUM, perhaps this discussion can be taken to editor talk pages. Can we please stay on track with the article, so the page doesn't unnecessarily clutter watchlists? SandyGeorgia (Talk) 16:55, 21 September 2008 (UTC)

Incurable

Hello. Should'nt we say "currently incurable" or "incurable at this time" instead of simply "incurable" ? It's not that important, but it's a hopeful way to put it. Remember that a lot of illness where considered incurable not long ago. —Preceding unsigned comment added by 86.77.21.152 (talk) 21:23, 21 September 2008 (UTC)

Wikipedia can't predict the future. Editors can't predict the future. So we don't use predictive qualifiers like "currently." OrangeMarlin ^{Talk• Contributions} 22:54, 21 September 2008 (UTC)

WP:MOSDATE#Precise language. SandyGeorgia (Talk) 23:11, 21 September 2008 (UTC)

I knew there was a regulation somewhere, I just couldn't find it. OrangeMarlin ^{Talk• Contributions} 23:13, 21 September 2008 (UTC)

Well, if "currently" is to be avoided because it will date quickly, then the current (sic) wording is surely even worse. Looie496 (talk) 23:15, 21 September 2008 (UTC)

Why? It is incurable, and since science doesn't predict the future, we can't say that it will change. Any other verbiage would presume otherwise. OrangeMarlin ^{Talk• Contributions} 23:30, 21 September 2008 (UTC)

You might consider this original research then again maybe not, but if we prevent a disease is that not a cure ?

If Alzheimers is caused by 'a metal' be it copper, aluminum etc in food or water, then we can cure it if we prevent it ?

--Caesar J.B. Squitti: Son of Maryann Rosso and Arthur Natale Squitti (talk) 21:07, 22 September 2008 (UTC)

Predicting the future again. It's not been shown. OrangeMarlin ^{Talk• Contributions} 22:05, 22 September 2008 (UTC)

Alternate wording proposal: "no known cure" — avoids the dilemma of "If it's incurable, why try to find a cure?"LeadSongDog (talk) 22:13, 22 September 2008 (UTC)

The "known" is redundant. The text used to say "for which there is no known cure" and I revised it to say the shorter "incurable". However, I will accept there may be a subtle difference between saying something is "incurable" and "there is no cure". The former does seem to be more a permanent and unchangeable state of affairs, rather than a statement about the current situation. I agree with the above comments that "currently incurable" or "there is currently no cure" would be suggestive of a future change, which may never come. Does anyone else see a difference between "incurable" and "there is no cure", or is it just me? Colin°^Talk 22:35, 22 September 2008 (UTC)

Sorry, but it's not redundant. Think scurvy or rickets. Ignorance of something is a distinct concept from nonexistence. We do not know that there is no extant, obscure cure any more than we know that a cure will be created at some time in the future. We do know that we don't know of an extant cure. That's what we should say.LeadSongDog (talk) 22:48, 22 September 2008 (UTC)

It is right now incurable. We have no indication that it can be cured, despite some promising research. "No known cure" sounds redundant, because it really just replaces "currently" with "no known." What if it is incurable permanently? Using "no known" implies there is a cure, which are the kind of statements that opens the door to a lot of crap being written in the article. This article is a snapshot in time, which is today, and there is no cure. OrangeMarlin ^{Talk• Contributions} 23:48, 22 September 2008 (UTC)

It strikes me as sort of a moot point. The sentence in the lead, "As of 2008, more than 500 clinical trials..." explains the situation so much more clearly than any single word could do that it hardly makes a difference whether an extra word is added. Looie496 (talk) 01:14, 23 September 2008 (UTC)

Maybe this is a matter of cultural expectations, but when I see incurable, I take it that there will never be a cure, not just that there isn't one presently. Incineration is incurable. In all probability, death is incurable. But AD is going to be a solved problem some day, whether it takes a decade or a century. There's no sound reason I know of to say that it's never going to happen.LeadSongDog (talk) 06:45, 23 September 2008 (UTC)

I really do not care which one to put. If anybody feels more comfortable with no known cure is fine for me. As good anyway as incurable... All diseases are incurable until they can be cured, Or is anybody capable of naming a incurable disease which will never for sure be cured? A disease is incurable when there is no known cure, so we are disscussing about synonyms... Clearly toooooooooooooo much has been written for such a silly discussion.--Garrondo (talk) 07:42, 23 September 2008 (UTC)

Consider the perspective of a young reader who knows (s)he has a family history of early onset. To that reader the difference is not at all trivial. It represents hope. Looie's observation is valid, though. With that close juxtaposition in the lead, it's clear enough.LeadSongDog (talk) 16:07, 23 September 2008 (UTC)

But hope is not very encyclopedic. We cannot write about hope...just about what can be verified. But if you do read the treatments section, there really is hope. OrangeMarlin ^{Talk• Contributions} 21:21, 24 September 2008 (UTC)

Alzheimer's name

There's been some back-and-forth on the umlaut in Alois. PMID 17941340 uses it, as does this article (PMID 18556270) but clearly most of the papers over the past century have omitted it, perhaps reflecting editorial policies on the use of diacritic marks in different journals. LeadSongDog (talk) 21:21, 28 September 2008 (UTC)

It's a little more general than that. It's the same typographical convention as for naïve vs. naive, ie to point out that the two vowels are pronounced separately and don't form a diphthong. It is not a German umlaut, it is an English diaeresis. Modern practice is to not use an typographical indication for the diaeresis in English (see the "naive" example above), although this was much more common in the past – I have a photocopy of a 1953 paper which deals with "coördination chemistry", for example. Hope this helps. Physchim62 (talk) 22:37, 30 September 2008 (UTC)

To clarify, the name is pronounced "ah-lo-ISS" and not "ah-LOYSS", and there is no need for a diacritic in German to indicate this. Physchim62 (talk) 22:49, 30 September 2008 (UTC)

Wow, I actually never knew that. So in Germany, his name is spelled Alois? I vote we remove the diaeresis marks then. OrangeMarlin ^{Talk• Contributions} 23:25, 30 September 2008 (UTC)

It's amazing what you can learn on Wikipedia! For the German spelling, why not check against de:Alois Alzheimer? Note that, in French, the diaeresis mark is obligatory, as can be seen on their article fr:Aloïs Alzheimer (otherwise, the French pronunciation would be ahl-WAH, ie completely wrong). This might also be a secondary source of the use of the diaeresis in older English-language publications. It wouldn't make it correct though! Physchim62 (talk) 23:58, 30 September 2008 (UTC)

Interesting... Lets remove them then. :-) --Garrondo (talk) 07:24, 1 October 2008 (UTC)

Thanks for clearing that up, Physchim62. Agreed. They should go.LeadSongDog (talk) 07:27, 1 October 2008 (UTC)

Unless you are writing an article for The New Yorker. ;-) --Itub (talk) 11:36, 1 October 2008 (UTC)

Y doneLeadSongDog (talk) 19:30, 1 October 2008 (UTC)

Opinion please

Does this and the cited paper have a place in the article? Sakurai T; et al. (2008). J. Cell Bio. doi:10.1083/jcb.200804075. {{cite journal}}: Explicit use of et al. in: |author= (help); Missing or empty |title= (help) Related: PMID 18378702, PMID 17472586 LeadSongDog (talk) 16:44, 20 October 2008 (UTC)

Too much specific? Not really sure what to do with it.--Garrondo (talk) 16:49, 20 October 2008 (UTC)

I have to agree. Kind of specific, but maybe it should go to Biochemistry of Alzheimer's disease? OrangeMarlin ^{Talk• Contributions} 17:51, 20 October 2008 (UTC)

Thanks, will do. Updated info on the cite:

Takashi Sakurai, Kumi Kaneko, Misako Okuno, Koji Wada, Taku Kashiyama, Hideaki Shimizu, Takumi Akagi, Tsutomu Hashikawa, and Nobuyuki Nukina (2008-10-20). "Membrane microdomain switching: a regulatory mechanism of amyloid precursor protein processing". The Journal of Cell Biology. 183 (2): 339–361. doi:10.1083/jcb.200804075. ISSN 0021-9525.{{cite journal}}: CS1 maint: multiple names: authors list (link) Related: PMID 18378702, PMID 17472586

Sorry, but it probably doesn't belong anywhere yet. That's a primary source and a news report of the sort that is usually written from a press release. Until this is covered by good secondary sources (review articles, "perspective" pieces, etc), it shouldn't be used by Wikipedia unless absolutely necessary. Looie496 (talk) 21:02, 20 October 2008 (UTC)

Update "Causes" ?

I've seen recent articles, such as one in Nature, that *basically* say (not a direct quote) "...although most scientists now agree on the cause of Alzheimer's, little progress has been made in treatment". This was just in the abstract, and I'm not someone who is very knowledgeable or interested in Alzheimer's, but it makes me question if this Wiki page is up-to-date and reflects the true sentiment in current peer-reviewed scientific journals. From the headlines and abstracts I get exposed to, much of the recent literature would seem to indicate that one particular theory as to the cause of this disease has become widely accepted over others. -JRP

And it says it in the article. OrangeMarlin ^{Talk• Contributions} 22:41, 19 November 2008 (UTC)

One needs to be a bit careful -- there are causes and then there are causes. There is pretty wide agreement that amyloid accumulation is at the heart of the matter. But what causes the amyloid to accumulate in any given individual? There is much less understanding of that. I think Aristotle would say this is a distinction between proximal cause and final cause, or something like that. looie496 (talk) 23:05, 19 November 2008 (UTC)

Alzheimer's and age

I read an article in today's Wall Street Journal about a former hedge fund manager in his 40s who was diagnosed with Alzheimer's disease. [1] There didn't seem to be enough discussion of age and how the onset of the disease can come as early as mid 30s for a small percentage of the population. I'm not sure how I should incorporate this into the article though. Any suggestions? --Jencat385 (talk) 09:56, 14 November 2008 (UTC)

Since early cases are the exception it was decided only to include the following sentence: While the rare, early-onset form of Alzheimer's disease is mainly explained by mutations in three genes, the most common form has yet to be explained by a purely genetic model. However early onset AD has its own article which can be greatly improved as long as reliable medical sources are used. Best regards. --Garrondo (talk) 11:49, 14 November 2008 (UTC)

I'm catching up on this talk page, and I just read the WSJ article. I think it freaked me out beyond belief, because that could be me. It's interesting that he retains skills with numbers. I need to find out more about that, because I find it fascinating. OrangeMarlin ^{Talk• Contributions} 23:30, 3 December 2008 (UTC)

An Alzheimer's / Parkinson's spectrum of opposites?

Is Alzheimer's mutually exclusive with Parkinson's disease due to their relation to the dopamine system and how some of their mechanisms are even seen to be treated/react to medications that work on such a system respectively? 4.242.195.89 (talk) 02:47, 2 December 2008 (UTC)

A quick Google-Scholar search shows that the two are not mutually exclusive. Anyway Alzheimer's doesn't really have a very strong association with the dopamine system to my knowledge -- the cholinergic system is implicated more strongly. Looie496 (talk) 17:24, 2 December 2008 (UTC)

Sleep apnea

This lay article discussing a paper in November's Journal of the American Geriatric Society by Sonia Ancoli-Israel et al. examines the use of CPAP machines to treat sleep apnea common in AD. It would seem on its face to be of interest to readers of the article. LeadSongDog (talk) 22:47, 3 December 2008 (UTC)

CPAP is relatively common treatment for sleep apnea, so I'm not sure how much it would add to this article, unless sleep apnea is a common pathology for AD patients. OrangeMarlin ^{Talk• Contributions} 23:24, 3 December 2008 (UTC)

From the physorg article "The prevalence of [obstructive sleep apnea] in patients with dementia has been estimated to be as high as 70 to 80 percent." Apnea impairs sleep. Tired people don't function as well. Doesn't seem like a big reach.LeadSongDog (talk) 05:26, 7 December 2008 (UTC)

Research directions

We might want to do some updates with the Research Directions section.

The clinical trial for MPC-7869 ended in June with negative results. I cleaned it off of the page. See ICAD 2008: Alzheimer's Association International Conference on Alzheimer's Disease, Presentation title: Safety and Efficacy of Tarenflurbil in Subjects With Mild Alzheimer's Disease: Results From an 18-Month Multi-Center Phase 3 Trial. Presented July 29, 2008. The complete trial results have not yet been published in a peer-reviewed journal.

If ACC-001 is not actively seeking patients, we might rewrite things to reflect the two most advanced programs--bapineuzumab and LY450139 which are both actively enrolling. As a Phase 3 compound, I would promote Dimebon and then put a hold on mentioning any of the others unless PBT-2 starts a Phase 3. --Chrispounds (talk) 00:27, 7 December 2008 (UTC)

Ibuprofen

"In some studies, ibuprofen showed superior results compared to placebo in the prophylaxis of Alzheimer's disease, when given in low doses over a long time."

http://en.wikipedia.org/wiki/Ibuprofen —Preceding unsigned comment added by 217.229.55.213 (talk) 22:23, 8 December 2008 (UTC)

We'll have to clean the cruft out of that article. OrangeMarlin ^{Talk• Contributions} 22:53, 8 December 2008 (UTC)

It's not exactly cruft. As that article says, this is not something that should be recommended to patients, but there is quite a massive high-quality literature on the topic. Looie496 (talk) 20:52, 9 December 2008 (UTC)

Herpes Virus

Could someone more knowledgeable than myself please look into this: http://www3.interscience.wiley.com/journal/121411445/abstract?CRETRY=1&SRETRY=0 --68.179.32.90 (talk) 20:13, 9 December 2008 (UTC)

That's very interesting, but it's a primary source, meaning that Wikipedia articles should avoid using it until it gets attention in secondary sources such as literature reviews or commentaries. Unfortunately, there are hundreds of really interesting things published each year that end up not panning out, and the only way to keep Wikipedia articles stable is to avoid jumping on new things until they have been validated to some degree. Our aim should be to get things right, not necessarily to be the earliest. Looie496 (talk) 20:35, 9 December 2008 (UTC)

I got there from here http://www.newscientist.com/article/dn16234-cold-sore-virus-might-cause-alzheimers.html?DCMP=OTC-rss&nsref=online-news Thought the source would be better. My grandfather died of alzheimer's. My mother is 56 and becoming forgetful. She gets cold sores, as do I. I have emotions tainting my objectivity and this article gives me both worry and hope.

--68.179.32.90 (talk) 21:03, 9 December 2008 (UTC)

Most of the things in New Scientist are written from press releases, so it doesn't count as a source. It's reasonable to be impatient, but the HSV1 hypothesis has been around for a couple of decades, and has only gotten limited support so far. Maybe this new study is the magic result that will win the day, but we'll just have to give the experts a chance to look at it and give us their opinions. One thing to think about is that whatever happens with Alzheimer's happens slowly, so a couple of months one way or another is hardly likely to make a difference. Looie496 (talk) 22:01, 9 December 2008 (UTC)

I can't say that makes much sense to me. Many publications are written from press releases. That doesn't preclude doing fact checks. Is there some reason to believe that NS fails to do due diligence?LeadSongDog (talk) 20:01, 14 December 2008 (UTC)

There are two kinds of articles in NS. There are long articles that are serious journalism and presumably involve fact-checking, though one should realize that the authors are reporters rather than scientists. But there are also lots of short "pointer" articles that basically just say "here's a cool thing that just came out" and don't involve any fact-checking whatsoever. Same story for Science Daily. Looie496 (talk) 20:48, 14 December 2008 (UTC)

Lewy body dementia predicted by sleep disorder?

See PMID 19109537 for recent publication.LeadSongDog (talk) 21:56, 26 December 2008 (UTC)

Yes, in about fifty percent of cases, LB Dementia is associated with REM Sleep Disorder. Ref. alzheimer's association http://www.alz.org/alzheimers_disease_dementia_with_lewy_bodies.asp

--Mainak (talk) 18:38, 27 December 2008 (UTC) Mainak

Interesting, however I will not add any mention in this article for two reasons: 1-is a primary source not suitable for a featured article, 2-it says it specially predicts lewy bodies dementia and parkinson, not AD dementia. Best regards --Garrondo (talk) 11:11, 29 December 2008 (UTC)

But, Garrondo, did you not enquire specifically about L B Dementia? Warm regards, Mainak (talk) 19:14, 29 December 2008

No. It was not me, and sorry: I thought that the info provided was intented to be included in the article: never mind. Bests. --Garrondo (talk) 15:24, 30 December 2008 (UTC)

ApoD

A recent result in knockout mice:

• "A protein that protects against Alzheimer's?". 6 January 2009.
• Ganfornina MD, Do Carmo S, Lora JM, Torres-Schumann S, Vogel M, Allhorn M, González C, Bastiani MJ, Rassart E, Sanchez D. (2008). "Apolipoprotein D is involved in the mechanisms regulating protection from oxidative stress". Aging Cell. 7 (4): 506–515. doi:10.1111/j.1474-9726.2008.00395.x. PMID 18419796. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Do Carmo S, Jacomy H, Talbot PJ, Rassart E (8 October 2008). "Neuroprotective Effect of Apolipoprotein D against Human Coronavirus OC43-Induced Encephalitis in Mice". Journal of Neuroscience. 28: 10330–10338. doi:10.1523/JNEUROSCI.2644-08.2008. PMID 18842892.{{cite journal}}: CS1 maint: multiple names: authors list (link)

Suited for the article?LeadSongDog (talk) 21:48, 6 January 2009 (UTC)

Mice, Apple Juice, and Alzheimer's

In January 2009, it was widely reported that mice given apple juice were less likely to suffer from alzheimer's than mice than were not given apple juice. I added some sentences reporting this fact, including a reference link: www.naturalnews.com/025344.html Not only were the sentences removed, but, I got a message saying that Wikepedia did not want anything that amounts to "original research", whatever that means. There is nothing in the article on alzheimer's that metions the Proven fact that mice given apple juice are less likely to suffer than mice not given apple juice. Go to Goggle.com, put in the search block: mice appple juice alzheimer's . There will be plenty of hits, including the one I used. Don't you want people to know that drinking apple juice might help to prevent alzheimer's? What is the problem with reporting the latest scientific study that shows giving mice apple juice might help to prevent the illness?204.80.61.110 (talk) 20:29, 23 January 2009 (UTC)Bennett Turk

I'm not the one who removed your cited paragraph, but only because someone beat me to it. The problems were (1) it's not 'reporting the latest scientific study' when neither the study, the publication, nor the researchers were actually named—this does not meet WP:Verifiability; and (2) the source you cited did not state that a study concluded that 'mice given apple juice were less likely to suffer from alzheimer's' - it stated that a study of 'mice with alzheimers' (emphasis mine) found that 'they exhibited improved cognitive performance and their brain tissue appeared to be protected from oxidative damage'. If you can provide any links to the actual studies, it would be a great starting point. Maralia (talk) 20:36, 23 January 2009 (UTC)

It's at doi:10.1111/j.1750-3841.2007.00632.x for what it's worth.LeadSongDog (talk) 20:39, 23 January 2009 (UTC)

That's not a very good source because going from metabolic effects in cell culture to a human disease is a huge leap. However there is substantial high-quality recent literature concerning antioxidant treatments with the aim of preventing or delaying dementia, including this and this. The thrust seems to be that there are some promising indications but no conclusive evidence so far. A brief mention in the Research Directions section might be appropriate. Looie496 (talk) 20:52, 23 January 2009 (UTC)

Here is another link about mice, apple juice and alzheimer's. http://www.webmd.com/brain/news/20060804/apple-juice-boost-memory I think telling people about the latest findings that drinking apple juice might help to prevent alzheimer's can have much more positive than negative results. Suggesting people drink inexpensive apple juice will probably harm no one and could prevent many from getting the illness. Is it being suggested that Wikipedia wait several years until humans are tested to include apple juice in the article?204.80.61.110 (talk) 21:51, 23 January 2009 (UTC)Bennett Turk

Yes, reading "The study was funded by an unrestricted grant from the U.S. Apple Association and the Apple Products Research & Education Council" does fill one with confidence, doesn't it... Really all Shea has said is that malnourished mice do better if some of the missing nutrients are replaced. That's hardly earth-shattering.LeadSongDog (talk) 22:23, 23 January 2009 (UTC)

Hey, I have nothing against apples. In fact, if american kid ate one instead of a bag of potato chips, I'd single handedly eliminate Type II diabetes. But there is no evidence that it prevents, cures, or otherwise effects the course of AD. But, I'd still recommend eating apples over said chips (or crisps for those of you in the UK). OrangeMarlin ^{Talk• Contributions} 22:36, 23 January 2009 (UTC)

(ec) It's being suggested that Wikipedia place its reliance for discussions of disease treatments on review articles in good medical journals, or on advisories from government agencies or other authorities. That's the only way to keep Wikipedia articles from turning into lists of fad treatments. New ones pop up every week or so: next week it will be grapefruit juice, or broccoli, or hot-tubbing. (To LeadSongDog: the rationale is really based on antioxidants, not nutrition per se, and it's plausible but needs a lot more support.) Looie496 (talk) 22:38, 23 January 2009 (UTC)

"Collateral history from relatives"

- does this mean "the history of the patient that relatives provide" or the history of relatives themselves (possible affection by AD)? I'm translating the article into Russian now and is unsure about this one bit. Thanx in advance, --CopperKettle 14:04, 24 January 2009 (UTC)

Another phrase seems ambiguous:

"These criteria require that the presence of cognitive impairment, and a suspected dementia syndrome, be confirmed by neuropsychological testing for a clinical diagnosis of possible or probable AD. "

--CopperKettle 16:14, 24 January 2009 (UTC)

• Another one: what are the "constructive abilities"? --CopperKettle 16:59, 24 January 2009 (UTC)

First of all thanks for translating the article into russian... I am one of the people that helped to take the article to FA status and it feels great to know that it is of help and it is being translated into other languages. Regarding your doubts: Collateral history from relatives meant "the history of the patient that relatives provide" but as you say, history of relatives themselves is also rutineously asked to know if somebody also suffered the disease. These criteria require that the presence of cognitive impairment, and a suspected dementia syndrome, be confirmed by neuropsychological testing for a clinical diagnosis of possible or probable AD.: These criteria classify Ad between possible and probable (definitive in these criteria is only used after pathologic assessment after death). To give the possible or probable AD diagnosis there has to be cognitive impairment, and in these criteria the stated tool to search for such cognitive impairment are neuropsychological tests. When talking about constructive abilities it is meant the capabilities that permit the integration of complex motor abilities: example of a early lost of such capabilities is the difficulties writting, and a later one would be the inability of the patient to dress on its own. Any other doubts just ask. Best regards. --Garrondo (talk) 08:33, 26 January 2009 (UTC)

"feels great to know that it is of help and it is being translated into other languages" - yes, its feel great that the knowledge once formulated could be spread into other languages, in other cultures! Each Featured article is a great gift to all Wikipedias! --CopperKettle 18:19, 29 January 2009 (UTC)

Thank you for the reply, Garrondo! --CopperKettle 10:24, 26 January 2009 (UTC)

• An easy one: " may have important secondary effects" - probably harmful side-effects? --CopperKettle 10:24, 26 January 2009 (UTC)

Sounds perfect.--Garrondo (talk) 10:53, 26 January 2009 (UTC)

• "The combination of memantine and donepezil has been shown to be "of statistically significant but clinically marginal effectiveness" - at the end of the "glutamate-memantine" paragraph that earlier says memantine is "moderately efficacios". So the reader may have to wonder whether it is effective \ marginally effective \ effective by itself, but only marginally when combined with donepezil. --CopperKettle 18:41, 26 January 2009 (UTC)

I would have to reread the original refs; since I am not sure now; but I would say that it could make sense if the clinically marginal effect is when compared with their separately effects. I'll try to take a look and say you something.--Garrondo (talk) 08:30, 27 January 2009 (UTC)

• "The placing of safety locks" = child safety locks or just locks? --CopperKettle 20:40, 27 January 2009 (UTC)

I did not know child safety locks existed... I suppose any lock would be of use as long as it works.--Garrondo (talk) 09:09, 28 January 2009 (UTC)

• "the labelling of household items to cue the person with the disease or the use of modified daily life objects." - ? Modyfiable? Or some new objects? --CopperKettle 20:43, 27 January 2009 (UTC)

Could be both; but mostly new specific ones: An example would be clothes with velcro instead of buttons for an easier dressing. This clothes can be modified from old ones or bought.--Garrondo (talk) 09:09, 28 January 2009 (UTC)

• "In such cases, the medical efficacy and ethics of continuing feeding is an important consideration of the caregivers and family members.[162][163]" - either this means "we wonder how long to feed until the person is satiated, because he cannot say himself" or "when to stop feed and leave the person to die". 0_o --CopperKettle 21:27, 27 January 2009 (UTC)

Second one. Quantities I suppose are standard.--Garrondo (talk) 09:09, 28 January 2009 (UTC)

• "Dementia, and specifically Alzheimer's disease, may be among the most costly diseases for society in the developed countries,[17][18] while their cost in developing countries such as Argentina,[182] or developed South Korea,[183] is also high and rising." - The cost is high in developed countries, but also in developing or developed. IMHO, that baffles a little and could be re-phrased somehow. --CopperKettle 17:35, 28 January 2009 (UTC)

I have rephrased it a bit, not saying the word "developed".--Garrondo (talk) 08:07, 29 January 2009 (UTC)

Thank you one more time, Garrondo! Translation's finished. (0: --CopperKettle 17:43, 29 January 2009 (UTC)

I do not understand a word but looks great. :-) As a minor comment unless you plan to translate also the subarticles I would eliminate the red links at the beginning of the sections (See also, further...). GOOD WORK. --Garrondo (talk) 08:58, 30 January 2009 (UTC)

• P.S. The Russian article is a GA candidate now, and one question was presented. They quote two parts:

  "Finally comes death, usually caused directly by some external factor such as pressure ulcers or pneumonia, not by the disease itself.[48][49]"

  and

  и "The disease is the underlying cause of death in 70% of all cases"

  and are asking where is the line dividing causes linked to AD from the causes in the other 30% of cases. --CopperKettle 17:11, 1 February 2009 (UTC)

Congrats on the good article thing. I have taken a look at the refs, but I do not have access to the article on the 70%, son I can not be of help, I do not exactly know how did they mark the line... Nevertheless both sentences mean the same: AD does not directly cause any deaths, and at the same time it causes most of them. It is not as a heart attack that directly kills you; but it gives some symptoms such as oral mobility problems that increase your death risk and in the long term would probably kill you; and are these symptoms which indirectly cause death in 70% of the cases.--Garrondo (talk) 09:19, 3 February 2009 (UTC)