We’re getting older, and it’s going to continue. I recently heard it estimated that, on average, a child born today can expect to live four hours longer than a child who was born yesterday. Someone who celebrates their 65th birthday today can expect to live two hours longer than someone who did so yesterday. Improvements in medical science and public health measures mean that most of us can reasonably look forward to our 80th birthdays, and many of us to our 90th or even 100ths. Our life expectancy at birth is easily double that of our medieval forebears. All of that is, of course, good news. As Tim Minchin puts it: “Twice as long to live this life of mine; twice as long to love this wife of mine.”
But this wonderful fact, that we get to spend more time on the Earth with the people we love, brings with it serious complications. One is financial: our working population has to support ever more state pensions with its taxes, as the retired population grows larger. But another is medical. Staying alive does not, necessarily, mean that we stay healthy.
There are over 800,000 people living with dementia in the UK, and that figure is expected to rise to over a million within the next decade. Worldwide, the projected growth is even more dramatic: there are believed to be 35 million sufferers now, and there will probably be 70 million by 2020. There is something uniquely terrifying – for me, at least – about dementia, and all brain injury and illness: the idea of losing my being, my self, is horrible and unsettling in a way that no other disease can be.
All this explains why we get so excited about possible breakthroughs in the search for treatments for Alzheimer’s disease, the most common cause of dementia. Yesterday it was widely reported that there had been a “turning point” in the research: a drug which seems to work at preventing the buildup of the harmful misshapen proteins in prion disease, a different but related condition.
As always, it’s important to stress the provisional, early nature of the study. The research was on mice; it’s a long, tortuous journey from there to preliminary human trials, let alone a licensed treatment. Also, the drug would be likely to have profound side effects, and while it’s promising that it seems to work on prion disease, that does not mean that it will also work on Alzheimer’s patients. It is a “turning point” in that it may open up a new and exciting avenue of investigation, but by even the most optimistic estimates, we won’t see a drug being used on patients for a decade or more, if we ever do.
Which is why, however promising new medical treatments may be, the main short- and medium-term policy focus for dealing with dementia needs to be about support and care, not cure. Around 670,000 people in the UK are caring for someone with dementia; it is exhausting and frequently thankless work. And it can be fantastically expensive: a 2007 Dementia UK report put the cost, to carers and to the NHS, of looking after someone with severe dementia at over £28,000 a year. If the person goes into a care home, it rises to over £31,000. The condition is often undiagnosed, leaving people and families in confusion. And, of course, living with dementia is frightening, and frequently lonely, and the people who live with it are often stigmatised. Whatever happens in the coming decades as regards the medical science, Britain – and the world – has a huge task making life better for sufferers and carers alike.
It’s nice, therefore, to be able to report that the British Government has taken an important step towards putting the dementia issue on the international map. The UK holds the presidency of the G8 this year, and in December David Cameron and Jeremy Hunt, the Health Secretary, are hosting a summit on dementia, with all the health ministers of the G8 nations in attendance. I attended one of the workshops last month, along with various interested parties – doctors, charity workers, relatives of sufferers – and it was pleasing that while, of course, the importance of supporting biomedical research was made clear, it was also understood that it can only be part of the story. Helping make life more bearable for people with dementia, and for their families, is an equally – if not more – pressing goal.
Whether the discussion will lead anywhere, and whether the Government will push through any of the summit’s eventual recommendations, remains to be seen. But as exciting as the drug trials might be, they are at best a long-term solution to an immediate and growing problem. For sufferers and families now, who might lack the money, time and education to deal with a diagnosis, the real light at the end of the tunnel is not a cure, but better support. At the G8 summit, and afterwards, Hunt and Cameron have a chance to do something they can really be proud of.