Alzheimer’s: the slow-motion epidemic

By Orlando Jenkinson
Herald Staff

(This article and its content were first published in the Buenos Aires Herald—print edition— September 21, 2015)

Cases of dementia expected to surge 150 percent in Latin America over two decades

Alzheimer’s disease, the debilitative mental health disorder that often leaves its victims as shadows of their former selves, has emerged as a quiet epidemic in Argentina and across the region as more people are suffering from the horrific, incurable illness — and the numbers are expected to keep growing.

The latest World Health Organization (WHO) data estimates there are at least 300,000 cases of Alzheimer’s in Argentina, and that across Latin America and the developing world the number of new diagnoses of the people suffering from the disease is picking up pace rapidly. Latin America is expected to see an increase of 134 percent to 146 percent in dementia cases over the next two decades, according to the WHO.

With Alzheimers currently in the global spotlight thanks to today’s World Alzheimers Day, local experts who pointed to a lack of public awareness over the disease suggested recently that the WHO figures for Argentina do not fully illustrate the scale of the problem both in the country and beyond, however, considering that many of those affected are never diagnosed.

They estimate that in 2010 there were at least 500,000 people affected by Alzheimer’s and that this number has certainly risen in subsequent years.

“Nobody knows exactly how many people have Alzheimer’s in Argentina, not least because many people fail to get diagnosed, but we do know it’s on the rise,” Dr. Guillermo N. Jemar, a neuropsychologist at Córdoba National University (UNC) and contributor to the expert support group Alzheimer’s Argentina, told the Herald.

“The latest figures we have put the number of cases at over 500,000 but we know there are many cases that are never reported,” he added, saying that the data came from 2010 and that the total of half a million Argentine’s suffering from the disease was likely to be significantly higher today.

Alzheimer’s, which accounts for between 60 and 70 percent of all cases of dementia globally, is a degenerative disease which causes loss or debilitation of neurons and synapses— the information receptors in the brain.

It becomes increasingly severe over a number of years, causing memory loss, delusion and decline in language abilities, eventually resulting in a loss of basic mental and physical functions.

TREATMENT AND INTEGRATION

As the world’s medical community places dementia in the spotlight in commemorating World Alzheimer’s Day, the disease in Argentina has become an increasingly serious concern among the medical profession who pointed to the stigma and lack of public awareness about the symptoms and effects of the disease being a major obstacle to improving treatment.

Dr. Natividad Olivar of the Argentine Neuropsychiatric Association and Alzheimer’s Argentina told the Herald that stigma surrounding the disease meant that sufferers felt a reluctance to report potential symptoms of dementia,

However, she said that greater integration between different fields in the health profession have helped provide a balanced approach to identifying the disease and fighting its worst aspects, for example, in combining psychological therapy sessions with pharmaceutical drugs that in turn slow down the degeneration of patients neurons and synapses.

“Here in Argentina there is deep integration now between the neurology and psychology fields when it comes to Alzheimer’s, and this has helped with diagnosis and treatment,” Olivar said.

She added that the profession of both herself and Dr Jemar of Alzheimer’s Argentina, as neuropsychologists — an experimental field in medicine — demonstrated well the enhanced cooperation of the two fields in combining resources and treatment in a bid to better stave off the worst symptoms of the disease, for which there is still no known cure.

WORLDWIDE CONCERN

One thing the country and Latin America as a whole do have in their favour in terms of vulnerability to the disease is a relatively youthful population, since the chances of contracting Alzheimer’s or dementia increase drastically when one passes 65 years of age.

“Fortunately, the population here in Argentina and in this part of the world generally is relatively young, and so the risk is lower than say in France or Germany,” Olivar said.

However, she also added that this demographic safety net “will change in time,” pointing like the WHO to the anticipated ageing of the Latin American population that will make Alzheimer’s a more prevalent issue, since dementia in all forms affects older people disproportionately.

In fact, the WHO expects that dementia generally and Alzheimer’s in particular to become a “global epidemic” in the decades to come as expected demographic changes in the developing world increase the average age of the global population.

The WHO underlined that the number cases globally (currently at 47.5 million) was expected to rise by at least 7.7 million cases year on year, to reach 75.6 million in 2030 and almost triple the current total by 2050 to 135.5 million.

“Much of this increase is attributable to the rising numbers of people with dementia living in low- and middle-income countries … Global population ageing will inevitably result in huge increases in the number of cases of dementia, of which Alzheimer’s disease is the most common form,” the WHO said.

http://www.buenosairesherald.com/article/199238/alzheimer%E2%80%99s-the-slowmotion-epidemic-

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Immigrants meet Freud in BA

By Orlando Jenkinson
Herald Staff
(This article and its content were first published in the Buenos Aires Herald (print edition), August 17, 2015). 
Buenos Aires has long been considered a hub of psychoanalysis, but one institution has set itself apart in recent years by offering a unique twist on the discipline in catering specifically to the City’s myriad immigrant communities.
“We try to create an intercultural experience. That’s the focus. So we have large group meetings and explore all the phenomena of intercultural relations,” says Dr Grace Bar Jones, the psychoanalyst director of Babel Psi, the institution to which she has dedicated over a decade of her life to and set on an orbit around the theme of multiculturalism, which dominates the narrative of the school for attendees and staff alike.

Founded in 2004 by Bar Jones, Babel Psi evolved from a previous organization, Babel Centre, which had practiced a similarly tailored form of psychiatry since 1990.

Multiculturalism is a theme Bar Jones considered highly relevant to the experience of everyone living in Buenos Aires, though the school focuses on foreign students, a unique niche in the widespread culture of psychoanalysis here.

“It can be very difficult living in a different country, because you are out of your familiar surroundings where naturally most people feel comfortable. The City can be tough too. It is an atmosphere with different practices, cultures, language. These things can foster a lot of stress,” she told the Herald.

Natural home

Buenos Aires is in many ways the perfect location for a psychoanalysis practice focusing on these issues, not least because the culture of psychology is so extensive here. The most recent World Health Organization (WHO) study found there were at least 202 practicing psychologists for every 100,000 Argentines, more than any other country, and the overwhelming majority work in Buenos Aires.

The City’s large immigrant population also makes multiculturalism a prevalent issue. Many of these are foreign students, like Alice Jothy from France, who chose to take time to study with Babel Psi, having formally attended the group therapy sessions that happen every Monday evening (8.15pm) and involve around 20 “participants” (Bar Jones rejects the term “client”).

“At the meeting we sat together and we started talking. It was very much like a conversation between friends, we heard everyone with respect and did not speak more than one person at a time — you had to raise your hand to ask for the floor and Doctors Graciela Bar Jones and Alberto Jones were responsible for moderating the discussion.”

Alice was typical for a Babel student in that she had a prior connection to the place before choosing to study.

Altogether different

By seeking a unique approach to the traditional service and study of psychoanalysis in Buenos Aires, Babel Psi deliberately set itself apart from the crowd, as Bar Jones readily admits.

“The psycho-analytical school in Buenos Aires is one of the most important in the world. However, the official school and academia can often be separate from everyday experience. It’s not genuine. Our approach strives for an understanding of people’s genuine everyday experiences and lives,” she said.

The individuality of the organization distinguished it from other psychology schools or universities that offer courses on the topic, not least since it insists on a focus on multiculturalism uber alles.

This brings certain challenges of its own, including that of juggling multiple languages of those in attendance. While making adding extra complications, however, the results Babel Psi has seen through this approach are often interesting in and of themselves.

“We always have someone to translate, since people tend to feel most comfortable speaking in their own language. However, we also find, most interestingly, that participants can also feel liberated speaking in another language, a sense of freedom that means they might more readily express feelings and emotions they’d feel less comfortable discussing in English or French or whatever.”

The unique approach to psychoanalysis offered by the organization goes hand in hand with its administration and funding, which remain independent and private. Those attending group therapy sessions that form the back bone of the services Babel Psi offers pay 260 pesos (some US$28) per month or 75 pesos (US$8.10) per session, though your first time is always free. “Multi-family Psychoanalysis” sessions are also on offer each Wednesday (8pm) for family groups and are free.

The courses Babel Psi offers for those like Alice who chose to study psychology with the school meanwhile are privately funded, and so set students back anywhere from 750 pesos (US$8) onwards, a contrast to Argentina’s long tradition of state-funded university education free at the point of use for students.

Focusing on multiculturalism, the make-up of group therapy sessions is varied between students across Latin America and further afield, while those choosing to pay for studies with the school are often European or North American. France, for example is one of the biggest origin nations of students, all of whom have sufficient disposable income available to afford the fees.

For those who do choose to sign up to study, though, it’s a service they’re willing to pay for. “They want to make it a personal experience so often it’s just two people. And they address the care aspect of the subject more than just looking at the theory. This type of degree and learning doesn’t exist anywhere else in the whole world,” French student Mathilde, told the Herald.

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