Mindfulness - Inside the Dementia Epidemic

Dementia I found myself thinking about life recently. About living. Of the average life, so to speak. And how it’s evolved over time in the recent past. Consider this, the average life expectancy for a person born in 1850 was about 38 years old. By the turn of the century it had risen to around 48 years. Thirty years later it was up to 58 years. By 1970, another 40 years later, and it had risen up to 68 years. Now, present day, another 40 years or so later and we find ourselves enjoying, under best circumstances, a life expectancy of about 76 for men and 81 for women in this country. That’s pretty remarkable when you think about it; the average life doubling in time over the span of a 150 years.

What that means for a society, a country, a community, is that more and more of us are going to be reaching an age that at one time wasn’t so commonplace. And more and more families are going to be touched by this effect in a very tangible way. In fact most are, or have been.

The word dementia is derived from latin and means to be ‘out of one’s mind’. Not a place anyone wants to be, as our mind is central to who we are, to our essence. But the risk for dementia goes up each decade of our lives to where, by the age of 65, nearly 1 in 10 will suffer from it. Just as the aging of one’s heart and the vessels that supply it can lead to health consequences, so can be seen elsewhere in the body with the aging of our brain.

I was sitting with friends recently discussing their personal experience with dementia in the household. The struggles it brought. The challenges. It requires the best of us as individuals. As families. As communities.

From a simplified perspective, dementia refers to a loss of function in the brain. In an acute setting such concerns require a prompt medical evaluation for potential reversible and/or treatable causes. Thyroid dysfunction and Vitamin B12 deficiency are examples of such treatable problems for which recommended screening tests exist. Other potential causes related to infectious causes such as lyme disease, syphilis, or HIV can be considered and screened for.

However in the majority of cases, dementia proves chronic. Over 50% will meet criteria for Alzheimers, and another 20% relate to vascular issues. Quite frankly dementia often becomes tied to the decline and aging of one’s brain. And with more of us living longer lives, and with parents or other family members doing the same, we all will ultimately prove to be touched by it.

It is difficult knowing this not to harbor a degree of fear over it, and it is not uncommon for a family physician to discuss this concern with a patient, that their memory isn’t what it used to be. True dementia requires more than this, however. It requires broader effects upon our brain’s function such as impacting speech or the ability to perform simple tasks, so it is often a matter of reassurance from a clinical standpoint.

When it is real. When it does exist. Effective treatment often proves elusive. The differences in treatment for the consequences of aging of our brain versus our heart, relates to our ability to acutely detect and then effectively intervene in the causes. As treatment from a surgical approach is infrequently indicated, the treatment from a pharmaceutical standpoint often proves to be of debatable value and must be determined on a personalized basis. Nonetheless there continues to be research and efforts aimed at making some inroads. Recently some may have become familiar with the notion that Resveratrol, a chemical found in the skin of red grapes and other plants, can potentially serve as a deterrent to dementia. Numerous clinical studies are presently ongoing to further explore this exciting possibility, and many patients of mine take a Resveratrol supplement daily already.

What isn’t debatable is the importance of being vigilant in early assessment. The earlier the identification, regardless of treatment options, the value found for families being able to effectively plan and address it is clear. We must also remain vigilant in our support of our friends, families, and neighbors who might confront it. Vigilant in our support of continued research for future treatments and hope for a cure. And most importantly, mindful of the value for such vigilance.