This article is part of an ongoing series, Science at the Cinema, which explores research and researchers portrayed in film.
“Still Alice,” released last December, catalogs the insidious cognitive decline of a woman with Alzheimer’s Disease. With a narrative about an illness that afflicts tens of millions of people worldwide, the film shows not only the disease’s biological toll but also its associated deterioration of personal relationships. As the nation’s average age grows increasingly older, the emotionally provocative film brings to light some pressing personal and public health issues associated with dementia.
The disease manifests itself in increasingly conspicuous ways in the life of the main character, Alice Howland, a linguistics professor at Columbia. She first notices her mind going awry when she gets lost while going for a routine run around Columbia’s campus. As her disease progresses, she becomes more forgetful, even struggling to remember her daughters’ names.
Alzheimer’s currently affects about 5.3 million people in the United States — two-thirds of them women, according to the Alzheimer’s Association. As the only top-10 cause of death in the United States that cannot be prevented or cured, the disease also has a large economic cost, projected to total $226 billion in 2015.
Alzheimer’s is a “major public health problem” now and for the future, as the portion of the population over 65 is growing, said Stephen Salloway, professor of neurology and psychiatry and human behavior. In Japan, another country with a disproportionately large elderly population, more elderly diapers are sold annually than baby diapers, he added.
Salloway is currently spearheading a research project aimed at finding viable preventative medications for early-onset Alzheimer’s — the same form of disease Alice has.
Brown hosts a variety of research that focuses on prevention and treatment of the disease, said Geoffrey Tremont, associate professor of psychiatry and human behavior. Some projects focus on attacking the malicious proteins that build up in a brain with Alzheimer’s, while others seek to find early detection methods, he added.
Professor of Neurology Brian Ott is developing a registry of people who may be at risk for the disease that could be used to identify risk factors, Tremont said.
Symptoms of Alzheimer’s include forgetting new information, repeating certain habits and struggling to learn, Tremont said. Family members typically notice that “little pieces fade over time” in the afflicted family member, he added. “Still Alice” did a “pretty good job of being realistic” about the issues surrounding the disease, he said.
The disease also takes a large chunk out of Alice’s ego, as she struggles with a cognitive disorder while trying to maintain her successful career in a high-caliber arena of academia. After she is diagnosed with Alzheimer’s, she writes down personal questions with which she quizzes herself every morning. She then records a video message saying that when she can no longer answer the questions, she should kill herself.
Behaviors like these are not typical of Alzheimer’s patients, as most, unlike Alice, are not aware of a decline in their capacities, Salloway said. But they are likely to become depressed, irritable or impatient, he added.
While the disease’s mark on the person afflicted is indelible and readily identifiable, the toll on caregivers and family members — poignantly featured in the film — is often overlooked. As the movie portrays, caring for a person with Alzheimer’s requires an enormous commitment of time and emotional resources. Toward the end of Alice’s cognitive decline, she is unable to recognize her own children, spurring familial turmoil. Her daughter Lydia ultimately decides to move in with Alice to provide more thorough care — a decision that requires immense personal sacrifice.
Alice’s daughter belongs to the “sandwich generation,” composed of people who must care for their aging parents while rearing families of their own, Salloway said.
“One of the biggest burdens for Alzheimer’s is that the care falls to the family,” he added.
In 2014, friends and family of people with Alzheimer’s and other dementias provided an estimated 17.9 billion hours of unpaid care, according to the Alzheimer’s Association.
Alzheimer’s care will ultimately include both a cocktail of medications and lifestyle factors, Salloway said.