What is to be made of the sharp increase in the diagnosis of dementia?

Dunno really. What was the question again?

29 thoughts on “What is to be made of the sharp increase in the diagnosis of dementia?”

  1. Well, l suggest that medical researchers start by looking back a few years (perhaps as much as a decade or two) and look for a parallel rise in the widespread prescription of a particular type of medication. In parallel they should look for the widespread adoption of one or more new food manufacturing processes, preferably ones that affect a lot of different foodstuffs. I think that those investigations might yield some good areas for more detailed research.

    Or, if they can’t be arsed with finding out what is actually the problem or don’t want to find answers that will cause them political problems, they could just dismiss it as a feature of increasing population age.

    My money is on the latter, I’m sad to say.

  2. >”This prompted the Government to introduce a £55 incentive payment for every new case identified in a six month period. As a consequence, the numbers rose by 20 per cent, only to slow again after the payment was withdrawn. ”

    Wow who would have thought it? Why not just make up the numbers to suit you, it’s cheaper.

    >”GP organisations have denounced the payment as “ethically odious””

    Evidently not odious enough to not be a grabbing bastard mind. Anyway what is a ‘GP Organisation”?

  3. What we are to make of it I would think is that stopping people dying of things they used to die of means more people get old enough to get diagnosable dementia.

    As part of other research on t’internet a few days ago I was reading a paper which analysed human life expectancy in various primitive hunter gatherer type cultures where data is available, which concluded that across the human species and all these societies, humans who get through the infancy naturally live a basically healthy life until about 70 (the figure was 72) when a rapid decline in health sets in. Three score years and ten seems to have been about right as a slogan.

    After that, anything else is a bonus and hence more and more people living into their 80s and 90s is going to rapidly increase the healthcare burden. My dad (86) appears to be starting the process of losing his marbles, so I’m quite interested (Ironman) in this at the moment.

  4. The UK GP I registered with seems to sending me a reqeust to partake of some test or other every few weeks. Presumably he’s working on the basis, he must be able to diagnose with something. Anything. Cash in somehow. (Curiously, the only problem I’ve had, I had to get diagnosed & treated in France.
    Not a money making ailment?)

  5. And where do all these dyslexic hoards come from and the nut allergy armies?

    Come to that, is it because of global warming that everyone now seems to be carrying a small bottle of mineral water?

    And what did we do before we all started having little rucksacks to carry around?

  6. JonD,
    Care to expound on your theories? Prescriptions of all sorts have risen in the last couple of decades, but mostly of painkillers (opiods) and anti-depressants. And what, if anything, has changed in food manufacturing lately?

  7. The strongest correlation is with the rise in type II diabetes, in both the fat and thin members of the population. The driver of insulin insensitivity seems mostly dietary esp sugar and processed carbohydrates and lack of exercise but Jon D could justify hunting down other factors.

  8. Dementia, like cancer, can be seen as a cluster of diseases rather than a single disease. Accordingly, the causes are likely to many and various.

  9. Andrew M

    As I don’t have data, I don’t have a theory. I simply observe that widespread phenomena are likely to have widespread causes and new phenomena are likely to have new causes.

    It is axiomatic that people do not develop degenerative diseases from a lack of pharmaceuticals and that the human genome has not recently undergone sudden change. It seems likely to me, therefore, that such diseases are caused, or perhaps precipitated, by some input to the living human. Of these inputs food/drink and pharmaceuticals seem the most likely candidates to me. Changes in food inputs are not only about process but also about eating patterns, so they would also be worth looking at, I feel.

    There is one specific thing I do wonder about, though I am not a medical researcher and have no data which might suggest any relationship, much less a causal one. The major effect of statin drugs, as I understand it, is to suppress the production of cholesterol. A major component of brain cells, according to my reading of the subject matter, is cholesterol. I recognise that there is a great danger of 2 + 2 equalling 27 here, but i still wonder whether suppression of cholesterol production might have an effect on cells that are mostly composed of it.

    I’m sure that I will get shotdown, for alarmism or some such, for this speculation but if there is research which demonstrates that there is no effect then I would be genuinely grateful if the shooters could provide me with a reference to it.

  10. And where do all these dyslexic hoards come from?

    I’ve long thought their ranks were swelled by “dyslexia” being used as a synonym for “slightly dim offspring of the upper-middle classes who couldn’t be arsed reading”. Easier to blame their little darlings’ dimness/laziness on a medical condition.

  11. “Pay doctors to do tests and you get a lot of tests.” My memory is that with diabetes they didn’t pay them for tests but for diagnoses. And at roughly the same time they reduced the diagnostic threshold. The consequence was a huge leap in diagnoses of diabetes. Whether there was, age-corrected, any per capita increase, God alone knows.

    Come to think of it, they need to correct not only for age but for % of South Asians in the population, their being particularly prone to the problem, apparently. Though how that can be is a mystery, given that race is a social construct.

  12. People get the degenerative diseases of old age because that is what getting old is. Everybody eventually dies due to the systems of their body degenerating. Different bodies degenerate in different ways first. Looking for some mysterious external cause misses the point of what’s happening as people age.

  13. There is epidemiological evidence (so not proof) of a correlation between smoking and NOT having dementia. Or at least there was before smoking was assumed to cause everything, and evidence was produced to show that it actually causes dementia. It’s a bit like drinking moderately now no longer protects you from heart disease. What is true that the decline in smoking is coincident with the rise in dementia, so it is extremely unlikely that smoking causes it, but then the truth is no longer an objective in the current World we inhabit.

    It looks to me as though there is a perfect storm of reduced thresholds, increased diagnosis and people living longer thus making them more susceptible to the disease (or is it illness). Expect more taxes and nannying.

  14. My first thought was “when did the diagnosis or reporting standard change”?
    My second thought was an aging population.

  15. “I’ve long thought their ranks were swelled by “dyslexia” being used as a synonym for “slightly dim offspring of the upper-middle classes who couldn’t be arsed reading”.”

    Other way around, I suspect. Dyslexia diagnoses have gone up because it’s not being dismissed as the kid is slightly dim or lazy.

    Regarding the question in the headline, it does explain to some degree the US presidential race this year.

  16. lemme see… post-war baby boom hitting the 70 age range combined with increased early detection?

    That’s a double spike right there…

  17. forgot: a lot of blokes no longer keeling over from heart failure at about the 50-55 age range getting to the 70 age range where the other bits and bobs of Wear and Tear become apparent.

  18. Matthew L – I agree with you as a majority of the dyslexic I have met werrew either undiagnosed or late-diagnosed.
    Incidentally, #2 son is dyspraxic, I’m just clumsy.

  19. There is epidemiological evidence (so not proof) of a correlation between smoking and NOT having dementia.

    This review paper is remarkable. It seems that when tobacco companies sponsor the research, smoking reduces Alzheimer’s risk; when they don’t smoking increases it.

    the decline in smoking is coincident with the rise in dementia, so it is extremely unlikely that smoking causes it

    It’s well established that smoking carries a risk of premature death, which is protective against senile dementia. Analysis of risk factors for Alzheimer’s excludes that effect.

  20. It seems that when tobacco companies sponsor the research, smoking reduces Alzheimer’s risk; when they don’t smoking increases it.

    Or to put it another way, when anti-smoker campaigners sponsor the research, smoking increases risk, but when they don’t, smoking decreases it.

  21. Any thought on lead in petrol being a factor in the associated age group, I recall reading somewhere that my generation will tend to have a significantly higher level of lead in our body than those born after the ban.
    I recall the junior school I went to they found very high levels of lead in the classrooms alongside the main road a few years back and had to shut them down so they could be cleaned properly.

  22. From MB:
    “Come to that, is it because of global warming that everyone now seems to be carrying a small bottle of mineral water?”

    This is the Big Question.

  23. The “it’s just because we’re all getting older now argument” is a very convenient explanation which I only find plausible up to a point.

    Many of us, I’m sure, have had very elderly relatives in our lives at one time or another. My experience of this is that some of these relatives had issues with hearing and seeing, some with mobility. One of them also had some level of memory impairment but not so they were unable to recognise their loved ones. What I’m getting to is that there have always been very old folks around and, anecdotally at least, very few seem to have suffered from dementia in times gone by. That is not the case now.

    To believe the convenient age argument what I would want to see would be the identification of at least one plausible mechanism by which age alone might lead to such mental degeneration. Without that the age argument, to me, looks too much like ‘explaining away’ and not enough like ‘explaining’.

  24. The problem lies not in the Aged but in the underlings.
    If anyone showed mental oddity it is the young of the west.
    They seem to be quite daft.
    They decide , en mass, to stop breeding ,
    to give their land and treasure to surrounding tribes -all on the basis of some quasi religious ideas.
    When once they defended now they yield.
    Such preoccupations has lead to the collapse of civilisations in the past.

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