The Forgetting: Alzheimer's: Portrait of an Epidemic

From Barnes & Noble

The Barnes & Noble Review
Scientists estimate that by the year 2050, Alzheimer's disease will afflict about 15 million Americans. Considering the severe mental debilitation wrought by Alzheimer's, the effects on both the families of patients and the health care system as a whole could be substantial. In this context, David Shenk's The Forgetting is a significant contribution to the public discussion of Alzheimer's. A synthesis of scientific information and personal stories, the book traces the known origins of the disease -- which was once thought to be a natural symptom of aging -- and offers a provocative look at the medical community's quest to cure it.

Made up of "plaques" and "tangles" that appear on the cerebral cortex and destroy neurons (and, with them, memory), Alzheimer's was first detected in a patient named Auguste D. at a psychiatric hospital in Frankfurt, Germany, in 1901. At the time, Auguste D.'s condition was an anomaly to neuropathologist and physician Alois Alzheimer because at age 51, the patient seemed to be free of any psychiatric condition but, rather, appeared to be suffering from the severe effects of old age. It was this experience that led Dr. Alzheimer to undertake research that eventually uncovered the disease.

Certainly, Alzheimer's existed long before it was assigned a name. Shenk cites historical figures and literary allusions -- found in the work of, among others, Shakespeare and Tolstoy -- that attest to the existence of Alzheimer's as far back as the first century A.D. The book cites a likely case of Alzheimer's in Ralph Waldo Emerson and confirmed cases in Willem de Kooning, Ronald Reagan, and Rita Hayworth. But equally affecting as these tragic examples of extinguished public careers are the cases of "normal" people slowly losing their recollection of the fabric of their lives. Quotes from such people begin each chapter, grounding all the scientific and historical information in the reality and horror of the human experience of Alzheimer's.

This is not a guidebook to treating or coping with Alzheimer's disease; readers seeking such practical advice will find ample guidance elsewhere. Rather, The Forgetting conveys the urgency and the heartbreak surrounding the disease and challenges the way we conceive of memory. It will indeed provide a measure of comfort to anyone grappling with the devastating effects of Alzheimer's, and yet it provides more than that, revealing much about a condition that has been shrouded in darkness for so long and simultaneously exposing how much remains to be discovered. (Karen Burns)

According to Shenk, Alzheimer's disease is reaching epidemic proportions and could affect as many as 15 million Americans by the year 2050. Over the next fifty years, some 80 to 100 million people worldwide may succumb to it. Shenk's compelling book traces the history of Alzheimer's from its first diagnosis in 1901, and it chronicles the latest scientific discoveries that may eventually lead to its cure. The author includes the stories of not only Alzheimer's patients but also the families and caregivers whose lives have been affected, sometimes devastated, by it. Along the way, Shenk mentions a number of famous figures, including Ralph Waldo Emerson and Ronald Reagan, who have been victimized by the debilitating affliction. But The Forgetting is more than a record of Alzheimer's; it is an interesting study of how scientists are feverishly working—and sometimes battling one another—to find a cure.
—Mike Shea

Library Journal

The price humans pay for increased longevity is a greater likelihood of developing degenerative diseases. Among the most devastating is Alzheimer's, predicted to reach epidemic proportions by midcentury. Journalist Shenk's "biography" of Alzheimer's disease explores the nature of the baffling plaques and tangles, discovered by Alois Alzheimer in 1907, that eventually consume the brains of victims, erasing a lifetime of memories. Notable sufferers whose stories Shenk tells here include Ronald Regan, Ralph Waldo Emerson, and Willem de Kooning; there are also personal accounts from the less famous he met in Internet chatrooms. Shenk also chronicles tales of driven researchers, hellbent to be the first to unlock the disease's secrets and the riches to be made by drug manufacturers hungry for a moneymaking cure. His engrossing book draws on an amazing array of scientific, historical, ethical, religious, mythological, literary, and artistic sources and is filled with fascinating characters and first-rate explanations of the science behind the disease. (His technical discussion of memory and other aspects of the disease is much clearer than Charles Pierce's in Hard To Forget, LJ 4/15/00.) A unique and welcome addition to any scientific, aging, or Alzheimer's collection. [Previewed in Prepub Alert, LJ 5/1/01.] Karen McNally Bensing, Benjamin Rose Inst. Lib., Cleveland Copyright 2001 Cahners Business Information.

Kirkus Reviews

An intelligent and helpful tour of Alzheimer's, by science writer Shenk (The End of Patience). Since ancient times, senility has been considered a natural result of aging. Although the etiology was never clear, by the mid-20th century some blamed hardening of the arteries. In fact, although normal aging produces a mild memory deficit (mostly difficulty finding names), dementia is never normal. The author begins with the 1901 case described by neurologist Alois Alzheimer, who first noticed peculiar plaques and tangles of fibers dotting brain tissue in his microscopic exam. Victims of Alzheimer's dementia begin by forgetting: Global brain function deteriorates (beginning with higher faculties such as judgment and personality) and eventually the patient becomes mute, bedridden, incontinent, and delirious. Alzheimer's research attracted little attention in his day, but as decades passed, more and more plaques and fibers turned up in brain autopsies and, by the 1970s, it became clear that Alzheimer's was not merely common, it was epidemic. Half a million Americans suffered in 1975; today the figure is closer to 5 million, making Alzheimer's far more common than AIDS. Like AIDS it's incurable; unlike AIDS no one knows how to prevent it. The author tells the story of famous historic victims (from Jonathan Swift to Ralph Waldo Emerson to Ronald Reagan) and describes how today's patients deal with the disease. He also travels to interviews and conferences, where he reports the scientific debates now taking place over cause and treatment. Like most laymen, Shenk believes that the dramatic progress in our understanding of Alzheimer's means that a good treatment is on the horizon, but nodramatic breakthrough seems imminent. Time alone will tell. The subject may be depressing, but it's also important, and the author holds the reader's interest to the end.