Alzheimer’s: don’t trust preconceived ideas
Is the quality of life of people affected by Alzheimer’s disease as mediocre as is often imagined? A study carried out by Pierre Missotten, a psychology researcher at the University of Liège, suggests that people with dementia are capable of maintaining an acceptable level of quality of life. These results clash with the often calamitous view society attaches to the pathology of dementia. This is reflected through the categorisation of people with dementia amongst the most marginalised and stigmatised group in society (1). This very negative view can accentuate the risk of ending up with certain mistaken paths being taken. Nonetheless, as Pierre Missotten states, steps forward are currently being taken in how a person affected by dementia is considered, now more seen as a subject rather than an object. These advances are reflected through various notions such as person centred care, those of personality and citizenship or adaptation, through theories of ageing being managed well and coping strategies.
Quality of life, comfort, well-being, satisfaction, etc. All terms regularly used in an interchangeable manner in the media and scientific research. Yet, if these different terms constitute important notions linked to the global concept of quality of life, each one has its own specificity. Their interchangeabilty is in particular explained by the absence of a consensus definition of the concept of the quality of life. In effect, if everyone is talking about quality of life, nobody agrees on a universal definition. Where some specialists privilege an ‘objective’ approach (mental/physical health, level of education, income, etc.), others feel that subjective criteria should be more used as a basis (satisfaction, objectives, happiness, etc.). ‘No consensus exists,’ sums up Pierre Missotten. ‘Definitions are pretty rarely set out explicitly and vary from one author to another. Certain of them are general (e.g. the W.H.O.’s definition (5)), some spring from the gerontological literature (e.g. Lawton’s definition (6)), others are specific to the pathology of dementia (e.g. the definition offered by Lyketsos and his colleagues). For my part, I think it is important to consider quality of life in terms of a person’s goals and expectations.’
(1) Graham, N., Lindesay, J., Katona, C., Bertolote, J. M., Camus, V., Copeland, J. R., et al. (2003). Reducing stigma and discrimination against older people with mental disorders: a technical consensus statement. Int J Geriatr Psychiatry, 18(8), 670-678.