Nikhil Kabadi

When a Father lying on a bed greets his Son with folded hands, asking the nurse/attendant, “Who is this gentleman?”, it is a heart-wrenching sight.

Dementia, a group of brain diseases marked by a decline in mental acuity, especially memory, is now one of the most common and rising causes of ambiguous loss (the unique grief when a loved one is physically present but psychologically absent) in modern families.

The number of people with dementia increased from ~22 million in the 1990s to around 57 million in 2021.

Worse, the risk rises steeply with age. While there is a probability of 5% of 60+ individuals having to deal with dementia, the risk increases to 35% as we hit 80.

But here is some excellent news:

1. The incidence of dementia (new cases) has declined by about 20% per decade from the late 1970s to the 2000s.
2. Some studies have shown up to a 30% relative decline in dementia rates between 2000 and 2016.

What brought about this decline?

There are two leading reasons:

1. More access to education and an increase in cognitive load (thinking, reasoning, learning).
2. Better vascular health (with the majority of the improvement attributed to widespread use of blood-pressure-lowering medications and a reduction in the absolute number of smokers).

Despite these improvements, the projection remains bleak. Come 2050, it’s expected that ~152 million people may suffer from dementia, with the risk beginning much earlier.

Why will dementia become an ever more risky disease?

History is a good guide…

In the early 1950s, Sir Richard Doll, the Godfather who linked smoking with lung and heart disease, hypothesised a future where smoking is cut down, and humanity has finally won the battle with heart disease.

What he could not foresee were the emerging future risks due to industrial and later technological advancements. Namely: obesity, diabetes, processed foods, and busyness.

With dementia, as mentioned earlier, mental effort, the process of learning, problem-solving, and reasoning, is one of the key determinants in its steady progress to decline.

It is not a stretch of imagination to see that it was also a period when a vast majority of the population moved from agriculture to knowledge industries. Within the knowledge industries, the last couple of decades have seen a breakneck pace in the evolution of our living standards, driven by innovative and thinking minds.

“Cognitive load is, after all, strength training for the brain.”

So, is it safe to assume that dementia will not follow in the footsteps of heart disease, but instead will continue to decline in the near future?

Or, like Sir Richard Doll, are we completely blind to an emerging risk, one that could abruptly reverse the hard-won decline in dementia?

I see one such risk (more on that in the next post), but I’m sure you’ve already guessed it…

A system unfolding at breakneck speed, training us to think less, reason minimally, and become comfortable with population thinking.

The early signs of a cognitive recession.

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