23 March 2022

The last 'nerve doctor' in the Netherlands

These are festive times for Frans Verhey, professor of Geriatric Psychiatry and Neuropsychiatry. Last year was the 20th anniversary of the Limburg Alzheimer’s Centre (ACL), which he founded; this year he will not only retire but also celebrate 40 years with his wife. He is proud of what the ACL has achieved and of its team, which works tirelessly to improve the quality of life of people with Alzheimer’s. “Alzheimer’s tends to be seen as a horrible, deadly brain disease that makes life unbearable. But with the right support and care, you can often still have a meaningful and enjoyable life.”

Frans Verhey
Frans Verhey

Verhey was, in effect, following in his father’s footsteps. In the mid-1960s his father co-founded the hospital psychiatric ward, and he too became a professor. “That said, it wasn’t an obvious path for me; I had to find my feet. My father was more of a general psychiatrist. I was particularly interested in the neurological side.”

Verhey and his twin sister were the third and fourth in a family of six children that lived in the centre of Maastricht. “A lovely family, we’re all close. It was expected that we’d go to university.” His mother died of adrenal cancer at the age of 43. “At the time, I’d been studying in Amsterdam for just a few weeks. She’d been ill on and off for six years, but still her death came as a shock. We didn’t know she was terminal, and my father, who did, found it hard to talk about. After her death, he was quite lost. At some point he got back on the rails by doing a PhD. When he married his former secretary a few years later, we children were very happy for him.”

Dementia is the flip side of getting old

In 1993, Verhey defended his PhD in Maastricht on dementia, memory and depression. His supervisor, Jelle Jolles, had been made a professor in 1986 and was tasked with establishing a centre for ageing. He asked Verhey to lead the dementia research. “Straight away we launched the country’s first memory clinic, which grew into what is now the ACL. From an academic perspective, it was a huge opportunity.

 

Frans Verhey

“Dementia is the flip side of growing old; it’s not something to be afraid of. It’s more like grey hair or wear and tear of the hip. Dementia cases are rising because there’s a solution for many other conditions: better treatments for cancer, better cardiovascular crisis management, healthier lifestyles. That means people are getting dementia at an increasingly older age. Over 90% of people have the potential to get dementia if they live long enough. Medically speaking, early-onset dementia is a different story. Parts of the brain look different and there are more genetic factors at play. It’s also much less responsive to lifestyle factors, though we don’t know why.”

Alzheimer’s drug

In December, the European Medicines Agency decided not to approve aducanumab, a drug used in the United States. Verhey was relieved. “The whole idea of ​​Alzheimer’s proteins that you have to remove in order to be cured doesn’t seem to work. That’s what aducanumab does, but we now see that the patients aren’t really improving and the side effects are significant. Without wanting to play the grumpy Smurf, the pros really don’t outweigh cons like swelling and bleeding in the brain. Twenty years ago, I was much more hopeful about a cure. That’s not to say there’ll never be one, but Alzheimer’s is so tied up with ageing that it’s not at all obvious there is a solution. We just don’t know. You’ll never hear me use the slogan ‘eradicate Alzheimer’s.’ It’s the sum of many damaging and protective factors earlier in life. The way I see it, research should focus more on biological ageing and how to improve quality of life. What support can you offer by means of technology? The new National Dementia Strategy by the Ministry of Health, Welfare and Sport focuses on the quality of life of people with dementia and their loved ones, which is a step in the right direction.”

Cinderella paradox

When it comes to dementia, euthanasia is a hot topic. What are Verhey’s thoughts on the subject? “I’m by no means opposed to it; it can bring peace of mind. I often meet people in the clinic who receive their diagnosis and then discuss euthanasia with their GP. I understand that. But many people are so afraid of missing the boat they think they have to make arrangements immediately, before it’s too late. We call this the Cinderella paradox. All evening Cinderella is the beauty of the ball, but at the stroke of midnight she turns back into a girl in rags. I’m against drawing too automatic a link between dementia and euthanasia; that would imply that living with dementia is by definition undignified. Many people live a decent life with dementia. We know we’ve achieved the mission of our Memory Clinic when people say ‘We used to fear it, but now we can put it into perspective. Even with Alzheimer’s my life is still pretty good.’ Life doesn’t end the moment you’re diagnosed with Alzheimer’s.”

The whole idea of ​​Alzheimer’s proteins that you have to remove in order to be cured doesn’t seem to work. (...) Twenty years ago, I was much more hopeful about a cure. That’s not to say there’ll never be one, but Alzheimer’s is so tied up with ageing that it’s not at all obvious there is a solution. We just don’t know. You’ll never hear me use the slogan ‘eradicate Alzheimer’s.

Milestones

Frans Verhey

For Verhey, this year is full of milestones. It has been 40 years since he met his wife, and that’s something to celebrate. “She’s from Tilburg, but I met her in Amsterdam through a mutual friend in my student house. It was love at first sight. She’s a nurse and together we have three children, two of whom also work in nursing. Apparently you pass that on. My father always thought I should study economics, but I wasn’t interested. I wanted contact with people, which is also why I chose neuropsychiatry over surgery.”

In May he will reach retirement age—is that cause for celebration? “For sure, I hope the corona rules allow it. I’m proud of what I’m leaving behind: a great team of talented people who view Alzheimer’s in a nuanced way. Good work has been and is being done on early diagnosis and biomarkers, prevention and psychosocial research. I’m glad to have made my contribution, but I’ll also be happy not to have such a full schedule any more. For the time being, I’ll stay on one day a week to help complete a few PhD projects and an international project. And I’ll see what the future holds—maybe a painting course. Definitely a hike to Santiago de Compostela.”

By: Annelotte Huiskes (text), Sem Shayne (photography)