For me the talk was like a badly needed holiday. I joked with Kay there, a colleague of Lisa, that it felt like a (happy) wedding reception.
@charbhardy hello Chars – not at all the same without you. Thinking of you and G. Very windy on seafront here at Brighton x
— shibley (@legalaware) February 27, 2014
Unknown to me, the title of Prof Banerjee’s talk is an allusion to this famous track from 1979 (when I was five). It’s “Reasons to be cheerful (part 3)” by Ian Drury and the Blockheads.
The Inaugural Lecture – Professor Sube Banerjee (“Professor of Dementia”), ‘Dementia: Reasons to be cheerful’ was held on 26 February, 2014, 6:30 pm – 8:30 pm, at Chowen Lecture Theatre, Brighton and Sussex Medical School, Sussex Campus. BN1 9PX. Details are here on the BSMS website.
I found Prof Banerjee to be a very engaging, ‘natural’ speaker.
I arrived with hours to spare, like how the late Baroness Thatcher was alleged to have done in turning up for funerals.
Brighton are very lucky to have him.
But his lecture was stellar – very humble, yet given with huge gravitas. Banerjee is one of the best lecturers of any academic rank in dementia I have ever seen in person.
Banerjee started off with a suitable ‘icebreaker’ joke – but the audience wasn’t at all nervous, as they all immediately warmed to him very much.
He is ‘quite a catch’. He is able to explain the complicated issues about English dementia policy in a way that is both accurate and engaging. Also, I have every confidence in his ability to attract further research funding for his various teaching and clinical initiatives in dementia for the future.
Most of all, I was particularly pleased as the narrative which he gave of English dementia policy, with regards to wellbeing, was not only accurate, but also achievable yet ambitious.
1979 was of course a big year.
Prof Banerjee felt there were in fact many ‘reasons to be cheerful’, since Ian Drury’s remarkable track of 1979 (above), apparently issued on 20 July of that year.
Banerjee argued that the 1970s which had only given fruit to 209 papers, but things had improved ever since then.
It was the year of course Margaret Thatcher came to power on behalf of the Conservative Party.
In contrast, there have already been thousands of papers in the 2000s so far.
Banerjee also argued that “what we know is more likely to be true” which is possibly also true. However, I immediately reminisced of the famous paper in Science in 1982, “The cholinergic hypothesis of geriatric memory dysfunction”. This paper, many feel, lay the groundwork for the development of cholinesterase inhibitors such as donepezil (“Aricept”, fewer than twenty years later.
It is definitely true that ‘we are better at delineating the different forms of dementia’.
I prefer to talk of the value of people with dementia, but Banerjee presented the usual patter about the economic costs of dementia. Such stats almost invariably make it onto formal grant applications to do with dementia, to set the scene of this particular societal challenge.
I am of course a strong believer in this as my own PhD was in a new way to diagnose the behavioural variant of frontotemporal dementia. In this dementia, affecting mainly people in their 50s at onset, the behavioural and personality change noticed by friends and carers is quite marked. This is in contrast to a relative lack of memory of problems.
Not all dementias present with memory problems, and not all memory problems have a dementia as a root cause. I do happen to believe that this is still a major faultline in English dementia policy, which has repercussions of course for campaigns about ‘dementia awareness’.
A major drive in the national campaigns for England is targeted at destigmating persons with dementia, so that they are not subject to discrimination or prejudice.
The dementia friendship programmes have been particularly successful, and Banerjee correctly explained the global nature of the history of this initiative drive (from its “befriending” routes in Japan). Banerjee also gave an excellent example to do with language of dementia friendship in the elderly, which I had completely missed.
Raising awareness of memory problems in dementia is though phenomenally important, as Alzheimer’s disease is currently thought to be the most prevalent form of dementia worldwide.
The prevalence of dementia may even have been falling in England in the last few decades to the success prevention of cardiovascular disease in primary care.
The interesting epidemiological question is whether this should have happened anyway. Anyway, it is certainly good news for the vascular dementias potentially.
That dementia is more than simply a global public health matter is self-evident.
I’m extremely happy Banerjee made reference to a document WHO/Alzheimers Disease International have given me permission to quote in my own book.
Banerjee presented a slide on the phenomenally successful public awareness campaign about memory.
Nonetheless, Banerjee did speak later passionately about the development of the Croydon memory services model for improving quality of life for persons with mild to moderate dementia.
In developing his narrative about ‘living well with dementia’, Banerjee acknowledged at the outset that the person is what matters at dementia. He specifically said it’s about what a person can do rather than what he cannot do, which is in keeping to my entire philosophy about living well with dementia.
And how do we know if what we’re doing is of any help? Banerjee has been instrumental in producing, with his research teams, acceptable and validated methods for measuring quality of life in dementia.
The DEMQOL work has been extremely helpful here, and I’m happy Banerjee made a point of signposting this interesting area of ongoing practice-oriented research work.
Banerjee of course did refer to “the usual suspects” – i.e. things you would have expected him to have spoken about, such as the National Dementia Strategy (2009) which he was instrumental in designing at the time: this strategy was called “Living well with dementia”.
“I’m showing you this slide BECAUSE I want YOU to realise it IS complicated”, mused Banerjee at the objectives of the current English dementia policy.
I asked Banerjee what he felt the appropriate ‘ingredients’ of the new strategy for dementia might be – how he would reconcile the balance between ‘cure’ and ‘care’ – “and of course, the answer is both”, he said to me wryly.
Banerjee acknowledged, which I was massively pleased about, the current ‘barriers to care’ in this jurisdiction (including the known issues about the “timely diagnosis of dementia”.
Clearly the provision at the acute end of dementia care is going to have to come under greater scrutiny.
I increasingly have felt distinctly underwhelmed by the “medical model”, and in particular the repercussions of this medicalisation of dementia as to how grassroots supporters attempt to raise monies for dementia.
That certain antidepressants can have a lack of effect in dementia – Banerjee’s work – worries me.
That antipsychotics can have a dangerous and destructive effect for persons with dementia – also Banerjee’s work – also clearly worries me.
I am of course very proud that Prof Alistair Burns is currently reading my book focused on the interaction between the person and the environment in dementia.
And of course I’m ecstatic that Lisa Rodrigues and Prof Sube Banerjee signed my book : a real honour for me.
I signed Lisa’s book which was most likely not as exciting for her! X
— Lisa Rodrigues (@LisaSaysThis) February 26, 2014
There was a great atmosphere afterwards: the little chocolate brownies were outstanding!
Being an antisocial bastard, I didn’t mingle.
BUT I had a brilliant chat with Lucy Jane Marsters (@lucyjmarsters) who gave me a little bag of ‘Dementia is my business’ badges, very thoughtfully.
We both spoke about Charmaine Hardy. Charmaine was missed (and was at home, devoted to G.)
I’ve always felt that Charmaine is a top member of our community.
@legalaware oh Shibley how did you enjoy it? I wish I could have been there but it’s not possible to leave G anymore. Good being by the sea.
— Charmaine Hardy (@charbhardy) February 27, 2014
A reason not to be cheerful was leaving Brighton, for many personal reasons for me.
Not even the Shard was a ‘reason to be cheerful’, particularly.
— Lisa Rodrigues (@LisaSaysThis) February 27, 2014
But when I came back, I found out that ‘Living well with dementia’ is to be a core part of the new English dementia policy.
— Living Well Dementia (@dementia_2014) February 27, 2014
I have, of course, just published a whole book about it.
The photograph of the poppy was of course taken by Charmaine Hardy: I have such great feedback on that one poppy in particular!
And what does the future hold?
Over to Prof Banerjee…