Making sense of the medical, ethical and social challenges of Alzheimer's disease

Jason Karlawish, MD, is quoted in a series of articles that explores the medical, ethical, and social challenges of Alzheimer’s disease.

Push Underway to Cut Drugs for Dementia Patients
Antipsychotics are meant primarily to help control hallucinations, delusions and other abnormal behavior in people suffering from schizophrenia and bipolar disorder, but they're also given to hundreds of thousands of elderly nursing home patients in the U.S. to pacify aggressive and paranoid behavior related to dementia. The drugs can limit seniors' ability to effectively communicate, socialize or participate in everyday life. But a series of warnings has prompted a movement of nursing homes trying to reduce the decades-old practice, often resulting in remarkably positive changes, according to the Associated Press. Jason Karlawish, MD, professor of Medicine and Medical Ethics and associate director of the Penn Memory Center, said he uses antipsychotics in only about 5 percent of his dementia patients. But sometimes they're the only thing that helps. "There is a role for these drugs," he said.
Associated Press article


A Squirt of Insulin May Delay Alzheimer’s
A small pilot study has found preliminary evidence that squirting insulin deep into the nose where it travels to the brain might hold early Alzheimer’s disease at bay, according to the New York Times. It comes at a time when there are no effective ways to prevent or delay the progress of Alzheimer’s. And although the results are preliminary and must be viewed with caution, “it is a provocative study,” said Jason Karlawish, MD, an Alzheimer’s researcher and ethicist at the University of Pennsylvania. But he and other experts caution that a bigger and longer study is needed to see if the initial results hold up and whether there are adverse effects that might negate any benefits.
New York Times article  


Pat Robertson Says Alzheimer's Makes Divorce OK
Religious broadcaster Pat Robertson stunned "700 Club" viewers Tuesday when he said divorcing a spouse with Alzheimer's disease was justified. The remarks sparked outrage throughout religious and medical communities, reports The progressive symptoms of Alzheimer's can put stress on relationships, leaving caregivers to cope with the loss of intimacy and other aspects of adult romantic relationships, said Jason Karlawish, MD, a professor of Medicine and Medical Ethics and associate director of the Penn Memory Center. "There's no question that this is an issue," said Karlawish. "But to a spouse who's struggling with this kind of issue, I would want to say after the patient has left this world, you want be able to look back and say you treated that person with dignity." article