Helen Martin: Is ignorance bliss when it comes to dementia?

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THE news that it’s now possible to pick up early warning signs of a certain type of Alzheimers as much as 25 years before the first symptoms appear, is a boost for science.

The tests, involving brain scans and spinal fluid, are being hailed as a great breakthrough which will allow us to learn more about the origins of the disease, have more time for drug trials and a better chance of slowing down the devastating progression.

So far, so good. The question is, do we really want to know — in our 30s and 40s — what lies in store, and that the fickle finger of demented fate is pointing directly at us?

Would I want to live for decades with the knowledge that the markers were already there, hard-wired into my DNA? Would I want to know that when I reached the next stage — little deposits or plaques forming in my brain — I had about 15 years to go before my memory began to fail and confusion set in?

Of course, having the ability to alter genetic predisposition is one of the great hopes of banishing everything from asthma to cancer.

In that sense we are all walking time bombs. But it’s knowing what disease is liable to get us — and in this case, when — that makes the difference between living in blissful ignorance and living in fear. My mother may have been aware that vascular dementia was taking hold of her, especially as she was a nurse. But she may not — and she never mentioned it. Since the condition has developed to the point where she is now totally dependant on nursing care, I have often thought about whether dementia is a bad or — wait for it — a good thing.

So often it is referred to as a terrible or cruel disease that turns able, talented and even eminent people into shadows of themselves with no or little memory, while robbing them of even the basics such as speech and continence.

On the other hand, I look at Mum (around 88 when symptoms began seriously, and 94 now) and feel grateful that she isn’t even aware of these afflictions, some of which might have come about anyway with old age or other illnesses. She doesn’t remember her brothers or sisters, let alone that out of eight siblings, only two others are still alive. She doesn’t remember me either, other than to occasionally believe I am her mother. She doesn’t recognise a picture of her mother.

How would she feel, if she had all her faculties, knowing that she had to be toileted, cleaned, dressed and fed by others, however caring they are, let alone that she was unable to recognise her own parents or children?

She was once sad to leave, and worried about, her house.

I don’t think she has completely forgotten about it; there are still moments when she seems to acknowledge the past, but as if it’s on another plane . . . there, but not there, and of no real substance or concern.

In general, she appears quite happy — albeit with short periods of agitation she cannot explain. Of course it is sad — for me and other relatives. But she seems cushioned from reality and protected from any real worry or sadness.

Having unlearned anything she ever learned, she has almost returned to a state akin to babyhood.

Terrible? Cruel? Only if she had been able at 40 to look in a crystal ball and see her elderly future.

Maybe dementia, senile dementia at any rate, is as much a blessing as a curse. Scientists must continue their quest for cures, particularly for those younger sufferers with premature onset.

But life is for living. Knowing when and how we might die or what diseases we might — or might not — endure along the way, is a recipe for madness.

Manners should do

MY fears have come to pass. New regulations for landlords of multiple occupancy flats in Edinburgh state that first floors and above must have carpets to protect neighbours from noise. But that’s where it stops. It does not extend to owner-occupiers, or families — and it should.

I fail to understand why four young professionals renting a flat would be more of a nuisance than a noisy family. I once lived below someone whose hobby appeared to be dragging heavy furniture around their polished floorboards so I know the feeling.

Regulation shouldn’t be necessary for anyone.

Simple consideration should make it obvious that if someone’s living below you, a hard or stripped floor is a no-no, as are unnegotiated parties, or hammering early on a Sunday morning.

Still, in the absence of manners there may yet be a queue to buy flats under HMOs, where at least carpets deaden the pain.