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Hi there, I (don’t) have dementia. But, what do you have?

It is said that there are more than 245.000 people diagnosed with dementia in the Netherlands, at this moment. The country has a mortality rate of approximately 35.000 dementia patients per year. For 7.000 of them dementia is listed as the primary cause of death. For another 10.000 people the event of death occurs in the final stages of dementia. Although the primary cause of death usually isn’t dementia itself. One effect of the disease is the increased susceptibility to all kinds of diseases. The most common cause of death is pneumonia. The patient’s immune system is known to weaken with age and also because of accelerated weight loss, patients are more likely to contract sinus- and long infections. 

Insiders say that it’s the treatment of people suffering from dementia that takes the biggest bite out of our healthcare costs. In 2011 these costs added up to a total of € 3,9 billion. The essential part of this was covered by the costs of intramural care for patients who are at too much risk to continue living at home. Due to the post World War baby boom the number of patients is anticipated to grow to approximately half a million in 2040. The fear of healthcare costs rising to unprecedented heights is what causes today’s government of liberal VVD and socialist PvdA to conclude: we need to take measures. 

“Ah,” you might think, “is this how they play it. But I could think of plenty of other examples of uneconomical medical conditions. How about cancer.” “No, no,” I’ll protest, “this is not what we’re going to do: we’re not going to bid against each other even though it does appear that way sometimes. It was only recently that the Dutch astronaut Wubbo Ockels – who has since passed away – appeared on national television. Ockels suffered from renal cell cancer, a very aggressive form of cancer, which is fatal in almost all cases. His philosophy was like mine: to stay active in body and mind. Obviously, Ockels had the advantage of being a celebrity and an astronaut too, which is probably why he was given a special, very expensive medical treatment in a hospital in Houston. In my opinion he had earned it. After all, he did have the courage to conquer space in a capsule once. By the way, before I continue there’s something I want to clear up: when a neurologist diagnoses you with an abnormality in the brain, does that automatically mean you have dementia? Fortunately the answer is “No”! How can I be so sure? Through first-hand experience. It happened some time ago, one evening around 7 pm, when I was riding my bike in a forest near my house. I suddenly wondered: am I allowed to drive a car when I have Alzheimer’s?  

It was days before we would be leaving for France to meet up with our children. Usually I’m behind the wheel for a greater part of the journey. Also navigating through the congested motorways around Paris is something my wife gladly leaves to me. I was cycling and I thought: what will happen in the event of a car accident, would we be held responsible because I have dementia? The question “am I allowed to drive a car” can only be answered by the treating neurologist. I had his cell phone number within reach and I decided to call him immediately. “My apologies for calling you at this hour, but I have a somewhat urgent question. Do I have dementia?” Not hesitating for one moment he laughed and subsequently tried to reassure me by launching into this rather complicated medical explanation. Being on a bike and all, my thoughts started to drift. He concluded our conversation by suggesting I’d call him after my holiday to schedule a driving test in a simulator. I still haven’t done that test though. However, we did go to France since then, not once but several times.  

Jacques Boersma