Cultural construction of disease: a "supernormal" construct of dementia in an American Indian tribe.

The cultural construction of disease model is used to analyze an unusual case of dementia in an American Indian family. Dementia is predicted to increase in American Indians due to recent increases in longevity. Longevity allows for more people to live into the ages of greatest risk for dementing diseases, like Alzheimer's disease and the vascular dementias. The dynamics of longevity, consequent increased risk for dementia, and the construction of meaning for dementia are postulated as a natural laboratory for observing the process of meaning evolution for dysfunctions producing perceptible symptoms, particularly ones that involve cognitive and behavioral aberrations. Dementias are medically considered pathological, but in popular folk terms often considered a normal outcome of aging. In this case, however, a non-pathological etiologic attribution is found and designated "supernormal" because the symptoms are interpreted as normal but special since the symptoms represent communications with the supernatural world.