Alzheimer's Disease Living with Alzheimer's Disease

Many with Alzheimer's Do Just Fine

Diagnosed with Alzheimer's when he was 61, William Utermohlen continued painting, a passion he developed as a young child. Most of his later artwork concentrated on self portraits, which had precise, accurate depictions of his physical appearance, often set to a stylized background.

Over the course of his disease, the paintings became increasingly abstract. Arms and legs were hard to recognize, and the sense of proportion that marked his early work was lost.

To art critics in France, these later portraits revealed a state of mind that seemed sad, angry and resigned. But to a group of Alzheimer's specialists who compared them to Utermohlen's earlier work, such themes were present throughout his career, suggesting little emotional change in the artist, despite a clear decline in his ability to paint.

"When you are painting it is always about how you feel," Utermohlen told the researchers.

The examination of Utermohlen's artwork, published in the journal The Lancet, offers a rare glimpse into the psychological health of those living with Alzheimer's. Depression and agitation are commonly seen in patients, who must struggle with forgetting once-familiar faces and the ability to do even simple tasks.

Strong Willed
But as doctors are finding from Utermohlen's paintings and various surveys, Alzheimer's is not automatically associated with the type of distress many seem to expect. Despite all the importance we place on memory, the disease may cause an unpleasant disruption at first, which fades in recognition as memories do. Those with Alzheimer's spend their remaining life possibly no worse or better off emotionally than before.

"They adapt surprisingly well," says Dr. Peter Rabins, a leading Alzheimer's expert at Johns Hopkins University.

The inability to answer complex questions makes it hard to tell if changing moods are normal or the result of Alzheimer's, but Rabins says that simple questionnaires are good at judging how a patient truly feels. Like plenty of others who face a debilitating disorder, those with Alzheimer's often express a resilient attitude about their fate.

"When bad events happen, most do their best to get by," says Rabins.

Alzheimer's, however, is unique in that it damages areas of the brain responsible for awareness and complex thoughts, raising difficult questions on how to best handle each individual patient. The reason why some might seem content is that they no longer comprehend what is going on around them. Do you confront your loved one with the truth, or leave them kindly in the dark?

Dr. Jason Karlawish, a dementia expert at the University of Pennsylvania, argues for honesty.

"Don't hide the diagnosis," he says. "Patients often want to know."

Part of the reason that people with other diseases do so well, he adds, is that they are aware of what they are up against and are compelled to make tough choices.

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