Ceisteanna—Questions. Oral Answers. - Alzheimer's Disease.

6.

asked the Minister for Health if he intends to accede to the requests of the Alzheimer Society of Ireland to provide additional assistance for those suffering from this condition, especially (i) to add Alzheimer's Disease to the list of long term illnesses (ii) to provide suitable day care centres and support the society's own centre (iii) to provide suitable long term stay care and (iv) to provide support for those looking after patients at home.

Health boards are now implementing their plans for the development of community based psychiatric services. This involves the provision of day care services of various kinds, including hostel places for people who for one reason or another cannot continue to live at home. The new developments will bring the services closer to the areas served. This will enable the psychiatric teams to provide a degree of family support which has not been possible in the past. Persons suffering from Alzheimer's Disease, and their families, will benefit from these new services. The early development of these service is, I believe, of more practical value than the application of the long term illnesses scheme to this group.

I am aware of the support given to families of sufferers by the Alzheimer Society of Ireland and in recognition of that I was pleased to be able to assist them with a grant from lottery funds last October.

Is the Minister aware that there are about 20,000 people in the Republic of Ireland suffering from Alzheimer's Disease and that is estimated that about 2,000 of those are what is known as pre-geriatric cases, in other words, they are not people who are in this situation as a result of old age? Is the Minister also aware that to a large extent these 2,000 are not catered for by the existing health care system? Does he not think that in these circumstances assistance should be given to the Alzheimers Society to provide this care? Would he also clarify the assistance he has given to the Alzheimers Society from the lottery which I understand was a small amount of money to buy furniture?

I take the point Deputy De Rossa makes about those suffering from Alzheimer's Disease not fitting easily into either the category of psychiatrically ill patients or geriatric patients but having said that I am satisfied that they are provided for in the same way as psychiatrically ill patients or indeed geriatric patients in that the range of services is available to them. I am not sure that the road to go for each specific illness is to set up a special discipline to look after them, and I am not sure that the multiplicity of staff that would be necessary in the community would be of advantage to the people suffering from Alzheimer's Disease.

On the question of the grant, a grant from the lottery of £5,000 was made through the Eastern Health Board towards the cost of furnishing a day centre at Blackrock and equipment for their headquarters. This was the full amount sought by the Alzheimers Society of Ireland.

Could the Minister confirm that there was a commitment given to the Alzheimers Society that sums would be made available, through the Eastern Health Board, for two medical posts to study pre-geriatric and psychiatric patients and can he say what is the state of that allocation?

That is a separate question and I do not have the up-to-date information. There was a proposal that there should be two posts created in psycho-geriatrics, the study of psychiatric illness in the elderly. I think one of those posts may have been filled but I will communicate with the Deputy about the up-to-date position.

I am not satisfied that the Minister or his Department are dealing with this matter in the urgent way it needs to be dealt with. We are talking about 20,000 people who we know have a brain disease which is incurable, which worsens progressively as time goes on, which destroys the physical and mental functions of the body. The Minister is saying that a system which is already creaking at the seems in relation to providing normal care and attention is adequate to deal with this situation. I have asked if he will agree that Alzheimer's Disease is suitable for inclusion in the long term illness scheme. He says he does not think so but he does not indicate what he is going to do in relation to that matter. Could the Minister please tell us what he is going to do as an alternative to including the disease under the long term illness scheme? What additional assistance is he going to give to relatives, particularly spouses, who look after these Alzheimer patients?

We cannot dwell unduly long on any one question. There are many questions to be disposed of today and I want to see some progress made.

There are existing services available to which patients suffering from Alzheimer's Disease are entitled. They are entitled to the whole range of community support services that are available. There is a problem in regard to what category or area of health care these patients fit comfortably into, whether it is the psychiatric or the geriatric sector, but that does not take from them having the full range of services available to them and being properly looked after. On the question of the provision of drugs for these people, my understanding is that they do not need very much by way of medical treatment and that is the reason I suggested they would not fit comfortably into the long term illness scheme. In reply to an earlier question I have said that that scheme and the drugs refund scheme are under review.

7.

asked the Minister for Health if his Department will initiate a study in this country to establish the relationship between the levels of aluminium in drinking water and the presence of Alzheimer's Disease in the population, or whether the disease is preventable if proper precautions are taken in adhering to recommended safety levels laid down by the EC; and if he will make a statement on the matter.

Aluminium has been associated with certain neurological disorders such as Alzheimer's Disease but it is not yet clear whether the presence of aluminium causes such conditions or not.

Some surveys carried out abroad have pointed to an association between levels of aluminium in drinking water and the incidence of Alzheimer's Disease but as in all epidemiological surveys care has to be exercised in interpreting the data as there may be other variables involved.

Further studies are being carried out at an international level into the possible relationship between aluminium and Alzheimer's Disease and I will bring the results of these studies to the attention of my colleague, the Minister for the Environment, who is responsible for the protection of the public water supplies and for compliance with the EC Directive.

Is the Minister aware of a recent British study, in association with a Norwegian study, which has linked the incidence of aluminium in drinking water with that of Alzheimer's Disease? Does he not consider that a recent Irish study of Dublin drinking water should be extended to examine drinking water around the country and to establish whether or not there is a link between aluminium in drinking water and Alzheimer's Disease, given that this could be a preventable disease? Is the Minister also aware of recent quite alarming reports about high levels of aluminium in baby foods and does he propose to take any action on this front?

I am aware of the study carried out in Britain to which the Deputy has referred. Indeed, it was recorded in the Lancet on 14 January this year. That study showed that the risk of Alzheimer's Disease was 50 per cent greater in districts where the average aluminium concentrations exceed 0.11 miligrams per litre of water but that the increased risk was not associated with how much above this value the concentrations were. That report also stated that care is needed in the interpretation because as in all epidemiological surveys the possibility exists that the relation observed is due to the operation of some unknown compounding factors. It states that further studies in different populations are required to confirm these results. The group is now proceeding with a case study to investigate the relationship between dietary aluminium and Alzheimer's Disease at an individual level.

On the question of a survey carried out by a researcher from Trinity College Dublin who found that the samples taken in the Dublin area exceeded the maximum admissible concentration, which was 0.2 miligrams per litre of water, I understand my colleague, the Minister for the Environment, dealt with that question on Tuesday last, 7 February. He has plans in hand to ensure that the level is kept at that recommended by the European Community.

I am well aware of what the Minister for the Environment said in reply to my question on Tuesday last. His reply indicates a very long term interest in changing the position at the Ballymore Eustace waterworks in particular. I would like to take the Minister up on his claim that there is no evidence that the incidence of the disease increases as the amount of aluminium found in drinking water increases. My understanding is that the report found that there was a higher incidence——

Sorry to interrupt the Deputy but we must proceed by way of supplementary questions.

Is the Minister not greatly concerned, given that, as Deputy De Rossa has said, there are 20,000 people in this country who suffer from this disease which could be preventable? Finally, could he address himself to the baby foods issue and say whether he is going to investigate the incidence of aluminium in baby foods?

Certainly we will investigate the incidence of aluminium in baby foods and I will communicate with the Deputy on that matter. As far as research in Ireland is concerned, I will convey the Deputy's views to the Health Research Board who have responsibility for deciding what research they should grant aid.