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What if dementia is not destiny for the oldest old?

Something different -- a positive study of aging and cognitive decline.  Last week in the midst of worse and most worse economic news, USA Today published the results of a decade-long study through Duke, Harvard and others that tracked 1049 older adults age aged 56-102 who at the beginning of the study showed no signs of dementia.  At the end of the study, two-thirds of the participants showed at most only “slow cognitive decline,” not the level of decline typically associated with requiring assistance or medical care. Why is this interesting? Remember the often-quoted statistic that nearly 50% of seniors aged 85+ suffer from Alzheimer’s? This study undermines that estimate and therefore the domino effect of the assumptions that are derived from it.

Maybe it is time to question entrenched assumptions.  The Duke/Harvard study is a chink in the armor of Alzheimer’s fear factoids and their implications. The Alzheimer’s Association and many others, including drug manufacturers, build fund-raising and research efforts and drug business investment assuming that half of the 85+ population will suffer from dementia. More to the point, these assumptions are based on a growth rate from today’s 4 million upwards of 14 million who will have late-onset Alzheimer’s by 2050 -- presumably this can be predicted (along with prospective revenue streams) based on circumstances today.

Less fear could mean a revision in treatment.  Of course studies must be repeated and further analysis must be done to actually shake today’s near-immutable assumptions about the prospective cognitive decline of older adults. But just as there is no historical precedent to lengthening life spans, there may be no precedent beyond studies like this one for cognitive fortune-telling. From the study’s press release: "With an understanding that cognitive decline is not normal, however, poor performance can be investigated and preventable or reversible conditions, such as delirium, medication side effects, or vitamin deficiency can be properly addressed." Does that make you wonder how many warehoused seniors who are believed to have dementia – maybe don’t?

Shake off dementia forecasts – and the aging world feels different.  For the moment, leave aside other aspects of physical decline – not addressed in the study. So with less anticipated dementia – even in the face of family history -- working and entrepreneurship cycles extend; senior housing companies tighten relationships and investment in home care versus assisted living and memory units; university program offerings for late life education are expanded, providing new revenue streams. Cognitive check-ups become non-stigmatizing standard routines in physical exams of the 90+ and the oldest seniors, who are now sporting their ever-smarter phones, living longer and higher quality lives and becoming fascinated with online games. Who knows, maybe someday, getting lost won’t mean you’re losing your mind, just that you, like everyone else, needs a GPS.    


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