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c h a p t e r f i v e The Health Politics of Anguish On 15 September 1983, the U.S. House of Representatives passed a resolution declaring November of that year National Alzheimer’s Disease Month. The representatives who spoke in support of the resolution recited a litany of arguments and statistics that would have been familiar to anyone remotely familiar with the professional and popular literature on aging and dementia of the previous few years. Congress passed the resolution in the hope that ‘‘an increase in the national awareness of the problem of Alzheimer’s disease may stimulate the interests and concern of the American people, which may lead, in turn, to increased research and eventually to the discovery of a cure.’’∞ There was nothing extraordinary about any of this, of course. The content of the speeches clearly echoed the arguments of a coalition of professionals and caregiving family members of people with Alzheimer’s disease (leaders of this e√ort were often both caregivers and well-placed professionals) whose organized e√orts were making Alzheimer’s disease a household word. Moreover, talk is cheap—and such resolutions cost Congress nothing. (The Alzheimer’s disease resolution was one of a handful being pushed through that day.) Within a week, President Ronald Reagan issued a proclamation making the resolution o≈cial, and in November he held a formal signing ceremony and photo opportunity in the Oval O≈ce for leaders of the campaign to raise awareness of the disease. However prosaic, the resolution (which has been an annual political ritual ever since) was a clear indication that new meanings for old age and dementia had attained political currency. If Reagan’s signature on this resolution marked the emergence in 1983 of 114 self, senility, and alzheimer’s disease in modern america Alzheimer’s disease as a popular national cause, his handwritten letter in 1994 telling the nation that he himself had been diagnosed with Alzheimer’s marked a high point in public awareness that would be matched only when he died a decade later. Although Reagan was 83 years old at the time, his trademark physical vigor and sunny disposition remained intact, heightening the tragedy of the diagnosis. His farewell letter was both characteristically plainspoken and elegiac: ‘‘I now begin the journey that will lead me into the sunset of my life. I know that for America there will always be a bright dawn ahead.’’≤ Ronald and Nancy Reagan won widespread praise for courageously and generously sacrificing their privacy in order to advance awareness and support for increased funding of biomedical research into the disease. They and other members of the Reagan family ultimately did far more than lend the Reagan name to the fight against the disease. In 1995, the Reagans launched the Ronald and Nancy Reagan Research Institute of the Alzheimer’s Association to raise and distribute private funds for the research. In addition, Nancy Reagan became an honorary member of the association’s board and indefatigable advocate for research, and Ronald Reagan’s daughter Maureen became an active member of the board.≥ Ronald and Nancy Reagan’s decision to share his diagnosis with the public did not occur in a vacuum, of course, but fit into a strategy established by Alzheimer’s advocates to put a human face on the disease—in Reagan’s case, one of the bestknown and widely admired faces in the world. If the reconceptualization of senility as Alzheimer’s disease generated excitement among researchers, when that reconceptualization was adopted by a well-organized, articulate coalition of family members and caregivers of people with Alzheimer’s, who spoke eloquently of its ravages in the mass media and congressional hearings, politicians wanted to show their support as well. By the mid-1980s, national politicians were eager to be seen as part of a crusade to eradicate this seemingly new dread disease. And, to a remarkable degree in an era in which budget deficits dominated federal policy making, they were willing to put up the money. Congressional funding for biomedical research on Alzheimer’s disease increased dramatically in the three decades following the scientific developments described in the previous chapter. In 1976, federal funding for Alzheimer’s research was less than $1 million. It had risen to more than $11 million by 1983, when Reagan signed the resolution for Alzheimer’s Disease Month; to more than $300 million when he announced his diagnosis in 1994; and to about $700...

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