A recent study published in the Malta Medical Journal found that the number of individuals with dementia over the age of 60 years in the Maltese islands in 2010 was significantly higher than previously projected.
About 2.3 per cent of the Maltese population will have dementia by the year 2030. In 2050, this percentage will climb to 3.3 per cent as more individuals will fall in the ‘oldest-old’ age bracket.
Dementia is an umbrella term that referes to a number of different medical conditions charactersied by a progressive decrease in cognitive abilities. Such decline includes memory impairment, loss of communication skills, inability to perform everyday functions and changes in personality and mood sufficient enough to influence negatively normal social activities.
We need to make dementia a national public health priority
Alzheimer’s disease is the most common form of dementia, accounting up to 70 per cent of all cases.
The dementia syndrome has long been considered as a silent epidemic and one of the most important major health challenges of this century.
It has been estimated that, in 2010, the yearly worldwide cost of dementia was €435 billion, equivalent to one per cent of the world’s gross domestic product. A significant percentage of this cost occurs in Western Europe and North America and is attributed mostly to unpaid care provided by family members of individuals with dementia and expenses relating to community, residential and medical care.
In Europe, an individual with dementia costs an average of €22,000 annually. In Malta, the overall expenditure is estimated to range between €63 million and €96 million.
The revised estimates reported in this study continue to highlight the need of increasing awareness on dementia management and care not only among the public but also among the health care professionals who come into direct contact with individuals with dementia, their caregivers and relatives. The medical, psychological and emotional impact on individuals with dementia and their families is of such an extent that it profoundly affects their quality of life.
Unfortunately, there is a lack of awareness and understanding of dementia. 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 and diagnosis. With appropriate support, many can and should be enabled to continue to engage and contribute within society, thus benefiting their quality of life.
The revised data also present a number of challenges to policymakers in planning services targeted towards individuals with dementia in the various levels of care settings.
In 2010, a number of recommendations were made to the health authorities by the Malta Dementia Strategy Group in order to consider, plan and develop a national dementia strategy that provides high quality care for individuals with dementia and their caregivers in Malta.
Although there was a noticable improvement in the way we care for these individuals in the recent years, the strategy document remains unpublished. This is indeed unfortunate when considering that Malta is only one of a handful of countries that are working on a national dementia plan.
Furthermore, the significant increase in the number of individuals with dementia in the coming years will invariably put greater demands on health care services that will lead to considerable socio-economic consequences. In order to face these present and future challenges, we need to make dementia a national public health priority. It is through an integrated effort by all stakeholders that we can truly change the face of dementia in the Maltese islands.
A copy of the study can be found at http://www.um.edu.mt/umms/mmj (volume 24, Issue 3, 2012).
Charles Scerri is a senior lecturer at the Department of Pathology, Faculty of Medicine and Surgery of the University of Malta.