This is actually a fairly tricky question. There are numerous considerations and nuances. For one thing, it depends on whether we’re using a rough definition of “terminal illness” (typical of everyday speech), or if we’re using a technical definition (as we might in insurance or medical contexts). Here’s the short answer.
There is no cure for Alzheimer’s. It is inarguably “terminal” in the sense that a person who is diagnosed with the disease will eventually die with it. Although it certainly diminishes longevity and negatively impacts quality of life, Alzheimer’s will probably not result in immanent death for people who are in its early stages. However, by the time that an individual is in its advanced stages, life expectancy may be as little as one to two years. Thus, late-stage Alzheimer’s is often “terminal” in the technical sense as well.
What Is a ‘Terminal Illness’?
A General Definition
In general, if you have a “terminal illness,” then you have an illness that is expected to end with your death. Intuitively, if a disease is expected to result in your death, then that disease is incurable.
This seems obvious since, if the disease were curable, then you wouldn’t be expected to die from it.
But, what does it mean to be “incurable”? As a first pass, let’s say that for a disease to be incurable means that it cannot be corrected, remedied, or reversed.
An incurable disease might still be “treated” in some broad sense. For instance, an Alzheimer’s sufferer might receive pharmaceuticals that are intended to slow the progression of the disease or to minimize or eliminate behavioral problems that are byproducts of the Alzheimer’s. But, the Alzheimer’s “treatments” that are available are not expected or advertised to correct, remedy, or reverse the dementia.
Broad Vs. Narrow Definitions
Perhaps the best way to think about the idea of a “terminal illness” is to think of it as having a broad (or “loose”) sense and a narrow (or “strict”) sense.
Let me put it like this. On the broad usage, a terminal illness is one that negatively affects your lifespan. Additionally, since it is incurable (see above), you will still suffer from the disease when you die. Whether or not you actually die from Alzheimer’s or merely with Alzheimer’s is another matter. (For more on that question, see the companion article “How Does a Person Actually Die From Alzheimer’s Dementia?”)
This broad use of the term is common in everyday speech, where people often speak loosely. For example, when a person is angry, he or she might say, “I could just kill someone!” But there is usually no cause to believe that an bona fide murder is about to take place. The phraseology simply means that the speaker is really put out. Or, less violently – and perhaps more on-point – we might say that we’re suffering from the “stomach flu,” when we have some gastrointestinal distress. In fact, the word “flu” is short for influenza, which is a respiratory virus. But the fact that this designation is not strictly accurate is beside the point. The utterance means that the speaker has major stomach problems, and the hearers all get the point.
So, in the broad and loose sense, yeah, Alzheimer’s seems pretty terminal. There’s no cure. And you’re going to die with it. If you get it, it’s really bad. This is probably the point of the utterance in everyday speech. And the point is understandable.
But there is also a technical definition. If you have a long-term care insurance policy – or a life-insurance policy with a long-term care rider – you’re going to want to at least familiarize yourself with this definition as well.
On the narrow definition, a “terminal illness” is one that you are expected within a specified – and highly compressed – time period. Usually, we’re talking about death within twelve months of fewer. Certainly, no longer than twenty-four months.
Thus, on the narrow definition, we have to be a bit more careful with the way that we wield the word “terminal.” Think about a person who has just been diagnosed with mild-cognitive impairment (MCI) or with early-stage Alzheimer’s. In many cases, the prognosis may be relatively good (or at least, not horrendously poor) for several more years. A person in beginning stages may have a decade or more to live.
We can see that if a “terminal illness” is one for which death is expected within 1-2 years; but a newly diagnosed Alzheimer’s patient has (let’s assume) five to fifteen years to live; then it follows straightforwardly that such a condition would not count as terminal in the strict sense.
I hasten to remind readers, though, that Alzheimer’s is a degenerative or progressive condition. Whereas it may be true that “Alzheimer’s” (period) is not a terminal illness, we might say that late-stage Alzheimer’s arguably is.
This is because, in its advanced stages, the sufferer may very well be facing the prospect of dying within one to two years.
So, what is the verdict?
I’ll summarize it this way. Alzheimer’s – without qualification – is “terminal” in a broad or loose sense, but perhaps not in a technical sense. But, late-stage Alzheimer’s is likely terminal in both a broad sense and in the narrow (or strict) sense.
A Philosophical Footnote
Necessary Vs. Sufficient Conditions
To be more thorough about things, we should probably make a distinction between a necessary and a sufficient condition. You didn’t think you were going to have a philosophy lesson today, did you?
A necessary condition for something is a condition that has to be there for that something to exist. Consider the so-called “fire triangle.” If you have a fire, then you have oxygen present. Oxygen has to be present for you to have a fire. So, oxygen is necessary for a fire.
Similarly, being incurable seems like it’s a necessary condition for a disease to be terminal. Pneumonia isn’t, per se, incurable. Even though a lot of people die from pneumonia, having pneumonia isn’t a death sentence –all things being equal. I had pneumonia when I was twelve years old. I survived. Even my dad had pneumonia when he was 83 and in a nursing home with Alzheimer’s. He survived.
At the same time, being incurable isn’t – by itself – a reason to think that a disease is terminal. If incurability by itself were enough to classify a disease as terminal, then we would say that incurability was a sufficient condition for a disease being terminal.
Consider fires, again. Even though oxygen is necessary for fire, it isn’t sufficient. You don’t automatically get a fire whenever and wherever there is oxygen. You need some other stuff (like a fuel supply and a spark). On the other hand, think of cooking eggs. You can fry, poach, or scramble eggs. Any of these methods is sufficient to “cook” eggs. If you have fried eggs, then you have cooked eggs. You don’t need to do anything else other than fry an egg to get it cooked.
Herpes simplex viruses aren’t curable. According to the received medical opinions, if you contract herpes, you’ll have herpes for the rest of your life. It can be controlled, but it cannot be corrected, remedied, or reversed in any straightforward way. But, herpes isn’t “terminal.”
This shows that even though it is necessary, incurability isn’t sufficient for a disease to be terminal. Incurability is to terminal illness as oxygen is to fires.
For Related Information, see:
“How Does a Person Actually Die From Alzheimer’s Dementia?”
Disclaimer
I have repeatedly noted on this website, and I will say again, that I am not a doctor. I cannot give medical advice. The information in the post, and on ALZHEIMERSPROOF.com, is simply a collection of what I have come to believe — through personal experience and research. Although I present the information in good faith, I do not warrant that it is true.