Table of Contents
Authors' Note ix
Preface xii
Part 1 The History of a Disease 1
Introduction: Revealing the Myth of Alzheimer's 3
Chapter 1 A Gateway to the Future of Old Age 21
Chapter 2 Alzheimer's 101: Taming the Scientific Story of AD 46
Chapter 3 The Troubling Legacy of Dr. Alois Alzheimer and Auguste D. 78
Chapter 4 The Birth of the Alzheimer's Empire 91
Part 2 Science and Treatment 111
Chapter 5 Waiting for Godot: Alzheimer's Treatments Past and Present 113
Chapter 6 A Brave New World of Genetics and Molecular Medicine? 148
Part 3 A New Model for Living with Brain Aging 173
Chapter 7 Identifying Who Needs A Prescription for Memory Loss 175
Chapter 8 Preparing for A Doctor's Visit 193
Chapter 9 A Prescription for Successful Aging Across Your Life Span 219
Epilogue: Thinking Like a Mountain: The Future of Aging 264
Acknowledgments 283
Appendix 287
Notes 292
Index 303
About the Authors 316
Read an Excerpt
Excerpt
When we think about myths, we usually think of timeless tales of gods, heroes, and monsters that entertain and enthrall. Since the Enlightenment, mythology has been regarded as the province of more primitive minds?something humanity has moved beyond in its embrace of scientific methodology. But has science been successful in purging contemporary civilization of all myths? I don?t believe that it has or likely ever will.
In fact, although we depend on the objectivity of science, scientifically influenced fields such as medicine are often rife with their own myths and misapprehensions. This is because, as the anthropologist Claude Lévi-Strauss1 believed, every myth?whether it be about a god hurling a lightning bolt from a mountain, a hero undertaking harrowing adventures filled with sirens, storms, and ferocious beasts, or a generation of scientists trying to fight a peculiar disease of old age?is driven by the need to address the complexities of the human condition and to try to resolve paradoxes that perplex us. In our modern age, in which remarkable scientific and technological advances have both extended and brought quality to human lives, we find major challenges to our rationality and values as science attempts to understand our own mysterious organ of rational thought?the brain?and the very processes of brain aging. From out of the depths of this paradox, a hundred-year-old monster has risen; it is called ?Alzheimer?s disease.?
The myth of alzheimer?s
Alzheimer?s disease represents our culture?s attempt to make sense of a natural process (brain aging) that we cannot control. Just as past civilizations posited mythical explanations for natural events theycould not explain, we have created an antagonist: a terrorizing disease of the brain that our scientists are fighting against. The pillars of the myth are as follows:
AD is a singular disease
Despite widespread belief that there is a disease called Alzheimer?s against which science is waging war, what the public isn?t told is that so-called Alzheimer?s disease cannot be differentiated from normal aging and that no two illness courses are the same. As you will learn, there is no one biological profile of Alzheimer?s that is consistent from person to person, and all the biological hallmarks of AD are also the hallmarks of normal brain aging.
People ?get? Alzheimer?s in old age
It seems as if more people fall victim to Alzheimer?s each year. Newspapers and magazines would have us believe that Alzheimer?s is spreading throughout human populations, and especially baby boomers, like an epidemic and claiming millions more victims.
However, what you aren?t told is that we don?t even know how to diagnose Alzheimer?s disease, let alone tabulate the numbers of disease victims. Because there is no single biological profile for AD, every clinical diagnosis is considered ?probable??and, frankly speaking, not even postmortem examination can differentiate a so-called AD victim from those who have aged normally. Hence, the claim that a diagnosis of ?definite? Alzheimer?s can be made after death is itself questionable. The gold standard of neuropathology is a bit tarnished. No one really ever ?gets? a singular disease called Alzheimer?s, and there is no evidence that Alzheimer?s is spreading throughout the baby boomer population other than the fact that the world is aging and there are more middle-aged people at risk for brain-aging phenomena.
We can cure Alzheimer?s through the continued
investment of our public and private dollars
The myth that Alzheimer?s is a disease separate from aging also carries the promise that science will one day win the ?war? against this disease. But if Alzheimer?s cannot be differentiated from normal brain aging, to cure AD we would literally have to arrest the natural process of brain aging. I am not alone in casting doubt upon this myth. As you will read, even scientists in the Alzheimer?s research field will tell you that a cure is unlikely and that we need to invest our dollars more wisely by putting them toward prevention and care rather than predominantly in cure. However, like the myth of the Fountain of Youth, which captivated past civilizations, the promise of a panacea for one of our most dreaded ?diseases? is a powerful cultural myth, and one purveyed by powerful pharmaceutical companies, advocacy organizations, and private researchers with much profit to gain. It is a myth we have been seduced by, and the combination of hype and fear it inspires has distorted our expectations and understandings about our aging brains.
My Story
For nearly twenty-five years, I have served as a leader in the Alzheimer?s field, and have helped international Alzheimer?s organizations and pharmaceutical companies shape the rules, guidelines, diagnostic categories, and accepted clinical approaches to Alzheimer?s disease. My experiences and relationships with other colleagues have endowed me with some influence and power and have enabled me to become what the science community calls a ?thought leader? (or KOL??key opinion leader?)?one who guides our conventional thinking about a particular condition.
In the beginning of my career, at a time when no medicines had been approved specifically for Alzheimer?s and companies were unsure about how to proceed in drug development, the pharmaceutical industry reached out to me and listened to my thoughts and opinions about treating persons with memory challenges. Once drugs made their way to the market in the 1990s the relationship shifted. Rather than being interested in having my thoughts influence their views, it seemed as if industry wanted to change my mind and convince me that their drugs were worth giving to my patients. This focus on biological approaches to brain aging across our society has shifted the whole dynamic of the field away from caring for the aging patient and his family and toward drugs as the primary means of ensuring the quality of his life. Too often, aging patients and their families leave the doctor?s office with little more than a pill prescription (often encompassing several pills) and fear generated by the Alzheimer?s myth, knowing little about how to effectively care for the condition.
This is inhumane and inexcusable.
Now, upon the one hundredth anniversary of the first case of Alzheimer?s, I feel obliged to share my stories and the insight I have gained, to inform the general public how I?a lifelong Alzheimer?s disease researcher and clinician?have evolved to espouse a different ideological position that transforms a significant portion of what I?ve believed in as a professional carer for patients. Having spent my life within the scientific, political, economic, and social institutions of the AD field?universities, hospitals, pharmaceutical companies?studying and treating human aging and disease, I am ready to challenge the power that the mainstream ?Alzheimer?s disease? myth has over us and help people see what I have seen and to think critically about the evolution in thought that has occurred over the past several decades, which has shaped the way we see our aging bodies and minds and the way we act toward them. I want to articulate a story of brain aging that can be a starting point for helping us better cope with and prepare for the travails of cognitive decline.
No longer can we safely assume that the march of progress in the ?War against AD? is moving at the hoped for speed or direction; no longer can we maintain the mythical illusion that AD is a battle against a specific disease that we will eventually ?win?; no longer can we keep looking at aging persons, however embattled, as somehow ?diseased.? Defining brain aging as a disease and then trying to cure it is at its root unscientific and misguided. In short, Alzheimer?s is a hundred-year old myth that is over the hill. The entire scientific, technological, and political framework for aging needs to be reassessed to better serve patients and families in order to help people maximize their quality of life as they move along the path of cognitive aging. Copyright © 2008 by Peter J. Whitehouse, M.D., Ph.D., with Daniel George, M.Sc. All rights reserved.0
Read a Sample Chapter
The Myth of Alzheimer's What You Aren't Being Told About Today's Most Dreaded Diagnosis
By Whitehouse, Peter J. St. Martin's Press Copyright © 2008 Whitehouse, Peter J.
All right reserved.
ISBN: 9780312368166
Excerpt
When we think about myths, we usually think of timeless tales of gods, heroes, and monsters that entertain and enthrall. Since the Enlightenment, mythology has been regarded as the province of more primitive minds—something humanity has moved beyond in its embrace of scientific methodology. But has science been successful in purging contemporary civilization of all myths? I don’t believe that it has or likely ever will.
In fact, although we depend on the objectivity of science, scientifically influenced fields such as medicine are often rife with their own myths and misapprehensions. This is because, as the anthropologist Claude Lévi-Strauss1 believed, every myth—whether it be about a god hurling a lightning bolt from a mountain, a hero undertaking harrowing adventures filled with sirens, storms, and ferocious beasts, or a generation of scientists trying to fight a peculiar disease of old age—is driven by the need to address the complexities of the human condition and to try to resolve paradoxes that perplex us. In our modern age, in which remarkable scientific and technological advances have both extended and brought quality to human lives, we find major challenges to our rationality and values as science attempts tounderstand our own mysterious organ of rational thought—the brain—and the very processes of brain aging. From out of the depths of this paradox, a hundred-year-old monster has risen; it is called “Alzheimer’s disease.”
The myth of alzheimer’s
Alzheimer’s disease represents our culture’s attempt to make sense of a natural process (brain aging) that we cannot control. Just as past civilizations posited mythical explanations for natural events they could not explain, we have created an antagonist: a terrorizing disease of the brain that our scientists are fighting against. The pillars of the myth are as follows:
AD is a singular disease
Despite widespread belief that there is a disease called Alzheimer’s against which science is waging war, what the public isn’t told is that so-called Alzheimer’s disease cannot be differentiated from normal aging and that no two illness courses are the same. As you will learn, there is no one biological profile of Alzheimer’s that is consistent from person to person, and all the biological hallmarks of AD are also the hallmarks of normal brain aging.
People “get” Alzheimer’s in old age
It seems as if more people fall victim to Alzheimer’s each year. Newspapers and magazines would have us believe that Alzheimer’s is spreading throughout human populations, and especially baby boomers, like an epidemic and claiming millions more victims.
However, what you aren’t told is that we don’t even know how to diagnose Alzheimer’s disease, let alone tabulate the numbers of disease victims. Because there is no single biological profile for AD, every clinical diagnosis is considered “probable”—and, frankly speaking, not even postmortem examination can differentiate a so-called AD victim from those who have aged normally. Hence, the claim that a diagnosis of “definite” Alzheimer’s can be made after death is itself questionable. The gold standard of neuropathology is a bit tarnished. No one really ever “gets” a singular disease called Alzheimer’s, and there is no evidence that Alzheimer’s is spreading throughout the baby boomer population other than the fact that the world is aging and there are more middle-aged people at risk for brain-aging phenomena.
We can cure Alzheimer’s through the continued
investment of our public and private dollars
The myth that Alzheimer’s is a disease separate from aging also carries the promise that science will one day win the “war” against this disease. But if Alzheimer’s cannot be differentiated from normal brain aging, to cure AD we would literally have to arrest the natural process of brain aging. I am not alone in casting doubt upon this myth. As you will read, even scientists in the Alzheimer’s research field will tell you that a cure is unlikely and that we need to invest our dollars more wisely by putting them toward prevention and care rather than predominantly in cure. However, like the myth of the Fountain of Youth, which captivated past civilizations, the promise of a panacea for one of our most dreaded “diseases” is a powerful cultural myth, and one purveyed by powerful pharmaceutical companies, advocacy organizations, and private researchers with much profit to gain. It is a myth we have been seduced by, and the combination of hype and fear it inspires has distorted our expectations and understandings about our aging brains.
My Story
For nearly twenty-five years, I have served as a leader in the Alzheimer’s field, and have helped international Alzheimer’s organizations and pharmaceutical companies shape the rules, guidelines, diagnostic categories, and accepted clinical approaches to Alzheimer’s disease. My experiences and relationships with other colleagues have endowed me with some influence and power and have enabled me to become what the science community calls a “thought leader” (or KOL—“key opinion leader”)—one who guides our conventional thinking about a particular condition.
In the beginning of my career, at a time when no medicines had been approved specifically for Alzheimer’s and companies were unsure about how to proceed in drug development, the pharmaceutical industry reached out to me and listened to my thoughts and opinions about treating persons with memory challenges. Once drugs made their way to the market in the 1990s the relationship shifted. Rather than being interested in having my thoughts influence their views, it seemed as if industry wanted to change my mind and convince me that their drugs were worth giving to my patients. This focus on biological approaches to brain aging across our society has shifted the whole dynamic of the field away from caring for the aging patient and his family and toward drugs as the primary means of ensuring the quality of his life. Too often, aging patients and their families leave the doctor’s office with little more than a pill prescription (often encompassing several pills) and fear generated by the Alzheimer’s myth, knowing little about how to effectively care for the condition.
This is inhumane and inexcusable.
Now, upon the one hundredth anniversary of the first case of Alzheimer’s, I feel obliged to share my stories and the insight I have gained, to inform the general public how I—a lifelong Alzheimer’s disease researcher and clinician—have evolved to espouse a different ideological position that transforms a significant portion of what I’ve believed in as a professional carer for patients. Having spent my life within the scientific, political, economic, and social institutions of the AD field—universities, hospitals, pharmaceutical companies—studying and treating human aging and disease, I am ready to challenge the power that the mainstream “Alzheimer’s disease” myth has over us and help people see what I have seen and to think critically about the evolution in thought that has occurred over the past several decades, which has shaped the way we see our aging bodies and minds and the way we act toward them. I want to articulate a story of brain aging that can be a starting point for helping us better cope with and prepare for the travails of cognitive decline.
No longer can we safely assume that the march of progress in the “War against AD” is moving at the hoped for speed or direction; no longer can we maintain the mythical illusion that AD is a battle against a specific disease that we will eventually “win”; no longer can we keep looking at aging persons, however embattled, as somehow “diseased.” Defining brain aging as a disease and then trying to cure it is at its root unscientific and misguided. In short, Alzheimer’s is a hundred-year old myth that is over the hill. The entire scientific, technological, and political framework for aging needs to be reassessed to better serve patients and families in order to help people maximize their quality of life as they move along the path of cognitive aging. Copyright © 2008 by Peter J. Whitehouse, M.D., Ph.D., with Daniel George, M.Sc. All rights reserved.0
Continues...
Excerpted from The Myth of Alzheimer's by Whitehouse, Peter J. Copyright © 2008 by Whitehouse, Peter J.. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Loading...