Wednesday, December 11, 2013

Age inappropriate

A thought occurred to me last week, as the British Chancellor, George Osborne, suggested in his 'Autumn Statement' that those entering the job market now in young adulthood might have to retire at 70. 

The thought in question was: "how will they?". Once hips and knees need replacing, bladder-related dashes to the office toilet become more treacherous. And what about accommodating all those days off for checkups on a variety of ailments and failing body parts?

Osborne also said that "people should expect to spend up to a third of their adult life in retirement", which is an interesting measure. Because, unlike my parents' generation - who grew up in or just after the war, went out to work for 30 or 40 years before retiring in their 60s - my post-baby boom generation will be working well into their late 60s at least, only to retire with barely enough time to take up bridge, bowls or ballroom dancing before an unpleasant age-related condition takes them down. That's assuming they haven't already stroked out on the job or been "respectfully let go".

It's all very depressing, I know, and apologies for this post not exactly fizzing with WWDBD?'s customary Woodhousean jamboree. But today, a special summit of the G8 opened in London to discuss one of the less than pleasant prospects for those entering the winter of their lives: dementia.

Once glibly regarded as 'part of getting old', dementia - and its most common form, Alzheimer's Disease - is a large, dirty time bomb. But as its ticks get ever louder, scientists are still struggling to understand the basic biology of dementia, let alone able to cure it.

The global cost of dementia is already more than $600 billion - around 1% of global GDP. "And not only is it costly," World Health Organisation Director-General Margaret Chan said today, "it is a heartbreaking disease." No kidding. And a disease that will impact 44 million families globally this year, and will impact twice that number by 2050.

One of those families is my own. My dad is 84. Next year he will celebrate 25 years of retirement. Not that he can remember much about his three or four decades in the television industry. Or what he did yesterday. Or earlier today. 

Some, though, might consider him fortunate. He has Alzheimer's in its early stages - enough for his memory to be like Swiss cheese, with progressively larger holes - but the progression is slow. Life is a predictable and increasingly immobile daily cycle of waking, breakfast, dozing, lunch, watching television, dozing, dinner, watching more television, and then sleeping. 

When he remembers to do so, he will still go around the house at night to check the windows and doors. It's a nightly ritual for as long as I can remember. Whether he can remember why he does it still, who's to say. But while his dementia gradually degrades the software in his head, there are still hard-wired lines of code that fire with impervious regularity. The windows and doors things is one of them. It's a ritual to cling to, a familiarity, a guide rope helping him find his way out of the increasingly smoke-filled room that is his brain.

Just like the author Sir Terry Pratchett (whom, by pure coincidence, is sat right opposite me as I write this), my dad's dementia is at the dawn of its progression. It will get worse, we don't know when. And what "worse" is, we can only imagine. When we get to that stage we will, as a family, face decisions about how best to proceed. The biggest wrench will be persuading the head of our household that he has to leave his home, the home he bought and paid for by working hard for the better part of 40 years, the home he still considers the family's foundation.

While sad for him, and worrying for us, the saddest part of this is that it will be a familiar story to those millions of other families around the world, who will be watching their family elders disappear into their own mental decay, the world around painfully closing off slowly.

We are, we're told, capable of preventing or postponing the dementia timebomb, or at least reducing the blast radius. The key is, apparently, to take better care of ourselves in middle age. Adopt the Mediterranean diet, exercise for 30 minutes every day, and limit ourselves to the one glass of red wine with dinner rather than the first of two bottles.

All very well, but for many, this is neither logistically or economically viable. Simply telling people to get off their sofas, eat salad and join a gym isn't going to solve the problem. According to the Alzheimer's Society, by 2050 - when the timebomb will have gone off - 71% of those 135 million people around the world expected to have the condition will be in poor or middle income brackets. 

For those in some countries with a reasonable degree of dementia care, their terminal decline will be comforted to some degree. But with dementia costing more than half a trillion dollars worldwide to manage today, the World Health Organization and similar bodies are growing increasingly worried that some countries just won't be able to cope.

Managing dementia is one thing: preventing its spread or even curing it is another thing entirely. Today, eight times more money is spent on cancer research than dementia. Pratchett himself - who was diagnosed with Alzheimer's in 2008 - has been speaking to the media this week ahead of the G8 summit to highlight the financial disparity between dementia research and other causes, telling the BBC's Newsnight that it was "a Cinderella issue". 

"I've been saying for a long time, it doesn't get noticed," he told Jeremy Paxman. "It does need a lot more money put in. It needs more people trying to see what they can do.”

The noises being made this week by the G8 are an encouraging start. But with almost eight million new dementia cases being added every year globally, we need more than just governments and world bodies saying, to borrow from Father Ted, "down with this sort of thing", and then doing nothing meaningful about it.

Inappropriate though it may be, PR haridan Bobbi Flekman in This Is Spinal Tap said it best when she said: "Money talks, and bullshit walks". Quite.


  1. Hi Simon, Lori LeRoy forwarded me your blog posting. This is really nice. My company, Eli Lilly, just announced a test in the UK that helps to diagnose AD. There are treatments in the horizon. Hopefully in the next few years we will see a treatment. But we definitely need more support from governments to make AD a priority. Keep up the good work