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
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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