Saturday, October 23, 2010

Time Magazine covers Alzheimer's; note Gibbs's backpage on caregivers

The October 25, 2010 issue of Time Magazine, which I consumed on an Amtrak train round trip to New York recently, is largely devoted to Alzheimer’s Disease, which a lead story by Alice Park (“Alzheimer’s Unlocked: After years of disappointing vaccine and drug trials, researchers are finding new ways to interrupt the memory-robbing disease, just in time for an anticipated explosion in cases”, p 53.
The most important piece appears on the back page, by Nancy Gibbs, “The Coping Conundrum: The longer we live, the more important elder care becomes. But who looks after the caregivers?” link here (requires subscription). Gibbs’s first sentence refers to the biological life cycle as if the answer to a biology test question, that we spend our final days being gently lowered, just as in our childhood we are raised up by our parents, as in that Josh Groban song.

She gives alarming statistics on women and Alzheimer’s and notes that the majority of caregiving for it, unpaid and much of it unchosen, falls on women. Another sidebar on p 55 by Patti Davis, regarding Ronald Reagan’s family, says “Particularly in a disease like Alzheimer’s, in which parts of a person die off gradually, it’s been my observation that men tend to back away in discomfort. Women, on the other hand, inhabit the experience fully…” That’s partly because, even in a free individualistic culture, men are brought up to see disease in moral terms.

Indeed, many people age into the late 90s or over 100 without much disability; but the demographic prognosis as the baby boomers retire is dire: people will spend many more years of their lives in disability (not just Alzheimer’s) than did previous generations, and there are fewer children to care for them, and institutions will be stretched. True, a lot more can be done in the CCRC area, as there is plenty of real estate market incentive to build more of them (an irony given the mortgage crisis).

Much of the Time issue deals with early testing and future opportunities for prevention. This raises new questions, about insurance or employment discrimination, for example, related to future genetic or neurological tests. It also says that, even given our debt-ridden economy, we can’t back off on research. Alzheimer’s has replaced AIDS (ironically, in the view of someone who survived and buddied the 1980s) as likely our number 1 public health problem.

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