The politics of Alzheimer's disease: a case study in apocalyptic demography

Catastrophic projections of the burden to society of an increasing aging population abound. The prevailing belief is that an increasing dependent aging population means increasing demands on the resources of society, including health care resources, in the face of competing interests and diminishing, or at best finite, resources. But how justified is this "apocalyptic demography"? This article presents one challenge to the apocalyptic scenario by considering the politics surrounding the most publicized, although not the most prevalent, disease of elders: Alzheimer's disease. The recent emergence of Alzheimer's disease as the "fourth or fifth leading cause of adult deaths" is critically examined, and the evidence for the social construction of Alzheimer's disease in terms of the "biomedicalization of aging" discussed. The author considers that it is, in part, the response of the health care system (as it is currently constituted) to changes in demography and disease distribution--and not, as is commonly asserted, the numbers of elders or their increasing "morbidity"--that drives up health care costs.