Monday, October 08, 2012

Beyond a Personal Sense of Urgency

Each person feels his own sense of urgency -- varying with age and state of health -- regarding his own lifespan, and his ability to live out his remaining lifetime to its fullest.   But it is time for modern human society as a whole to feel an existential sense of urgency, as demographic trends begin to place constraints on humanity's ability to work itself out of a deepening hole.

The problem is one of diminishing human brain power, and one aspect of this problem is the rapid increase in proportion of individuals suffering from dementia -- Alzheimer's dementia and other types.

One illustration of the effect of dementia on the brain of an individual, is the following set of paintings by an American artist living in London, who was diagnosed with dementia at the beginning of the series:

The latest global demographic analysis, from a World Health Organization report issued earlier this year, paints the dimensions of that slow-motion catastrophe in quick strokes. An estimated 36 million people worldwide currently suffer from dementia; experts predict the number will double, to approximately 70 million, by 2030 and triple by 2050. (China, India, and Latin America in particular face daunting medico-economic crises.) Since the prevalence of the disease doubles with every five-year age increment after 65, projections for 2050 put the total global population at risk for dementia (people 65 or older) at two billion. The calculus is as grim as it is simple: as more people live longer, more slide into dementia. Care for those patients currently costs $100 billion a year in the United States, with a projected cost over the next 40 years of $20 trillion; by 2050, the cost to U.S. society is projected to be $1 trillion a year.

An even more sobering perspective on the problem comes from a small unpublished pilot study that Granieri and her colleagues at Columbia recently undertook. They did a standard cognitive evaluation of every person 70 or older who was admitted to Allen Hospital for any reason—heart problems, pain, diabetes, breathing difficulties. The results stunned them. "In this hospital, of patients 70 years of age or older, 90 percent have cognitive impairment of some kind, which is much higher than we anticipated," she says.

Not only is dementia distressingly widespread, but the complex overlap of symptoms and possible causes makes addressing the problem broader and trickier than just treating Alzheimer's. The emerging reality, which has become increasingly apparent with better brain imaging, is that the majority of cases among the elderly are so-called "mixed dementias"; the cognitive impairment is due to a combination of vascular problems, such as mini-strokes in discrete parts of the brain, and the more classic Alzheimer's pattern of amyloid plaques. Large-scale international studies in the past three years have shown, according to a recent scientific summary, that dementias caused by blood-vessel lesions in the brain, including vascular dementia and mixed dementia, "together comprise the most common forms of dementia at autopsy in community-based studies." _The Dementia Plague

At this point, no one knows if medical science is any closer to an effective treatment for dementia than it was 30 years ago. Several competing hypotheses are scrambling for research funds, while the underlying problem itself continues to swell, around the world.

As populations continue to age in most countries except in sub Saharan Africa and tribal areas of Asia, the population proportion susceptible to these dementias will continue to grow. And unfortunately, the regions of the world where young populations will continue to outnumber old populations for the foreseeable future, are also regions with populations possessing rather low average IQ. This means that more and more resources in the developed world will be spent on the tertiary care of dementia patients, while the undeveloped world is likely to sink below its pre-colonial baseline due to overpopulation.

At the same time, the developed world will be suffering from excessive debt, unwise immigration policies, and massively oversized governments of a parasitic nature. All of these problems will converge to make large-scale research programs very difficult to fund.

And so there is a sense of urgency now, not to waste resources on frivolous pursuits of an ideological nature, but to rather focus on problems which are critical and undeniable.

If we allow our best minds to slip away uncontested and un-utilised, we will be throwing away our chances to achieve longer, healthier, more fulfilling, more productive, wide-ranging lives.

We need to move beyond ideology, beyond political correctness, and dedicate ourselves to the very dangerous pursuit of an abundant human future.



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