In April this year, the World Health Organisation, in collaboration with Alzheimer’s Disease International, published a report calling upon governments, policymakers and other stakeholders to make dementia a global public health priority.
Dementia sufferers in Malta are set to increase from about 5,000 to over 14,000 in 2060- Charles Scerri
This new report – Dementia: A Public Health Priority – provides the most authoritative and comprehensive dementia knowledge base to date.
It also includes an overview of global epidemiology and the impact of dementia, national-level approaches to dementia, including the role of health and social care systems and workforce, issues dealing with caregiving and caregivers, and awareness raising and advocacy for dementia.
Dementia is a syndrome due to a disease of the brain in which there is disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning capacity, language and judgement. This impairment of cognitive function is commonly accompanied by a deterioration in emotional control, social behaviour or motivation.
Alzheimer’s disease is the most common form of dementia accounting for approximately 70 per cent of all dementia cases. Worldwide, the number of people with dementia is set to almost double every 20 years, from 36 million at present to 66 million in 2030. In Malta, the number will increase from about 5,000 at present to over 14,000 in the year 2060.
Dementia is devastating not only for those individuals who have it but also for their caregivers and families. With an increasing number of people being affected by dementia, almost everyone knows someone who has dementia or whose life has been touched by it.
The consequences for societies and economies are considerable and the costs entailed extremely high. It has been estimated that dementia alone costs over $600 billion annually worldwide, more than cardiovascular disease and all types of cancer. This figure rounds up to one per cent of the world’s gross domestic product.
A recent study published by Karolinska Institute in Sweden puts the overall costs of dementia care in Malta at between €63 million and €96 million annually.
While the numbers and the costs are daunting, the medical, psychological and emotional impact on those with the illness and on their caregivers and families is extreme. The behavioural and psychological symptoms linked to dementia profoundly affect the quality of life of people with dementia and their caregivers.
Unfortunately, there is lack of awareness and understanding of dementia, at some level, in most countries. It is often considered to be a normal part of ageing or a condition for which nothing can be done. This false perception affects individuals with dementia, their caregivers and families and their support structure in a number of ways.
Low awareness levels contribute to stigmatisation and social isolation. Poor understanding creates barriers to timely diagnosis and to accessing ongoing medical and social care, leading to a large gap in treatment.
Individuals with dementia live for many years after the onset of the symptoms. With appropriate support, many can and should be enabled to continue to engage and contribute within society, thus benefiting their quality of life.
As a society, we need to ensure that the debate around the best care of individuals with dementia remains high on the public health agenda. Only eight of 194 WHO member states have a national dementia plan in place whereas several other countries, such as China, the Czech Republic, India, Malta, Northern Ireland and the US are in the process of developing national approaches to respond to the impact of dementia. However, these have not yet been finalised or implemented.
According to the report, now is the time to take action. This can be achieved by promoting a dementia-friendly society, making dementia a national public health and social care priority, improve public and professional attitudes and understanding of dementia, investing in health and social systems to improve care and services for individuals with dementia and their caregivers and increase the priority given to dementia in the public health research agenda.
The challenges are substantial. It is only through an integrated and coordinated effort by policymakers and other stakeholders that we can truly face the global crisis that dementia is presenting us with.
Dr Scerri is a senior lecturer at the Department of Pathology, Faculty of Medicine and Surgery, University of Malta.