[Alzheimer's disease: cerebral illness or the illness of the mind?].

The use of considering Alzheimer's disease as a "primary degenerative dementia" prevails and the disease is thus considered of purely cerebral origin without taking into account the possible effects of the minds of subjects designated Alzheimer sufferers and/or the communicational and relational disorders which may develop between the patient and others. This perspective, which considers the totality of the dementia as a biological phenomenon while overlooking the fact that the human being is also a being of language appears like an act of iatrogenic censure. A consequence of the fear of death so present in our thanatophobic culture, it is related to negation of the elderly subject, too patently mortal, to be recognized and accepted as similar to us. This refusal to identify induces processes of intra-psychic and inter-individual abjection commanded by horror and repulsion. These processes act on all our minds and result in the development of Alzheimer-type dementia syndromes in certain subjects. In this sociopsychogenetic context, the syndromes appear secondary to disorders of identification. The elderly person, denied by those like him and by himself as the image and symbol of death, must live a veritable stage of the disappearing mirror. In contrast to what occurs at the time of the "Lacanian mirror stage" in the child, the elderly subject is pushed out of the symbolic field and towards dementia. Taking the metaphor "senile shipwreck", the author invites the reader to rethink dementia not as a simple cerebral deterioration but rather as a complex disease which is both a disease of the brain and a disease of the mind.