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The usual suspects: why techno-fixing dementia is flawed

Abstract

Dementia is highly prevalent and up until now, still incurable. If we may believe the narrative that is currently dominant in dementia research, in the future we will not have to suffer from dementia anymore, as there will be a simple techno-fix solution. It is just a matter of time before we can solve the growing public health problem of dementia. In this paper we take a critical stance towards overly positive narratives of techno-fixes by placing our empirical analysis of dementia research protocols and political statements in a framework of technology assessment. From this perspective, it becomes obvious that a techno-fix is just one of many ways to approach societal problems and more importantly that technologies are way less perfect than they are presented. We will argue that this narrow scope, which focusses on the usual suspects for solving illnesses, reduces dementia to organismic aspects, and may be counterproductive in finding a cure for dementia. We conclude with outlining how the narrow scope can be balanced with other narratives and why we should have a reasonable scepticism towards the usual suspects.

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Notes

  1. 1.

    Dementia is a term used to describe various symptoms of cognitive decline such as forgetfulness, but is not a disease itself. Dementia is a symptom, caused by progressive neuro-degenerative diseases, of which Alzheimer’s disease is the most well known and most widely studied.

  2. 2.

    A more general analysis that focuses on Dutch dementia research protocols and on the exclusion criteria used in research trials, as well as a detailed description of the data analysis of the empirical data is to be found in Jongsma KR, van Bruchem-Visser RL, van de Vathorst S and Mattace-Raso FUS. Has dementia research lost sense of reality?—A descriptive analysis of eligibility criteria of Dutch dementia research protocols. Neth J Med. 2016, Jun;74(5):201-9.

  3. 3.

    The following search terms were used: dement*, cognitive decline, Alzheimer*, Parkinson*, Lewy body* LBD*, familial dement*, frontotempor*, and vascular dement*.

  4. 4.

    For American politicians, for instance, it was mandatory to take the results of Mihail Roco’s and William Bainbridge’s report Converging technologies for improving human performance into account, which was published 15 years ago and highly influential on the American National Nanotechnology Initiative (NNI) (see Roco and Bainbridge 2003; Rip and Voß 2013; Simakova and Coenen 2013).

  5. 5.

    Evgeny Morozov (2011) has pointed out that Weinberg’s controversial essay is still topical today, above all because many technologist still believe in Weinberg’s initial idea. He writes with regard to Google’s research efforts: ‘This [Weinberg’s] debate is still raging today, in part because Google, founded by a duo of extremely ambitious engineers on a crusade to “organize the world’s information and make it universally accessible and useful, “has put the production of technological fixes on something of an industrial scale. […] Name a problem that has to deal with information, and Google is already on top of it.’.

  6. 6.

    It is ironic that the WHO aims to deal with it by ‘fostering innovation and research and development of new vaccines, diagnostics, infection treatment options and other tools.’ (http://www.who.int/mediacentre/factsheets/fs194/en/).

  7. 7.

    It can be suggested that this bias partially originates from the circumstances of the engineering education, which is mostly concerned with the technical side of the coin does not offer interdisciplinary training.

References

  1. Alzheimer Europe. 2006. Paris declaration. http://www.alzheimer-europe.org/Policy-in-Practice2/Paris-Declaration-2006. Accessed 20 Aug 2016.

  2. Alzheimer Europe. 2012. National Dementia Strategies: The Netherlands. Avalaible at: http://www.alzheimer-europe.org/Policy-in-Practice2/Country-comparisons/2012-National-Dementia-Strategies-diagnosis-treatment-and-research/Netherlands.

  3. Bessant, J.R. 2013. Innovation in the twenty-first century. In Responsible emergence of science and innovation in society, ed. Richard Owen, J.R. Bessant, and Maggy Heintz, 2–25. London: Wiley.

  4. Bostrom, N. 2005. The fable of the dragon tyrant. Journal of Medical Ethics 31(5): 273–277. doi:10.1136/jme.2004.009035.

  5. Bruce, Susan. 2008. Introduction. In Three early modern utopias: Utopia, New Atlantis and the isle of pine, ed. Susan Bruce. Oxford: Oxford University Press.

  6. Byers, Thomas, Richard C. Dorf, and Andrew J. Nelson. 2011. Technology ventures. From idea to enterprise, 3rd ed. New York: McGraw-Hill.

  7. Cabrera, E., C. Sutcliffe, H. Verbeek, K. Saks, M. Soto-Martin, G. Meyer, H. Leino-Kilpi, S. Karlsson, and A. Zabalegui. 2015. Non-pharmacological interventions as a best practice strategy in people with dementia living in nursing homes. A systematic review. European Geriatric Medicine 6(2): 134–150.

  8. Cameron, David. 2013. G8 Dementia summit: Prime minister’s speech, Cabinet Office and Prime Minister’s Office, 11 December 2013. https://www.gov.uk/government/speeches/g8-dementia-summit-prime-ministers-speech. Accessed 29 Jan 2016.

  9. Chaufan, Claudia, Brooke Hollister, Jennifer Nazareno, and Patrick Fox. 2012. Medical ideology as a double-edged sword: the politics of cure and care in the making of Alzheimer's disease. Social Science & Medicine 74(5): 788–795.

  10. Cuijpers, Yvonne, and Harro van Lente. 2015. Early diagnostics and Alzheimer’s disease: Beyond ‘cure’ and ‘care’. Technological Forecasting and Social Change 93: 54–67. doi:10.1016/j.techfore.2014.03.006.

  11. Deltaplan Dementie2012. http://www.neurodegenerationresearch.eu/wp-content/uploads/2014/ 08/rapport-deltaplan-dementie.pdf. Accessed 26 Jan 2016.

  12. de Grey, Aubrey, Michael Rae, and Patrick Burgermeister. 2010. Niemals alt! So lässt sich das Altern umkehren : Fortschritte der Verjüngungsforschung, 1st ed. Körperkulturen. Bielefeld: Transcript Verlag.

  13. Dierkes, Meinolf, Ute Hoffmann, and Lutz Marz. 1992. Leitbild und Technik. Zur Entstehung und Steuerung technischer Innovationen. Berlin: Edition Sigma.

  14. Drexler, K.Eric. 1986. Engines of creation. The coming era of nanotechnology. New York: Anchor Books.

  15. European Parliament. 2011. European initiative on Alzheimer’s disease and other dementias (2010/2084(INI). http://www.europarl.europa.eu/oeil/popups/ficheprocedure.do?lang=en&reference=2010/2084(INI).

  16. Fisher, Erik, and Arie Rip. 2013. Responsible innovation: Multi-level dynamics and soft intervention practices. In Responsible innovation: Managing the responsible emergence of science and innovation in society, ed. Richard Owen, J.R. Bessant, and Maggy Heintz, 165–183. London: Wiley.

  17. George, Daniel R., and Peter J. Whitehouse. 2014. The War (on Terror) on Alzheimer’s. Dementia (London, England) 13(1): 120–130. doi:10.1177/1471301212451382.

  18. George, D.R., E.R. Whitehouse, and P.J. Whitehouse. 2016. Asking more of our metaphors: Narrative strategies to end the “War on Alzheimer’s” and humanize cognitive aging. The American Journal of Bioethics 16(10): 22–24.

  19. Gordijn, Bert. 2004. Medizinische Utopien. Eine ethische Betrachtung. Göttingen: Vandenhoeck & Ruprecht.

  20. Gordijn, B., and Henk ten Have. 2016 Dementia and technology. Medicine Health Care and Philosophy 19(3): 339–340.

  21. Grunwald, Armin. 2012. Technikzukünfte als Medium von Zukunftsdebatten und Technikgestaltung, vol. 6. Karlsruhe, Hannover: KIT Scientific Publishing.

  22. Grunwald, Armin. 2015. Ökomodernismus ist verantwortungsethisch nicht haltbar. GAIA - Ecological Perspectives for Science and Society 24(4): 249–253. doi:10.14512/gaia.24.4.10.

  23. Innes, Anthea, and Jill Manthorpe. 2013. Developing theoretical understandings of dementia and their application to dementia care policy in the UK. Dementia (London, England) 12(6): 682–696. doi:10.1177/1471301212442583.

  24. Jasanoff, Sheila. 2015. Future imperfect: Science, technology, and the imaginations of modernity. In Dreamscapes of modernity: Sociotechnical imaginaries and the fabrication of power, ed. Sheila Jasanoff, and Sang-Hyun Kim, 1–33. Chicago, London: The University of Chicago Press.

  25. Jing-Bao, Nie, Adam Gilbertson, Malcolm de Roubaix, Ciara Staunton, Anton van Niekerk, Joseph D. Tucker, and Stuart Rennie. 2016. Healing without waging war: Beyond military metaphors in medicine and HIV cure research. The American Journal of Bioethics 16(10): 3–11.

  26. Jongsma Karin, van Bruchem-Visser Rozemarijn, van de Vathorst Suzanne, and Mattace-Raso Francesco. 2016. Has dementia research lost sense of reality? A descriptive analysis of eligibility criteria of Dutch dementia research protocols. Netherlands Journal of Medicine 74(5): 201–209.

  27. Lösch, Andreas. 2006. Means of communicating innovations. A case study for the analysis and assessment of nanotechnology’s futuristic visions. Science, Technology & Innovation Studies 2: 103–125.

  28. Lyman, K.A. 1989. Bringing the social back in: a critique of the biomedicalization of dementia. The Gerontologist 29(5): 597–605.

  29. McGhee, David J.M., Craig W. Ritchie, John P. Zajicek, and Carl E. Counsell. 2016. A review of clinical trial designs used to detect a disease-modifying effect of drug therapy in Alzheimer’s disease and Parkinson’s disease. BMC Neurology 16: 92. doi:10.1186/s12883-016-0606-3.

  30. McGhee, David J.M., Craig W. Ritchie, Paul A. Thompson, David E. Wright, John P. Zajicek, and Carl E. Counsell. 2014. A systematic review of biomarkers for disease progression in Alzheimer’s disease. PLoS ONE 9(2): e88854. doi:10.1371/journal.pone.0088854.

  31. More, Max, and Natasha Vita-More (eds.). 2013. The transhumanist reader. Classical and contemporary essays on the science, technology, and philosophy of the human future. Chichester, West Sussex: Wiley-Blackwell.

  32. Morozov, Evgeny. 2011. The net delusion. The dark side of internet freedom, 1st ed. New York: PublicAffairs.

  33. Morozov, Evgeny. 2014. To save everything, click here. The folly of technological solutionism. New York: PublicAffairs.

  34. Moser, Ingunn. 2008. Making Alzheimer’s disease matter. Enacting, interfering and doing politics of nature. Geoforum 39(1): 98–110. doi:10.1016/j.geoforum.2006.12.007.

  35. Nowotny, Helga. 2006. Introduction: The quest for innovation and cultures of technology. In Cultures of technology and the quest for innovation, ed. Helga Nowotny, 1–26. Making sense of history, v. 9. New York: Berghahn Books.

  36. Nuffield Council on Bioethics. 2009. Dementia. Ethical issues. London: Nuffield Council on Bioethics.

  37. Peel, Elizabeth. 2014. ‘The living death of Alzheimer’s’ versus ‘Take a walk to keep dementia at bay’: Representations of dementia in print media and carer discourse. Sociology of Health & Illness 36(6): 885–901. doi:10.1111/1467-9566.12122.

  38. Prince, Martin, Renata Bryce, Emiliano Albanese, Anders Wimo, Wagner Ribeiro, and Cleusa P. Ferri. 2013. The global prevalence of dementia: A systematic review and metaanalysis. Alzheimer’s & Dementia 9(1): 63–75. doi:10.1016/j.jalz.2012.11.007.

  39. Richard, Edo, Ben Schmand, Piet Eikelenboom, Rudi G. Westendorp, and Willem A. van Gool. 2012. The Alzheimer myth and biomarker research in dementia. Journal of Alzheimer's disease 31(Suppl 3): S203–S209.

  40. Ritchie, Craig, Nadja Smailagic, Anna H. Noel-Storr, Yemisi Takwoingi, Leon Flicker, Sam E. Mason, and Rupert McShane. 2014. Plasma and cerebrospinal fluid amyloid beta for the diagnosis of Alzheimer’s disease dementia and other dementias in people with mild cognitive impairment (MCI). The Cochrane database of systematic reviews (6): CD008782. doi: 10.1002/14651858.CD008782.pub4.

  41. Ritchie, Craig W., Graciela Muniz Terrera, and Terence J. Quinn. 2015. Dementia trials and dementia tribulations: Methodological and analytical challenges in dementia research. Alzheimer’s Research & Therapy 7(1): 31. doi:10.1186/s13195-015-0113-6.

  42. Rip, Arie. 2012. The context of innovation journeys. Creativity and Innovation Management 21(2): 158–170. doi:10.1111/j.1467-8691.2012.00640.x.

  43. Rip, Arie, and Jan-Peter Voß. 2013. Umbrella terms as mediators in the Governance of emerging science and technology. Science, Technology & Innovation Studies 9(2): 39–59.

  44. Robin, Pierce. 2010. A changing landscape for advance directives in dementia research. Social Science & Medicine 70(4): 623–630.

  45. Roco, Mihail C., and William Sims Bainbridge (eds.). 2003. Converging technologies for improving human performance. Nanotechnology, biotechnology, information technology and cognitive science. Dordrecht, Boston, Mass: Kluwer.

  46. Rokstad, A.M.M., J. Røsvik, Ø. Kirkevold, G. Selbaek, J. Saltyte Benth, and K. Engedal. 2013. The effect of person-centred dementia care to prevent agitation and other neuropsychiatric symptoms and enhance quality of life in nursing home patients: A 10-month randomized controlled trial. Dementia and Geriatric Cognitive Disorders 36: 340–353.

  47. Schicktanz, Silke, Mark Schweda, Jesse F. Ballenger, Patrick J. Fox, Jodi Halpern, Joel H. Kramer, Guy Micco, Stephen G. Post, Charis Thompson, Robert T. Knight, and William J. Jagust. 2014. Before it is too late: professional responsibilities in late-onset Alzheimer’s research and pre-symptomatic prediction. Frontiers in Human Neuroscience 8: 921. doi:10.3389/fnhum.2014.00921.

  48. Schmidt, Eric. 2012. The world around us. Zeitgeist America.

  49. Simakova, Elena, and Christopher Coenen. 2013. Visions, hype, and expectations: A place for responsibility. In Responsible innovation: Managing the responsible emergence of science and innovation in society, ed. Richard Owen, J.R. Bessant, and Maggy Heintz, 241–266. London: Wiley.

  50. Tenner, Edward. 1996. Why things bite back. Technology and the revenge of unintended consequences, 7th ed. New York: Knopf.

  51. The, Anne-Mei. 2014. Leven met dementie: van verhalen naar inzicht. Amsterdam: De Werkvloer Centraal.

  52. van der Worp, H.B., David W. Howells, Emily S. Sena, Michelle J. Porritt, Sarah Rewell, Victoria O’Collins, and Malcolm R. Macleod. 2010. Can animal models of disease reliably inform human studies? PLoS Medicine 7(3): e1000245. doi:10.1371/journal.pmed.1000245.

  53. van Lente, Harro. 1993. Promising technology. The dynamics of expectations in technological developments. WMW-publikatie, vol. 17. Delft: Eburon.

  54. Weinberg, Alvin M. 1991. Can technology replace social engineering? In Controlling technology: Contemporary issues, 1st ed, ed. Eric Katz, Andrew Light, and William B. Thompson, 286–290. Amherst, NY: Prometheus Books.

  55. Weinberger, N., and Michael Decker. 2015. Technische Unterstützung für Menschen mit Demenz?: Zur Notwendigkeit einer bedarfsorientierten Technikentwicklung. Technikfolgenabschätzung - Theorie und Praxis 24(2): 36–45.

  56. Weinberger, N., Bettina Johanna. Krings, and Michael. Decker. 2016. Enabling a mobile and independent way of life for people with dementia: Needs-oriented technology development. In Ageing and Technology: Perspectives from the Social Sciences, ed. Emma Domínguez-Rué and Linda Nierling, 183–204, 1st edn. Aging Studies, vol. 9. Bielefeld: Transcript.

  57. Weiner, Michael W., Dallas P. Veitch, Paul S. Aisen, Laurel A. Beckett, Nigel J. Cairns, Robert C. Green, Danielle Harvey, Clifford R. Jack, William Jagust, Enchi Liu, John C. Morris, Ronald C. Petersen, Andrew J. Saykin, Mark E. Schmidt, Leslie Shaw, Judith A. Siuciak, Holly Soares, Arthur W. Toga, and John Q. Trojanowski. 2012. The Alzheimer’s Disease Neuroimaging Initiative: a review of papers published since its inception. Alzheimer’s & dementia: the journal of the Alzheimer’s Association 8(1): S1–S68. doi:10.1016/j.jalz.2011.09.172.

  58. World Health Organization (WHO), and Alzheimer’s Disease International. 2012. Dementia. A public health priority. Geneva.

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Acknowledgements

We thank R.L van Bruchem-Visser for her contribution to the initial analysis of empirical data. Karin Jongsma received a grant to conduct the initial analysis of the empirical data from the Netherlands Organization for Health Research and Development (ZonMW) with No. 40-41500-98-99002. The funder had no influence on the design, methods, subject recruitment, data collections, analysis and preparation of the paper. We also like to thank the two anonymous reviewers whose comments have helped us to improve earlier versions of the manuscript.

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Correspondence to Karin Rolanda Jongsma.

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Karin Rolanda Jongsma and Martin Sand have contributed equally to this paper.

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Jongsma, K.R., Sand, M. The usual suspects: why techno-fixing dementia is flawed. Med Health Care and Philos 20, 119–130 (2017). https://doi.org/10.1007/s11019-016-9747-9

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Keywords

  • Dementia
  • Technology assessment
  • Biomedical
  • Narration
  • Health policy