Unfolding dementia epidemic requires dealing with huge shortfalls in infrastructure and awareness

Unfolding dementia epidemic requires dealing with huge shortfalls in infrastructure and awareness

Subject: Science and Technology

Section: Health

Introduction

• India’s elderly population is projected to reach 20 crore by 2031, leading to an increased demand for a national action plan to address Alzheimer’s and dementia.

Rising Dementia Cases in India

• A multicentric study revealed a dementia prevalence rate of 7.4% among individuals aged 60 and above, equivalent to nearly 9 lakh Indians living with dementia.
• The prevalence of dementia is estimated to rise from 88 lakh in 2016 to 1.7 crore by 2036.
• The study, titled ‘Prevalence of dementia in India: National and State estimates from a nationwide study‘, was published in Alzheimer’s and Dementia journal in July this year.
• Some states like Jammu and Kashmir, Odisha, and West Bengal reported higher rates of dementia than expected.
• WHO declared dementia a public health priority in 2012 and launched the Global Action Plan (2017-2025) emphasizing dementia awareness, risk reduction, diagnosis, treatment, caregiver support, and research.
• NIMHANS and Dementia India Alliance (DIA) are collaborating with the Karnataka government to formulate a Karnataka State Dementia Action Plan aligned with WHO’s global action plan.

Understanding Dementia: Clinical Presentation and Diagnosis

• Dementia is a clinical syndrome caused by various brain diseases or injuries.
• Alzheimer’s disease is the most common cause of dementia, responsible for up to 70% of diagnoses.
• Early symptoms of dementia include forgetfulness, difficulty recalling names, disorientation, and reduced social engagement.
• Advanced stages involve severe memory loss, mood swings, apathy, and loss of bodily functions.
• Diagnosis is based on clinical grounds, neuroimaging, and neuropsychological tests.
• Cognitive assessments using tools like MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment) help differentiate dementia from normal aging.
• Currently, there is no genetic or biomarker test for diagnosing dementia.

Preventing Dementia: Lifestyle and Risk Factors

• The WHO emphasizes preventing Alzheimer’s disease as a key element in fighting the global dementia epidemic.
• Delaying the onset of dementia by even one year could reduce its prevalence by 11%, while a delay of five years could halve it.
• Lifestyle risk factors such as sedentary behavior, unhealthy diet, smoking, and excessive alcohol use contribute to dementia risk.
• Managing vascular risk factors, including hypertension, high cholesterol, diabetes, and obesity, is crucial in preventing dementia.
• Smoking cessation can reduce dementia risk.
• Regular exercise, managing depression, and higher education levels are protective against dementia.
• The cognitive reserve theory suggests that education stimulates brain development and delays clinical symptoms.

Dementia Care: Treatment and Support

• Dementia care involves managing the disease’s effects and cognitive, neuropsychiatric, and functional symptoms.
• A dementia care team includes psychiatrists, therapists, nurses, psychologists, and social workers.
• Non-pharmacological interventions are the first-line therapy.
  • Behavioral and psychological symptoms of dementia are addressed through non-pharmacological interventions.
• Medications like cholinesterase inhibitors are used to treat cognitive symptoms.
• Neuropsychiatric symptoms respond to various therapies, including aromatherapy, physical therapy, and speech therapy.

Commonly known diseases that can cause dementia: