The Alzheimer conundrum : entanglements of dementia and aging

429 Pages·2017·2.71 MB·English

by  Lock

The Alzheimer Conundrum
The Alzheimer
Conundrum
Entanglements of Dementia and Aging
Margaret Lock
Copyright © 2013 by Princeton University Press Published by Princeton University Press, 41
William Street, Princeton, New Jersey 08540
In the United Kingdom: Princeton University Press, 6 Oxford Street, Woodstock, Oxfordshire
OX20 1TW
press.princeton.edu
Jacket art: William Utermohlen (1933–2007), detail of Self Portrait with Cat 1955.
Pencil on paper, 44 x 32 cm. Courtesy of Galerie Beckel-Odille-Boïcos, Paris.
All Rights Reserved
Library of Congress Cataloging-in-Publication Data Lock, Margaret M.
The Alzheimer conundrum : entanglements of dementia and aging / Margaret Lock.
pages cm Includes bibliographical references and index.
ISBN 978-0-691-14978-3
1. Alzheimer’s disease—Age factors. 2. Older people—Mental health. 3. Brain—Aging—
Molecular aspects. I. Title.
RC523.L63 2013
362.1968’31—dc23 2013011850
British Library Cataloging-in-Publication Data is available This book has been composed in
Verdigris MVB Pro Text.
Printed on acid-free paper. ∞
Printed in the United States of America
1 3 5 7 9 10 8 6 4 2
Dedicated to the memory of my parents,
Albert A. Foreman and Anne Foreman
Contents
Acknowledgments ix
Orientations 1
Chapter 1
Making and Remaking Alzheimer Disease 26
Chapter 2
Striving to Standardize Alzheimer Disease 51
Chapter 3
Paths to Alzheimer Prevention 76
Chapter 4
Embodied Risk Made Visible 100
Chapter 5
Alzheimer Genes: Biomarkers of Prediction and Prevention 132
Chapter 6
Genome-Wide Association Studies: Back to the Future 156
Chapter 7
Living with Embodied Omens 174
Chapter 8
Chance Untamed and the Return of Fate 207
Chapter 9
Transcending Entrenched Tensions 229
Afterword:
Portraits from the Mind 243
Notes 247
Bibliography 277
Index 301
Acknowledgments
Without the unstinting donation of time by the many experts in the
Alzheimer’s world to whom I have talked over the past ten years, some
of them repeatedly, this book could never have been written. Among
those from whom I have learned the most are Howard Chertkow, a
neurologist who works at the Jewish General Hospital, part of the McGill
University Health Center and Carol Brayne, who is the Professor of
Public Health Medicine in the Department of Public Health and Primary
Care, Cambridge University. Exchanges often took place while
consuming delicious meals prepared in one or other of our respective
homes. In addition, many other extraordinarily busy scientists,
clinicians, and genetic counselors have given generously of their time to
teach me about the world to which the majority have devoted their life’s
work. Exchanges with these experts were, inevitably, exceptionally
rewarding.
Numerous patients and families readily agreed to meet with my
research assistants or myself, often spending up to an hour or more
talking with us. These conversations frequently touched on painful
subjects, but, even so, virtually everyone insisted that they were only too
happy to assist with the research project. Robert Green, Professor of
Genetics, Neurology and Epidemiology at Harvard University medical
school, made it possible for my research team to meet with research
subjects who had volunteered to be part of the REVEAL randomized
controlled trial, for which I am very grateful. Involved researchers flew
in from several cities in the eastern United States in order to meet with
us for a whole day in Boston in preparation for the interviews we would
carry out over the following months. Howard Chertkow made it possible
for us to meet with patients who were attending a memory clinic in
Montréal, and Tom Dening, an old-age psychiatrist who resides in the
United Kingdom, was kind enough to take me along with him to meet
with families in his care living in the vicinity of Cambridge.