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Keeping dementia at bay

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This has been a month of good news for two of my annoying habits.

The first is my penchant to watch sappy films from Indonesia. I lived in the country after college, and the films help me keep up my Indonesian language skills. A recent review of hundreds of dementia sufferers in India finds that dementia among speakers of multiple languages comes, on average, four years later than it does to people with dementia who are monolingual. Prior studies had found a similar phenomenon, but the new study shows that multilingualism likely postpones dementia regardless of a person’s class or formal education.

My next habit, forgive me, is singing along to musicals. A paper read this month at the Society for Neuroscience meeting in San Diego finds that when nursing home patients with Alzheimer’s disease sing along to The Sound of Music and The Wizard of Oz, they score better on measures of their cognitive abilities.

The good news on dementia is a welcome tonic against some overwhelmingly frightening facts. Because we are adding, on average, at least two years to our lifespan every decade, we are all more prone to dementia. One’s chances of dementia double every five years after age 65; one of every two Americans older than 85 is afflicted with Alzheimer’s.

In addition, the percentage of older people in our population keeps growing.

A recent investigation led by Michael Hurd at the RAND Corporation and Ken Langa at the University of Michigan, among others, looked into the overall costs of dementia in the U.S. The study tallied the $109 billion Americans spend on professional medical care annually together with up to $106 billion in costs and lost wages that individuals bear to care for family members. The number of dementia sufferers, Hurd and Langa argue, will roughly double by 2040. So will the costs to care for them.

The emotional price of dementia on its sufferers and their caregivers is harder to calculate. Yet, those emotional costs contribute to a vicious circle that balloons the burden of care. Fifteen million Americans care for a family member with Alzheimer’s or other dementia. The toll on caregivers ushers in some of the same risk factors that hasten dementia. Family caregivers often suffer depression. They let their own health slide. They grow socially isolated.

There is already a laundry list of factors that research suggests could stave off dementia, at least for a few years. Steady exercise is one. Steven Albert, with the Health Policy Institute at the University of Pittsburgh, says there is a body of evidence to show "that if you can control the co-morbidities (two or more diseases existing at the same time) of dementia, you can keep dementia down."

Albert says some of the clearest evidence identifies exercise as a way to build a buffer against cognitive decline. Working longer and retiring later also seem to postpone dementia. So do eating a Mediterranean diet high in vegetables and keeping a healthy weight. A good education and an ability to read and produce rich texts are other likely buffers.

Good practices and a right life bring no guarantees for individuals, but widespread adoption of them would likely decrease and delay dementia for the population overall. As Hurd points out, "Imagine we could delay dementia for 10 years. There would be a 10-year period where few, if any, people were newly stricken."

That means during the window when there are few new dementia cases, the savings could be hundreds of billions of dollars. This is so big, we ought to rethink how we treat it.

The Centers for Disease Control and Prevention has recently started a Healthy Brain Initiative that is exploring ways to buffer the public against dementia. What might a public health approach entail? Each risk factor warrants its own solution, but some programs can strike at several at once. Encouraging walking by making communities pedestrian-friendly is a relatively easy public health program. Programs that help people to keep working later in life also keep people cognitively fit.

Dementia is scary because it saps us as individuals and because, as it grows, it saps us collectively, too. Yet, keeping dementia at bay can give us all more of the private good we want most. A longer, better life.

Granted, it might come with neighbours singing The Lollipop Guild in Indonesian.


Ted C. Fishman, author of Shock of Gray and China, Inc., is a member of USATODAY’s board of contributors.



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