Wednesday, September 3, 2014

The Illness That Will Define Our Times

We Are Entering the Age of Alzheimer's You and everyone you know will touched by the disease. How are we going to get through this?

Try as we do, us Americans still croak. One and all, somehow, even today. We are done in by ten likely suspects: heart disease, cancer, stroke, diabetes. Nephritis. Suicide. Yet we can and do fight these things. We have working cures, preventive regimens, ways to halt the damage for all of these commonest causes of death.

All of them, that is, save one.

Alzheimer’s disease is practically unheard of in adults younger than 40, and very rare (one in 2,500) for those under 60. It affects 1 percent of 65-year-olds, 2 percent of 68-year-olds, 3 percent of 70-year-olds. After that, the odds start multiplying. The likelihood of your developing Alzheimer’s more or less doubles every five years past 65. Should you make it to 85, you will have, roughly, a fifty-fifty shot at remaining sane.

Eighty-five, though! That’s infinity-and-a-day away. Except that, by 2030, the population of Americans aged 65 and over also will have doubled. At that point, the number of people suffering from Alzheimer’s or related dementias around the world is expected to hit 76 million. Twenty years after that, in 2050, the number will be 135 million, including new cases in rapidly modernizing places like China and sub-Saharan Africa. The cost of their care in this country alone is projected to hit $1 trillion per annum, inflation not included.

There’s nothing new about aging. But Alzheimer’s is not simply a byproduct of old age. It is a degenerative brain disease, a fatal one. A degenerative brain disease that almost exclusively targets people who, prior to the twentieth century, were demographic anomalies.

In 1900, about 4 percent of the U.S. population was older than 65. Today, 90 percent of all babies born in the developed world will live past that age. Barring a miracle cure, or some kind of Stand-esque superfluenza, dementia will become the public health crisis of our time. A late interpolation into the shared story of human existence.

So far in the future, my guy! you might say. Who knows what medical science will cook up in the meantime? Anyway, I’ve seen the movies; I remember the dad from The Corrections. I know how this story plays out.

To the former bit of rhetoric, about the future: very true. A breakthrough may come. To the latter statements, about artistic representation—that all is great! It is great that the specter of Alzheimer’s disease (in particular) and dementia (in general) is beginning to ghost around our culture.

But this trickle of Alzheimer’s narratives will one day be an inundation. And, already, it’s ossifying into a genre. We know what to expect in a dementia tale: The devastated spouse, say, whose husband of 60 years flinches fearfully whenever she wipes at his mouth. Or else the pampered (if not little loved) child who comes of age while overseeing what age has ravaged.

I could tell you any number of such true stories. I could tell you about one or another patient at Isabella Geriatric Center in north Manhattan, which I frequented when I lived a few blocks up the street. I could tell you about the mute, smiling seniors I met on a reporting trip to Hogewey, the pioneering dementia facility just outside of Amsterdam. I could tell you my own story, about the three family members who metamorphosed into jabbering Lears before my eyes.

For the rest of the story:

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