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Dementia

Untangling Our American Dementia: Beyond the Myths of Alzheimer's

Moving a stagnant field forward.

Key points

  • "Alzheimer’s” is a heterogeneous syndrome and entangled with brain aging processes.
  • People living with dementia can still maintain quality of life.
  • Dementia rates have been falling in the US and Western Europe across the last several decades, thanks to successful public health approaches.

We are pleased to relaunch our blog, American Dementia, in conjunction with our release of a book by the same name. A decade ago, we published our first book called The Myth of Alzheimer’s in which we critically examined what we felt were deep misapprehensions in the field. Among them, were the notion that Alzheimer’s is one discreet “disease,” that it is unrelated to aging, and that people with dementia are irretrievably “lost selves.” A consequence of these assertions, which we pointed out in the book, is that biomarkers and molecular fixes are not likely to be helpful in clinical practice. We called for broader perspectives.

American Dementia: Brain Health in an Unhealthy Society
Source: American Dementia: Brain Health in an Unhealthy Society

Since the book’s release in 2008, its thesis has held up. It is now broadly accepted that “Alzheimer’s” is a heterogeneous syndrome and entangled with brain aging processes, a reality we have confronted in the face of consistent failures of anti-Alzheimer’s drugs over the past two decades. The person-centered care and dementia-friendly communities movements have continued growing globally, dispelling the notion that people with Alzheimer’s diagnoses must necessarily fade away into that good night. And, most recently, the controversies with amyloid biomarkers and therapies have emerged full force with the unfortunate accelerated approval of aducanumab, a monoclonal antibody directed against amyloid, that has not adequately demonstrated clinical value.

In our latest book, we pick up where The Myth left off, taking stock of a wayward field and trying to reframe what brain health might mean in an unhealthy society. Core to the story we tell is the surprising recent finding that dementia rates have actually been falling in the US and in Western Europe across the last several decades. This trend has little to do with drug development and much to do with public policies of the mid-20th century that collectively improved brain health at the population level. Our book considers what this means for the present and future, and lays out a comprehensive plan for brain health while exploring how communities can most humanely care for our elder neighbors.

We plan to use this blog to build on the message of American Dementia, and identify not merely the challenges and problems in the Alzheimer’s field but also areas where we see genuine hope and life-affirming action. In terms of our background, Danny is an associate professor at Penn State College of Medicine, where he is a faculty member in the Department of Humanities and Department of Public Health Sciences. He has over 140 professional peer-review publications, and his research on intergenerational issues in dementia care has been recognized by the global advocacy group Alzheimer’s Disease International.

Peter is a neurologist, ethicist, and psychologist who is Professor of Neurology, with secondary positions as Professor of Psychiatry, Cognitive Science, Neuroscience, Organizational Behavior, and Design and Innovation and former appointments (but current interests) in Psychology, Bioethics, History, and Nursing at Case Western Reserve University. He is also currently Professor of Medicine at the University of Toronto a former fellow at the University of Oxford, and Founding President of Intergenerational Schools International (now InterHub). In 1999 Peter founded with his wife, Catherine, The Intergenerational Schools, unique public, multiage community schools in Cleveland. He is a serial/parallel social innovator with a focus on learning environments, and author and editor of hundreds of academic papers, book chapters, books, and multimedia projects ranging from genetics and cognitive neuroscience, to clinical issues, to community and public health, and ethics and the humanities.

We look forward to starting a conversation here and appreciate the chance to share our perspective with the Psychology Today community.

References

George, DR, Whitehouse PJ. (2021). American Dementia: Brain Health in an Unhealthy Society. Baltimore: Johns Hopkins University Press.

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