经济学人｜The rising prevalence of dementia is a global emergency

经济学人

The rising prevalence of dementia is a global emergency

Of all the troubles facing the world, the rising prevalence of dementia might seem among the less pressing. The reason behind it—longer lifespans—is to be cheered; it does not advance at the speed of a viral infection but with the ponderous inevitability of demographic change; and its full effects will not be felt until far into the future. But the reality is very different. As our special report this week makes clear, dementia is already a global emergency. Even now, more people live with it than can be looked after humanely. No cure is in the offing. And no society has devised a sustainable way to provide and pay for the care that people with it will need.

在世界上面临的所有困难中，痴呆症患病率的上升似乎不那么紧迫。它背后的原因——更长的寿命——是值得欢呼的; 它不会以病毒感染的速度蔓延，但是会随着迟缓的人口结构的必然变化而发展; 其全部影响要到将来才会感受到。但现实却大相径庭。正如我们本周的特别报告表明的，痴呆症已经是一个全球性的紧急情况。即使是现在，患病的人也要比能够得到人道照顾的患者多。没有治愈的方法。没有一个国家设计出一种可持续的方式来提供和支付人们所需要的护理。

pressing

urgent or needing to be dealt with immediately

紧迫的，迫切的

a pressing need for housing对住房的迫切需求

a pressing issue紧迫的问题

The most pressing question is what do we do next?最迫切的问题是接下来我们要做什么？

lifespan

寿命；可持续年限，有效期

The average human lifespan in the developed countries has increased over the last hundred years.发达国家的人均寿命在过去的100年间延长了。

The project's lifespan is estimated at about five years.预计这项工程为期5年左右。

advance

a(使）前进；使进步，使进展；使发展；促进

The fire advanced steadily through the forest.大火在森林中不断蔓延。

The troops advanced on the city (= approached it, ready to attack).军队向该城推进。

We have advanced greatly in our knowledge of the universe.在认识宇宙方面，我们已经取得长足的进步。

Her study has considerably advanced (= helped) the cause of equal rights.她的研究极大地促进了权利平等运动的事业。

He's just trying to advance (= improve) his own career.他只是在努力拓展自己的事业。

ponderous

（因重或大而）行动迟缓的，笨拙的

He had a slow and ponderous manner.他的举止缓慢笨拙。

demographic

人口的；人口统计的；人口学的

There have been monumental social and demographic changes in the country.该国的社会和人口状况已经发生了巨大的变化。

current demographic trends目前的人口发展趋势

live with sth

接受，容忍（困境或令人不快的情形）

I can't change the situation so I'm going to have to learn to live with it.既然无法改变这种状况，我只好试着去接受它。

humane

/hjuːˈmeɪn/

showing kindness, care, and sympathy towards others, especially those who are suffering

（尤指对待受苦者）善良的，仁慈的，人道的

The humane way of dealing with a suffering animal (= the way that causes the least pain) is to kill it quickly.对待为病痛所折磨的动物，比较人道的办法就是尽快结束它的生命。

in the offing

likely to happen soon

即将来临的；即将发生的

With an election in the offing, the prime minister is keen to maintain his popularity.选举在即，首相非常注意保持其声望。

devise

巧妙构思；巧妙设计；发明

He's good at devising language games that you can play with students in class.他善于设计可供师生在课堂上使用的语言游戏。

The cartoon characters Snoopy and Charlie Brown were devised by Charles M. Schultz.卡通人物史努比和查理‧布朗是由查尔斯‧M‧舒尔茨设计的。

“Dementia” is an umbrella term for a range of conditions, with a variety of causes, of which the most common is Alzheimer’s disease, accounting for 60-80% of cases. It usually starts with forgetfulness and a mild loss of cognitive functioning. But as it advances, people lose the ability to look after themselves. Many require round-the-clock care long before they die. It does not just affect the elderly, but they are much more likely to have it—and life expectancy globally has climbed from not much more than 30 a century ago to over 70 now, and over 80 in rich countries. By some estimates, 1.7% of 65- to 69-year-olds have dementia and the risk of developing it doubles every five years after that. At present, about 50m people around the world have the condition, a number expected to rise to 82m by 2030 and 150m by 2050. Most of the new cases are in the developing world, where populations are rising and ageing.

"痴呆症"是一一系列疾病的总称，其原因有多种，其中最常见的是阿尔茨海默氏症，占病例的60-80%。它通常从健忘和认知功能的轻微丧失开始。但随着病情发展，人们失去了照顾自己的能力。许多人在去世前很长一段时间就需要24小时护理。它不仅仅只影响到老年人，但老年人更有可能患痴呆症——全球的预期寿命从一个世纪前不到30岁攀升至现在的70多岁，在富裕国家超过80岁。据估计，65至69岁的人中，有1.7%患有痴呆症，此后每五年患痴呆症的风险会增加一倍。目前，全世界约有5000万人有此病，到2030年，这一数字预计将上升到8200万，到2050年将上升到1.5亿。大多数新病例在发展中国家，那里的人口正在上升和老龄化。

umbrella

综合体；总体

He runs a group of companies under the umbrella of Universal Foods.他经营一组公司，总称为Universal Foods。

The Organization of Islamic Conference is an umbrella organization representing 57 Muslim nations.伊斯兰国家组织是代表57个伊斯兰国家的机构。

Existentialism was really an umbrella term to lump together the works of several philosophers and writers.存在主义实际上是一个把几位哲学家和作家的作品归并在一起的总称。

condition

疾病

to suffer from a heart/skin condition患有心脏／皮肤病

a medical condition内科疾病

account for sth

（在数量上）占

Students account for the vast majority of our customers.我们的顾客绝大多数是学生。

mild

温和的；和缓的；轻微的

She can't accept even mild criticism of her work.即使別人对她的作品略有微词，她都不能接受。

He has suffered a mild heart attack - nothing too serious.他只是轻微的心脏病发作，并不太严重。

round-the-clock

全天的，全天候的；不分昼夜的

He's very sick and needs round-the-clock care.他的病很重，需要全天候护理。

climb

（价格、数量等）上涨，增长，攀升

Our costs have climbed rapidly in the last few years.过去几年里我们的成本增长很快。

life expectancy

（尤指人的）预期寿命

Life expectancy in Europe increased greatly in the 20th century.欧洲人的预期寿命在20世纪大幅增长。

The problems these numbers will bring everywhere have already been felt in countries where people are older, and especially acutely during lockdowns—witness the difficulty of looking after people with dementia in their own homes, and the large numbers in overstretched care homes who receive little individual attention. As families shrink, single children and grandchildren will struggle to cope with their old folk. Already, dementia care has had a knock-on effect on general health care. Before the pandemic as many as a quarter of beds in British hospitals were occupied by people with dementia. There was nowhere else for them to go.

这些数字将给每一个地方带来的问题，在人口年龄较大的国家已经感受到问题所在，特别是在疫情封锁期间感受极其明显，经历了在自己家中照顾痴呆症患者的困难，有大量的老年人在数量紧缺的护理院没有得到足够的个人关注。随着家庭的缩小，单身子女和孙子孙女将难以顾及他们的老人。痴呆症护理已经给大众医疗护理带来了连锁反应。在流感大流行之前，英国医院多达四分之一的病床被痴呆症患者占用。他们无处可去。

acutely

完全地；极其

Management is acutely aware of the resentment that their decision may cause.管理层非常清楚他们的决定可能会招致愤恨。

Another scandal would be acutely embarrassing for the government.如果再出现一次丑闻，政府将陷入极度尴尬之中。

overstretched

缺少（资金、人力、器材等）的

Hospitals are overstretched, and patients are not getting the treatment they need.医院人力、物资紧缺，病人们得不到必要的治疗。

cope

（成功地）对付，应付，处理

It must be really hard to cope with three young children and a job.要照顾3个小孩还要工作肯定不容易。

It's only been a year since he died - how's she coping?他过世刚一年时间——她的情况怎么样？

He had so much pressure on him in his job that eventually he just couldn't cope.他工作压力太大，最后便扛不住了。

folk

（尤指某一群体或类型的）人们

old folk老人

Ordinary folk can't afford cars like that.普通人买不起那样的轿车。

knock-on effect

连锁反应

If one or two trains run late, it has a knock-on effect on the entire rail service.如果有一两列火车晚点，会进而影响整个铁路系统。

Not all the news is bad. Recent research has shown that behaviour such as smoking less, exercising more and losing weight in middle age has reduced the risk of dementia among old people in some Western countries in the past 30 years. And America’s Food and Drug Administration has promised to decide by March 2021 whether to license a drug said to be the first to stem cognitive decline in Alzheimer’s patients. But the risk of dementia still seems to be rising in much of the world and any new therapy in the foreseeable future is likely to benefit only some patients partially.

不是所有的新闻都是坏消息。最近的研究表明，在过去30年中，在一些西方国家，老年人患痴呆症的风险可以通过减少吸烟，多运动和中年时减肥降低。美国食品和药物管理局（FDA）承诺，将在2021年3月前决定是否批准一种据说是首次阻止阿尔茨海默氏症患者认知衰退的药物。但是，痴呆症的风险似乎仍在世界很多，在可预见的将来，任何新的疗法都可能只部分地使部分患者受益。

license

许可，授权，特许

Several companies have been licensed to sell these products.一些公司获得了这些产品的销售许可。

stem

阻挡；阻止；遏制

These measures are designed to stem the rise of violent crime.这些措施旨在遏制暴力犯罪的增加。

We must take action to stem the tide of resignations.我们必须采取行动制止愈演愈烈的辞职潮。

in/for the foreseeable future

在可预见的将来

I'll be living here for the foreseeable future.在可预见的将来我肯定会继续住在这里。

He asked me if there was any point in the foreseeable future when I'd like to have children.他问我是否想在不久的将来某个时候想要个孩子。

That is why governments should act now to lessen the social and economic harm from the growing prevalence of dementia. The first step is to recall the urgency with which many were promising to tackle the problem just a few years ago—in 2013, for example, when David Cameron, then Britain’s prime minister, used the rotating chairmanship of the G8 to convene a “dementia summit”, which promised to fund research with the goal of finding a “disease-modifying treatment” by 2025. Instead, funding for work on dementia has lagged far behind that for cancer or coronary heart disease. And as the pandemic hampers or prevents clinical trials and research, and sucks resources away from other areas, dementia risks again being left behind.

这就是为什么政府现在应该采取行动，减少痴呆症日益流行造成的社会和经济危害。第一步是召回几年前许多国家承诺解决这一问题的紧迫性——例如，2013年，当时的英国首相大卫•卡梅伦（David Cameron）利用八国集团轮值主席国召开"痴呆症峰会"，承诺为研究提供资金，目标是在2025年前找到"改变疾病的治疗方法"。然而，用于痴呆症的研究资金远远落后于癌症或冠心病。由于新冠大流行病阻碍或阻止临床试验和研究，并消耗了其他领域的资源，痴呆症的研究有可能再次被抛在后面。

lessen

减少，降低，减轻

A healthy diet can lessen the risk of heart disease.健康饮食能降低患心脏病的危险。

tackle

对付，处理；与…交涉

There are many ways of tackling this problem.处理这个问题有许多办法。

I tackled him about his careless work.就他工作马虎一事我与他进行了交涉。

chairmanship

主席职位（或身份），主席任期

His chairmanship lasted a year.他担任主席一职有一年时间。

convene

召开，召集（会议）；集合；开会

The prime minister convened (a meeting of) his cabinet to discuss the matter.首相召集部长（开会）讨论这个问题。

The council will be convening on the morning of the 25th.市政会议将于25日上午召开。

lag

缓慢移动；掉队，滞后

He's lagging behind - I think we'd better wait for him to catch us up.他有点掉队了——我看我们最好等他赶上来。

Sales are lagging at the moment.目前的销售很不景气。

hamper

阻碍，妨碍

Fierce storms have been hampering rescue efforts and there is now little chance of finding more survivors.猛烈的暴风雨妨碍了救援工作的进行，现在找到更多生还者的希望已经很渺茫了

clinical

门诊的，临床的

clinical tests/training临床试验／实习

the Department of Clinical Medicine临床医学部

Clinical trials of the new drug may take five years.这种新药的临床试验可能需要5年时间。

Governments also need to think about long-term care for people with dementia. The question that is most often asked is how to pay for it. Japan’s compulsory long-term-care insurance scheme, requiring everyone aged 40-65 to pay a premium, seems attractive, as it avoids penalising the young. But it is not self-financing. The increasing burden there as elsewhere will fall on individuals and the taxpayer.

政府还需要考虑对痴呆症患者的长期护理。人们经常问的问题是如何承担费用。日本的强制性长期护理保险计划，要求每个40-65岁的人支付保费，似乎有吸引力，因为它避免让年轻人承担这一费用。但这不是自筹资金。与其他地方一样，日益沉重的负担将落在个人和纳税人身上。

scheme

方案，计划

Under the current marking/mark scheme, you need 90 percent to get an A.在现在的评卷系统下，你必须有90分才能得A。

a training/housing/play scheme培训／住房／娱乐活动方案

a pension/savings scheme养老金／储蓄金计划

premium

保险费

Car insurance premiums have increased this year.今年汽车保险费涨了。

The premiums for healthcare plans are high.保健计划的保险费很高。

self-financing

自筹资金的

Fees would have to triple to make the courses self-financing.收费必须增加到原来的3倍，这些课程才能做到资金自给。

And an even more fundamental question than who pays for care is: who will do it? Undertaken with humanity and dignity, it is extremely labour-intensive. Technology can help lighten the load—using remote monitoring to let people stay at home and, perhaps in future, robots to perform some basic tasks. But looking after people with dementia requires people. The job is usually classified as low-skilled and is often poorly paid. In fact, it demands huge reserves of patience, empathy and kindness. It should be better rewarded and more highly regarded even though that would add to the bill. In countries such as Japan and Britain, with acute shortages of care-workers, immigration will have to be made easier for those willing and able to do it.

比谁支付护理费用更根本的问题是：谁将提供这些护理？它承担着人道和尊严，是劳动密集型的工作。技术可以帮助减轻负担——使用远程监控让人们呆在家里，也许将来还可以让机器人执行一些基本任务。但是照顾痴呆症患者需要人。这份工作通常被归类为低技能，而且报酬通常很低。事实上，它需要巨大的耐心、同情和体贴。它应该得到更好的奖励和高度评价，即使这将增加费用。在日本和英国等护理工作者严重短缺的国家，必须让那些愿意且有能力的人做护理工作的人更容易地移民。

undertaken

（开始）做，承担，从事（尤指耗时或困难之事）

Students are required to undertake simple experiments.要求学生们做些简单的实验。

lighten sb’s burden, load, etc.

减轻（某人的）负担／压力（等等）

Getting a new assistant will lighten (= reduce) the workload considerably.配备一名新助手会极大地减轻工作压力。

reserve

贮藏（物）；储备（物）；备用（物）

She keeps a little money in reserve (= for use if and when needed).她留下了一些钱以备不时之需。

The librarian has put the book on reserve for me (= will keep it for me when it becomes available).图书管理员已经替我预约了这本书。

We still have a reserve of food/food reserves in case of emergency.我们仍然还有储备粮／粮食储备以应付紧急情况。

regard

考虑，思考；将…认为；看待

Her parents always regarded her as the smartest of their children.她父母一贯把她看作是所有子女中最聪明的。

He is generally/widely regarded as the father of international law.他被普遍／广泛认为是国际法之父。

acute

十分严重的

She felt acute embarrassment/anxiety/concern at his behaviour.她对他的行为感到极其尴尬／忧虑／担忧。

The problem of poverty is particularly acute in rural areas.贫困问题在农村地区尤为严重。 Lastly, evidence suggests that as many at 40% of cases of dementia can be delayed or averted by changing behaviour earlier in life. The trouble is that public-health campaigns have a patchy record and they do nothing for dementia’s most intractable pre-existing condition—old age. No cure, insufficient financing and a tricky public-health message: perhaps that is enough to make you throw up your hands in despair. Instead, however, it only underlines how the solutions to dementia, like the disease itself, will take decades to unfold. It is yet another reason to start working on them right away.

最后，有证据表明，多达40%的痴呆症病例可以通过早期改变行为来延缓或避免。问题在于，公共卫生宣传的效果参差不齐，而且它们对痴呆症最棘手的先决条件——衰老——没有任何作用。没有治愈的方法，资金不足，还有难以发挥作用的公共卫生信息：也许这足以让你绝望地举手。然而，它只强调了如何解决痴呆症，就像要了解疾病本身一样，将需要数十年的时间才能解开真相。这是另一个需要立即开始有多行动的原因。

avert

防止，避免

to avert a crisis/conflict/strike/famine避免危机／冲突／罢工／饥荒

to avert disaster/economic collapse防止灾难／经济崩溃

campaign

（尤指政治、商业或军事的）专项活动，运动

The government have just launched (= begun) their annual Christmas campaign to stop drunken driving.政府刚刚展开其一年一度的制止酒后驾车的圣诞专项活动。

a controversial new advertising campaign备受争议的一则新广告的宣传活动

patchy

时好时坏的

Matthew found the service extremely patchy.马修发现服务时而极好，时而极差。

intractable

难驾驭的；难对付的；难解决的

We are facing an intractable problem.我们面临着一个棘手的问题。

tricky

难办的；难对付的

It's tricky to learn to ride a skateboard, but you never forget how.学习滑板挺难的，但是一旦学会就不会忘记。

I'm in a tricky situation - whatever I do I'll offend someone.我的处境真有点儿难办——我无论怎么做都会得罪人。

throw up your hands in despair/horror

感到惊恐／绝望；强烈反对

They threw up their hands in horror at his suggestion.他们强烈反对他的建议。

underline

强调，突出

She gave some shocking examples to underline the seriousness of the situation.她举了一些令人震惊的例子以强调形势的严峻。

unfold

（形势或故事）发展，展现，呈现，披露

Like a lot of people, I've watched the events of the last few days unfold on TV.和许多人一样，我这几天一直在电视上关注着事件的发展。

As the plot unfolds, you gradually realize that all your initial assumptions were wrong.随着情节的展开，你会慢慢意识到自己最初的那些猜测都是不对的。