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0Annual dementia cases could double by 2050
Host: We begin with an important new study about a condition that is a major cause of deaths around the world. Dementia develops slowly. Symptoms like a decline in memory and social skills start gradually, but can then spread to areas that control those vital physical functions like breathing and swallowing. In many countries around the world, the rise of dementia is putting enormous pressure on healthcare systems.
Now, one of the most comprehensive studies on dementia has warned that by 2050, the number of people being newly diagnosed every year will double to 24 million. It suggests that low and middle income nations, where average ages are now on the rise, will show particularly rapid increases in dementia in the coming years.
Professor Henry Brodaty is co-author of the study that was carried out by the Centre for Healthy Aging at the University of New South Wales in Australia.
Henry: In countries like the UK and Australia, where I'm from, particularly in the UK, I think you're already about 20% of your population over 65. We're at about 17%. But in low and middle income countries, that ageing is just starting to catch up now. The rate of dementia doubles every five years after the age of 65.
So the more people you have who are older, particularly people who are over 80 or 90, then you have a much more rapid increase. The epidemic is not of dementia, it's of ageing.
Host: But there is also an issue with women being disproportionately vulnerable to this disease. Why is that?
Henry: That's really interesting. There may be social and environmental reasons, as well as biological reasons. So the social reasons, particularly in years gone by, is women had less education. They had less opportunity to be engaged in occupations, which were intellectually demanding and therefore build up cognitive reserve.
They were also more likely to have obesity in midlife and hypertension in midlife, which are risk factors for dementia, and also more likely to have depression, which is also another risk factor.
On the biological side, it may be that hormones have, oestrogens have a neuroprotective action in the brain that's been postulated. And it may be that women have more of the toxic protein called the amyloid beta protein in the brain. And amyloid beta protein is the main culprit for Alzheimer's disease and the new treatments now available are targeting that protein.
We know that women who've had their ovaries out at a younger age before menopause, who then go on to HRT, are less likely to get dementia later in life.
Host: What are the social and financial costs of the overall increase in dementia, numbers that we can expect over the next 25 years?
Henry: Currently, it's estimated we spend 1.3 trillion US dollars on dementia worldwide. And even by the end of the decade, that will be 2 trillion dollars US. So dementia is a big ticket item.
Host: We're all forewarned by reports like this. What can be done about it?
Henry: We know that about 45% of the risk of dementia are environmentally modifiable factors, things that we can do something about individually and also as a society. So, for example, we know that people with more education build up more cognitive reserve, which is a buffer against the pathology that may build up in the brain as we age.
People who exercise more are less likely to develop dementia. People who don't have hypertension, or if they do have high blood pressure, have it treated. And for every year of treatment, that reduces the risk. Detox for high cholesterol or lipids.
From a societal point of view, air pollution has been associated with dementia. We know that if people have spaces where they can walk and enjoy green spaces and blue spaces, that's protective as well. And also if there's spaces where they can meet and socialize, the Italian piazzas would be a nice example of that. And for every year we can delay the onset, we reduced the numbers of new cases by 10%.
词汇表
dementia [dɪˈmenʃə] n. 痴呆症，失智症
epidemic [ˌepɪˈdemɪk] n. 流行病；（疾病等的）流行，蔓延
disproportionately [ˌdɪsprəˈpɔːʃənətli] adv. 不成比例地，不相称地
be vulnerable to [ˈvʌlnərəbl] 易受…伤害的，易患…的
intellectually demanding 智力要求高的，需要脑力的
cognitive reserve [ˈkɒɡnətɪv rɪˈzɜːv] 认知储备（大脑应对衰老和病理变化的缓冲能力）
obesity [əʊˈbiːsəti] n. 肥胖，肥胖症
hypertension [ˌhaɪpəˈtenʃn] n. 高血压
oestrogen [ˈiːstrədʒən] n. 雌激素
neuroprotective action [ˌnjʊərəʊprəˈtektɪv] 神经保护作用
postulate [ˈpɒstjuleɪt] vt. 假定，假设
amyloid beta protein [ˈæmɪlɔɪd ˈbiːtə ˈprəʊtiːn] β-淀粉样蛋白
culprit [ˈkʌlprɪt] n. 罪魁祸首，元凶
Alzheimer's disease [ˈæltshaɪməz] 阿尔茨海默病，老年痴呆症
ovary [ˈəʊvəri] n. 卵巢
menopause [ˈmenəpɔːz] n. 更年期，绝经期
HRT 激素替代疗法（hormone replacement therapy）
big ticket item 高价商品，巨额支出项目
forewarn [fɔːˈwɔːn] vt. 预先警告，提醒，事先告诫
modifiable [ˈmɒdɪfaɪəbl] adj. 可改变的，可修正的
buffer [ˈbʌfə(r)] n. 缓冲物，缓冲器，起缓冲作用的事物
pathology [pəˈθɒlədʒi] n. 病理，病理变化，病变
detox [ˈdiːtɒks] n. 排毒，解毒（此处指控制、清除）
cholesterol [kəˈlestərɒl] n. 胆固醇
lipid [ˈlɪpɪd] n. 脂质，血脂，类脂
piazza [piˈætsə] n. （意大利的）广场，露天市场
onset [ˈɒnset] n. 发病，发作，开始
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