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.
Margaret Lock is the Marjorie Bronfman Professor Emerita in the Department of Social Studies of Medicine and the Department of Anthropology at McGill University. Lock's many books include Encounters with Aging, Twice Dead, and An Anthropology of Biomedicine.
"[A] diligent survey of research, literature, conferences, and interviews. . . . Lock proves that the science of the disease is just as compelling as poignant accounts from caregivers and those suffering from Alzheimer's disease. Lock highlights just how much we don't know, from problems with Alzheimer's pathology, testing, and diagnosis to the search for a drug treatment. . . . While science plugs away at solving the Alzheimer's conundrum, Lock's call for improved care and social support takes on a new urgency."--Publishers Weekly
"[Lock] delivers key concepts in epidemiology, neuroscience and genetics in a way that is both scholarly and free of unnecessary technical details. Lock's bird's-eye view and mix of diverging sources of information is refreshing. . . . For its wide scope and balanced critical evaluation, The Alzheimer Conundrum is an inspiring read for everyone working in the field."--Eus Van Someren, Nature
"Comprehensive, cogent, and densely detailed, The Alzheimer Conundrum provides a useful antidote to media hype about 'silver bullets' that are 'just around the corner' and makes an important contribution to our understanding of an achingly tragic disease that touches virtually all of us."--Glenn Altschuler, Psychology Today
"Bringing together an anthropology of predictive medicine with a social study of science, and discussing recent biological discoveries as well as crucial public health problems, The Alzheimer Conundrum offers an insightful approach to the uncertain boundaries between aging and dementia, and brilliantly revisits the philosophical theme of the normal and pathological. Evocatively written, it is a major contribution to the understanding of one of the most perplexing and tragic issues of our time."--Didier Fassin, Institute for Advanced Study
Table of Contents:
Chapter 1 Making and Remaking Alzheimer Disease 26
Chapter 2 Striving to Standardize Alzheimer Disease 51
Chapter 3 Paths to Alzheimer Prevention 76
Chapter 4 Embodied Risk Made Visible 100
Chapter 5 Alzheimer Genes: Biomarkers of Prediction and Prevention 132
Chapter 6 Genome-Wide Association Studies: Back to the Future 156
Chapter 7 Living with Embodied Omens 174
Chapter 8 Chance Untamed and the Return of Fate 207
Chapter 9 Transcending Entrenched Tensions 229
Afterword: Portraits from the Mind 243