Tuesday, October 7, 2014

Alzheimer’s disease a global burden Sep 25, 2014 - Mala Kapur Shankardass

It is currently estimated that Alzheimer’s disease and other age-related dementias afflict over 44 million people worldwide




Sep 25, 2014 - Mala Kapur Shankardass


Globally, September is observed as Alzheimer’s disease awareness month starting from 2012. In different parts of the world various events such as walks, discussion meetings, and memory screenings mark the raising of awareness about the disease.
In India, Alzheimer’s and Related Disorders Society of India with 20 chapters spread across the country organises observance of the World Alzheimer’s Day on 21st September and throughout the month brings together medical professionals, care providers, nursing and paramedical professionals, social and health organisations and government agencies to deliberate on issues related to risk factors, preventive strategies, advocacy and policies for better diagnosis and care facilities.
In fact this year, the theme is “Dementia: can we reduce the risk.”
It is currently estimated that Alzheimer’s disease and other age-related dementias afflict over 44 million people worldwide, with nearly 60 per cent living in developing countries and this figure is projected to rise with ageing of the populations.
Dementia, of which Alzheimer’s is the most common, is a syndrome that can be caused by a number of progressive disorders that affect memory, thinking, behaviour and the ability to perform everyday activities.
The World Alzheimer’s Report 2014 observes that Alzheimer’s disease and other forms of dementia must become a national and international public health priority. Governments must develop adequate strategies to deal with the epidemic holistically including tackling both reduction in risk for future generations, and adequately caring for people with the condition and supporting their friends and family. The focus is on ways through which we may be able to help reduce our risk of developing dementia with brain healthy lifestyles.
Mounting evidence suggests that modifiable factors in mid-life will alter an individual’s risk of dementia in later decades. For example, one analysis concluded that almost half the statistical probability of getting Alzheimer’s disease may be accounted for by seven modifiable risk factors diabetes, midlife hypertension, midlife obesity, smoking, depression, cognitive inactivity or low educational attainment, and physical inactivity and reducing the prevalence of these risk factors by 10 per cent could prevent up to 1.1 million cases of the disease worldwide.
In discussing the global impact of non-communicable diseases in recent times, Alzheimer’s disease is counted as an important part of the global burden. Evidence from various studies, collectively, presents that outcome of public health strategies and improved individual quality of life results in delayed onset of dementia with fewer years spent in a state of reduced independence and needing care.
However, given the emergence of chronic diseases in countries of East and South Asia, such as China and India, indicates a worrying trend towards the increase in prevalence of dementia.
Increasing epidemic of obesity and blood pressure levels, stroke, Ischaemic heart disease, diabetes, etc., is bringing an epidemiological transition which is likely to bring greater burden of different dementias including Alzheimer’s disease.
Efforts towards improving public health measures can greatly positively impact upon dementia risk in later life. Countries need to monitor the impact of prevention programmes on the future scale of the dementia epidemic. It is an encouraging development that India and the Netherlands have taken up a joint research project to test strategies to prevent dementia.
The costs of dementia, including informal and formal care, are high to society. The total estimated worldwide cost of dementia reported in 2010 was $604 billion. In India, as it is in other developing countries, informal care accounts for the majority of total costs and direct social care costs and direct medical care costs are much lower.
However, in reviewing the global burden of dementia, combining efforts to deal with non-communicable diseases will contribute towards efficient use of national resources and public health funds.
As experts point out that consideration needs to be given to ways in which dementia specific approach might complement and add value to the broader non-communicable disease prevention initiative. Greater attention needs to be given to health promotion activities to achieve a change through aggregated modification of individual lifestyles and behaviours. It is never too late to start.

The author is a health sociologist and gerontologist



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