It is estimated that in Malta, 1.24 per cent of the population has dementia. Is an increase in those affected by this condition inevitable?

If there is no cure, and I don’t see any in the foreseeable future, the number of individuals with dementia worldwide, including Malta, is expected to increase. In 2015, slightly over 6,000 individuals will have dementia in Malta. This number is expected to more than double by 2050.

This is without taking into account the fact that individuals who act or will act as informal caregivers experience most of the burden, being physical, psychological, financial or otherwise. For every individual with dementia there are at least two or three other individuals who are directly affected by it.

Is Malta prepared for this challenge?

No, at least not yet. The medico-social consequences of dementia on the affected individual are enormous. With disease advancement, memory is progressively lost. Social contact ceases and the individual becomes isolated, often homebound. The need of community care, of which presently there is little, is therefore essential in any management plan for individuals with dementia and their caregivers.

Dementia can also strike early on in life. The consequences here are more dire on the family structure. Currently, family members absorb many of the financial and social costs of providing dementia care.

Malta has made significant progress and is among the leading European countries in addressing this problem. The National Dementia Strategy, to be launched in the beginning of next year, has been given priority by the Parliamentary Secretary for the Rights of Persons with Disability and Active Ageing. It is a step in the right direction, a good start in a long process with which we intend to enhance the quality of life of these individuals.

What is this strategy’s main drive and what does it seek to achieve?

I was impressed by the feedback I got from different sectors of the society on the public consultation document. As a national focal point on dementia and author of the strategy document, this fills me with enthusiasm. This is important as awareness reduces stigma and discrimination.

The strategy highlights various measures that need to be implemented in order to achieve the main objective of enhancing the quality of life of these individuals and those who care for them. Necessary actions include increase in awareness and understanding of dementia, provision of timely diagnosis, availability of a trained workforce, improving community and central services, promoting an ethical approach to dementia care and strengthening research in this field.

Although the document has not yet been published, a number of initiatives are already being adopted including the organisation of information sessions targeting healthcare professionals who come into direct contact with individuals with dementia on a daily basis. We also held meetings with mayors of local councils in Malta and Gozo to explain what we will be trying to achieve at community level. Two information booklets on dementia in general and another intended for caregivers at home were also launched by the Parliamentary Secretariat last September. The National Dementia Strategy document contains 82 recommendations which need to be implemented by 2023. Inevitably, this will entail substantial investment in human, financial, technical and infrastructural resources.

An ageing population brings with it various challenges: is dementia one of these challenges?

Malta is facing a demographic shift. Current projections indicate that the Maltese population will decline but a significant chunk of that will be made up of individuals above the age of 65 years. This will have a significant impact on old age dependency ratio as fewer individuals will occupy the working age bracket.

That comes at a price. Neurodegenerative conditions in which advanced age is a major risk factor, such as dementia, will increase. According to the World Health Organization Global Burden of Disease Report, dementia contributes to approximately 11 per cent of all years lived with disability in people aged 60 years and over, the main reason being that dementia has a disproportionate impact on independent living. Dementia is also the most costly medical condition with an annual cost of one per cent of the global GDP. In Malta, the annual expenditure for dementia ranges between €63 and €96m in both formal and informal costs.

What role does active ageing play in holistic dementia care?

The National Strategic Policy for Active Ageing launched last year makes reference to dementia-friendly communities where individuals with dementia can continue to live in and contribute to society.

Bettering community services through targeted support will enhance the quality of life and delay institutionalisation. If residential services are required, these should promote diverse, enabling and meaningful activities. Also, leading an active life, has been shown to be protective against developing common forms of dementia.

How important are knowledge and awareness of dementia?

Knowledge and awareness are the best tools that we have to decrease fear and stigma associated with dementia, both among the general public and healthcare professionals.

Increasing awareness should also reduce the widespread misconception that dementia is a natural consequence of old age, leading in unwillingness to seek professional assistance. Although the past years have seen progress in enhancing awareness through the distribution of information booklets and the launch of the dementia helpline, more needs to be done.

A recent initiative currently under discussion between the Parliamentary Secretariat and the Malta Dementia Society is the engagement of trained dementia activities that will promote dementia awareness in the diverse sectors of the community, including schoolchildren.

What is the role of the Malta Dementia Society in providing knowledge and raising awareness of dementia?

Awareness of dementia remains at the top of our agenda. Over the years, we have built a strong relationship with government and media. Society members are frequent contributors to the printed press and regularly appear on television and radio programmes to discuss the various aspects of dementia management and care. We also launched our official webpage nine years ago and recently, our Facebook page.

These information portals are essential in keeping direct contact with our members and inform them on events including talks and seminars for individuals with dementia and their caregivers as well as for healthcare professionals.

In February 2013, we launched our support group, which is an important step towards offering the best assistance to dementia caregivers as well as organising activities that bring them together. We are also involved in regular consultations with policy makers in introducing services aimed at individuals with dementia, their caregivers and family members.

Dr Charles Scerri is a senior resident academic at the Department of Pathology, Faculty of Medicine and Surgery, University of Malta. He is one of the co-founders and secretary of the Malta Dementia Society, honorary secretary of Alzheimer Europe and national focal point on dementia.

For more information visit www.maltadementiasociety.org.mt.