Maanya Agarwal
Still Alice (2014) is a drama film that follows the life of a linguistics professor named Alice who is diagnosed with Familial Alzheimers Disease at 50 years old. The movie follows Alice as she navigates her disease along with her husband and three children and the profound effect it has on her identity. This movie shows a raw and meaningful look into living with such a disorder and leaves one with a realistic depiction of the symptoms. This article breaks down the portrayal of Familial Alzheimers, the experience of dealing with it as well as the impact on its audience.
Alzheimer's disease (AD) is a progressive neurologic disorder which is the most common cause of dementia - a continuous decline in thinking, behavioural and social skills that affect a person's ability to function independently (Mayo Clinic, 2022). The disease disrupts normal cell function in the brain and eventually leads to cell death (Mayo Clinic, 2022). Most people start experiencing symptoms after 65 years of age but around 6 to 10% of people experience symptoms before 65, known as Early onset Alzheimers. Familial Alzheimers is where a single gene mutation passes through families, leading to early onset Alzheimers in about 5% of AD patients (UCSF, n.d).
Through Alice, the film manages to show the rawest components of Alzheimer’s and its symptoms as well as a realistic approach to how she and her family deal with it. Alice’s first encounter with the symptoms happens as she forgets a word during a speech. While not a generally alarming occurrence, for a linguistics expert like her, she is stunned by the mistake. The audience then sees a gradual increase in such occurrences as her forgetting her path back home on a run and forgetting a family recipe, prompting her to take some tests advised by her doctor. These scenes and more portray a few recognizable early signs of AD which include memory loss, concentration and visual-spatial difficulties, and social withdrawal (Jha, 2016). We also see a scene where she forgets who her daughter is at one point in the day but then remembers her at the end of it, A helpful portrayal of how the symptoms can vary even through the day there is no set rate of advancement or set direction, especially when it comes to Early onset AD (Jha, 2016). She is diagnosed with FAD and the film picks up pace as we see her further deterioration. We witness Alice plan out her suicide, preparing recorded instructions for herself if she begins to forget her family and her identity. The risk of suicide is nearly seven times higher after a diagnosis of young-onset dementia and suicidal ideation is more likely in the first few months of this diagnosis (Upham et al., 2022). This could be partly due to the rarity of this disease for under-65-year-old patients and there is more existing autonomy to make such a decision about their future. She initially hides her diagnosis with the film exploring the role of technology - it is an easy way to help mask and manage dementia symptoms. This is shown through her phone addiction and dependence on her organising systems (Jha, 2016). Alice’s actress, Julianne Moore, further portrays symptoms of language difficulty, a self-dissolving and at the start, her being aware of her own dissolution. With this, she loses gradual control over her autonomy, an important component of the disease described in the DSM-5.
The movie focuses heavily on the concept of self as Alice’s condition advances. We see her lose speech and motor control. She loses mobility functioning to the point she is completely dependent on her caregivers. Research shows that there is a severe decline in the patient’s sense of self as dementia advances due to these symptoms (Norberg et al., 2019). This is the main theme behind the movie, titled “still” Alice, referring to if she is still considered her original self after she has lost her personality and self-concept. This question is also explored in context to her family, as we see her husband contemplate a career move to a different state as he thinks that Alice isn’t the old Alice he was married to, thus, he feels he can make decisions from a solely medical perspective. There is no cure for the disease, and the film emphasises the hopelessness that comes with that till the end of the film as Alice is a semblance of herself at that point of her disease and has been left by her husband due to there being nothing more to be done.
While the movie manages to explore and accurately portray these experiences, There are other nuances and factors that it glosses over. FAD is an extremely rare condition and shows differently than general Alzheimers. Alice’s condition deteriorates rapidly in a year but that isn’t the case generally where there can be a 4-8 year window (Dabak, 2020). It was also found that the prevalence of non-memory presentations among the patients with early-onset AD was five times more in comparison to the late-onset AD cases (Koedam, et al., 2010). These differences in symptoms and timeline of advancement are not explicitly identified in the film. This leaves audiences with a very specific view of Alzheimer’s that most people do not experience. Familial AD is genetic and thus a big part that comes into it is testing for her children. While there is a scene where they make their decisions to get tested or not, This storyline and the weight of that decision are barely explored.
Despite these shortcomings, Still Alice manages to portray the cruel toll of a disease such as Familial Alzheimers, building awareness and encouraging people to research more about this rare condition and hopefully advocate for better research and healthcare resource developments. The film also helps empathise with AD patients and the heavier message it carries about living with Alzheimer’s and its effect on one’s identity makes it more than a drama film and a far more important piece of media to be consumed.
References
Carpenter, B. (2018, June 22). 'still Alice': The cruel toll of early-onset alzheimer's. Center for the Humanities. Retrieved December 11, 2022, from https://humanities.wustl.edu/features/Brian-Carpenter-Still-Alice
Dabak, S. (2020, February 21). To educate or to not educate: A look into scientific accuracy of films. Lake Forest College. Retrieved December 11, 2022, from https://www.lakeforest.edu/news/to-educate-or-to-not-educate-a-look-into-scientific-accuracy-of-films
Jha, A. (2016, April 13). The portrayal of alzheimer's disease in "still Alice". GRIN. Retrieved December 11, 2022, from https://www.grin.com/document/321031
Koedam, E. L., Lauffer, V., van der Vlies, A. E., van der Flier, W. M., Scheltens, P., & Pijnenburg, Y. A. (2010). Early-versus late-onset Alzheimer's disease: more than age alone. Journal of Alzheimer's disease : JAD, 19(4), 1401–1408. https://doi.org/10.3233/JAD-2010-1337
Mayo Foundation for Medical Education and Research. (2022, February 19). Alzheimer's disease. Mayo Clinic. Retrieved December 11, 2022, from https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447
Norberg, A. (2019). Sense of self among persons with advanced dementia. Alzheimer’s Disease, 205–221. https://doi.org/10.15586/alzheimersdisease.2019.ch13
USCF. (n.d.). Familial alzheimer's disease. Memory and Aging Center. Retrieved December 11, 2022, from https://memory.ucsf.edu/genetics/familial-alzheimer-disease
Upham, B., Dunleavy, B. P., Upham, B., Rapaport, L., Kaufman, P., Edrie, E., & Vann, M. R. (2022, October 5). People diagnosed with early onset dementia are at higher risk for suicide. EverydayHealth.com. Retrieved December 11, 2022, from https://www.everydayhealth.com/dementia/people-diagnosed-with-early-onset-dementia-at-higher-risk-for-suicide/
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