The surrounding wheel represents the environment and comprises biological, social, and physical dimensions. Introduction. The wheel consists of a hub that represents the host and its human characteristics such as genetic makeup, personality, and immunity. The generally accepted figures are that 5% of individuals of the age of 65 have severe dementia, and another 10% have moderate dementia, with 30% having developed dementia if they live to the age of 90. Transmitted causes ("causes of causes") tend not to be systematically analysed. 1. For long, man was groping in darkness about the causation of disease. The wheel of causation, an alternative model, according to Harkness and DeMarco (2012), “…de-emphasizes the agent as the sole cause of disease, whereas it emphasizes the interplay of physical, biological, and social environments” (p.94). The Wheel of Causation The Wheel of Causation (Mausner & Kramer, 1985) de-emphasizes the agent as the sole cause of disease, while emphasizing the interplay of physical, biological and social environments (Figure 7). It also brings genetics into the mix. Several theories were advanced from time to time to explain disease causation such as the supernatural theory of disease, the theory of humors by Greeks and Indians, the theory of contagion, the miasmatic theory which attributed disease to noxious air and vapours, the theory of spontaneous generation, etc. Models of Disease Causation, Germ Theory, Epidemiological Triad, Web and Wheel of Disease Causation. Alzheimer’s disease will be the epidemic of the twenty-first century (1,2). Cause and effect basically. Methods of diagrammatic modelling have been greatly developed in the past two decades. The purpose is to identify risk factors that can be modified. The wheel allows for a multiple-causation theory of disease, it is more useful for analyzing complex chronic conditions. First articulated in a 1960 U.S. epidemiology textbook, the 'web' remains a widely accepted but poorly elaborated model, reflecting in part the contemporary stress on epidemiologic methods over epidemiologic theories of disease causation. the wheel of causation de emphasizes the agent as the sole cause of disease. Web of causation models are especially helpful for finding the causes of genetic diseases. When the cause is determined, medical professionals learn more about which groups of people are prone to developing or contracting a certain disease. Two conceptual questions currently face epidemiology, both relating to causation. First, how should it handle certain diseases, which appear to be etiologically more complex than the infections and deficiencies by which epidemiology made its name?In particular, chronic non-communicable diseases (CNCDs) account for a larger proportion of deaths, at least in the … Theories of causation • Old theories • Modern theories – germ theory – multifactorial causation – socioeconomic, cultural, genetic, psychological – epidemiological triad (tetrad) – web of causation – wheel of causation 6First MBBS – Epidemiology series 7. 'Multiple causation' is the canon of contemporary epidemiology, and its metaphor and model is the 'web of causation.' Abstract. ** ... causation is the theory that something happened due to a given cause. Outside the context of infectious diseases, systematic use of diagrams in epidemiology has been mainly confined to the analysis of a single link: that between a disease outcome and its proximal determinant(s). 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