Hole Ousia believes that there is a pervasive and reductionist understanding of Alzheimer’s disease that no longer seems to have such clear ‘para-digmatic’ post mortem pathology. The risk is that our older citizens are misunderstood through this label and that generally fear of it only gets worse.

“Trickles down from the upper echelons”

I read this letter by Dr William Durward, a retired NHS Scotland Consultant with interest. It was published in the Herald, 7 November 2018, and was written in response to … Continue reading “Trickles down from the upper echelons”

Psychiatric medications and potential effects on cardiac rhythm

In the last month we have been having discussions at work about the potential for psychiatric medications to adversely effect cardiac rhythms, and in particular QTc prolongation.  The advice on ECG … Continue reading Psychiatric medications and potential effects on cardiac rhythm

Key opinion leaders and Industry: Snakes, ladders and Monopoly

Dr Margaret McCartney in her recent ‘No Holds Barred” perspective set this challenge: “Here’s a game: try and find a doctor’s conflicts of interest. Set a timer, and give yourself … Continue reading Key opinion leaders and Industry: Snakes, ladders and Monopoly

Two years of no sunshine

On Thursday 22nd March 2018 I will be standing outside the Scottish Parliament with this banner. This will be a peaceful, one-man protest, two years to the day that my … Continue reading Two years of no sunshine

Mild Cognitive Impairment

This recently-published Guest editorial in International Psychogeriatrics concludes that the concept of MCI faces extinction. As a doctor practising in this field I found this editorial difficult to follow and self-contradictory.

Paradigms, pathologies and shifts

The following extracts are taken from this perspective published in the Scotsman, 11 January 2018: Pfizer has seemingly concluded that Alzheimer’s disease is far more complex than we had ever … Continue reading Paradigms, pathologies and shifts

Finding balance

This unedited clip (apart from titles) is from the evidence session on NHS Targets given to the Health and Sport Committee of the Scottish Parliament on 9 January 2018. I share … Continue reading Finding balance

Back in the driving seat: Industry

Historical backdrop (the last decade): UK Key Opinion Leaders argued robustly and consistently for an early approach to the diagnosis of dementia without articulating uncertainties, risks and necessary ethical aspects of person-centred … Continue reading Back in the driving seat: Industry

The ‘Edinburgh Consensus’

I was born in Edinburgh:   It was by accident that I learned that this “consensus” has been “operationalised” across the NHS.   This  small group consensus needs to explain how … Continue reading The ‘Edinburgh Consensus’

NHS Targets: learning from experience

The following Report was published in November 2017: The Foreword began [highlights are mine]: The Report author Sir Harry Burns states: “experience with existing targets and indicators has been positive in … Continue reading NHS Targets: learning from experience

Might the experts themselves be confused?

I recently read a British Geriatrics Society (BGS) blog which was titled: “Antidementia medication may improve survival in Alzheimer’s disease”. Having read this blog several times I wrote to the … Continue reading Might the experts themselves be confused?

‘Dementia overload?’

Sunday 23rd July 2017. “Dementia overload“: how the Scotland on Sunday titled their front cover My view is that there is no shortage of “awareness” of dementia in Scotland! The Editor … Continue reading ‘Dementia overload?’