Suchergebnisse

Purpose
Dementia is a growing problem worldwide, due to an ageing population. It has significant human and economic costs. There is no effective medical treatment. The paper aims to discuss these issues.


Design/methodology/approach
Using earlier reviews, the author discussed the difference between dementia and cognitive ageing and the different types of dementia, in terms of manifestation and pathology. The author reviewed non-modifiable risk factors for dementia, such as age, gender, genetics and education. Education can possibly have lifelong protective effects, as it may promote cognitive reserve. This paper focussed on lifestyle interventions to further increase brain reserve capacity. Findings from earlier reviews were summarised to provide guidelines for policymakers and practioners.


Findings
The reviews suggested that most nutritional approaches may have limited effectiveness, and should be implemented in midlife, before dementia symptoms are present and probably only in people who are actually nutritionally deficient. The author found a reasonable positive evidence base of engagement in cognitive and physical activities to prevent dementia, which may also help reduce symptoms of dementia.


Practical implications
From the studies reviewed, it was suggested that keeping physically and mentally active may help in all stages of life to prevent, but also reduce dementia symptoms. A focus on nutrition and treating heart disease risk factors is possibly limited to midlife, or before dementia symptoms are present.


Originality/value
The author used an evidence based approach to review which lifestyle interventions could help prevent dementia or reduce dementia symptoms. The main outcome of this paper was that stage of life and ability (dementia present or not) may interact with success of the intervention.

Indonesia, like many rapidly ageing lower-middle-income countries (LMICs), tends to portray older citizens as 'vulnerable' and 'dependent'; yet the country has few public policies to support them. To this discourse, an alternative stereotype is emerging, influenced by notions of 'successful ageing', which promotes models of older people as healthy and contributing to families and the nation state. In this article, we argue that both stereotypes ignore the varied and context-specific conditions of later life. Importantly, the dominant representations ignore the frailty and dependence that many people in LMICs experience towards the end of their lives. This results in dependence and frailty being concealed from view and treated as a purely familial responsibility, which households living in economic, social and demographic precarity can ill afford. 'Familism by default' spells invisible, unsupported and unsustainable care for many older Indonesians. This article draws on ethnographic fieldwork between 2018 and 2022 from two research projects on ageing, livelihoods, vulnerability and care in disparate communities across Indonesia. By juxtaposing dominant representations with the social, economic and health realities in which lives are lived, we trace the implications for policies, values and practices around care in later life.