Framing the Aging Experience of Today

This spring the Section on the History of Medicine and Public Health at The New York Academy of Medicine (NYAM) is hosting a lecture series examining the shift of key notions about aging. Americans’ life expectancy increased dramatically in the twentieth century, climbing from 47 years in 1900 to 77 years in 2000. In New York City the percentage of residents over the age of 65 is expected to increase by 45 percent within the next 20 years. And with this

The next installment of the series will discuss the study on successful aging and its profound revisions to our understanding of the social process of aging.

extension of age comes deep transformations in its timing, nature, and experience, lengthening both the vibrant middle age and life’s final phase, dying and death.

This series aims to deconstruct the way we think of aging and addresses the correlation between disease and aging. What are we going to do with the extra years of life that biomedicine, public health and nutrition provide? The answer to the question lies in our understanding of disease and how we incorporate policy into the cultural shifts of our time.

Assistant professor and historian Jesse Ballenger, PhD, kicked-off the series on February 5 at NYAM with "To Conquer Confusion: Aging, Culture, and Concepts of Dementia" looking at the historical arguments on whether Alzheimer’s disease should be regarded as a disease or as an extreme variant of the normal aging process. Ultimately the attitude toward aging has framed the way the disease is seen.

Dr. Ballenger suggests that scientific fact is one aspect of how we come to name a disease as such. "From a historian’s perspective disease is not just a set of biological facts clinical facts and epidemiological facts. It is also a verbal construct reflecting medicine’s intellectual and institutional history. It is a mediating structure in the doctor patient relationship, and an aspect of individual identity in an ascribed social role one can be labeled with a disease. It is an occasion and an arena for public policy debate, a focal point for expressing cultural values and frequently it is all these things at once." The history of dementia captures this as it is linked to our culture and treatment of the aging.

Dr Ballenger talked about the three historical phases of dementia starting with the first twenty years of the twentieth century when Alzheimer and his colleagues established the basic facts and frame it as a prototypical brain disease. For the next thirty years from 1930 to 1960 American psychiatry reframed dementia as a problem of aging and interpreted it in psychodynamic terms which were in accord with the dominant theory at the time, but also had some interesting ramification in terms of how gerontology approached it and contributed to some policy change. Since 1970, Alzheimer’s has been framed as the dread disease.

Once dementia became thought of as a psychosocial disease it starts to become a way of thinking about aging itself. Dementia starts to help explain a lot about the entire process of aging. It becomes apparent that modern life could be the culprit. Our social set up presents hazards for individuals growing old. Loss of friends, relatives and outlets add to the aging experience and contributes to the onset of dementia. Aging now becomes a "moral imperative". In the 1950s gerontologists began to advocate for more generous and robust public policy for older people focused on adequate pensions and recreation programs.

Dr Ballenger’s interest in aging and Alzheimer’s began in the 1980’s when he worked as a nursing assistant in a geriatric ward of a hospital. He saw first hand the rise of Alzheimer’s from what had been an obscure disease entity to a dominant diagnostic category of dementia.

Please join us for the second of this series on Wednesday, March 11, "Development of the Concept of Successful Aging." John W. Rowe, Director of the MacArthur Foundation’s Research Network on Successful Aging, will discuss the study and its profound revisions to our understanding of the social process of aging.

Posted on February 10, 2009

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Contact:
Andrew J. Martin
Director of Communications
The New York Academy of Medicine
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amartin@nyam.org

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