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What Would Reagan Do? Check the MRI

The views expressed are those of the author and are not necessarily those of Scientific American.

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A debate rages on whether President Reagan did or didn’t have Alzheimer’s disease during his time in office.

With what we have learned in the last decade about the disease, the question is relatively meaningless, except perhaps to score political points.

The simple answer: of course he did.

The newest technology—consisting of imaging and spinal taps—shows  that the disease process begins its relentless course as many as 15 years before a firm diagnosis. By the time the first symptoms appear, the disease is already progressing. While in office, Reagan had moments of incomprehension interspersed with fully lucid thinking. So Reagan was well along the glide path to dementia when he was staring down the Evil Empire.  The beloved conservative acronym WWRD might have been reframed: WSHBDAR: What Should Have Been Done About Reagan.

It doesn’t really matter. Reagan will retain his exalted status within conservative hagiography. The more interesting question lurks ahead for future presidential candidates. The most significant advance in the Alzheimer’s field in recent years is the advent of these imaging and spinal fluid "biomarkers" that can probe the course of the disease years before the first symptom. The techniques might not be fully ready for prime time, but they’re getting there fast. In January, an FDA advisory panel voted to recommend, with just a few conditions, the approval of an imaging test that shows in living patients the buildup of the amyloid protein fragments characteristic of the disease.

Aging remains the biggest risk factor for Alzheimer’s and, reminiscent of Reagan, many presidential candidates are well on in years. Once these tests gain acceptance, pressure will justifiably grow for a candidate to undergo testing to prove that the slip-of-the-tongue on the campaign trail was just an innocuous error. A man or woman who holds the public trust to make a decision about when to push The Button to send ICBMs hurtling on their way needs to be playing with the fullest of decks. In Search of the President’s Brain—with a nod to Garry Trudeau—may become a refrain of future campaigns. Watch for bioethicists and neurologists to take a place alongside pollsters and other handlers during this new decade.

 SOURCE: Executive Office of the President


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  1. 1. quincykim 4:35 pm 02/7/2011

    What in the world is this piece doing in SA? I’m not particularly conservative, yet I find this biased blog to be inappropriate for this site. Just because it mentions MRIs and Alzheimer’s doesn’t qualify it as scientific. Is it simply supposed to stir things up? Thumbs down.

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  2. 2. rgcorrgk 7:45 pm 02/7/2011

    Does seems like a cheep shot (the day after RR’s 100 th B-day).

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  3. 3. letxequalx 8:16 pm 02/7/2011

    What would Reagan do? Whatever Donald Regan told him to, of course.

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  4. 4. niells 4:16 am 02/8/2011

    Please, Gary, enlighten us, what should have been done about Reagan?

    Here’s another question, what if the onset of Alzheimer’s could be determined genetically at birth?

    Should anyone so diagnosed be constitutionally precluded from seeking the presidency? Who’s to say it doesn’t start before 15 years prior to diagnosis?

    How do we prove that our President’s continuous "mis-speaking" lapses are just innocuous errors? I’m growing increasingly concerned myself.

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  5. 5. alflanagan 7:04 am 02/8/2011

    I think those who see this as an attack on Reagan are missing the point. At the time, no one could have known, nor is there any way to know to what extent the disease affected him during office. It’s a legitimate concern for the future, however.

    Fortunately, my mis-speaking has been characteristic since birth, so Alzheimer’s isn’t implicated.

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  6. 6. billcross23 6:49 pm 02/9/2011

    On the one hand, "The American People Need To Know!!" On the other, imagine the witch hunts that will ensue once this testing is commonly done in all walks of life. Think it’s just the President who will have to account for his momentary lapses ?? I think not.

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  7. 7. deike 8:46 am 02/10/2011

    I am certainly no fan of Reagan and believe he demonstrated exceedingly poor judgment on a number of occasions while in office. IHMO, whether his judgment was clouded by dementia or astrology is effectively immaterial.

    For example, does it really matter if the Iran-Contra affair resulted from a buildup of protein fragments in his brain or a misguided expression of patriotic fervor? Either way, it was a demonstrably bad, and Constitutionally suspect, decision.

    Our current political system suffers from a lack of intellectually honest commentators, not an absence of neurological diagnostics.

    Given the level of histrionics and absurdities that have attended recent presidential campaigns, the prospect of pre-qualification by MRI or protein analysis is both singularly terrifying and fantastically comical.

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  8. 8. bucketofsquid 5:24 pm 02/10/2011

    Can we apply this technology to celebrities and news commentators as well? I’m no Republican but every president makes mistakes as well as good descisions. The article seemed a bit mean to a man that suffered from a horrible malady.

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