Brain health in social context
Historical understandings
Dementia has a long history in human society, and it has not always been viewed as a disease. The Ancient Greeks, for example, saw the gradual loss of physical and cognitive abilities as a normal part of ageing. Beliefs about dementia also vary between different cultures; in some it is seen as an illness, in others a normal part of ageing, and in others it is understood in relation to spiritual or religious beliefs.
In Western society in the 20th century, dementia came to be seen as a disease and as separate from normal ageing – particularly Alzheimer’s Disease, the most common form of dementia. Although this has led to advancements in scientific understanding of the condition, including in relation to prevention, some argue that the re-framing of Alzheimer’s Disease as a medical condition has had both positive and negative effects.
Dementia in medicine and media
The growing focus in recent decades on finding a medical treatment or cure for dementia – so far unsuccessful – has fuelled fears of being diagnosed with an ‘incurable’ disease. It has also contributed to less attention being paid to improving dementia care and support services, for both people with dementia living at home and in residential aged care.
Media portrayals of dementia and widespread ageist attitudes do not help. Depictions of people living with dementia are often disempowering and paternalistic, and alarmist narratives about our ageing population and rapidly growing numbers of people with dementia add to the perception of the disease as a heavy burden on society. You may like to watch this video, in which people living with dementia share their experiences of stigma and discrimination.
Living with dementia
We hear much less often about positive experiences of living with dementia, of evidence that dementia rates may be decreasing in some countries, or that it is reportedly being diagnosed at older ages (meaning the length of time people live with the condition may be decreasing).
While living with or caring for someone with dementia can be challenging, it is much less so when those affected are surrounded by good support and understanding, from people who have a strengths-based, holistic perspective.
It is encouraging to see researchers, policymakers, and dementia advocates increasingly call for such a response, as part of an integrated approach to dementia that gives a leading role to people with lived experience and goes beyond a narrow medical understanding of the condition.