The New York Times has a thought-provoking piece contrasting the public health reaction to AIDS to the public health reaction to Alzheimer’s disease.
The article notes that this year AIDS has fallen out of the list of the top 10 causes of death in New York City — replaced by Alzheimer’s. In fact, the article reports, research now indicates that deaths attributable to the latter disease are grossly underestimated and that it may be responsible for nearly as many deaths in one year as AIDS has been in the more than three decades since its terrible emergence. And yet, while AIDS research remains a public health focus supported by a robust social movement, there is no similarly active movement lobbying for increased Alzheimer’s research, prevention, and treatment. Why?
Although the article correctly points out the success of the fight against AIDS as a public health movement, it was not always that way. In the early days of AIDS, there was a lot of denial and politicization of the underlying health issues, discussed in appalling detail in the excellent book And the Band Played On: Politics, People, and the AIDS Epidemic, by Randy Shilts. It wasn’t until people got past the denial and politicization and focused on the awful public health cost of AIDS that effective education, prevention, and ultimately treatment programs were developed. The fact that the disease was so terrible in its toll, and cut down our friends and family members in the prime of their lives, helped to drive the public health effort.
With Alzheimer’s, the toll of the disease is great, but the catalyzing circumstances that energized the fight against AIDS seem to be lacking. Alzheimer’s is an affliction primarily of the elderly, who are regarded as already in their twilight years. It’s a painful and somewhat embarrassing disease for surviving family members to deal with, as the victim gradually loses his mental faculties and all memories of loved ones. So far as we know, Alzheimer’s is not readily communicable, and we’ve already got facilities in place where those unfortunate souls who become debilitated can be kept and cared for while the disease does its grim and inexorable work. Those different circumstances, perhaps, explain why Alzheimer’s simply doesn’t command the same kind of attention that AIDS received.
Or, alternatively, it may be that these factors have simply kept Alzheimer’s in the denial stage for a much longer period, and only now are people finally confronting the disease and its awful consequences, which leave formerly vibrant people empty, haunted shells of their former selves. The aging of the Baby Boom generation no doubt will help to increase awareness and attention. I hope so, because the clock is ticking, and the prospect of contracting Alzheimer’s should scare the hell out of us.