The Lessons for All of Us in Margaret Thatcher's Final Years

Former British Prime Minister Margaret Thatcher, the first woman to hold the post — and, at 11½ years, the country's longest-serving 20th-century leader — died today at age 87, after a stroke.
 
Thatcher had been largely absent from public life since a series of mini-strokes in 2002 and lived with dementia for the past decade.

Thatcher's conservative policies during her three terms in office continue to be hotly disputed in Britain and around the world, but in recent years, the private and public handling of her condition inspired a different kind of debate, one with profound relevance for anyone who has a parent or spouse living with dementia or Alzheimer's disease.

(MORE: Silent Strokes and Alzheimer's: Break the Connection)
 
Thatcher's daughter, Carol, was pilloried by many in 2008 for writing a memoir and conducting a series of interviews in which she spoke candidly — too candidly, for many Brits — about her mother's state of mind. Thatcher was often confused and could not remember such details as what she'd had for breakfast, her daughter said. Perhaps most heartbreaking, she frequently forgot that her husband, Denis, had died.
 
While many British commentators insisted that such details ought to be kept secret to preserve the former prime minister's privacy and dignity, the response here was quite different.

Jane Gross, founder of The New York Times' New Old Age blog, and now a Next Avenue contributor, wrote at the time that despite the public discomfort, such revelations can humanize larger-than-life figures and help to show all of us that illness like dementia is a great equalizer. We know that many of our parents — and us — will someday have dementia. Would we want to be hidden away from the world? As one friend told Gross at the time, "If you refuse to talk about it, you're treating it as something shameful." That's how we once wrongly approached cancer, Gross noted.
 
We've come to learn that we should be talking about dementia and its impact so that we can support one another as caregivers, prepare family and friends for the road ahead and advocate for the money, research and policies we need to help families affected by Alzheimer's and related conditions.
 
(MORE: The U.S. vs. Alzheimer's: The Fight Heats Up)

Thatcher was a public advocate for dementia research in the early years of her illness, becoming a patron of Alzheimer's Research UK. Here in the United States, another "Iron Lady," Hall of Fame women's basketball coach Pat Summitt, retired in 2012 because of early-onset Alzheimer's. But through the Pat Summitt Foundation she has done her best to remain in the public eye to push for progress in diagnosing and treating the condition.
 
(MORE: Why Pat Summitt's Alzheimer's Feels So Personal)

There are an estimated 5.5 million Americans living with Alzheimer's disease today, a number projected to triple by 2050. Just last week, a comprehensive new report estimated that the nation already spends between $159 billion and $215 billion annually on care for people with all dementia-related conditions, a figure expected to reach at least $379 billion to $511 billion by 2040.
 
(MORE: Cost of Dementia Care, Already High, Will Only Soar)

While there is no cure for Alzheimer's and no sure treatment to limit its advancement, we have learned a few things:

• Exercise and diet appear to be crucial to warding off dementia as long as possible. When University of Illinois researchers asked a group of adults to start taking a brisk walk three times a week, they found that, over time, participants reversed the expected age-related shrinking of their brain. Other research has revealed an apparent connection between high cholesterol levels in midlife and the risk of Alzheimer's in later years, as well as a significant link between diabetes and dementia. As preventive measures, a major study published in the Journal of the American Medical Association found that both regular exercise and adherence to the Mediterranean diet could reduce our risk of contracting Alzheimer's disease.
• Engagement with the arts may be just as potent as regular exercise in preserving our mental health and acuity. For example, neuroscientist Peter Davies of New York’s Albert Einstein Medical Center has reported on the striking power of dance to ward off dementia in older people. Participation in dance programs among the group seemed to reduce the development of dementia by as much as 75 percent, a success rate he deemed far greater than "any drug even on the horizon."
• When we take on new challenges that maintain and stretch "plasticity" in our brains, we can limit the negative effects of aging and potentially increase production of proteins that help us maintain memory function and ward off dementia.
• Scientists are discovering more about the critical but less well-known connection between stroke and Alzheimer's, which appears to have contributed to Thatcher's decline. Dr. Adam Brickman of the Columbia University Medical Center in New York recently piloted a study of 658 people over 65 years old without dementia. He found, as expected, that people with a shrunken hippocampus, the area of the brain responsible for memory, performed less well on memory tests. But subjects whose MRI results showed evidence of having had previously undetected or "silent" strokes — about a quarter of the group — also did not score well on the tests, even if they did not have a shrunken hippocampus. "Our results support stroke prevention as a means for staving off memory problems," he told Next Avenue. "If we can control all those risk factors, then we think we might be able to reduce the burden of Alzheimer's or minimize the risk."

Rebecca Wood, chief executive of Alzheimer's Research UK, told the BBC this morning: "Thanks to Lady Thatcher, we have made inroads with our research to defeat dementia. The answers will come too late for her, but they will come, and this will be another important part of our collective memory of her life and work."