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The Unwanted Guest

We live with an unwanted guest. We don't see it every minute but when we do, it is ugly and obstinate. While our encounter with it is once-removed, we have loved ones who are constantly entangled with it. It has a name that rolls off your lips with surreptitious ease: dementia.

Before our run-in with it, I thought of dementia as a disease of forgetfulness. You forget details, long term memory remains, short-term memory is shot. Little did I know that it takes over your brain, wipes out chunks of memory, causes neural and muscular loss, and leaves nothing but anxiety and distress in its wake. It ties your tongue, fogs your brain, kills your appetite, makes you afraid, and compromises your movement. I often see Mother holding her head in her hands. In those moments, I get a glimpse of the agony, while not feeling any of it. We give her medicines for temporary relief, hoping for the relief to last.

When we are born our brains have enough mass for the essentials but not much more. As we grow, our brain evolves like a tree; it gets more and more full with branches and leaves. In young adulthood, the tree thrives at its peak, full of vitality and energy. Then we start losing the leaves and finally the branches evaporate. When dementia strikes, we rapidly descend into a massive loss of the brain's capacity to remember and endure. This picture from the internet is symbolic of our brain's journey.

Dementia literally eats into the richness of the brain and puts physical and neural functions into a downward spiral. Take swallowing for instance: the act requires a dance between nerves and multiple muscles to push food from the oral to the pharyngeal to the esophageal phases. It is not just a matter of squeezing your throat muscles. It is more like an orchestra of a hundred instruments. With dementia, the body tries to deliver music without the conductor.

The statistics about dementia are eye-popping. 47.5M people are living with the disease worldwide. By 2013, there will be over 75 million people and by 2050 we will hit 135M. Other than the sheer magnitude of these numbers, consider the economic impacts of caregiving. The latest number I can find is 800B+ in 2015.

Why is this important to us? Aren't we years away from the tentacles of this disease, if at all. If you are not touched by caregiving responsibilities, it is even harder for you to stop and listen to me.

It is important because, first, it is not if this interloper shows up at our mind's doorstep, it is when and, second, there is something you can do to stave the onset.

A randomized control trial in 2015 called the FINGER trial definitively found lower cognitive decline over a period of two years in elders who followed healthy habits - a good diet, regular exercise, and sustained social interaction. The last of these comes easily to many of us. The other two are hard, to say the least.

We know our unwanted guest is here to stay. We see its impacts everyday and I don't want it to revisit Tarun and me for many, many years. We walk and we try to eat responsibly but we are neither consistent nor focused. We have good days and bad ones. When I remind myself that I have only one tree to nurture, I seem to take more responsibility. Please do the same.

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