Because of rapidly aging populations, the number of people
worldwide experiencing dementia is increasing and the projections
are grim. Despite hundreds of millions of dollars invested in
medical research, no effective treatment has been discovered for
Alzheimer's disease, the most common form of dementia. "The
Alzheimer Conundrum" exposes the predicaments embedded in current
efforts to slow down or halt Alzheimer's disease through early
detection of presymptomatic biological changes in healthy
individuals.
Based on a careful study of the history of Alzheimer's disease
and extensive in-depth interviews with clinicians, scientists,
epidemiologists, geneticists, and others, Margaret Lock highlights
the limitations and the dissent implicated in this approach. She
stresses that one major difficulty is the well-documented absence
of behavioral signs of Alzheimer's disease in a significant
proportion of elderly individuals, even when Alzheimer
neuropathology is present in their brains. This incongruity makes
it difficult to distinguish between what counts as normal versus
pathological and, further, makes it evident that social and
biological processes contribute inseparably to aging. Lock argues
that basic research must continue, but it should be complemented by
a realistic public health approach available everywhere that will
be more effective and more humane than one focused almost
exclusively on an increasingly frenzied search for a cure.
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