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                Cover Story







              患有阿茲海默是正常的。                                      用藥仍難以根治
                  失智症與其他高齡問題不同,患者經常能

              活上幾年,甚至幾十年,但會需要他人竭力照                                  這和幾項因素有關,首先,兩位作者指出
              顧,而且患者可能無法自己做出財務決策。這                             阿茲海默症很難治療;目前的藥物只能讓病程
              表示我們因應失智症問題時,不但得使用保險                             拖緩幾個月,而且有副作用,只能讓患者每天
              和退休金這類財務規劃,還得思考信託之類的                             需要照護的時間減少一小時。當然,所有進展
              複雜工具。                                            都是好事,但這速度實在比心臟病或癌症領域
                  失智症罹患率上升在經濟上會造成很大                            慢太多。
              影響,甚至會影響到未來的總體經濟。英國                                   我們腦部周圍有一圈血腦障壁(Blood-Brain
              經濟學家馬諾˙普拉丹(Manoj Pradhan)和                       Barrier,  BBB),可以防止腦部受到外界干擾,但
              查理斯˙古德哈特(Charles  Goodhart)                      這層障壁也使腦部難以被診斷,使許多腦部疾病

              在2 02 0年 出版的《 人口結 構大 逆轉》                         無法早期治療。雖然持續運動等健康習慣可以
              (The  Great  Demographic  Reversal)一             避免或延緩失智症發生,但仍不足以對抗整
              書中指出,目前討論高齡問題時,都太低                               體趨勢。因為引起失智的病因有幾十種,除
              估失智症發病率不斷攀升的現象。他們認                               了占60至70%的阿茲海默症以外,還有巴金
              為這個現象會將全球資本的整體平衡進一                               森氏症等其他神經退化性疾病。
              步從儲蓄推向消費,結束幾十年來的反通                                    其次,照護失智者的費用很高。以美國
              膨壓力。                                             為例,住在養老院,一個人每年要花4萬至





              UK economists Manoj Pradhan and Charles Goodhart   of a few months, and with side effects, reducing
              argued last year that rising rates of dementia around   the need for caregiving on the order of an hour per
              the world are under-appreciated part of the aging   day. While any progress is commendable, this is far
              process. According to their analysis, this factor, among   slower than progress in other fields such as heart
              others, will shift the overall balance of global capital   disease and cancer.
              from saving to consumption, ending several decades of   The blood-brain barrier, designed to protect
              disinflationary pressure.                        the sensitive brain  from  outside  interference, is
                                                               a fundamental difficulty for treatment. It likewise
              Medical treatment is limited                     also hinders diagnosis, making it difficult to start

                                                               treatment earlier in the process. Dementia can be
                  Several factors enter this prediction. First, the   avoided or postponed through healthy habits like
              authors first note that Alzheimer’s has stubbornly   exercise, but not enough to counteract these trends.
              resisted treatment. Current medications manage to   Note that dementia has dozens of causes, although
              slow down the course of the disease for only a matter   Alzheimer’s  makes  up  about  60-70%  of  cases,






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