Margaret Lock, PhD. |
regarding possible causes, diagnostics, biomarkers, genetics and cures. She questions prevalence estimates for the impending “Alzheimer’s epidemic” that has been forecast with great assurance by some interest groups. Lock raises provocative questions that extend beyond the realm of Alzheimer disease, such as: When is a disease not a disease? When is pathology normal? When does a natural entity become pathological? Worth a read for those of us who are charged with the responsibility of ultimately diagnosing Alzheimer disease at autopsy.
2 comments:
Thanks for the heads-up, Brian! I knew Dr. Lock was working on this, but didn't know it'd been published. For those of your readers who don't know, Dr. Lock is considered the leading medical anthropologist of our time. Her An Anthropology of Biomedicine is brilliant, and I'm looking forward to reading The Alzheimer Conundrum.
-A86
This is an interesting philosophical mechanism but not necessarily a medical one. It raises the question of what is "normal"...if 80% or so of men who die over the age of 80 are autopsied and turn out to have prostate cancer, is that "normal"? We know from papers as old as Blessed, Tomlinson, & Roth from the 1960s that 80% or more of unselected persons over 80 who came to autopsy had plaques and tangles...are the 20% who didn't "normal" or is a process which leads to plaques and tangles "normal"? No matter how one comes down on one side or the other of this philosphical debate, people are not going to want to have memory loss and cognitive failure prior to their deaths, so a search for ways to prevent the possibility (even if only half of those with plaques and tangles end up with symptoms) needs to go on.
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