Is there a pathological way of ageing?

This think piece discusses ‘Alzheimer’s disease’ from a critical anthropological perspective. I aim to challenge the taken-for-granted biomedical framing in four steps. First, a brief genealogical account shows that Alzheimer’s disease as a biomedical category has only recently become a public and global health preoccupation. Second, the concept of medicalization is mobilized to illustrate the construction of and the uncertainty around this new medical object. Third, I build a case for analysing this medical category within a sociocultural context. Finally, a brief account of the relevance of social intervention is given.

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CLINICAL AND COST-EFFECTIVENESS OF DONEPEZIL, RIVASTIGMINE, AND GALANTAMINE FOR ALZHEIMER'S DISEASE

International Journal of Technology Assessment in Health Care ◽

10.1017/s026646230200034x ◽

2002 ◽

Vol 18 (3) ◽

pp. 497-507 ◽

Cited By ~ 48

Author(s):

Andrew Clegg ◽

Jackie Bryant ◽

Tricia Nicholson ◽

Linda McIntyre ◽

Sofie De Broe ◽

...

Keyword(s):

Quality Of Life ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cost Effectiveness ◽

Global Health ◽

Cochrane Library ◽

The Impact ◽

Health Cognition ◽

Economic Studies

Objectives: Systematic review of the clinical and cost-effectiveness of donepezil, rivastigmine, and galantamine for people suffering from Alzheimer's disease.Methods: Sixteen electronic databases (including MEDLINE, the Cochrane Library, and Embase) and bibliographies of related papers were searched for published/unpublished English language studies, and experts and pharmaceutical companies were consulted for additional information. Randomized controlled trials (RCTs) and economic studies were selected. Clinical effectiveness was assessed on measurement scales assessing progression of Alzheimer's disease on the person's global health, cognition, functional ability, behavior and mood, and quality of life. Cost-effectiveness was presented as incremental cost per year spent in a nonsevere state (by Mini Mental Health State Examination) or quality-adjusted life-year.Results: Twelve of 15 RCTs included were judged to be of good quality. Although donepezil had beneficial effects in Alzheimer's patients on global health and cognition, rivastigmine on global health, and galantamine on global health, cognition, and functional scales, these improvements were small and may not be clinically significant. Measures of quality of life and behavior and mood were rarely assessed. Adverse effects were usually mild and transient. Cost-effectiveness base case estimates ranged from £2,415 savings to £49,476 additional cost (1997 prices) per unit of effect for donepezil and a small savings for rivastigmine. Estimates were not considered robust or generalizable.Conclusions: Donepezil, rivastigmine, and galantamine appear to have some clinical effect for people with Alzheimer's disease, although the extent to which these translate into real differences in everyday life remains unclear. Due to the nature of current economic studies, cost-effectiveness remains uncertain and the impact on different care sectors has been inadequately investigated. Further research is needed to establish the actual benefits of acetylcholinesterase inhibitors (AChEls) for people with Alzheimer's disease and their caregivers, the relationship of these changes to clinical management, and careful prospective evaluation of resource and budgetary consequences.

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Alzheimer’s Disease Diagnostics Must Be Globally Accessible

Journal of Alzheimer s Disease ◽

10.3233/jad-210663 ◽

2021 ◽

pp. 1-3

Author(s):

Nicholas Clute-Reinig ◽

Suman Jayadev ◽

Kristoffer Rhoads ◽

Anne-Laure Le Ny

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Global Health ◽

Low Cost ◽

High Income ◽

Middle Income ◽

Middle Income Countries ◽

Disease Diagnostics ◽

Low And Middle Income

Dementia and Alzheimer’s disease (AD) are global health crises, with most affected individuals living in low- or middle-income countries. While research into diagnostics and therapeutics remains focused exclusively on high-income populations, recent technological breakthroughs suggest that low-cost AD diagnostics may soon be possible. However, as this disease shifts onto those with the least financial and structural ability to shoulder its burden, it is incumbent on high-income countries to develop accessible AD healthcare. We argue that there is a scientific and ethical mandate to develop low-cost diagnostics that will not only benefit patients in low-and middle-income countries but the AD field as a whole.

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O2-02-06: Alzheimer's Disease International's efforts to make dementia a global health priority

Alzheimer s & Dementia ◽

10.1016/j.jalz.2012.05.633 ◽

2012 ◽

Vol 8 (4S_Part_7) ◽

pp. P238-P239 ◽

Cited By ~ 1

Author(s):

Marc Wortmann

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Global Health ◽

Health Priority

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Alzheimer’s Disease Pharmacotherapy in Relation to Cholinergic System Involvement

Biomolecules ◽

10.3390/biom10010040 ◽

2019 ◽

Vol 10 (1) ◽

pp. 40 ◽

Cited By ~ 12

Author(s):

Gabriela Dumitrita Stanciu ◽

Andrei Luca ◽

Razvan Nicolae Rusu ◽

Veronica Bild ◽

Sorin Ioan Beschea Chiriac ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Global Health ◽

Disease Progression ◽

Cholinergic System ◽

Cholinesterase Inhibitors ◽

Current Understanding ◽

Brain Functioning ◽

System Involvement ◽

Global Health Challenge

Alzheimer’s disease, a major and increasing global health challenge, is an irreversible, progressive form of dementia, associated with an ongoing decline of brain functioning. The etiology of this disease is not completely understood, and no safe and effective anti-Alzheimer’s disease drug to prevent, stop, or reverse its evolution is currently available. Current pharmacotherapy concentrated on drugs that aimed to improve the cerebral acetylcholine levels by facilitating cholinergic neurotransmission through inhibiting cholinesterase. These compounds, recognized as cholinesterase inhibitors, offer a viable target across key sign domains of Alzheimer’s disease, but have a modest influence on improving the progression of this condition. In this paper, we sought to highlight the current understanding of the cholinergic system involvement in Alzheimer’s disease progression in relation to the recent status of the available cholinesterase inhibitors as effective therapeutics.

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IMPACT OF THE COVID-19 OUTBREAK ON THE CLINICAL AND RESEARCH ACTIVITIES OF MEMORY CLINICS: AN ALZHEIMER’S DISEASE CENTER FACING THE COVID-19 CRISIS

Journal of Prevention of Alzheimer's Disease ◽

10.14283/jpad.2020.17 ◽

2020 ◽

pp. 1-2

Author(s):

P.J. Ousset ◽

B. Vellas

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Global Health ◽

Health Systems ◽

Cognitive Aging ◽

Health Crisis ◽

Research Activities ◽

Memory Clinics ◽

The Impact

The 2020 Coronavirus pandemic is the greatest global health crisis we have had in recent decades, both by its own consequences and by the impact of the measures that have been taken by various countries to deal with it (1). The effect is major on Western health systems, affecting all areas of care and research, including research on Alzheimer’s disease and cognitive aging.

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The rise and fall of global health issues: an arenas model applied to the COVID-19 pandemic shock

Globalization and Health ◽

10.1186/s12992-021-00691-7 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Stephanie L. Smith ◽

Jeremy Shiffman ◽

Yusra Ribhi Shawar ◽

Zubin Cyrus Shroff

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Global Health ◽

News Media ◽

Agenda Setting ◽

Systematic Investigation ◽

Health Issues ◽

Focusing Events ◽

Health Agenda ◽

Hiv Aids

Abstract Background The global health agenda is ill-defined as an analytical construct, complicating attempts by scholars and proponents to make claims about the agenda status of issues. We draw on Kingdon’s definition of the agenda and Hilgartner and Bosk’s public arenas model to conceptualize the global health agenda as those subjects or problems to which collectivities of actors operating nationally and globally are paying serious attention at any given time. We propose an arenas model for global health agenda setting and illustrate its potential utility by assessing priority indicators in five arenas, including international aid, pharmaceutical industry, scientific research, news media and civil society. We then apply the model to illustrate how the status of established (HIV/AIDS), emergent (diabetes) and rising (Alzheimer’s disease) issues might be measured, compared and change in light of a pandemic shock (COVID-19). Results Coronavirus priority indicators rose precipitously in all five arenas in 2020, reflecting the kind of punctuation often caused by focusing events. The magnitude of change varied somewhat by arena, with the most pronounced shift in the global news media arena. Priority indicators for the other issues showed decreases of up to 21% and increases of up to 41% between 2019 and 2020, with increases suggesting that the agenda for global health issues expanded in some arenas in 2020— COVID-19 did not consistently displace priority for HIV/AIDS, diabetes or Alzheimer’s disease, though it might have for other issues. Conclusions We advance an arenas model as a novel means of addressing conceptual and measurement challenges that often undermine the validity of claims concerning the global health agenda status of problems and contributing causal factors. Our presentation of the model and illustrative analysis lays the groundwork for more systematic investigation of trends in global health agenda setting. Further specification of the model is needed to ensure accurate representation of vital national and transnational arenas and their interactions, applicability to a range of disease-specific, health systems, governance and policy issues, and sensitivity to subtler influences on global health agenda setting than pandemic shocks.

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P4-084: A Multifaceted and Semi-tailored Psycho-social Intervention for Patients With Mild Alzheimer'S Disease And Their Primary Caregivers (DAISY): A Rater-blinded, Randomised Controlled Trial

Alzheimer s & Dementia ◽

10.1016/j.jalz.2010.08.144 ◽

2010 ◽

Vol 6 ◽

pp. e47-e47

Author(s):

Gunhild Waldemar ◽

Frans B. Waldorff ◽

Ane Eckermann ◽

Dorthe V. Buss ◽

Marie-Louise Hansen ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Primary Caregivers ◽

Social Intervention ◽

Randomised Controlled

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Olhando Para Trás: os dois nascimentos da doença de Alzheimer e a senilidade no Brasil

Estudos Interdisciplinares sobre o Envelhecimento ◽

10.22456/2316-2171.4650 ◽

1999 ◽

Vol 1 ◽

Author(s):

Annette Leibing

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

History Of ◽

Medical Category

Resumo: Este artigo tenta mostrar que a doença de Alzheimer é uma categoria médica que define a senilidade diferente das noções populares no Brasil, levantando a questão das conseqüências para as pessoas envolvidas com este mal. Favorecemos um olhar histórico para mostrar como dois momentos na história da doença de Alzheimer - os "dois nascimentos"- resultam do olhar científico de uma determinada época e sua maneira de produzir saberes. Palavras-chave: Alzheimer. Memória. Abstract: This article tries to show that Alzheimer’s disease is a medical category which defines senility in a different way from popular notions in Brazil - raising that question about possible consequences for the persons involved. We favour a historical gaze to show how two moments in the history of Alzheimer’s disease - the "two births"- are the result from the scientific gaze in a certain epoch and its way of producing knowledge. Keywords: Alzheimer. Memory.

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Taking Care to Play

Advances in Psychology, Mental Health, and Behavioral Studies - Psychosocial Studies of the Individual's Changing Perspectives in Alzheimer's Disease ◽

10.4018/978-1-4666-8478-2.ch004 ◽

2015 ◽

pp. 76-103

Author(s):

Shika Card ◽

Huali Wang

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Family Caregivers ◽

Observational Data ◽

Crucial Role ◽

Anthropological Perspective ◽

Ethnographic Fieldwork ◽

The Common ◽

Therapeutic Settings ◽

Taking Care

This chapter takes an anthropological perspective to examine how different modes of communication play a crucial role in caregiving for a person with Alzheimer's disease (AD) in the context of modern-day China and to rethink the predominant perception of AD as a condition of degeneration, loss, and disability. This chapter is based on 10 weeks of ethnographic fieldwork research in Beijing, including 13 interviews with clinicians and family caregivers, as well as observational data gathered in diverse therapeutic settings. Putting into question the common impulse to listen primarily for the semantic qualities of speech, the authors argue that alternative and experimental forms of communication make possible a different interactive space between people with AD and their caregivers. This research proposes the notion of play as a particular mode of communication that can enact new and transformative practices of care and, as a result, reconfigure and reaffirm relationships of care.

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