Notes from my Knapsack 4-7-24

Notes from my Knapsack 4-7-24
Jeff Gill

The politics of public health and cognitive decline
___


We're eight months away from the presidential election, and I have something to say.

It's from the heart, and it's not really meant to be political at all, but in a time when everything seems to be politicized, sometimes you just have to "grasp the nettle" and grab an issue as firmly as you can, discomfort aside.

In the discussions around the two leading candidates currently, the word "dementia" is getting tossed around rather casually.

This is where I can easily envision partisans rising up in a cold fury, or even something hotter, to retort angrily to my obtuseness.

One candidate, the older one to be sure, has the tag "dementia" attached to him quite often. I doubt this very much. My concern in looking at him is that I read his appearance as "frail," which is not unusual for someone into their 80s. Frailty is an issue, and I can discuss that as a reason for one's support or opposition.

The other candidate is chronologically not far behind, though, and his affect is often one of manic self-regard, if not showing a bit of cognitive decline himself. Those who are firmly opposed to him will often throw the word "dementia" around in his direction, too.

If you're still with me, I'd like to make a totally non-partisan distinction between cognitive decline and dementia. Any of us can have cognitive decline, such as me before my morning coffee. Cognitive decline can be something that comes and goes, and in cases where it's the result of an illness or physical condition, it can be reversed. Dementia is something that we can in a very few cases slow but in no way stop it.

Columbia University researchers recently found that around 10% of U.S. adults 65 and older have some form of dementia, while another 22% have mild cognitive impairment. Paralleling those findings, the Alzheimer's Association says 1 in 3 seniors will die of some form of dementia.

It's worth pointing out this means 2 of 3 seniors won't. Not everyone gets dementia, or even shows significant cognitive decline, just by getting older. Some of the sharpest people I've known were in their 80s and 90s.

But dementia is a steadily increasing problem in our country, with 6 million Americans believed to have Alzheimer's right now, and that number expected to reach 13 million by 2050. There's no pill or surgery that cures it. Those with dementia need care, which is personal and challenging, and one way or another expensive. We all need to talk about dementia and how to deal with it when it arises in our families and friend groups.

The current political debate is not helping. Dementia is not a casual insult. It's a diagnosis, and a reality all around us. I hope we can change how we see and share what we know, as we work and pray for better solutions ahead.


Jeff Gill is a writer, storyteller, and preacher in central Ohio; he's working with dementia related issues these days, but you figured that out already. Tell him how you deal with dementia in your circles at knapsack77@gmail.com, or follow @Knapsack77 on Threads.