American Dementia: Brain Health in an Unhealthy Society

by Daniel R. George, Peter J. Whitehouse

Overview

Have the social safety nets, environmental protections, and policies to redress wealth and income inequality enacted after World War II contributed to declining rates of dementia today—and how do we improve brain health in the future?

Winner of the American Book Fest Health: Aging/50+ by the American Book Fest, Living Now Book Award: Mature Living/Aging by the Living Now Book Awards

For decades, researchers have chased a pharmaceutical cure for memory loss. But despite the fact that no disease-modifying biotech treatments have emerged, new research suggests that dementia rates have actually declined in the United States and Western Europe over the last decade. Why is this happening? And what does it mean for brain health in the future?

In American Dementia, Daniel R. George, PhD, MSc, and Peter J. Whitehouse, MD, PhD, argue that the current decline of dementia may be strongly linked to mid–twentieth century policies that reduced inequality, provided widespread access to education and healthcare, and brought about cleaner air, soil, and water. They also

• explain why Alzheimer's disease, an obscure clinical label until the 1970s, is the hallmark illness of our current hyper-capitalist era;
• reveal how the soaring inequalities of the twenty-first century—which are sowing poverty, barriers to healthcare and education, loneliness, lack of sleep, stressful life events, environmental exposures, and climate change—are reversing the gains of the twentieth century and damaging our brains;
• tackle the ageist tendencies in our culture, which disadvantage both vulnerable youth and elders;
• make an evidence-based argument that policies like single-payer healthcare, a living wage, and universal access to free higher education and technical training programs will build collective resilience to dementia;
• promote strategies that show how local communities can rise above the disconnection and loneliness that define our present moment and come together to care for our struggling neighbors.

Ultimately, American Dementia asserts that actively remembering lessons from the twentieth century which help us become a healthier, wiser, and more compassionate society represents our most powerful intervention for preventing Alzheimer's and protecting human dignity. Exposing the inconvenient truths that confound market-based approaches to memory enhancement as well as broader social organization, the book imagines how we can act as citizens to protect our brains, build the cognitive resilience of younger generations, and rise to the moral challenge of caring for the cognitively frail.

Product Details

ISBN-13:	9781421440477
Publisher:	Johns Hopkins University Press
Publication date:	09/14/2021
Pages:	424
Sales rank:	1,121,231
Product dimensions:	6.12(w) x 9.25(h) x 1.24(d)
Age Range:	18 Years

About the Author

Daniel R. George, PhD, MSc, is an associate professor in the Department of Humanities and the Department of Public Health Sciences at Penn State College of Medicine.

Peter J. Whitehouse, MD, PhD, is a professor of neurology at Case Western Reserve University and the cofounder of the Intergenerational Schools. Together, they are the coauthors of The Myth of Alzheimer's: What You Aren't Being Told about Today's Most Dreaded Diagnosis.

Table of Contents

Preface
Chapter 1. Occupy Alzheimer's! Setting the Scene for Resistance
Chapter 2. Alzheimer's and the Neoliberal Turn: "Politics of Anguish," Visions of a Cure
Chapter 3. Alzheimer's Today: Inconvenient Truths in the Marketplace of Memory
Chapter 4. Treating Populations: Collectively Strengthening the Brain Health of the Many, Not the Few
Chapter 5. Flint Still Doesn't Have Clean Water: What the Lead-Poisoning Tragedy in Michigan Means for Alzheimer's
Chapter 6. #PoorLivesMatter: Fighting Poverty to Resist Alzheimer's
Chapter 7. Turning Up the Heat on Global Warming: The Neurologic Costs of Climate Change
Chapter 8. Occupy the Nursing Home! Breaking Down Walls and Breaking Out "Socialceuticals"
Chapter 9. A Bridge beyond Loneliness: The Gathering Momentum of Age- and Dementia-Friendly Communities
Chapter 10. The Intergenerational Schools: Desegregating and Revaluing the Cognitively Frail
Acknowledgments
Appendix: An Intergenerational Interview with the Authors
Notes
Index

What People are Saying About This

Mona Hanna-Attisha

George and Whitehouse brilliantly diagnose America's dementia and prescribe a timely antidote—a society built on empathy and equality. As we emerge from the pandemic and face a future of increasing crises, this is the playbook we need.

Veljko Dubljević

A breath of fresh air. Strong both scientifically and ethically, American Dementia is a practical and engaging book.

From the Publisher

A breath of fresh air. Strong both scientifically and ethically, American Dementia is a practical and engaging book.
—Veljko Dubljevic, North Carolina State University, coeditor of Advances in Neuroethics book series

George and Whitehouse present a deceptively simple but radical hypothesis: Making life better at a population level has already lowered rates of dementia and, going forward, is the best strategy for preventing dementia. Their wide-ranging defense of this proposal should spark discussion, a commitment to change, and action.
—Peter V. Rabins, MD, MPH, Professor Emeritus, Johns Hopkins School of Medicine, author of Is It Alzheimers?

A compelling narrative that describes how we arrived in 2020 with persisting and obvious inequalities in brain health and no 'cure' for the disorder called Alzheimer's disease, despite massive investment. Most particularly, the book explores how history, politics, and culture have interacted with business and academic worlds to create this situation. A must-read.
—Carol Brayne, Cambridge Public Health, University of Cambridge

George and Whitehouse brilliantly diagnose America's dementia and prescribe a timely antidote—a society built on empathy and equality. As we emerge from the pandemic and face a future of increasing crises, this is the playbook we need.
—Mona Hanna-Attisha, MD, Flint pediatrician, author of What the Eyes Don't See: A Story of Crisis, Resistance, and Hope in an American City

In this thought-provoking book, George and Whitehouse make clear that, in order to understand brain health and cognitive decline more fully, we must consider the quality and inclusiveness of the environments through which we travel from birth to death. Policymakers should pay attention to this book as we try to rebuild a healthier and fairer country after COVID-19.
—Kenneth Langa, MD, PhD, University of Michigan

Kenneth Langa

In this thought-provoking book, George and Whitehouse make clear that, in order to understand brain health and cognitive decline more fully, we must consider the quality and inclusiveness of the environments through which we travel from birth to death. Policymakers should pay attention to this book as we try to rebuild a healthier and fairer country after COVID-19.

Mona Hanna-Atisha

"George and Whitehouse brilliantly diagnose America's dementia and prescribe a timely antidote—a society built on empathy and equality. As we emerge from the pandemic and face a future of increasing crises, this is the playbook we need."

Carol Brayne

A compelling narrative that describes how we arrived in 2020 with persisting and obvious inequalities in brain health and no 'cure' for the disorder called Alzheimer's disease, despite massive investment. Most particularly, the book explores how history, politics, and culture have interacted with business and academic worlds to create this situation. A must-read.

Peter V. Rabins

George and Whitehouse present a deceptively simple but radical hypothesis: Making life better at a population level has already lowered rates of dementia and, going forward, is the best strategy for preventing dementia. Their wide-ranging defense of this proposal should spark discussion, a commitment to change, and action.

Editorial Reviews

Reviewer: Ashley Holdridge, DO (The Comprehensive Headache Center)
Description: The title "American Dementia" would lead one to infer the content would be about an update in dementia or how dementia may have evolved differently in the United States as opposed to other parts of the world. However, "American Dementia" serves as a metaphor for the political malice over the last four decades. The book "interrogates" how capitalism has led us down a path of greed and selfishness at the expense of the greater good of society. The book briefly touches on the history of the basic pathophysiology of Alzheimer's disease, but the main focus is on the barriers created by neoliberalism and capitalism resulting in an unhealthy and unsafe environment that, in turn, fuels the degradation of brain health. The idea of a "cure" for Alzheimer's via pharmacologic methods is repeatedly crushed. Socialistic ideals of universal health care, free upper-level education, and a higher minimum wage are explored as a means to approach dementia. It is not until the last chapter that a more realistic, cheerful, and hopeful solution is revealed - the idea of intergenerational schools as a means to re-integrate an aging society.
Purpose: The purpose of the book is to reveal the pitfalls that have emerged from the neoliberal and capitalistic era we are in. The authors' aim is to expose the alterative motives of government and Big Pharma to name and promote Alzheimer's as a "disease" that can be "cured" by medication as well as point out the vast amount of money and resources that have been sunk into the development of new drugs for a "cure." The schemes have resulted in the "rich getting richer" at the expense of the middle and lower classes. The authors advocate not for a "cure," but for changes within society that would benefit the greater good of all as opposed to individuals. Socialistic ideals of universal health care, free upper-level education, and a higher minimum wage are offered as solutions. The authors go as far as offering alternative methods of playing football as a way to reduce traumatic brain injuries, which can lead to cognitive impairment. The book does meet the objectives that are extensively presented in the first half of the book.
Audience: The book does not target a specific specialty despite the title inferring a neurologic focus. It focuses more on the political climate as opposed to the actual pathophysiology of Alzheimer's. The book does not appear to be written toward a specific group, such as students, residents, physicians, etc., as it is not a "medical book." The authors are credible authorities on the subject as both are professors, one in humanities and public health and the other in neurology.
Features: The book aims to expose the "commercialization" of Alzheimer's disease. An interesting point is that it was not until the 1970s that "Alzheimer's became a household word." The authors reveal that it was a political push resulting in millions of dollars spent on drug development that has come up short and agendas to line the pockets of the wealthy. The authors delve into how capitalism has created more of a divide with the increase in monetary growth of the 1% at the expense of the rest of the 99%. The disparities of race, education, and poverty are discussed. The link between unhealthy food consumption leads to an increased risk of cardiovascular and cerebrovascular disease, which, in turn, can affect the brain. Insight into lead exposure and fracking as well as stress, loneliness, and sleep deprivation can result in an increased risk of dementia. The first third of the book paints a very somber picture; however, the book concludes with the example of intergenerational schools. One of the authors describes how he was one of founders of The Intergenerational School, which brings those with cognitive disorders into elementary schools to mentor children. This gives purpose to the "cognitively frail" while offering coaching and motivation to the children. This example provides a comforting and realistic ideal for the future of our aging population. While it is important to understand the background on how capitalism and neoliberalism have shaped our current situation, a shortcoming would be the amount of redundancy in pointing out the faults. While the goal of providing for the masses as opposed to the individual is certainly refreshing, the socialistic dreams of universal health care and free higher-level education does not take into account the run-off costs that would inevitably be passed on to consumers.
Assessment: The first few chapters were difficult to read. Personally, I was expecting to update my knowledge of dementia (full disclosure, I did not have the book's description ahead of time). After coming back to the book multiple times, I was able to get past the redundancy of the political anguish and political climate and was able to connect the message of social inequality and dementia. While it is common knowledge, at least in the medical community, that dementia is not only pathologic but has environmental influences, pointing out the deficiencies in the social and environmental systems is key. It is mind boggling to understand why a country as rich as the United States still has as many impoverished citizens with poor access to clean water and healthy food options. These environmental factors lead to decreased access to healthy foods, which, in turn, lead to an increased risk of cardiovascular and cerebrovascular disease. What is not commonly acknowledged, however, is loneliness and how this affects brain health. One stretch was offering ways to alter American football to decrease the risk of traumatic brain injuries. While this seems logical, implementing these changes would be difficult. The final chapter introduced the integration of the "cognitively frail" into schools and society, which was a breath of fresh air and a pleasant conclusion rather than a dismal outlook.

Doody's Review Service

George and Whitehouse had me turning each page with wonder over topics I know well, to which their insight brought newperspective . . . [American Dementia] will enlighten a lay public, and experts in Alzheimer's disease, new and old.
—George Perry, PhD, Journal of Alzheimer's Disease

From the Publisher

George and Whitehouse had me turning each page with wonder over topics I know well, to which their insight brought newperspective . . . [American Dementia] will enlighten a lay public, and experts in Alzheimer's disease, new and old.

Journal of Alzheimer's Disease - George Perry