In the run up to this year’s annual conference, we will hear from professionals to former delegates, to gain insight into the importance of the conference, and the topics we will discuss. Professor Craig Ritchie is one of our key speakers, and Director of the Centre for Dementia Prevention and Professor of Psychiatry of Ageing at the University of Edinburgh.
Dementia prevention and maintaining brain health: when it comes down to it, does the language really matter that much?
What is clear is that we need to achieve either, or both, urgently, and that Scotland is poised to lead the world in implementing and undertaking the research that will make a dramatic difference to our entire understanding and perspective of brain health.
I personally think they are very different concepts, one is clinical and pessimistic; the other globally accessible and optimistic. I also worry a lot that ‘dementia’ is a loose clinical syndrome that has maybe seen its day as a clinical entity and is ready to be replaced by better, more accurate diagnostic concepts – like ‘Neurodegenerative Brain Disease’.
So, why is this so important? Well, we now know without a shadow of a doubt that the neurodegenerative brain diseases (NBD) which lead to ‘dementia’ have their genesis in mid-life. They follow a very long silent period of development affecting numerous brain processes, which ultimately damage the synapse. The brain then becomes unhealthy and functions poorly, creating the symptoms we associate with dementia.
However, for far too long we have seen this entire 40-year long process through the peep hole of ‘dementia’ – we have been holding ourselves back dreadfully in risk modification (too late), disease modification with drugs (too late) and understanding of disease processes (too advanced and complex) to ever truly advance the field. Alzheimer’s disease is a disease of mid-life which expresses itself in late life as ‘dementia’. Imagine if we sought to understand how the embryo and the foetus develops in pregnancy by only examining the mother and her baby in the 2 weeks before the child was born – it just wouldn’t make sense.
We need to be starting the process earlier, to look at the earliest stages of NBD using neuroimaging, blood and spinal fluid analysis. In fact, we already are! The EPAD and PREVENT Dementia Programmes, led from Scotland, are the largest and most comprehensive studies ever embarked upon to truly understand the processes in the brain that lead to severe and symptomatic NBD.
Our knowledge is changing, our ability to view the brain is advancing so must our whole perception of ‘dementia’ and brain health.
In the recent Alzheimer’s Europe Conference in Barcelona, I chaired a session where a researcher used the term Brain Health and Dementia Prevention interchangeably in the same slide. I paused the talk and asked the audience to vote on which term they preferred: of about 120 people in the room, only 2 voted for ‘dementia prevention’. The main reason is that every child and adult, both middle aged and elderly, would want to do all they can to maintain their health and their brain health. Children won’t take action to ‘prevent dementia’ – if you are worried about ‘preventing dementia’ it is probably already too late.
Let’s change the language which has been holding us back today: no more dementia. Let’s talk throughout life about brain health – then we will be unshackled from last century’s bias.
Want to find out more about brain health and dementia? Prof Ritchie will be talking in-depth of the ground-breaking initiatives mentioned within this blog during the Alzheimer Scotland Annual Conference. Join us on Monday 3 June at the EICC, Edinburgh.