Dementia and its preventability: Some TV programs bad, karaoke is good

Dementia seems the cruelest joke fate can play on us. It assaults the brain, stuns the intellect. The brain staggers, the intellect reels. High intelligence is no defense. Shukan Gendai (April 23) cites an ironic example. Tokyo University neurosurgeon Susumu Wakai showed his first symptoms at 54 – incidental proof that you needn’t be old. Wakai lived with the disease for 20 years before passing away at age 74. From a biography written by his wife the magazine learns of his frustration, rising at times to rage, as the twilight deepened. 

The warning signs are there for those who dare face them: the sudden confusion in the train station (“where am I going?”); the bewilderment at an ATM (“what’s my business here?”); the weird inability to decipher a kanji character you know is perfectly familiar; the failure to recognize the smiling neighbor greeting you as a friend.

Denial is natural and understandable. “It’s nothing, I’m tired, I work too hard; a good night’s sleep, a short vacation, there’s the ticket; I’ll be fine, if only I think I will.” Sometimes it’s true; positive thinking can be curative; negative thinking, poisonous.

What if the vacation doesn’t help?

Brain deterioration begins early – around 40, Shukan Gendai hears from its medical sources. It’s usually harmless at first and with luck remains so. The longer you live, the chancier the luck. What’s dementia? Crudely: neural trash going uncollected. In Alzheimer’s and similar disorders, the main culprit is an amino acid called amyloid beta, which has its (poorly understood) role to play in body chemistry but, building up as plaque, encrusts brains as they age, impeding normal cognitive function. Some short-term memory loss is normal in middle age. At what point should we start worrying? The magazine offers this yardstick: “It’s okay to forget what you had for breakfast; ominous if you forget that you had breakfast.”

The descent once begun, the slope steepens – not inevitably, not always rapidly, but often enough. Health ministry statistics are not comforting. As of 2025, out of a population of 123 million, 36 million will be 65 or over, 7 million suffering dementia.

There’s no cure – yet. Medication currently available at best slows symptoms. A new drug that has clinicians excited is called Lecanemab, developed jointly by Japan’s  Eisai Corp. and U.S. multinational Biogen. In trials it significantly lowers amyloid beta plaque. Possible side effects include cerebral hemorrhage and cerebral edema. Testing is proceeding.

Meanwhile, there are things you should do and things you should not do. Dementia is partly a lifestyle disease. Choose your lifestyle carefully, Shukan Gendai advises.

Television, habitual viewers will be glad to learn, is not bad per se – but a great many programs are, and must be watched, if at all, carefully. Not, in other words, inertly, blankly, simply letting the stuff into your brain because you’ve nothing better to do. Find something better to do. Turn the thing off.

To elaborate: The brain, the magazine explains, processes information in three stages: (1) input; (2) organization; (3) output. Stage 2 is key. Input unchecked overwhelms organization and waste disposal. Unorganized and unexpelled, trivial and inconsequential data forms a kind of intellectual plaque. Watch, if watch you must, with attention and discrimination – not simply as random sights and sounds to distract or accompany a blank mind.

News is another potential poison – the more so if the world’s in turmoil, as it is now as perhaps never before in living memory. How can one turn off the news? One must, of course, know what’s going on – up to a point, the magazine says. Beyond that point lies a region of stress the brain is hard pressed to cope with. News tracking tends to become compulsive. Know when to turn it off. Easier said than done, granted.

Sing, better. Karaoke gets the magazine’s thumbs up. Ah, the power of song! It stimulates production of all four of the so-called “feel-good  hormones” – dopamine, serotonin, oxytocin and the endorphins. Likewise, laughter. Sing and laugh, laugh and sing, even if you have to defy reality to do it. The choice seems to be: you either escape reality on your own terms and so remain anchored to it; or else risk ejection from it into a void from which, as of now, there is no exit.

 Michael Hoffman’s latest book is “Cipangu, Golden Cipangu: Essays in Japanese History.” 

© Japan Today