Commentary

Pat Summitt faces many challenges

Updated: August 23, 2011, 6:58 PM ET
By Dr. Michael Kaplan | ESPN

Tennessee women's basketball coach Pat Summitt will face numerous challenges as she contends with early onset dementia. The Lady Vols' coach says she plans to continue coaching and does not intend to step down. Her announcement raises several questions about the disease and its prognosis. Here are some of those questions and their answers.

What is early onset dementia?

Dementia is a phenomenon of brain cell loss, which is a natural consequence of aging. But Alzheimer's, as a disease is premature dementia, meaning accelerated beyond that which you would expect for someone's age. Summitt's diagnosis was likely made by a spinal tap, in which a doctor finds a certain protein in the fluid. The protein is distributed in the brain cells and essentially renders them nonviable -- not working. The disease process typically progresses relatively rapidly, usually within five years. There is considerable functional and cognitive loss. Memory, speech pattern, thinking -- all those things that you would assume are part of the practices of the mind.

Is it reasonable to think she could continue to coach?

I think it's reasonable she can coach this season, although it's now clear she was already having some challenges with her mind that were noticeable enough for her to seek medical attention. It's possible she was more forgetful, not thinking as clearly or as accurately.

She's a coach known for being in charge, in control. How big of a challenge will this be for her?

Not being in control is going to be the biggest challenge, and I gather she's wrestling with some of that already. Typically there's some denial then some anger. There's usually some attempt to meet the disability, but there's no way to beat it, if you will. There are some medicines that are now available but they have a less-than-curative response. Dementia is an irreversible and progressive disease.

What will her treatment and care be like?

Because the disease is progressive, she'll eventually need some assistance.

What does her announcement mean for the larger understanding of this disease?

It is an important and big move for her to announce this publicly. I think it's very good for society that she's coming out with it because those who have it now can better understand and deal with it.

Dr. Michael Kaplan is an ESPN medical analyst.