Recently, a major turning point in the field of dementia research has occurred: serious and independent studies have shown that there are risk factors that can be modified in ways that reduce dementia risk. However, the reality behind this hopeful message is much more complex than simply translating it into concrete public health prescriptions regarding medications and lifestyle changes. The objective of this article is twofold: 1. In line with observations from other authors in the field of critical public health, the recent turn in dementia epistemologies will be described as a fallacy when conceived as individualized behavioral recommendations; 2. The profound change in the notion of risk for Alzheimer’s disease (AD) – now defined using nearly identical risk factors as Vascular dementia (“vascularization of AD”) – has also had an important impact on whether people are classified as “good citizens.” After a short description of recent studies about Alzheimer’s disease and the new risk factors associated with it, three interrelated historical changes are described as being constitutive of the “new dementia.” Based on fieldwork in geriatrics in Brazil, one example will be given that illustrates how recent changes in understanding dementia result in value-laden models which, as a consequence, are sorting out people.

中文翻译：

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转向预防——道德叙事和阿尔茨海默病的血管化

最近，痴呆症研究领域出现了一个重大转折点：严肃且独立的研究表明，存在可以通过降低痴呆症风险的方式修改的风险因素。然而，这一充满希望的信息背后的现实远比简单地将其转化为关于药物和生活方式改变的具体公共卫生处方要复杂得多。这篇文章的目的有两个： 1. 与批判性公共卫生领域其他作者的观察一致，最近痴呆症认识论的转变在被视为个性化行为建议时将被描述为谬误；2. 阿尔茨海默病 (AD) 风险概念的深刻变化——现在使用与血管性痴呆（“AD 血管化”）几乎相同的风险因素进行定义——也对人们是否被归类为“好公民”产生了重要影响。在简要描述了最近关于阿尔茨海默病及其相关新风险因素的研究后，三个相互关联的历史变化被描述为“新痴呆症”的组成部分。基于巴西老年病学的实地调查，将给出一个例子，说明最近对痴呆症的理解的变化如何导致价值负载模型，从而对人们进行分类。三个相互关联的历史变化被描述为构成“新痴呆症”。基于巴西老年病学的实地调查，将给出一个例子，说明最近对痴呆症的理解的变化如何导致价值负载模型，从而对人们进行分类。三个相互关联的历史变化被描述为构成“新痴呆症”。基于巴西老年病学的实地调查，将给出一个例子，说明最近对痴呆症的理解的变化如何导致价值负载模型，从而对人们进行分类。