An instructive, consciousness-raising look at Alzheimer's that not only makes painfully clear what it does to an individual and a family, but also clarifies how politics and cultural attitudes are intertwined with Alzheimer's research. To put a human face on her story, Gillick (Harvard Medical School) has created a composite patient, Sylvia Truman, from among the many she has known in her clinical practice in geriatric medicine. Sylvia is first brought to Gillick by her daughter, son, and daughter-in-law because of their concern about problems she is having with memory. The odd-numbered chapters chronicle Sylvia's downward spiral as she gradually loses her competence and independence. While telling Sylvia's story, Gillick shows a supportive family making tough decisions about tests, medications, and living arrangements. Adult day-care centers, assisted living, and nursing homes are imperfect at best, and the story of Sylvia's decline and her family's suffering is not a pretty one. In the in-between chapters, Gillick provides a historical perspective by describing changing attitudes toward and scientific theories about aging and senility, and research into Alzheimer's and other dementias. With the creation of the National Institute of Aging at the NIH in 1975, research into Alzheimer's moved into high gear, and owing largely to the lay advocacy movement led by the Alzheimer's Disease and Related Disorders Organization (now the Alzheimer's Association), the illness rapidly became a national concern. Gillick emphasizes, however, that the scientific goal of understanding a disease is quite different from the clinical goal of treating people and that neither a cure nor effective treatment yet exists; until that cure comes, we must learn to accept people with dementia just as we accept those with physical disabilities. While this frank and discerning book will be especially illuminating to families already beginning to cope with Alzheimer's, Gillick speaks to a much larger audience, for as her closing words warn, we are all at risk.