Struggling over subjectivity: debates about the "self" and Alzheimer's disease.

The current conception of Alzheimer's disease emerged in the 1970s and achieved wide acceptance and popularization because it effectively served political-economic interests, solved pragmatic, clinical, and psychological problems, and met philosophical and ethical concerns. But the very success of this widespread acceptance and popularization has produced a troubling dilemma regarding the subjectivity of the person diagnosed with Alzheimer's disease. A "loss of self" is implicit in the current Alzheimer's construct, and it has been argued that, consequently, the subjective experience of being and becoming old has become increasingly distressing. It has been further suggested that a response to this unintended assault on the self can be seen in the now burgeoning literature offering diverse representations of and debates about the "self" in Alzheimer's. What appears to be at stake in these competing voices is our very notion of what comprises the self and what constitutes subjective experience. Finally, one can speculate why, as a culture, we tell these stories about aging: it could be that, as a society as well as a community of gerontological thinkers and practitioners, our struggle with the nature of the self-in-Alzheimer's reflects our struggle to grapple with what it will be like, and what it will mean, to be and become old.