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Comment by melling | Hacker News Reader

I would hope that within 30 years (2055), we’ll have effective treatments.

Of course, 25 years ago, I would have thought modern medicine would have advanced more by now

It would be cheaper to cure the disease than treat the symptoms in all the people who are going to suffer from the disease.

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We don't have any miracle cures but we do have more and more evidence of effective preventative lifestyles. High cardiovascular fitness, good diet, and mental stimulation throughout life (think learning a musical instrument, not crosswords) all appear to lower the risk of dementia.

> think learning a musical instrument, not crosswords

Could you go into more detail on this distinction?

I think the assumption here is that one would be continually learning new material.

While crosswords help with exercising pattern recognition and recall, you're not generally learning anything 'new' (except the occasional word, and this diminishes over time).

Sight-reading random piano sheets, for example, would exercise most if not all of your faculties

Learning a musical instrument is:

- embodied

- self-directed

- open-ended

and includes things like playing in a band, performing for others

Doing crossword puzzles is:

- all in the brain

- exclusively solitary

- closed-off (just looking for the right answer)

Not an expert, but I think you are more likely to escape dementia if you balance physical, mental, and social activities, as well as do things that are opened-ended (let some light in!)

I'm not gonna argue that crosswords are primarily cognitive and don't have any muscle memory component, but my parents do the crossword together and their curiosity tends to make the try to understand the puns and jokes that usually make up the clues when they've only gotten a word to fit and not necessarily make sense.

A proper crossword is a great exercise for lateral thinking. I'm not aware of others that make my brain feel as flexible.

My understanding is that it's about building complex neural networks that your brain can use as a backup when others fail (although that's probably a massive oversimplification).

Crosswords are too simple, they only teach you how to get better at crosswords. Learning an instrument is a whole lifestyle - you need to combine aural, verbal, proprioception, social, and so on.

"It would be cheaper to cure the disease..."

<pessimist> Cheaper would also mean less revenue generated by ongoing symptom control medication. (Asthma inhalers for example: ~$13.4B global 2021, CAGR=20% !!)

There is less business incentive these days to prevent or cure disease from what I can see. We have prevented a lot of the really big diseases that scared the hell out of people in history. (with some notable exceptions)

Today a cured person is a lost consumer to a pharmaceutical company.

The only solution to that issue, that I know of, is some form of government incentive to artificially subvert the natural market pressure but that is distasteful in free-market countries and money "invested" in political campaigns can "motivate" politicians to steer clear of those waters.

</pessimist>

Though I share your pessimism, “fortunately” the drug companies don’t make much from dementia directly, the cost burden is borne by children and care facilities.

And for what it’s worth, if there were a drug I could buy for nearly any amount of money to get just a few months of slightly improved lucidity for either of my parents, I would pay it in a heartbeat.

Maybe we'll see a sudden explosion, that how cycles works. Prediction that disappoint, then when you least expect it, a revolution pops, rinse, repeat.

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