Let’s chat about dementia

Ministers from around the world, as well as experts from the research, clinical and NGO communities, are coming together in Geneva for the first time to discuss the global problems posed by dementia. The aim of the conference is to raise awareness of the socio-economic burden created by dementia, and to highlight that this burden […]

Ministers from around the world, as well as experts from the research, clinical and NGO communities, are coming together in Geneva for the first time to discuss the global problems posed by dementia. The aim of the conference is to raise awareness of the socio-economic burden created by dementia, and to highlight that this burden can be reduced if the world collectively commits to placing dementia high on the global public health agenda. The conference is supported by the Department of Health of the United Kingdom of Great Britain and Northern Ireland, and the Organization for Economic Cooperation and Development (OECD).
WHO recognizes dementia as a public health priority. It published a report ‘Dementia: a public health priority’, in 2012, which aims to provide information and raise awareness about dementia. It also aims to strengthen public and private efforts to improve care and support for people with dementia and for their caregivers.
While we await the outcome of this important conference, it’s imperative for us to talk about Dementia, a problem afflicting many but not widely reported. The report Dementia; a Public Health Priority co-authored by World Health Organization and Alzheimer’s disease International revealed that “improvements in health care in the past century have contributed to people living longer and healthier lives. However, this has also resulted in an increase in the number of people with non-communicable diseases, including dementia. Current estimates indicate 35.6 million people worldwide are living with dementia. This number will double by 2030 and more than triple by 2050. Dementia doesn’t just affect individuals. It also affects and changes the lives of family members. Dementia is a costly condition in its social, economic, and health dimensions. Nearly 60 percent of the burden of dementia is concentrated in low- and middle-income countries and this is likely to increase in coming years.”
It highlighted key messages as follows;
1. Dementia is not a normal part of ageing.
2. 35.6 million People were estimated to be living with dementia in 2010. There are 7.7 million new cases of dementia each year, implying that there is a new case of dementia somewhere in the world every four seconds. The accelerating rates of dementia are cause for immediate action, especially in LMIC where resources are few.
3. People live for many years after the onset of symptoms of dementia. With appropriate support, many can and should be enabled to continue to engage and contribute within society and have a good quality of life.
4. Dementia is overwhelming for the caregivers and adequate support is required for them from the health, social, financial and legal systems.
5.  Countries must include dementia on their public health agendas. Sustained action and coordination is required across multiple levels and with all stakeholders – at international, national, regional and local levels.
6. People with dementia and their caregivers often have unique insights to their condition and life. They should be involved in formulating the policies, plans, laws and services that relate to them.
7. The time to act is now by: – promoting a dementia friendly society globally; – making dementia a national public health and social care priority worldwide; – improving public and professional attitudes to, and understanding of, dementia; – investing in health and social systems to improve care and services for people with dementia and their caregivers.
Dementia is a syndrome – usually of a chronic or progressive nature, in which there is deterioration in cognitive function (i.e. the ability to process thought) beyond what might be expected from normal ageing. It affects memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. Consciousness is not affected. Alzheimer’s disease is the most common cause of dementia and may contribute to 60–70% of cases.
Dementia is caused by a variety of diseases and injuries that primarily or secondarily affect the brain, such as Alzheimer’s disease or stroke.
Signs and symptoms;
Dementia affects each person in a different way, depending upon the impact of the disease and the person’s personality before becoming ill. The signs and symptoms linked to dementia can be understood in three stages.
1. Early stage: the early stage of dementia is often overlooked, because the onset is gradual. Common symptoms include: forgetfulness, losing track of the time, becoming lost in familiar places.
2. Middle stage: as dementia progresses to the middle stage, the signs and symptoms become clearer and more restricting. These include: becoming forgetful of recent events and people’s names becoming lost at home, having increasing difficulty with communication, needing help with personal care, experiencing behaviour changes, including wandering and repeated questioning.
3. Late stage: the late stage of dementia is one of near total dependence and inactivity. Memory disturbances are serious and the physical signs and symptoms become more obvious. Symptoms include: becoming unaware of the time and place, having difficulty recognizing relatives and friends, having an increasing need for assisted self-care, having difficulty walking, experiencing behaviour changes that may escalate and include aggression.
Treatment and care; There is no treatment currently available to cure dementia or to alter its progressive course. The principal goals for dementia care are: early diagnosis, optimizing physical health, cognition, activity and well-being, identifying and treating accompanying physical illness, detecting and treating behavioral and psychological symptoms, providing information and long-term support to caregivers.
All comments to Dr Aminu Magashi Publisher Health Reporters ([email protected])