These days, I seem to spend a considerable amount of time looking for my keys or my phone. I often venture upstairs to fetch something, only to be utterly perplexed upon arrival as to what I went up there for. Is this a sign of something sinister in my future? Dementia is something likely to affect us all at some stage, either directly or indirectly, but statistically considerably more women develop it in the Western world than men, and that isn’t just because we live longer. Research shows that women with memory problems experience faster rates of cognitive decline than men and are even more susceptible to developing dementia after surgery. Researchers are largely in the dark as to why this is – it seem there is still a long way to go before the medical profession unravels all the complex causes.
There are currently 850,000 people with dementia in the UK, with numbers set to rise to over 1 million by 2025. This will soar to 2 million by 2051. Currently 1 in 6 people over the age of 80 are diagnosed and it is estimated that 225,000 will develop dementia this year alone - that's one person every three minutes.
It is difficult to predict who will and who won’t develop dementia, but over the past 30 years, apart from being a woman, research has also linked moderate and severe traumatic brain injury to a greater risk of developing Alzheimer's disease or another type of dementia.
One of the key studies showing an increased risk found that older adults with a history of moderate traumatic brain injury had a 2.3 times greater risk of developing Alzheimer's than seniors with no history of head injury, and those with a history of severe traumatic brain injury had a 4.5 times greater risk. Emerging evidence suggests that individuals who have experienced repeated traumatic brain injuries (concussions) or multiple blows to the head without loss of consciousness, such as professional athletes and combat veterans, are at higher risk of developing a brain condition called chronic traumatic encephalopathy (CTE) than individuals who have no experience of such an injury.
Following our recent successes in Rio, I wonder if any of our Olympians have considered the long term risks to their health given their chosen sport? Boxers, in particular, receive many blows involving something called rotational force, which is definitely implicated in concussion. Repeat concussions can lead to dementia pugilistica – which is a type of CTE, a neurodegenerative disease with features of dementia. Muhammad Ali, arguably one of the greatest boxers of all time, famed for his punches, his incredibly light foot work and his constant rhetoric, developed various symptoms 3 years into his retirement that eventually led to the diagnosis of Parkinsons.
The term ‘punch drunk’ was coined way back in the 1920’s by a pathologist who recognised a peculiar condition occurring among prize fighters, so it came as no surprise to anyone, including Ali himself, that he developed the condition. “I've been in the boxing ring for 30 years, and I've taken a lot of punches,” said Ali in 1984, then aged 42, “so there was a great possibility something could be wrong.” It appears he was fully aware of all the risks but carried on regardless. No doubt his fame and fortune enabled him and his carers to ensure that the champ was well cared for, but what becomes of the less successful?
But it’s not just boxing that is the problem, there are other sports that have come into the dementia spot light of late. A brain injuries expert has discovered what he believes to be the first confirmed case of early onset dementia caused by playing rugby. Dr Willie Stewart, a Consultant at the Southern General Hospital in Glasgow claims that contact sports in particular, which include American football and ice hockey, display all the indicators in pathology. It is estimated that a full body tackle involves the same force as being hit by a small truck. Dr Stewart said the discovery suggested that at least "one or two" players competing in the Six Nations every year may go on to develop the condition.
So is it just contact sport that is the problem? Apparently not. It has been reported that at least three of England’s 1966 World Cup winning football squad— Martin Peters, Nobby Stiles and Ray Wilson — have been diagnosed with Alzheimer’s believed to have been caused by head injuries suffered while playing. My father was a player in the 50’s and 60’s and, as an imposing centre forward, he scored many winning goals heading the heavy leather ball, which soaked up the mud and the rain like a sponge, into the back of the net. In 1963, he suffered a career ending fractured skull in a qualifying Olympic game playing for England. Not surprisingly, and very sadly, he is now in the advanced stages of vasculitis dementia.
A significant proportion of the population used to smoke, but when it was proven to be a major contributor to the development of cancer, they stopped. Will these statistics have the same impact on the playing fields of this green and pleasant land? I doubt it. Will we see a time in the future when dementia care is excluded from your policy if you have participated in activities proven to contribute? Possibly.
The total cost of dementia currently stands at £26.3 billion per annum in the UK. It is, however, benefiting from a significant amount of research these days, probably due to raised awareness, diagnosis and the spiralling costs, and because of that some developments have been made. But sadly there is still no known cure for this terrible, debilitating disease. Drug and non-drug treatments can help with both cognitive and behavioural symptoms, whilst researchers desperately explore new treatments to alter the course of the disease and improve the quality of life for sufferers. However the emotional and financial impact on the victims and their families is still huge. Whether care is provided in the home or a facility, a significant amount of hard cash is involved, mainly due to the constant supervision required to ensure the safety of the patient.
Whilst prevention is always better than cure, until we know the cause of dementia (and there are many, many different types) we can only hope that we don’t fall prey, and do what we can to ensure we have everything in place should the worst happen. Insurers have come under heavy criticism for years over rejected claims because of exclusions buried in the small print, however there have been significant amendments for the better of late – at least for new customers – and as a result, the benefits of a large lump sum are there to make a colossal difference to quality of life.
Raluca Boroianu‑Omura, Head of Health and Protection at the Association of British Insurers, assures us that 'Insurers are committed to ensuring that policies deliver when they're needed, with clear terms and conditions, so policyholders understand exactly what they are covered for.'
So why isn’t everyone insured? Why am I not insured? Research conducted by Ageas Protect shows 34% of women who do not currently have critical illness cover just don’t consider it a priority, while 37% of those polled said it was simply too expensive. Some 8% say they don’t have cover because they don’t like thinking about death or illness, and the same proportion say it is too complicated, or they don’t even know what it is.
I asked the question amongst my colleagues at Aston Charles and only the more senior members currently have cover. Like a good pension and quality foot wear, it is clearly not something the younger generation want to invest in just yet.
Depending on the age and relationship of the patient (insured, spouse, child, parent etc) any critical illness could very well involve a sudden and dramatic loss of income to the household, just as the care costs mount. An already stretched and underprepared NHS may not be in a position to meet all your needs. Or may not be obliged to.
It is a competitive market and therefore possible to get even the most basic cover for a few pounds a month to help you, should the worst happen.
“Spending my day looking for insurance is a great use of my time”, said no one, ever…. But it’s certainly what I’ll be doing next.