The Dementia Time Bomb

Picture: A Health Blog, Flickr

Picture: A Health Blog, Flickr

There is no doubt that people are living longer lives, and even in recent years the global life expectancy has continued to increase; between 1990 and 2011 life expectancy for both sexes has climbed from 64 years to 70 years. This is a pattern seen across the world with the majority of nations seeing an increase in life expectancy. However, this spike in life expectancy has some less happy ramifications. The most acute of these is a spike in diseases associated with old age particularly in neurodegenerative diseases like dementia.

It should be stated that dementia is not a normal part of ageing. Dementia is an umbrella term for a range of degenerative cognitive symptoms. These are brought about by damage to the brain by disease (such as Alzheimer’s disease, dementia with Lewy bodies (DLB), Pick’s disease, et cetera) or ischemic damage as a result of a stroke. This damage can result in difficulty in a range of tasks such as concentration, memory, thinking, language, problem-solving, mood and behaviour. Dementia is a progressive condition meaning that over time the condition gets worse. As the condition worsens a patient with dementia requires more support to undertake day-to-day tasks and rely more on the support of carers.

It is estimated that, as of 2013, 44.4 million people live with dementia. This figure is set to grow to 135.5 million in 2050 with most of this growth occurring in developing nations. Of the 193 nations that are represented in the World Health Organisation (WHO) only thirteen have national dementia plans – and none of those nations are considered developing nations. However, even in developed nations it is claimed that deaths due to dementia are being underreported, and that dementia may be a larger public health problem than previously thought.

With the future burden of dementia clear, what can be done to help aid people in preventing the impact of the dementia time bomb? The answers may be simpler than they first appear – no doubt they will be costly but it is not impossible to build support networks and research efforts that can do much to stem the impact on society of the increasing rates of individuals with dementia. In addition, acting early on this problem with concerted effort will reduce the overall costs to all and maximise potential benefits gained.

Firstly, dementia needs to be acknowledged as the public global health problem it is. In some counties a lack of knowledge, awareness and understanding are the main barriers to diagnosis and treatment. Planning for the future needs of people with dementia needs to be included into more countries public health agendas, particularly in developing nations which are predicted to bear the brunt of dementia.

The stigma attached to the condition further isolates not only dementia sufferers but their families too. In order to tackle the problem of dementia in the future there needs to be an effort to increase public awareness of dementia across the world and to improve the global public’s attitude towards the condition.

This must be done in tandem with an effort to improve the knowledge of health professionals on diagnosing and treating those with dementia as early detection can greatly improve the lives of people with dementia. Earlier detection can mean that people with dementia have more time to find information and support, can come to terms better with their diagnosis, maximise their quality of life and plan for their future.

Research into finding treatments and medications to prevent, treat or possibly even curing dementia needs to be stepped up globally. The search for a cure for dementia will be one of the great medical challenges of the 21st century. A ray of hope can be provided by a G8 summit on dementia held in London last December. There it was decided to aim to find a cure or treatment for dementia by 2025, this means that significantly more money and resources will be put into dementia research.

More research needs to be undertaken on the impact of dementia across the world. Work is being undertaken by the 10/66 Dementia Research Group into the impact of dementia in low/middle income countries. The group’s name comes from the fact that despite 66% of the world’s population coming from low/middle income countries only 10% of population based research on dementia is undertaken there. If this situation is to improve more funding is needed to generate better research in poorer countries so they have a better awareness of their dementia problems. This can shape their public policy and services in a better way to fit the needs of their citizens.

Dementia is a growing threat to the health of the world. However, the effects of dementia can be controlled by making dementia a global health priority; developing a global dementia friendly society; improving detection of the signs and symptoms of sufferers earlier; supporting dementia patients and their families; improving research and development of treatment, and building towards a cure. The world’s population is ageing and the clock is ticking, and if we want to diffuse the dementia time bomb policymakers must act now.

ALAN CARTWRIGHT