The prospect of dementia


shalev_hsBy Micha Shalev

Only few want to grow old, as most of us are afraid of becoming senile. But now that our bodies last longer in better health, including our brains, the prospect of living a fulfilled old age is better than ever before.

It is not difficult to think of somebody who at an advanced age is still as sharp as a razor blade, driving, playing golf and visiting the gym. That sole fact is scientific logic against the notion that old age makes you automatically confused. Old age and dementia are two separate entities that, although often coming together, are as different as old age and grey hair. Why then do so many people believe that the two are closely attached?

The worldwide attention afforded to Alzheimer’s disease, as dementia is erroneously called, did not appear out of the blue. For a long time dementia disappeared entirely into the background as a recognized illness, and people who became confused in old age were declared to be “senile.” Senility was thought to be a result of the “normal” aging process and in the middle of the last century little attention was paid to their problems.

The denial of the existence of dementia is a sign of the discrimination that old people faced. In 1975, led by US-based Dr. Robert Butler, the first director of the National Institute on Aging, a new dawn of research emerged to break down this fatalistic view. Butler was a pioneer and wanted to make a statement for both young and old. “Alzheimer’s disease” was finally recognized by doctors and medical research scientists.

The positive part of the “war on Alzheimer’s” is that it put the issue of dementia back on the map. Opinion formers and policymakers in many developed countries have predicted horror scenarios, with the numbers of dementia patients increasing drastically in the coming years. This is partly true because the post-war baby boom generation will have reached a very old age by that time. After all, dementia is a disease that principally affects old people.

But those prognoses are based on the assumption that the statistical risk of getting dementia will remain the same. This is a false assumption. Dutch researchers have shown that the risk of getting dementia in old age was significantly lower after the year 2000 than before.

Brain scans carried out after 2000 showed far less damage due to cerebral vascular disease, which would be a plausible explanation for the reduced risk. The epidemic of cardiovascular disease has long been on the decline, beginning with a fall in the numbers of heart attacks in middle age, and followed by a drop in the number of strokes suffered by old people. Now, bringing up the rear, we see dementia figures falling for the oldest members of society.

Is early testing necessary? There is general consensus that screening for dementia makes absolutely no sense at all, and can even be considered unethical. Tests for early stages of dementia can be a huge hazard, as people who receive such a diagnosis believe they are doomed to die with dementia, but that is far from always being the case. After delivering the diagnosis of dementia, modern medicine has nothing to offer them by way of slowing down any cognitive degeneration.

 Micha Shalev MHA CDP CDCM CADDCT is the owner of Dodge Park Rest Home and The Adult Day Club at Dodge Park, 101 Randolph Road, Worcester, as well as the new state of the art Oasis at Dodge Park which is scheduled to open in the fall of 2015. He is a graduate of the National Council of Certified Dementia Practitioners program, and well-known speaker covering Alzheimer’s and Dementia training topics. The programs at Dodge Park Rest Home specialize in providing care for individuals with dementia and Alzheimer’s disease. The facility holds a FREE monthly support group meeting on the second Tuesday of each month for spouses and children of individuals with dementia and/or Alzheimer’s disease.

Shalev can be reached at 508-853-8180 or by e-mail at For more information, visit Archives of articles from previous issues can be read at