Last Sunday, we looked at memory care specialist Stephen Post’s discussion with neurosurgeon Michael Egnor of rementia. — when deeply forgetful seniors suddenly remember things.

On Monday, we also looked at new strategies in preventing or delaying dementia. Of course, for a senior, preventing and delaying can amount to the same thing. That is, with the right strategies, a person could live a long, full life and die in the late eighties — but dementia would perhaps have set in during the mid-nineties.

Even if it does set in, London-based journalist Isabel Sutton points out, it can mark a new beginning. For one thing, the role of social isolation in hastening the progress of the disease is becoming clearer and more easily avoided:

Evidence from long-term studies consistently shows that having more social participation in the middle and later stages of life is associated with 30 to 50 per cent lower risk of developing dementia. This represents one of the most important shifts in how the condition is understood.

Isabel Sutton, “Dementia is not a death. For some, it marks a new beginning,” Psyche, July 23, 2024

It’s a classic vicious circle because when people stop interacting with the diagnosed person, further declines follow from lack of normal mental and emotional exercise. Brain damage may not be reversible, but stimulation can mean that its effects are much less severe:

Person-centred approaches that focused on social factors grew only stronger toward the end of the 20th century. Rose-Marie Dröes, a professor of psychosocial care in dementia, was a young PhD student in the Netherlands when she started a research project in 1991 that led to a lifetime’s focus on the social dimensions of dementia. Her study involved movement therapy sessions with residents of a nursing home. Staff at the facility were amazed to find that those who often spent their days immobile and passive were, after participating in the sessions, transformed into people who, Dröes says, ‘looked at each other, talked, helped each other’. This made her realise that the behaviour associated with dementia was not entirely caused by the brain. ‘I thought it must be the environment, or because we’re not activating people or not listening or talking to people enough.’

Sutton, “A new beginning”

Dröes and colleagues found a steep decline in the requirement for nursing home care among patients who were able to stay in touch with their community and maintain social bonds.

In recent years, several authors have written books about living with dementia, including Wendy Mitchell (1956–2024), who was diagnosed at 58. Recounting her decade-long struggle, she wrote Somebody I Used to Know: A Memoir (Ballantine 2018) and What I Wish People Knew About Dementia (Bloomsbury 2022).

Dementia care expert John Zeisel, author of I’m Still Here (Avery 2009), says it’s not really very surprising that some dementia fighters can write books:

Semantic memory, Zeisel reminds us, is only a small part of our memories. People with dementia, he writes, may have trouble ‘recalling a name or a recently posed question’, but they can still access memories with emotional meaning, such as collective experiences, pieces of music and significant life events. What the brain is often missing, especially for older people, is the stimulation required to access these memories.

Sutton, “A new beginning”

Sutton recounts that retired British radio journalist Willy Gilder found drawing more and more difficult after his Alzheimer diagnosis. But he largely recovered the ability as a result of immersing himself for two weeks in his beloved Beatles and Rolling Stones. This is easier to understand if we recall that creativity requires many parts of the brain and music affects many parts as well.

In the UK, through BOLD (Bringing Out Leaders in Dementia), many other diagnosed people have begun to reach out and see what they can still actually do.

It’s early days yet but if dementia were no longer treated as a social death sentence, the future would be brighter for many people.

You may also wish to read: Dementia: New insights in caring for deeply forgetful people. Dr. Stephen Post, an expert in memory disorders, talks to neurosurgeon Michael Egnor about when and how people suddenly remember again. Dr. Post considers it implausible that “rementia,” the sudden, brief return of a personal identity, can be explained purely in material brain terms.

and

A status report from the war on late life dementia. Almost half of dementia cases could be prevented or delayed, researchers believe. Increasing longevity and widespread early diagnosis will means that delaying the progress of the disease becomes very important over the next few decades.