The turn towards prevention – moral narratives and the vascularization of Alzheimer’s disease

Abstract

Recently, a major turning point in the field of dementia research has occurred: serious and independent studies have shown that there are risk factors that can be modified in ways that reduce dementia risk. However, the reality behind this hopeful message is much more complex than simply translating it into concrete public health prescriptions regarding medications and lifestyle changes. The objective of this article is twofold: 1. In line with observations from other authors in the field of critical public health, the recent turn in dementia epistemologies will be described as a fallacy when conceived as individualized behavioral recommendations; 2. The profound change in the notion of risk for Alzheimer’s disease (AD) – now defined using nearly identical risk factors as Vascular dementia (“vascularization of AD”) – has also had an important impact on whether people are classified as “good citizens.” After a short description of recent studies about Alzheimer’s disease and the new risk factors associated with it, three interrelated historical changes are described as being constitutive of the “new dementia.” Based on fieldwork in geriatrics in Brazil, one example will be given that illustrates how recent changes in understanding dementia result in value-laden models which, as a consequence, are sorting out people.