[ExI] The Dementia Plague
pharos at gmail.com
Fri Oct 5 10:05:53 UTC 2012
Good article about the coming dementia disaster.
Almost every dementia patient has worried family members huddled in
the background, and almost every story about dementia includes a
moment when loved ones plead with the doctor for something—any
medicine, any intervention, anything—to forestall a relentless process
that strips away identity, personality, and ultimately the basic
ability to think. Unfortunately, Evelyn Granieri is the wrong person
to ask. In 2010 she served on a high-level panel of experts that
assessed every possible dementia intervention, from expensive
cholinesterase-inhibiting drugs to cognitive exercises like crossword
puzzles, for the National Institutes of Health; it found no evidence
that any of the interventions could prevent the onslaught of
Alzheimer's. She can—with immense compassion, but equally immense
conviction—explain the reality for now and the immediate future:
"There really is nothing." Dementia is a chronic, progressive,
terminal disease, she says. "You don't get better, ever."
The latest global demographic analysis, from a World Health
Organization report issued earlier this year, paints the dimensions of
that slow-motion catastrophe in quick strokes. An estimated 36 million
people worldwide currently suffer from dementia; experts predict the
number will double, to approximately 70 million, by 2030 and triple by
2050. (China, India, and Latin America in particular face daunting
medico-economic crises.) Since the prevalence of the disease doubles
with every five-year age increment after 65, projections for 2050 put
the total global population at risk for dementia (people 65 or older)
at two billion. The calculus is as grim as it is simple: as more
people live longer, more slide into dementia. Care for those patients
currently costs $100 billion a year in the United States, with a
projected cost over the next 40 years of $20 trillion; by 2050, the
annual cost to U.S. society is projected to be $1 trillion a year.
Not only is dementia distressingly widespread, but the complex overlap
of symptoms and possible causes makes addressing the problem broader
and trickier than just treating Alzheimer's. The emerging reality,
which has become increasingly apparent with better brain imaging, is
that the majority of cases among the elderly are so-called "mixed
dementias"; the cognitive impairment is due to a combination of
vascular problems, such as mini-strokes in discrete parts of the
brain, and the more classic Alzheimer's pattern of amyloid plaques.
Large-scale international studies in the past three years have shown,
according to a recent scientific summary, that dementias caused by
blood-vessel lesions in the brain, including vascular dementia and
mixed dementia, "together comprise the most common forms of dementia
at autopsy in community-based studies."
So, if we are going to cure ageing to give us longer lives, we also
have to cure all the diseases associated with ageing.
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