Man Unknowingly Drives 3 Miles with Half a Body Through His Windshield (1 Viewer)

[Dome Vongvises]

Never heard of it that way. I've always thought that Alzheimer's leads to dementia much in the same way HIV infections can lead to AIDS.

 

[Linda Thompson]

From snopes.com (includes this news item, plus other similar, documented cases):

http://www.snopes.com/horrors/gruesome/bargrill.asp

 

[andrew markworthy]

A feature of the illness can be that well-rehearsed skills can be preserved very late into the illness. E.g. a surprisingly high proportion of demented patients can read fluently and with expression, even though they cannot remember a word of what they've read a couple of minutes later. Thus, being able to drive and recognise road signs may not be all that unusual. But anything out of the ordinary may lead to abberrant reactions (simply because there isn't a well-rehearsed response to fall back on and the capacity to initiate a new response has decayed to the point of uselessness). There was a case in the UK a few years ago of an elderly man with dementia who leaving a gas station knocked over a woman walking to the kiosk to pay for her fuel. His reason for doing this? There usually wasn't anyone in his way.

This is why someone with dementia shouldn't drive - they cannot handle the unpredictable, and as we all know, it's the unpredictable which tends to cause accidents.

 

[Dome Vongvises]

Thanks andrew. Wasn't there something about beta amyloid plaques as one of the causes of alzheimer's?

 

[andrew markworthy]

Yes and no ... We know that plaques are associated with Alzheimer's (for the uninitiated, plaques = clumps of dead brain cells). But:

(1) plaques are probably a symptom of the problem rather than the initial cause (rather like blood stains might show there's been a stabbing)
(2) although plaque density is strongly correlated with psyhcological symptoms, the correlation isn't perfect
(3) a lot of non-dementing people get plaques. They are fewer in number than in Alzheimer's but it can't just be plaques in and of themselves that cause the illness.

However, every time I pick up an academic journal, another paper arguing the case either for or against plaques seems to be there. So I think the best answer is that the jury is out.

 

[Adam Lenhardt]

I was being morbidly tongue-in-cheek, but your explanation was actually very enlightening! Thanks for sharing.

 

[David Brown Eyes]

We do not let 10 year olds drive. And here in Colorado they are enacting more and more legislation restricting teen driving.

Driving is a privilage and not a right in this country. People young or old who do not have the capacity to operate a vehicle safely should NOT be allowed behind the wheel.

 

[PhillJones]

That's not really true anymore. We've pretty much honed in on the cause being a protein called Amyloid-beta, formed by the cleaving of Amyloid precursor protein that agregates and forms senile plaques in the parenchyma. These plaques cause dendrites to become dystrophic and reduce dendritic spine motility and formation. At the same time, a protein known as tau, forms 'tangles' inside neurons and causes them to apoptote.

Clearing the plaques with immunotherapy recovers behavioural deficits in mouse models of AD and the first human trial was successful in clearing plaques but caused swelling and early mortality in some patients so the trial was stopped.

There's a lot more, we know many of the genetic risk factors for it and reasons why it progresses faster in some people than in others. It's definatley a single disease with a discrete pathology although many people with AD also develop Cerebral amyloid angiopathy and/or have strokes.

While we don't quite have all the details, we have a better understanding of AD than we have of cancer.

http://adams.mgh.harvard.edu/cagn/ad.htm#6

One final point, dementia rates are rapidly rising as the population ages. I'm not sure if my figure is exactly right so don't flame me but it's something like 60% in people over 90 although late onset is generally associated with slow progression so a lot of very elderly people have 'a touch of Alzheimer's', die of something else entirely and have the diagnosis confirmed at autopsy.

I'm a bio-physicist with the Massachussetts Institute for Neurodegenerative Disorders.

 

[andrew markworthy]

Not sure about this. I agree that classical AD is a unitary phenomenon and that vascular problems may be a smokescreen. However, I think there are still significant groups with variants who currently get labelled as having 'AD' because we lack the diagnostic criteria to label them as anything else (don't you just love diagnosis by default?).

However, good luck with the research. I worked on testing AD patients for a couple of years, mapping out the behaviours and how they related to brain lesion sites. I eventually deserted the field for 'normal' ageing because I found it so frustrating. I honestly believe that the solution to the problem will come at the level you are working at.

 

[PhillJones]

I absolutely agree, that's why we have developed sophisticated cognitive tests, biomarkers and contrast agents. Of course, the estimates of number of affected people are a bit of a guess but the techniques used are a little more sophisticated than a naive head-count of number of diagnosed cases. Pathology data is used to estimate the 'hit rate' of diagnoses, there are also experimetnts using PET techniques and so on to guage the real number of cases and even the most conservative estimates are truelly shocking.

I understand you frustration over things like the Cholinesterase inhibitors and the immunoglobulin study but there's a big difference between throwing the first compound remotely related to a symptom in the vague hope it'lll help and the present structured effort to understand the basic pathology of the disease. I took issue with your statement that nobody know what causes AD to mean that we don't know what the basic pathology is and that isn't fair. We know that it is a 3 pronged attack 1) Tauopathy 2) Plaques 3) cell death. There may be an underlying link, and we're actually pretty close to that as well. Which make AD probably the best understood of the sporadic neurodegenerative diseases. However, understanding is not curing and therein lies the real problem.

 

[Mike Frezon]

Its just amazing the conversations you find here at the HTF.

 

[andrew markworthy]

I could talk about my stamp collection ...

Where's everyone gone?

[sound of coyote howling in wilderness]

 

[MickeS]

Where do you live? In the US, it's a privilege in name only. The fact that my driver's license expires in 2035 just proves it... completely ridiculous. There should be mandatory driving tests at least every 10-15 years or so, if they really want to call it a privilege.

 

[MarkHastings]

MickeS, you lost me...How come your license expires in 30 years??? I agree with that. Why do licenses expire if it only takes a trip down to the DMV to renew it? There should either be more to the renewal process or they shouldn't have expiration dates.

 

[MickeS]

I don't get that either.

 

[MarkHastings]

SERIOUSLY?? Damn! We have to do it every 4 years. and again, there's no testing involved, it's just a matter of renewing your photo.

I guess they don't care how crappy your driving skills deteriorate, all they care is that you still have a face.

 

[Sami Kallio]

My TX DL would have expired today, on my 34th birthday. Of course, I renewed it online so it's just a way for the DMV to generate income. I believe I got it in 1999.

 

[Dome Vongvises]

Is there some online literature or abstract I can read where I don't have to be a member of a scientific society? I've vaguely heard of the tau protein, and I'm curious to learn about the amyloid protiens as well. I'm not a researcher per se, but I'm involved in a research lab, and this kind of stuff fascinates me on an intellectual/Gary Larson level.

 

[PhillJones]

No need to apologize. Argueing about stuff is what the Internet's for. Well, that and porn.

Back to the point of the thread.

I think they should more readily take licenses away. Like my Dad told me when I was 12, if you abuse trust, you loose it. Like repeat offendor DWIs or reckless driving, instead of just having licences revoked for a while, offenders should have to retake thier tests. If they do it repeatedly, they should be banned for life.

The 10-15 year retake or at least a competancy test is a pretty good idea too. I remmeber there was a big debate about this back home in Britain a few year back. The BBC had neurological deficit exams done on a bunch of drivers. Obviously, they sensationalized it but they found one old dear who's had a stroke some time ago and had been driving arround with left side neglect for some time and didn't even know.

 

[David Brown Eyes]

Mike, chill, we are on the same side here dude. I would have no problem being tested every 10 - 15 years or more like every 5 years.

People in this nation, no matter what age, treat driving as some "right" and it is not.