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Portrait of an Epidemic

by David Shenk

Pub Date: Sept. 4th, 2001
ISBN: 0-385-49837-3
Publisher: Doubleday

An intelligent and helpful tour of Alzheimer’s, by science writer Shenk (The End of Patience, 1999).

Since ancient times, senility has been considered a natural result of aging. Although the etiology was never clear, by the mid-20th century some blamed hardening of the arteries. In fact, although normal aging produces a mild memory deficit (mostly difficulty finding names), dementia is never normal. The author begins with the 1901 case described by neurologist Alois Alzheimer, who first noticed peculiar plaques and tangles of fibers dotting brain tissue in his microscopic exam. Victims of Alzheimer’s dementia begin by forgetting: Global brain function deteriorates (beginning with higher faculties such as judgment and personality) and eventually the patient becomes mute, bedridden, incontinent, and delirious. Alzheimer’s research attracted little attention in his day, but as decades passed, more and more plaques and fibers turned up in brain autopsies and, by the 1970s, it became clear that Alzheimer’s was not merely common, it was epidemic. Half a million Americans suffered in 1975; today the figure is closer to 5 million, making Alzheimer’s far more common than AIDS. Like AIDS it’s incurable; unlike AIDS no one knows how to prevent it. The author tells the story of famous historic victims (from Jonathan Swift to Ralph Waldo Emerson to Ronald Reagan) and describes how today’s patients deal with the disease. He also travels to interviews and conferences, where he reports the scientific debates now taking place over cause and treatment. Like most laymen, Shenk believes that the dramatic progress in our understanding of Alzheimer’s means that a good treatment is on the horizon, but no dramatic breakthrough seems imminent. Time alone will tell.

The subject may be depressing, but it’s also important, and the author holds the reader’s interest to the end.