Why Dementia Is a Population-Level Problem

Dan Garisto in Nautilus:

Dementia is typically thought of and treated as an individual sickness. Unlike something like measles, dementia is non-transferrable, and can’t be vaccinated against. But Malaz Boustani, a professor of medicine at Indiana University, thinks that the right way to think about dementia may be through the lens of epidemiology—“the branch of medicine that deals with the incidence, distribution, and possible control of diseases and other factors relating to health.” After all, like many viral diseases, dementia ends up affecting a large swathe of the population. As the populations of highly-developed countries age, treating dementia at scale will be more important than ever.

Nautilus caught up with Boustani earlier this month.

How does dementia impair function?

If you have dementia, then you become more likely to lose your attention. And a lot of cognitive abilities require you to first pay attention. Take language—in order for you to speak, first you have to pay attention. If you’re not speaking well, I can’t tell if you’re not speaking well because you’re not able to pay attention, or because your language center has died. Stuff that makes your attention fluctuate is very different from the stuff that makes you have memory or language problems.

What distinguishes the treatment of dementia from the treatment of other conditions?

First, dementia creates a burden not just on the patients who suffer from the disease, but also on family members, so the definition of patient is expanded. Second, dementia itself affects your cognition. Your self-management, your self-awareness, your competency becomes cloudy. That means that, in addition to your cognitive problems, you start behavioral and psychological disabilities. There is a clear line between dementia and normal aging. If your aging makes you unable to function in your physical and social environment and leads you to have a disability, then it’s not normal aging anymore. The cutoff is your ability to maintain your independence socially and physically in your changing environment. Normal aging does not take that away. You have people over 100 and they’re still adapting to their physical and social environment without any disability.

More here.