The ageing artist: what does dementia teach us?

Recently, singer and musician Milton Nascimento (pictured) was diagnosed with Lewy Body Dementia (LBCD) - a neurodegenerative, progressive and incurable disease whose main signs and symptoms are: visual hallucinations, parkinsonism (a set of signs manifested by tremors, rigidity and slowness of movement), cognitive fluctuations, behavioral disorders of REM sleep (rapid eye movement), dysautonomia (such as constipation, orthostatic hypotension and urinary incontinence) and sensitivity to antipsychotics or neuroleptics.

Unlike Alzheimer's disease, which typically presents memory loss as its first and most prominent cognitive deficit, CLD is characterized by early impairment of attention and executive and visuospatial functions, with memory affected later in the course of the disease. Early symptoms include difficulty driving, such as getting lost, miscalculating distances or not seeing road signs and other vehicles, as well as impaired work performance.

It was Milton Nascimento's son who revealed his father's condition on social media. And he went further, making it clear that this would probably be his last statement on the singer's health: “It's been a daily battle, intense pain and a huge void in my chest, because somehow my best friend is leaving me little by little. Sometimes, while I'm watching TV with him, in the middle of the silence, he pulls and holds my hand. It's also been common for him to only agree to some meals when I'm there encouraging him... I think these have been his ways of telling me what, at times, he hasn't been able to express through words. I've been trying to repay all the good, love, care and affection, giving him as much dignity and comfort as he can and deserves at this time. From the moment the universe put us in each other's path, we are inseparable and invincible - and we will remain so as long as we are together in this life.”.

We are currently living through the “decade of healthy aging” (2021-2030), an agenda of actions led by PAHO and the United Nations (UN) to raise awareness among governments, politicians, health managers, international agencies, professionals and civil society to improve the lives of older people, their families and communities.

At the same time, in an unprecedented way, we are going through a period of demographic transition - more and more families are having fewer children, and the elderly population is outnumbering young people between the ages of 15 and 24. With around 15.6% of the Brazilian population made up of elderly people, the challenges in terms of health care, safety, well-being, social support and preserving the autonomy and independence of this population are enormous and are set to grow.

People with dementia, their families and caregivers need concrete and safe actions so that they can have their rights guaranteed and universal access to health care. The figures are impressive: it is estimated that around 1.8 million people live with dementia in Brazil, representing approximately 8.5% of the elderly population. By 2025, this figure could triple. This inevitably raises some questions:

• What if I have dementia in the future? How would I like to be cared for by whom?
• What are the spiritual causes of dementia?
• Why is this happening to my family member?
• What can I do to deal with this situation?

Without intending to give definitive answers to these questions, I would like to offer some reflections on the subject of pain and suffering in the light of the Spiritist Doctrine. Physical or mental illness is, on the one hand, the crucible of regeneration and healing of the Spirit; on the other, it is a momentary state of loss, anguish, pain and sorrow.

The Gospel according to Spiritism teaches us the importance of patience and understanding pain as an opportunity for awakening. Life has its difficulties and limitations - like pinpricks that sensitize us and cause pain - but it also invites us to look at the duties that were once imposed and the future compensations.

Moments of illness can signal collective learning, family readjustments, the need for self-denial in order to care for someone or the recognition that we need to be cared for. They can also remind us of the fragility of the physical body and our finitude, leading us to see spiritual and moral values over those in which materialism tries to overpower the core of being.

In short, such experiences can be triggers for awakening in us a sense of interdependence, showing that our future depends on solidarity between generations. Illness - however serious and limiting - never erases in us what we have done well for others, our legacy, what has given purpose to the trajectory of our lives.

The light will never go out, and death will never be the end, but a new beginning.

Luís Gustavo Mariotti is a doctor specializing in Geriatrics at the Escola Paulista de Medicina, with a specialty in Palliative Medicine, and coordinator of the Palliative Care Department of the Associação Médico-Espírita do Brasil (AME-Brasil).

Reference

KARDEC, Allan. The Spirits' Book. Translation by Guillon Ribeiro. 93. ed. Brasília, DF: FEB, 2019. Available at: https://www.febnet.org.br/wp-content/uploads/2012/07/WEB-Livro-dos-Esp%C3%ADritos-Guillon-1.pdf. Accessed on: October 29, 2025.