Joan Bakewell: Alzheimer's research can no longer be sidelined

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It's good news for Terry Pratchett, Britain's highest-profile Alzheimer's sufferer. Alzheimer's syndrome is a disease of old age that could lie in wait for any of us and sometimes ambushes those who think of themselves as merely middle aged. Terry Pratchett is 59. The good news is that research is showing that cannabis slows down memory loss. The recent report from the Hebrew University of Jerusalem, has involved mice, but is now moving towards human trials.

This won't come as a surprise to America's Drug Watch Oregon, whose Marijuana Research Review has been publishing for decades the many investigations and tests going forward on marijuana. With 400 chemicals present in the plant it's hardly surprising it has diverse, sometimes contradictory, effects. Many of the Review's findings have come with substantial warnings that the ever-stronger forms of the drug common in the 1990s, carry a whole variety of risks: adverse effect on the immune system; interference with the capacity to control body heat; short-term memory loss; and an impaired ability to learn.

Reports also found that smoking marijuana enhanced abnormalities in some multiple sclerosis patients. So this latest news is by no means a call to return to the weed by those for whom 50 years ago it was simply part of a free-wheeling lifestyle. There is an irony, though, in the thought that those same independent spirits now in their sixties may be needing it for an altogether more serious condition.

The fact is the Oregon Health Division has just expanded the state's medical programme by adding Alzheimer's disease to those conditions that qualify for state-sanctioned marijuana use. Their 1998 initiative already allows it in cases of cancer, glaucoma, HIV/Aids, severe nausea, seizures, and persistent muscle spasms.

But Oregon is not expecting a rush. A representative from among Oregon's 60,000 Alzheimer's patients calls for "an extensive scientific study... to examine both positive and negative effects". "That clearly has not happened yet, and we really cannot endorse it at this point," he said. The good news for Terry Pratchett is that work is going forward steadily to find a treatment.

For me, the fear of losing my memory is even more haunting than the prospect of death. The older I get the more I realise I am defined by all that I have done and known, and when memories begin to thin out, something intrinsic to my sense of identity goes too. We can't recall everything that's happened: the brain would choke on its own superabundance.

And there is no doubt some peace of mind to be gained in repressing traumatic and damaging occasions. I have always been suspicious of those talking cures that insist on retrieving long-dormant pain and suffering. But old age is made up of memories and living with them is saner than living without them.

I sat with friends recently thumbing through old photograph albums in which we all figured. Each of us remembered different faces and circumstances. Each had forgotten different things. That is part of being old. And incidentally the final use for all those accumulating heaps of old snaps. Forgetfulness shades only gradually into memory-loss. The daily trivia begins to recur more often: where did we leave the keys, what did I come upstairs to fetch, have I told this anecdote to you before? Long before... or half an hour ago?

So worry creeps up on us, wondering how soon to ask the doctor, go for tests. The British are more reticent than the Germans who apparently turn up early and are put on appropriate drugs sooner. Old people fear making a fuss, and are so often treated with casual disregard by society that they simply shut up and put up. This won't do any longer.

The government spends on Alzheimer's research a mere 3 per cent of what it spends on cancer. Given the demographic trends that predict a steady rise in the proportions of us over 50, Alzheimer's deserves a higher priority. Pratchett has been afflicted for two and a half years: he has just finished his latest novel and begun the next. He believes that in future a combination of lifestyle and drugs may hold back the development of his Alzheimer's into the seriously disabling dementia we all fear.

Alzheimer's is a private ailment and a private dread. How many of us have aged parents drifting silently into a world of unknowing. But with people like Pratchett speaking out and scientific researches making the headlines the Government must be left in no doubt that this is an issue with a growing constituency. They must not let it slip their memory!

joan.bakewell@virgin.net

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