Competitive Exams: Current Affairs 2011: Dementia

Dementia

  • World Alzheimer's Day (September 21) was marked this year, in India, by the release of a comprehensive Dementia India Report. Prepared by national experts, converging under the Alzheimer's and Related Disorders Society of India (ARDSI) umbrella, it estimates that there are 3.7 million elderly currently living with dementia in India.

  • With the exponential increase in the population of the elderly (60 + years) in India, an estimated 100 million today, expected to rise 198 million in 2030 and 326 million in 2050, dementia poses a looming public health challenge.

What it is

  • Dementia is a neuropsychiatric disorder in which memory and other cognitive functions like thought, comprehension, language, arithmetic, judgment and insight deteriorate progressively.

  • While it increases in prevalence with advancing age, it is not a normal feature of ageing, a common misconception. Further, dementia is a clinical syndrome, one with many underlying causes, some potentially treatable.

What the Report Highlights

  • The report highlights two areas of great import for dementia sufferers and their families: Activities of daily living (ADL) an important measure of the human condition, and behavioural and psychological symptoms associated with dementia (BPSD), an important predictor of health related quality of life (HRQoL).

  • It also lays stress on the importance of structured caregiver interventions as part of standard treatment including psycho-educational interventions for dementia; psychological therapies such as cognitive behaviour therapy, cognitive retraining and family and caregiver counselling; as also caregiver support and respite care.

  • The report differentiates risk factors into those that are non-modifiable (genetic factors for example) and those that are potentially modifiable.

  • It is important that policy makers recognise these factors as targets for both primary (early) and secondary (after the onset) risk factor prevention. It points to the low level of awareness about dementia as an important reason why diagnosis is delayed and public health consciousness remains poor. Worryingly, it observes that the lack of awareness extends to health professionals, formal training in dementia diagnosis and care not being a part of most medical, nursing and paramedical curricula; a matter of great concern needing immediate remediation. That stigmatisation of persons with dementia is rampant and that there is a need for raising awareness about the condition across segments of society is explicitly stated.

  • The report concludes with several key recommendations. The most important of these are:

  • Make dementia a national priority

  • Increase funding for dementia research

  • Increase awareness about dementia

  • Improve dementia identification and care skills

  • Develop community support mechanisms

  • Guarantee caregiver support packages

  • Develop comprehensive dementia care models

  • Develop new national policies and legislation for people with dementia

  • While these recommendations do address the need for dementia to be integrated into the National Policy for Older Persons (NPOP), they predominantly highlight the specific needs of dementia as a disabling and common condition among the elderly; one that can and will challenge Indian public health systems.

  • However, the report acknowledges that dementia must be viewed in the context of other elder health problems, and within the framework of the NPOP.

Courtesy: The Hindu and Times of India