There are still no clear markers for identifying those at risk of developing dementia
WHO IS it that can tell me who I am?” So muses the tragic figure of King Lear in Shakespeare’s poignant lament on the indignities of old age. Senility may be a polite word, but it doesn’t quite capture the horrors brought on by a gangrenous mind as the capaciously graphic dementia, which evokes the same kind of dread as cancer. It’s a catchall syndrome describing a clutch of symptoms, notably loss of memory and language skills, arising from a progressive wasting of the brain.
In the great bard’s time, only a few souls were unlucky enough to bear this cross as most perished early due to some disease or the other. But now, with more and more people living longer, dementia has mushroomed rapidly—it affects about 48 million people today, says the World Health Organization. There are no reliable figures for India, but one conservative estimate puts it at around four million, which is expected to triple by 2050. Besides, it’s a massive drain on the world economy— a 2010 study put the medical and social cost of caring for dementia patients at US $640 billion per year.
That’s not the only bad news. Worse, there is no cure in sight despite pharmaceutical companies and public research institutes pumping billions of dollars in the quest of a drug. Even though scientists now know a good deal about the nature and origins of Alzheimer’s—dementia’s most dreaded form accounting for 50-70 per cent of the overall corruption—translating that knowledge into therapeutics is a totally different story.
So when this August scientists from two drug companies claimed for the first time that they had hit upon a drug that could clear the “plaques” and “tangles”—clumps of proteins gone bad that fester between and within nerve cells causing the brain to shrink—in both mice and a few humans, it caused much excitement. However, peers are cautious in their endorsement, as they fear it could be another case of déjà vu. More rigorous trials are needed to clear the air.
Part of this skepticism arises from the fact that scientists still do not know how misbehaving proteins make memories disappear, or turn words into gibberish. Some believe we may never find the subliminal link, as the modus operandi is most likely hopelessly complex. So most scientists say we must stop looking for the magic pill that will restore broken memories, and instead, look for ways to intercept the culprit before it throws, so to speak, the spanner into the mind-works.
Some others are undeterred by this defeatist stance. They believe the drug is still elusive because researchers have been barking up the wrong tree. For them, the right tree grows not in the messy tissues of biology, but within the clear crystals of chemistry. They say all they need is to find a chemical broom that gnaws away the offending plaques, just like statins mop up excess cholesterol in the blood. Reportedly, a few candidate molecules are already in the pipeline.
When and whether an effective drug will be found is anybody’s guess. Looking for the possible triggers is an even more hopeless task. Early this month, a new study looked at a comprehensive rogue gallery and found that dementia can be spiked by as wildly different factors as air pollution, Vitamin D deficiency, and power lines. Then there are enduring enigmas—like why Ballabgarh, a small town in Haryana, is practically dementia-free, whereas almost everyone in a Dutch village is in its thrall. Is it genetic, cultural, environmental, gastronomical, or all of them? Your guess is as good as mine. In fact, one of the frustrations of dealing with dementia is that there are no clear markers for identifying those at risk of developing it.
So while modern druids take their time to deconstruct the pulp-fictions of an addled brain to eventually brew a magic potion, it may not harm if all of us, either inside or nearing the dementia borderlands, take Canadian psychiatrist Norman Doidge’s advice seriously by turning our minds into playgrounds of creativity. That way, there is a good chance that the dreaded ogre might lose its way into the deep recesses of our Byzantine brain.