It’s not only Americans who are dealing with the impact of Alzheimer’s disease and other age-related dementias. Dementia knows no borders. People around the globe are impacted by dementia, as have people throughout time.
Since ancient times, people have experienced age-related dementia memory impairment. According to a June 1998 article in the Journal of Neurological Science by F. Boller and MM. Forbes, “The history of dementia is probably as old as mankind itself.” A January 2006 article from the same journal, titled Dementia in the Greco-Roman World and written by Axel Karenberg and Hans Forstl, credits the Ancient Greeks as first recognizing and describing dementia.
About 2,400 years ago Plato described an illness that “gives rise to all manners of forgetfulness as well as stupidity.” Dementia in the Greco-Roman World also quotes the Roman poet, Juvenal, who almost 2,000 years ago characterized a phenomenon that’s easily recognized as dementia:
“Diseases of all kind dance around the old man in a troop. But worse than any loss in the body is the failing mind which forgets the names of slaves, and cannot recognize the face of the old friend who dined with him last night, nor those of the children whom he has begotten and brought up.”
Evidence of dementia in Ancient Egypt exists as well. A paper by Dr. Deborah Sweeney of Tel Aviv University, quotes a 25th century BCE Egyptian, Ptahhotep, describing in hieroglyphs an aging person who “every night becomes more and more childish.” This, in fact, may be the earliest extant piece of writing describing dementia.
During the Dark Ages, advancement in understanding of dementia halted abruptly. There’s no doubt that dementia continued to afflict people in the times between Antiquity and the Enlightenment, but it was hardly written about. According to a 1998 article in the Neurobiology of Aging by Berchtold and Cotman, the next notable leap in understanding of dementia after ancient times was in the early 1600s by English philosopher Francis Bacon, who authored a work called Methods of Preventing the Appearance of Senility. Bacon may have been the first to recognize dementia as a brain disease, noting, “In the posterior part of the brain occurs oblivion, concerning the saying that old age is ‘the home of forgetfulness.'” Shakespeare’s plays Hamlet and King Lear also used dementia as dramatic device.
It’s also widely recognized by historians, including Berchtold and Cotman, that many of the victims of the 17th century witch trials in Europe and the United States who were burned at the stake may have been simply afflicted with dementia.
Public understanding of dementia didn’t enter the modern age until the German psychiatrist, Alois Alzheimers, described the first case of what we now know as Alzheimer’s Disease in 1910, classifying it as a subtype of “senile dementia.”
People are living longer than ever. According to the World Health Organization the global average lifespan was just 31 years in 1900. Today the global average is 70 years. This trend means that age-related dementia has become a major worldwide problem. In a groundbreaking report, the World Alzheimer’s Association estimated that as of 2010 there were 35.6 million people worldwide with dementia and that the global costs of dementia are over $300 billion dollars. According to the report, dementia is most prevalent in the Caribbean, with 8.12% of those over 60 having dementia.
The region of the world with the lowest rate of dementia is Western Sub-Saharan Africa (Nigeria and nearby countries), with only 2.07% of those over 60 reported as having the disease. But the worldwide differences in estimated dementia prevalence may actually have to do with the way we diagnose (or fail to diagnose) the illness. According to a study by the National Institute of Health, low rates of dementia in Africa may be due to “the hiding of cases by relatives because of stigma, reluctance to seek medical assistance, poor access to medical care, and defective-case finding techniques.” These same barriers to diagnosis could apply equally to any other area of the developing world.
Whatever the actual rates of dementia across different parts of the globe, it’s clear that all nations—especially those with a large aging population—face a difficult burden of caring for people with dementia. A recent New York Times article describes how American-style memory care communities are beginning to sprout up in China. The article quotes an official in Shanghai who says, “We’re planning to build at least one nursing home that can care for dementia patients in every district. Every year, we’ll need at least 5,000 additional beds.” But unlike America, where memory care homes have names like “Whispering Creek Manor” or “Sunny Brooke Estate,” the new memory care home described in the New York Times article is known simply as (in classic communist fashion), “Shanghai No. 3 Elderly Home.” While Shanghai No. 3 Elderly Home may not have the most creative name, its care is cutting-edge:
“He says the new facility has a multimedia room that can display images of Shanghai streets, and even images that appear to show the neighborhoods of the patients. This is supposed to make them feel at home. Many patients also wear GPS armbands that help the staff monitor their locations.”
In Europe, the cities of Bruges in Belgium and York, Britain’s first “dementia friendly city,” have adapted their city plans to consider the needs of a large aging population. These forward thinking cities are making everyday activities such as taking the bus, navigating city streets and shopping easier for elderly people who may suffer from memory impairment. In the Netherlands, an innovative Alzheimer’s care community nicknamed Dementiaville that emphasizes activity, freedom and nostalgic settings, was built in the city of Weesp 20 years ago. As of writing, a second “Dementiaville” is being constructed in Switzerland at a price of more than $30 million.
Dementia is so ubiquitous that we could include a story from each of the world’s countries; but it’s already clear that dementia affects people everywhere, and has been basic, element of humanity since its dawn. We recently reported that the Department of Health and Human Services has set a goal to cure Alzheimer’s by 2025, with extra funds devoted to research and caregiver support. The goal may strike many as overoptimistic, but a goal-setting approach is probably better than complacently accepting dementia as a part of life.
What experiences with Alzheimer’s have you had? What are your thoughts on Alzheimer’s around the world? Share your thoughts with us in the comments below.