It’s not a disease but a definition for the impaired ability to remember, according the Center for Disease Control. While a decline in memory or change in thinking and behavior effects everyday activities, dementia according to the CDC has little or nothing to do with age.
There were 55 million people experiencing dementia in 2023, and when Jessica Chastain read the script for “Memory,” a film by Michel Franco released on Friday, she was struck by the memory’s relationship with objective truth. “Motion pictures can sound like moral lectures,” she says. “They’re best when they provoke thoughts and questions.”
Franco’s search for truth follows Sylvia (Chastain) hired by the family of a man named Saul (Peter Sarsgaard) to keep him company as he navigates early onset dementia. With a background in social work, Sylvia is observed by the family in a romantic embrace with Saul.
Reckoning with her own past, Sylvia attests she was sexually assaulted in high school, a claim her own family denies, though she experiences intermittent flashbacks of child abuse, too. Which sets the stage for a caveat the MeToo Movement’s awareness campaign for sexual abuse, harassment, assault and rape never quite closed.
Truth and justice are often strange bedfellows.
Alzheimer's disease (AD) is a neurodegenerative disease that starts slowly and progressively worsens. It accounts for 60–70% of all cases of dementia.
Causing the brain to shrink and brain cells to eventually die, AD creates a protein called amyloid that builds up into plaque. These plaques are thought to be toxic and damage the cells of the brain, but researchers are developing drugs which can clear amyloid from the brain. Called immunotherapies, they target the amyloid plaques in the brain and break them down.
There are 141 drugs being tested in clinical trials for the treatment of Alzheimer’s disease and most are designed to slow down how quickly the disease progresses. Cholinesterase inhibitors like Galantamine, Rivastigmine, and Donepezil merely moderate Alzheimer's symptoms.
While existing drugs treat the symptoms of Alzheimer’s disease, they address neither the cause of the disease nor its progression. Immunotherapies are already being used in the treatment of some cancers, and researchers believe that by clearing amyloid plaques from the brain they’ll be able to slow down how quickly memory and thinking skills get worse.
Eli Lilly’s Donanemab slowed how fast memory and thinking gets worse by more than 20% when administered by intravenous drip to 1182 people. Called Trailblazer-ALZ4, the trial also slowed the decline of everyday activities like driving, doing hobbies and managing finances by 40 per cent.
Eisai’s Lecanemab removes plaque; slows the progression of Alzheimer’s disease by 27% and was approved by the FDA in 2023.
Finally, Eli Lilly’s Remternetug is under clinical development and currently in Phase III for Alzheimer’s Disease. It’s been hailed as a second generation immunotherapy and will be administered via subcutaneous injection. Similar to insulin pens used for diabetes, data shows that after 6 months of treatment 75% of 41 people in trial had amyloid entirely cleared from their brain. Due to conclude next year, Remternetug is poised for approval in 2025.
While the full results of each trial were released at the Alzheimer’s Association International Conference in 2023, every health care provider around the world can and should be in command of this research.
Is the inability to remember any more of a disadvantage than the way we skew or color the past? Seeing and believing in only our version of reality is to put subjective spin on the past. The key to the present lies with understanding the past, and therein lies the subject and object of truth.
Something is subjective if and when dependent upon perception. For example, one person may consider an encounter consensual, while another may consider it unwelcome. Both are subjective: a perception which interprets, acts upon, or wields power over an object or event. In philosophical terms, the subject and object refer to an observer and the thing being observed. It is the sole mechanic of law, civics, religion, culture, and civilization.
But when does the subject run afoul of the object? Franco’s “Memories” alights the way.
Leap of Faith
“I spoke with ten different strangers every week on the telephone when preparing for this role,” Sarsgaard says, “some of whom had early onset dementia and other who did not. I almost never knew who was who.”
While the subtext of the film was dementia and sexual assault, Franco’s treatment of the movie’s theme, tone, character and plot were its characters. “The first step in doing that is not to think of dementia as the object,” Sarsgaard says. “For the resplendent story of life and living always lies with the subject.”
While living creatures tend to focus on the unique relationship between themselves and their environment, its worth considering a subjective truth.
The Danish philosopher Soren Kierkegaard was heralded as the “father of existentialism” for daring to explore existentialist thought, crisis, dread, and anxiety in the face of an absurd world. For Kierkegaard, authenticity courage and virtue lies in human free will: the capacity or ability to choose between different possible courses of action.
“Most people are subjective toward themselves and objective toward all others, frightfully objective sometimes,” Kierkegaard writes in “The Concept of Anxiety.” He called it “a leap of faith” to consider the road less traveled.
Matter and Memory
The French philosopher Henri Bergson, a 1927 Nobel Prize winner in Literature, went further than Kierkegaard to consider memory from the perspective of both science and psychology. He postulates in Matter and Memory:
We possess two fundamental different types of memory: an intellectual memory of the present; and a non-intellectual spiritual memory of the will.
Habit Memory is an implicit, non-representational motor memory of the body that manifests itself as a disposition to react in a more or less fixed way to one's surroundings. The human brain is believed to simplify the control of large muscle groups in the body by flexibly combining muscle coordination patterns. Called muscle synergy, the brain can put the body into a seemingly endless grief loop; and be responsible the inability to make emotional closure with past events.
Conversely, Recollection Memory is the explicit representation of an event or episode from one's past life. It is precisely here, in the valiant search for memories, that any notion of a soul is saved. “If, then, spirit is a reality,” Bergson says, “it is here in the phenomenon of memory.”
Before scraping proteins, amyloid and plaque from the brain, its at least worth considering the road less traveled. Hermann Ebbinghaus, a German psychologist who pioneered the experimental study of memory, and renown for his discovery of the Forgetting Curve and the Spacing Effect observes:
All memories weaken over time. If we learn something new, but then make no attempt to relearn that information, we remember less and less of it as the hours, days and weeks go by.
The trick, of course, to rediscovery is that we become objective toward ourselves, and thoroughly open minded and subjective toward others, allowing the seasons to change while the path remains the same.