Is Alzheimer’s really a disease? Or is it perhaps nothing more than an exacerbated expression of normal cerebral and cognitive aging, rather than a separate entity? This is certainly a change of view that clashes head-on with the dominant biomedical stance. And yet, this is what Professor Martial Van der Linden from the University of Liège and Anne-Claude Juillerat  propose in a work entitled Penser autrement le vieillissement (A new look at aging). An assertion based on some 300 scientific studies.

In 2008, Peter Whitehouse, from Case Western University in Cleveland and Daniel George, from Penn State University, caused a stir by publishing a book entitled The myth of Alzheimer's. A challenging piece of work that doesn’t deny the existence of sometimes extremely serious cognitive disorders in the elderly, but defends the idea that Alzheimer’s disease isn’t a specific entity. On the contrary, it is part of a continuum where a multitude of expressions of cerebral and cognitive aging exist side by side, shaped by a myriad of factors that can be genetic, medical, psychological or environmental.

The dominant biomedical approach attempts to describe the problematic aspects of cerebral and cognitive aging in terms of separate diseases – Alzheimer’s, frontotemporal dementia, Lewy body dementia, etc. Whitehouse’s and George’s book refutes this idea. However, one of its shortcomings is a lack of scientific argument.

A year after it was published, Martial Van der Linden, head of the cognitive psychopathology and cognitive neuropsychology units at the Universities of Liège and Geneva, and Anne-Claude Juillerat Van der Linden, clinical neuropsychologist and lecturer at the University of Geneva, translated the work of their American colleagues into French(1). While they supported the arguments presented in this book because of the many empirical observations that call into question the validity of the traditional biomedical stance, they were also aware of the book’s weaknesses. As a result, they spent a considerable effort studying the available literature with the aim of underlining, in a scientifically argued manner, the inconsistencies of the dominant biomedical approach.

Martial Van der Linden and Anne-Claude Juillerat referred to some 300 scientific studies, some of them very recent, to write Penser autrement le vieillissement (Think aging differently)(2), an essay in which they breathe new life into the ideas of Whitehouse and George by developing and fine-tuning them. The authors remind us that the medicalisation of cerebral and cognitive aging emerged in the 1970s, and gradually increased. In particular, they draw our attention to cultural and mercantile reasons. Faced with an increase in life expectancy and the associated functional and cognitive problems, Robert Butler, director of the National Institute on Aging, in the United States, pointed out that significant means would be required to grasp these issues. As Martial Van der Linden quotes him as saying: “I decided that we had to make Alzheimer’s disease a household name. And the reason I felt that, is that’s how the pieces get identified as a national priority. And I call it the health politics of anguish.”

A well-orchestrated scenario

This saw the development of an approach focused on the need to find the cause of every type of dementia, in particular Alzheimer’s, and to find the corresponding drugs. A pious hope and the bearer of many adverse effects, according to the anti-establishment movement initiated by Whitehouse and George. Indeed, according to this new view, many of the changes in the brain and cognitive difficulties observed in people diagnosed with Alzheimer's are the same as those seen in normal aging. The difference? They are simply greater.

(1) The myth of Alzheimer's, by Peter Whitehouse and Daniel George, translated by Martial Van der Linden and Anne-Claude Juillerat Van der Linden, Solal, 2009.
(2) Martial Van der Linden et Anne-Claude Juillerat Van der Linden, Penser autrement le vieillissement, Mardaga, 2014.