{'fraction_non_alphanumeric': 0.012625445127873098, 'fraction_numerical': 0.0016186468112657818, 'mean_word_length': 4.8522727272727275, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
How far to investigate dementia?

Dementia is a diagnosis at the level of shortness of breath, or liver disease, better than malaise but only just. Before discussing the virtue of further investigation it is apposite to examine the value of diagnosis in general. The first function is to distinguish a disease with a specific and effective treatment in order to free the patients from their suffering. The second is to provide information, so that the implications of even an untreatable disease can be known to the patient and their family (e.g. acquired immunodeficiency syndrome). The third is to isolate and define a disease with a similar pathology and aetiology to provide both a focus for research and a profile for the public at large. The latter two functions are likely to lead to treatment in the long term and should not be undervalued. Before delving deeper it may be helpful to examine the extreme positions in this debate. The view that patients with dementia should not be investigated would take this form. Health service priorities should be devoted to helping those where the treatment is effective and the potential for a future contribution to society is high. Neither of these propositions generally apply to dementia. Furthermore the affected patients are usually unaware oftheir deficiencies, and are likely to be distressed by what they perceive as unnecessary medical intervention. In the few cases where a treatable condition is discovered the treatment will at best prevent the condition developing further and will leave a chronically disabled subject for society to support indefinitely. Most people who are compos mentis would prefer a quick death and would certainly not wish their life to be prolonged when they had lost their faculties. Dementia is largely a disorder of ageing, and medicine should beware of treating ageing, any cure for which would destroy the world by rapid expansion of the population. The interventionist might argue as follows: every human being deserves respect which should apply especially to the elderly who have contributed so much to our present prosperity. Medicine advances through curiosity and the temptation to write offpatients is not only socially dangerous, but introduces a Luddite attitude into medicine which could stifle advance. Modern techniques of investigation are largely riskfree and painless and even brain biopsy is well tolerated. Knowledge is a precious commodity which should be sought at every opportunity, and the outcome of such research often illuminates other areas as well as the original subject. If we ourselves had a disease of our brain we would wish no stone to be unturned in searching for a treatable cause, our brain being the seat of our soul and our most fundamental organ. Every time we miss a treatable case ofdementia we are not only causing distress to the patient and his family but we are committing the state to spend £10,000 a year on their support, which may last many years. Cases that are untreatable today may be treatable tomorrow if we are allowed to study them thoroughly.