One in three of us will get dementia — but there are a few misconceptions about the condition.
One in three of us will get dementia — but there are a few misconceptions about the condition.
Most of us have some knowledge of this devastating condition, which represents a large variety of diseases. Dementiacauses progressive damage to various parts of the brain, leading to steadily worsening problems with cognition, memory and behaviour.
One in three of us will ultimately die of some form of dementia, according to the UK charity Race Against Dementia.
Of course this sounds gloomy, but increasingly, there is hope. While dementia is often regarded as untreatable, more research shows early diagnosis and lifestyle changes can play a key role in slowing down and possibly even halting the progression of the disease. Earlier this year, a study in the journal Frontiers in Nutrition reported a nutrient-rich diet such as the Mediterranean, Mind and Dash diets, along with regular exercise, can help to slow decline.
Lifestyle factors such as a healthy diet can help prevent dementia. Photo / 123rf
“We are still waiting for a definitive treatment or a cure but today in 2023, there’s so much that can be done,” says James Rowe, professor of cognitive neurology at the University of Cambridge. “There’s real grounds for optimism.”
Rowe points out that statistics show we have made real progress in preventing cases of dementia over the past two to three decades. “A person’s individual risk of developing dementia at any given age is much less than it was,” he says. “If you’re 70 for example, your chances of having dementia are about 25 per cent less than it was 25 years ago. So we’ve done a lot of risk reduction already.”
Overall there are lots of misconceptions when it comes to dementia. Here are six of the biggest ones:
Myth 1: Dementia is a natural consequence of ageing
While dementia is most common in people over 65, Rowe says it is incorrect to see it as a normal part of the ageing process. Instead, he says we should view it as a potentially curable age-related disease just like stroke, cancer, heart attacks and blindness.
“For these other diseases, we don’t just roll over and say, ‘Oh it’s just a part of getting old’,” he says. “Instead, we say ‘This is intolerable — we demand treatment’. There’s this great myth that dementia is just part of normal ageing, but instead we should approach it as a disease, and invest in research as well as funding health services to diagnose, treat and prevent it.”
Myth 2: Dementia and Alzheimer’s are the same thing
Alzheimer’s is the most common form of dementia, but it is only one of many dementias. In fact, there are more than 200 types of dementia overall, including vascular dementia, frontotemporal dementia and mixed dementia, each of which has its own symptom profile and underlying pathology. Scientists are making progress all the time in understanding the factors driving each of these dementias, and this could in future yield new treatments.
“The most prominent myth that I have encountered is some people thinking that all types of dementia are the same,” says Dr Adekunle Bademosi, a Race Against Dementia research fellow who works at the Queensland Brain Institute. “As such, they have trouble understanding that frontotemporal dementia for example, where people initially experience behavioural changes with no associated memory loss, is a type of dementia.”
Myth 3: We’re not making much progress in developing dementia treatments
Treatments have begun to emerge that are capable of slowing down the progression of the disease more effectively than before. Rowe points to drugs such as lecanemab and donanemab, which made headlines this year after the results of large clinical trials yielded promising outcomes for patients in the early stages of Alzheimer’s disease. In future, these drugs could form part of a cocktail of therapies used to treat different aspects of a particular dementia in a similar way to the combination therapies given for HIV and various cancers.
“Their effects were modest but real, and I think this is the vanguard of a really radical new way to think about treating and preventing dementia,” says Rowe. “There’s a genuine sense of optimism as a result. For me it’s similar to a disease like multiple sclerosis, which was essentially untreatable 30 years ago, but then the first drugs emerged, setting in motion a train of events and now we’ve got very good ways of helping to improve the long-term outcomes.”
Contrary to popular belief, dementia isn't just an older person's disease. Photo / 123rf
Overall, the NHS estimates there are 40,000 people under 65 in the UK who are living with dementia. “While dementia really explodes in prevalence as you come into much later life, there are many people in their 20s through to their 50s who have dementia,” says Rowe.
At the same time, research into some of the mechanisms behind young-onset dementia could provide new insights into treatment possibilities. Rowe points out some of the biological changes of dementia can begin as early as the teenage years, and understanding the difference between people who are more vulnerable or resilient to these changes could be illuminating.
“The tau tangles and classic changes associated with Alzheimer’s, they can start to appear at a young age,” he says. “But for a lot of people, it’s possible to live normally with low levels of these molecules in the brain over a whole lifespan without any noticeable symptoms.”
Myth 5: Tackling dementia is too expensive
According to the Alzheimer’s Society, the cost of dementia to the UK is £34.7 billion (NZ$72 billion) a year, a figure predicted to nearly triple to more than £94 billion by 2040.
Rowe says we can do a lot more to improve the care of people living with dementia by helping manage their symptoms and enabling them to live well for longer, as well as investing more in the search for future cures.
“Even after someone’s been diagnosed with dementia, there’s an enormous amount that can be done to improve outlook and help with symptoms, not just memory but also sleep, mood and risk-taking so the impact on the person and their family is less,” he says.
“And we can absolutely invest more when it comes to research. Compared to what we’re currently spending on dementia care, less than 0.1 per cent of that goes into the search for a cure. But as a society, I would say that we cannot afford not to get to grips with this.”
Myth 6: There’s nothing we can do to prevent dementia
Scientists are increasingly finding a sizeable proportion of dementia cases are indeed preventable. This was first shown by the Lancet Commission in 2020, while last year a research study published in the journal JAMA Network Open reported 41 per cent of dementia cases are driven by preventable lifestyle factors such as high blood pressure and lack of exercise.
“That’s four out of 10 cases that can be prevented by best practice,” says Rowe. “Things like tackling obesity, heart disease, hearing loss, diabetes, pollution, smoking, alcohol and diet, encouraging people to exercise and so on. It’s not easy but it’s also not rocket science. If we apply what we know today, 40 per cent of dementia cases would be prevented in the long run.”
