Treating and caring for people with dementia currently costs the world more than US$604 billion per year. This includes the cost of providing health and social care as well the reduction or loss of income of people with dementia and their caregivers.
Only eight countries worldwide currently have national programs in place to address dementia. A new report “Dementia: a public health priority”, published by the World Health Organization (WHO) and Alzheimer’s Disease International, recommends that programs focus on improving early diagnosis; raising public awareness about the disease and reducing stigma; and providing better care and more support to caregivers.
Lack of diagnosis is a major problem. Even in high-income countries, only one-fifth to one-half of cases of dementia are routinely recognized. When a diagnosis is made, it often comes at a relatively late stage of the disease.
“We need to increase our capacity to detect dementia early and to provide the necessary health and social care. Much can be done to decrease the burden of dementia,” says Dr Oleg Chestnov, assistant director-general, Noncommunicable Diseases and Mental Health at WHO. “Health-care workers are often not adequately trained to recognize dementia.”
The report points to a general lack of information and understanding about dementia. This fuels stigma, which in turn contributes to the social isolation of both the person with dementia and their caregivers, and can lead to delays in seeking diagnosis, health assistance and social support.
“Public awareness about dementia, its symptoms, the importance of getting a diagnosis, and the help available for those with the condition is very limited. It is now vital to tackle the poor levels of public awareness and understanding, and to drastically reduce the stigma associated with dementia,” says Marc Wortmann, executive director, Alzheimer’s Disease International.
Strengthening care is also key. In every region of the world, most caregiving is provided by informal caregivers - spouses, adult children, other family members and friends. The report notes that people who care for a person with dementia are themselves particularly prone to mental disorders, such as depression and anxiety, and are often in poor physical health themselves. Many caregivers also suffer economically as they may be forced to stop working, cut back on work, or take a less demanding job to care for a family member with dementia.
The report recommends involving existing caregivers in designing programs to provide better support for people with dementia and those looking after them. Community-based services can provide valuable support to families caring for people with dementia in both high- and low-income countries - delaying the need for people to enter into high-cost residential care. At the same time, health workforce training needs to pay closer attention to dementia, and the skills required to provide both clinical and long-term care.
Dementia is a syndrome, usually of a chronic nature, caused by a variety of brain illnesses that affect memory, thinking, behavior and ability to perform everyday activities. Alzheimer’s disease is the most common cause of dementia and possibly contributes to up to 70% of cases. Although dementia affects people in all countries, more than half (58%) live in low- and middle-income countries. This is likely to rise to more than 70% by 2050.