A. Bob, to have formulated such a question, you indeed have a long-term perspective on health matters that in part must be due to your stated age. In these times diseases become prominent or popular because of three elemental pressures: 1. Presence, 2. Progress, and 3. Personalities. The pressure of presence refers to how common the disease is. For example, we hear about heart attacks, strokes, and cancer because they are leading killers in our society. In the middle Ages, there was not much talk around the castle about the princes heart. No, most of the health issues related to infectious diseases, such as the Plague and syphilis as they were the great killers then. Now people are living much longer, infections are less common, and the diseases of older adults are present on the health scene and therefore much discussed. You specifically asked about Alzheimers disease. One hundred years ago, the average life expectancy was about fifty years. Alzheimers Disease was defined as a specific medical problem in that era. As more and more people live longer, the problems of specific memory disorders become more prevalent; with this presence comes greater general awareness. Alzheimers disease has likely existed for centuries but was considered a necessary component of aging rather than a potentially treatable or preventable (not yet) neurodegenerative disease with specific brain matter changes. Another example of the influence of presence on popular diseases must be that of obesity. In our affluent society, half of the entire society is fat. Debilitation and death from diabetes, atherosclerosis, and other obesity-related disorders are our version of the Great Plague. It is everywhere and killing millions. That is why obesity is such a popular disease now. Life styles a mere fifty years ago did not lead to obesity. Today, life styles (less activity, more food, etc.) make obesity almost inevitability. The second factor or pressure on disease popularity is progress in medical science. Any time a disease becomes truly treatable, preventable, or curable because of an advance in medical science, it becomes very much more interesting to scientists, the press, and the public. Examples of progress leading to popularity would include heart bypass surgery, AIDS treatments, treatment of the H. pylori bacteria to cure ulcer disease (led to 2006 Noble Prize in Medicine), and organ transplantation. Another very good example is the development of the vaccine against the human papilloma virus (HPV) that causes cervical cancer. It is now being advertised and promoted for every young girl. Progress has made the issue popular. Regarding your question about reflux disease, surgery became less common for ulcers and reflux following the development of potent anti-ulcer drugs in years of 1975-1995. In the early 1990s advances in minimally invasive surgery led to more interest in medically resistant reflux disease and popularization of the surgical treatment of reflux disease. That enthusiasm is waning as we find that after surgery, many patients may still require medications. In any case, reflux disease is popular because of the great medications and surgical advances of the past twenty-five years. The third pressure is personalities that make diseases popular. Think Michael J. Fox, Magic Johnson, Katie Couric, Christopher Reeves, and Bob Dole and you are reminded of Parkinsonism, HIV, colon cancer, spinal cord injury, and erectile dysfunction. These diseases vary widely as a cause of death. No, ED is not lethal. We know about them because of the impact of the personalities who champion them. Bill Gates will impact the worldwide malaria problem with both his money and his personality. Personalities include politics to be sure. The pressures brought to bear in the 1990s by such people as Rock Hudson, Elizabeth Taylor, Arthur Ashe and others led to funding by the federal government for HIV research out of proportion to the presence of the disease in the US at the time. However, the mortality in the US from AIDS has fallen by sixty percent in the past decade. The pressure of personality-driven medical research is always a difficult topic. If there are 15,000 AIDS victims but 50,000 breast cancer deaths annually (i.e. presence), should not breast cancer research funding be three times that dedicated to HIV/AIDS? Not necessarily. Worldwide, HIV/AIDS kills many more people annually than does breast cancer. Also, virus research will promote finding cures not only for HIV/AIDS but also for Polio, Rabies, Hepatitis, and Influenza. Also, virus research may lead to ways of preventing and treating cancers such as we see today with the anti-HPV vaccine program to prevent cervical cancer. Of course, I favor more funding for both breast cancer research as well as for HIV, but one should not be too upset if personality-driven disease awareness leads to research funding out of proportion to the apparent disease presence. Good things will come of it for the entire society at some point. So, in summary, when you read about a disease, consider if it reached you because it is common (presence), it is due to a scientific breakthrough (progress) or because a star (personality) brought it to your attention. If you learn something that promotes your own or a loved ones health, any route should be appreciated. Bob, I hope this answers your question.