Cultural representations of dementia
Authors: Alexandra Hillman, Joanna Latimer
Journal: PLoS Medicine (2017)

Dementia has been positioned as one of the global health priorities of our age [1].This positioning has been accompanied by an increased attention from governments, biological and clinical sciences, practitioners, care providers, and the wider public, laying the foundations for a cultural preoccupation with loss of memory.As Margaret Lock [2], an American cultural anthropologist, suggests, Alzheimer disease (AD) and other Alzheimer-like dementias personify all that is most feared about growing old-a fear widely expressed in research on aging and experiences of aging (e.g., [3]).Dementia itself is, in part, a culturally determined phenomena, one that relies upon biomedicine's ability to name and give form to a collection of changes, behaviours, and experiences.Anthropologist Lawrence Cohen 's [4] research in India, for example, describes a community in which dementia was previously not culturally marked as something associated with suffering or warranting medical intervention.Following the growth of clinical professionals like geriatricians, alongside global media and marketization of lifestyle interventions directed at older people, local perceptions of "the elderly" changed and created a socially constructed, yet locally experienced, dementia "epidemic" [5].Indeed, cross-cultural research identifies how understandings of dementia as either a natural part of the aging process or as a result of brain disease are culturally shaped [6,7].Lock's [2] work, although not a cross-cultural comparison, is careful to consider the sociohistorical and cultural conditions-as well as the scientific developments-that have informed the separation of AD from the "normal" aging process.Similar to the growth in diagnosable mental illnesses that occurred at the turn of the twentieth century [8], dementia represents an increasingly wide compendium descriptor for many different effects [9].Differences in the ways in which dementia is conceptualised may also be shaped by social location.Although work on social class and dementia tends to be restricted to differences in associated risk factors for developing the condition or different levels of access to diagnosis, care, and support, there is a growing recognition that social class identities have a significant role to play in the ways in which dementia is both experienced and conceptualised [10].This body of research not only highlights the diverse ways in which dementia is experienced but also suggests that the cultural meanings attached to dementia-even within societies-are also not universal [11].Meanings of dementia are interpreted, embodied, or resisted by people in their social contexts, and these processes are shaped according to their social location (gender, social class, and ethnicity) and their individual biography [12][13][14].As Cohen's research in India identified, cultural representations of dementia also become entwined with other social meanings, such as the social expectations of aging [15].Recognising this complexity goes some way to helping social scientists understand how particular meanings associated with dementia gain traction over others, what the implications of these cultural representations are for those