“Regardless of whether the country is lower or high-income, when it comes to diseases, prevention is always better, and more cost-efficient than cure. In the case of dementia, simple risk reduction measures have been shown to cut down the risk of cognitive decline. The words ‘dementia’ and ‘Alzheimer’s ‘ carry a lot of weight. Without proper education, people may not understand the full impact or challenges of the disease. Consequently, talking about risk-reduction measures would be futile if large parts of the population don’t see the importance of it. However, we can always think of a way to strategize the implementation of any policy. If we take the example of smoking, most people today understand its negative impact on heart-health. We also know that smoking is a risk factor for dementia. Thus instead of telling people that smoking may contribute to cognitive decline, it can be simplified as ‘what is good for your heart is good for your brain’. Since cardiovascular health receives much more attention in the media and education, people are more likely to be aware of it and take steps to ensure better heart health which would contribute to better brain health.”
Speaking about the effectiveness of implementing new policies, Dr. Kalache says, “Change may be slow but it is not impossible. The key is to raise awareness, to make people realize that what doesn’t affect them today, may affect them in the future. Thirty years ago, over 45% of adult men in Brazil were smokers. Thanks to education, extensive campaigning, and control measures such as where one can smoke, today less than 10% of people smoke. What has been especially effective is using children as agents of change. Children are more receptive to new ideas and more likely to participate as changemakers without even knowing. When you teach small children about the harmful effects of smoking, they don’t fear to shout words such as “poison” when they see someone smoking. With determination, drive, and intervention, we can create the same level of awareness about brain health. Of course, in this case, it would be to end the stigma and create a dialogue around it.
If we look at the status of dementia-care, we understand the gaps in skill and competency development between and within societies. How can we close this gap?
“One word that goes well with longevity is solidarity. We share the same world and have the same goals. If we don’t collaborate, forge alliances for the better and think about the future together, then we are going to pay a huge price.
The first kind of collaboration we need is intergenerational. I am privileged to have had all the opportunities to age well. It is now my duty to put in all I can so you can age well too. We need to inspire, we need to guide, we need to be mentors. We need to involve the youth in this discussion instead of alienating them as we traditionally do when we talk about aging. Older people need to share their knowledge and support younger people who can share their skills and talents. Everybody needs to participate in the conversation surrounding aging and dementia and feel like they have a voice – that they can make a difference.
The second kind of collaboration we need is academic. The world is developing fast and we are not investing in people, we are leaving them behind. Good knowledge needs to be accessible no matter where you come from. If people aren’t educated, they are not going to benefit from new technologies that are changing the way we work. They will then resort to conventional means of income largely dependent on deforestation and unsustainable fishing. The same applies to cognitive decline and brain health. Individuals need to be empowered with knowledge to make better decisions.
The third and final kind of collaboration we need is between the public and the private, local and global. Currently, the only group of people that do not have a convention is older people. Women, children, refugees, all have conventions. We need a convention for the rights of older people because they have set frameworks that call for the dedication of resources for their development, a restructuring of rules and regulations and greater support to ensure their dignity and wellbeing. Many LMICs advocate for the establishment of such a convention, however, HI countries are the ones that vote against it. The reasons for this are two-fold: one, developed countries already have established structures to ensure adequate care for the elderly. They don’t ‘feel the need’ to invest in further resources. Two, a convention would also urge these countries to channel resources in the development of elderly care in LMICs which may not be their first priority. However, without support from groups in a position of privilege, it won’t be possible for resource-poor countries to participate in achieving this shared goal to improve the lives of the people on whose backs our countries were built on.”
SCI understands the value of collaboration and aims to bring together experts from the sectors of finance, society, care, research, and business and discuss and forge partnerships to address the challenges the dementia diseases pose to society at Dementia Forum X. Dr. Kalache was a participant at this year’s Dementia Forum X. We thank him for his valuable insights and work in improving the state of elderly and dementia care globally.
