Farewell, then, to Andrew Sachs. His body died at 86, some 62 years older than I am now. But as his son revealed on the Today programme this morning, he’d lost his mind by 2012. When he was shown a DVD of Fawlty Towers – in which he played his defining role as the loveable Manuel – he displayed not the faintest glimmer of recognition.

By then, Sachs literally had no idea who he was, or had been. But in his awful, final isolation, the great comic had at least kept his sense of timing: only last weekend, it was reported that dementia had overtaken heart disease to become the leading cause of death in England and Wales.

True, on Monday, a curious moment of respite was granted when European and US research suggested that in fact, according to data recorded since 2000, rates of the disease were dropping. But any optimism this news may have prompted was quickly dashed on Tuesday, when a study into the effects of the drug solanezumab on Alzheimer’s patients showed no beneficial impact. Disappointing but hardly surprising.

Dementia is one of those conditions to have caught the public’s imagination, fearful of both its increasing prevalence as well as its unnerving impact. No manner of death could be called pleasant, yet there is something rather more harrowing about the prospect of slowly losing oneself. The inability to recognise surroundings, recall memories or identify friends and loved ones speaks to our natural apprehension of the end of self, at the point of death. Dementia has the audacity to rob us of it long before our bodies stop breathing.

But the truth is, dementia’s rise is intrinsically linked to how we live our lives, and the priorities of modern society. The old-school mass killers, such as heart disease and cancer, are under assault and people are living longer. With longevity, though, has come a strange sense of security which – by extension – has led to an almost perverse sense of entitlement.

Medicine’s march of progress has broken into a sprint in recent decades, while general awareness of “wellbeing” is at an all-time high. The explosion of the health and exercise industries on both sides of the Atlantic is as responsible for lowering rates of diabetes and stroke as modern medicine. People smoke and drink less, eat clean, and while away months of their lives in the gym. Yet by prolonging our natural lifespan, we leave ourselves vulnerable to this most pernicious of conditions. And frankly, why would anyone want that?

A consumer culture where everything, even healthcare, is available on demand, lends to this sense of entitlement when it comes to having, rather than living, a healthy life. But in this instance, it is the state which possesses a near-monopoly on medical care. By demanding protection from even minor ailments, and ever more shrill calls to fund “our NHS” above all else, the British public surrender themselves to the whims of government, and allow themselves to be molly-coddled.

What we are left with is a desperate situation where people are bullied and shamed into living a certain way: “clean”, “healthy” and essentially “dull”, only to eke out the end of their days diminished and wholly reliant on others.

Perhaps this is an acceptable way to go. But is there not something nobler, something damned more exciting, about a life lived to the full? People drink and over-eat, and die of heart attacks. They may go in great pain. But they remain that same person who took those decisions; and when they go, they go on their own terms. The body does not cling on, linger, while the person within recedes, dying, alone and frightened.

The gonzo writer Hunter S Thompson is famed for the line “Buy the ticket, take the ride” and he certainly did that. Although his end was tragic – he shot himself – it was at least quick, with a full life to show for it. And that’s the thing: though it may be awful that a man be driven to such extremes, there is something less awful about his demise than that of Sachs.

Surely Thompson was right about buying that ticket. Better to recall the ride, no matter how fleeting, than to forget if one took it at all.

by Edward Baer