, Volume 17, Issue 3, pp 197-212

Cultural construction of disease: A ``supernormal'' construct of dementia in an American Indian tribe

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The cultural construction of diseasemodel is used to analyze an unusual case ofdementia in an American Indian family. Dementia is predicted to increase in AmericanIndians due to recent increases in longevity. Longevity allows for more people to live intothe ages of greatest risk for dementingdiseases, like Alzheimer's disease and thevascular dementias. The dynamics of longevity,consequent increased risk for dementia, and theconstruction of meaning for dementia arepostulated as a natural laboratory forobserving the process of meaning evolution fordysfunctions producing perceptible symptoms,particularly ones that involve cognitive andbehavioral aberrations. Dementias aremedically considered pathological, but inpopular folk terms often considered a normaloutcome of aging. In this case, however, anon-pathological etiologic attribution is foundand designated ``supernormal'' because thesymptoms are interpreted as normal but specialsince the symptoms represent communicationswith the supernatural world.