Second Opinion: Global initiative on dementia a major turning point

For those who care about a better life for those affected by dementia, an early Christmas present came from an unexpected source. The G8, the group of leading industrialised nations, held a summit on dementia in London last week, Global Action Against Dementia.

This represented a major turning point for an illness whose ravages have been greatly compounded by undue negativity and nihilism among both the population and the professions.

The headline-grabbing aspect of their declaration was the ambition for a cure or disease-modifying treatment by 2025.

Even more remarkable was the upbeat, can-do attitude of the G8 defining their primary aim in terms of improving quality of life for those affected with dementia while reducing emotional and financial burden.

This understanding and belief that often simple measures can make a big difference to those affected by dementia is critical: the routine provision of support and advisory services after diagnosis, the development of dementia-friendly hospitals, the opening out of social and recreational projects for those with dementia to name but a few.

A recent appearance of a choir with people with dementia from Dún Laoghaire-Rathdown on Morning Ireland was a moving reminder of the potency of an open and positive approach.

Failure of hope and will
That these do not occur routinely and in a systematic way, as is likely to be shown in the forthcoming report of the Irish National Audit of Dementia Care, represents a failure of hope and will as much as that of resources.

Just as the focused political drive of Mary Harney was a key factor in the ramping up of cancer services in Ireland, the G8 declaration should prompt a similar degree of determination from our current Government.

In this it should perceive an important message in an often cynical world on the key role of political leadership in forging radical change in healthcare.

A classic example was the determination of Jacques Chirac to reduce traffic fatalities and injuries in France, where a laissez-faire attitude to traffic enforcement on speed and alcohol had left it with one of the worst records in Europe.

Galvanised from the top, over the space of a few short years France became among the safest countries in Europe.

National effort
To his successor, Nicolas Sarkozy, we are indebted for the first serious and sustained national effort to respond appropriately to the enormity of the challenge of dementia.

Out of this ambitious programme arose the first ever joint action between all national medical research councils in Europe, with a primary focus on Alzheimer’s disease.

Many Irish researchers in social, clinical and laboratory sciences have engaged with this European project.

In a similar vein, and in a way perhaps not yet given due credit on this side of the Irish Sea, David Cameron has been driving a major programme in improving dementia care in the UK.

The results are quite astonishing over a short period, including a rapidly expanding dementia-friendly hospital network, the development of integrated community care pathways, and a major boost for memory services.

This inspired Anglo-French leadership prompted the momentous G8 declaration, with aspects ranging from scientific and commercial collaboration, dementia training and awareness, and inter-sectoral working.

Without decrying the ambition, a cure by 2025 is unlikely as the vast majority of those with dementia do not have a single cause for the illness, but we will surely make much progress.

Informed by science
It is vital that developments remain informed by science. A particular area of concern is emerging commercial pressures for early detection of memory problems, a strategy of no demonstrable benefit.

Reports of plans for memory testing in pharmacies are worrying, as are advertising campaigns for expensive nutrition supplements of dubious value for memory problems.

This European and global ferment on positive approaches to dementia comes at an opportune moment for Ireland.

A national strategy for dementia is currently being finalised through the Department of Health, and is an opportunity for a programme with bite and relevance, unlike the anodyne Positive Ageing Strategy from earlier this year.

So, as Christmas approaches, Enda Kenny and his Cabinet colleagues should reflect that dementia initiatives in politics turn the literary canon on its head: the good that men do will not be interred with their bones, and the Ghost of Christmas Yet to Come can bring good tidings.

Des O’Neill is a consultant in geriatric and stroke medicine