Font size:
Print
Dementia in India
Context:
India is set to face a significant rise in dementia cases, with experts warning that the country will account for more than 15% of the world’s elderly population by 2050.
Prevalence and Projections:
- Current Prevalence: Approximately 7.4% of Indians aged 60 and above are affected by dementia.
- Future Projections: The number of dementia cases is expected to rise from 8.8 million to 17 million by 2036, marking a 97% increase.
- Increased Risk in India: This may be exacerbated by demographic transitions, urbanisation, dietary habits, and genetic predisposition. Widespread use of tobacco and alcohol contributes to the higher prevalence of dementia.
Risk Factors:
- Age is the leading risk factor for neurodegenerative diseases, with Alzheimer’s typically developing after age 65. Dementia prevalence increases with age, affecting one in three people by age 85.
- Genetics: Family history can increase the risk.
- Lifestyle: Such as diabetes and hypertension contribute to the risk.
- Early-onset cases (5-6% of cases) can occur between ages 30-60, with rare conditions like Huntington’s disease appearing between 30-50.
About Dementia:
- Dementia is a term used to describe a group of symptoms affecting memory, thinking, and social abilities. It is not a specific disease but rather a syndrome caused by various diseases and conditions that affect the brain.
- Causes:
-
- Alzheimer’s Disease: The most common cause of dementia, accounting for 60-70% of cases.
- Vascular Dementia: Caused by conditions that block or reduce blood flow to the brain, such as strokes.
- Other Causes: Includes Lewy body dementia, frontotemporal dementia, and other medical conditions.
- Symptoms:
-
- Memory Loss: Difficulty remembering recent events or information.
- Confusion: Getting lost in familiar places or difficulty following conversations.
- Behavioural Changes: Changes in mood, personality, or behaviour.
- Difficulty with Daily Tasks: Struggling with routine activities such as cooking, dressing, or managing finances.
- Complications: If left untreated, dementia can lead to memory loss, loss of independence, and inability to communicate.
- In later stages, dementia may cause malnutrition, infections, aspiration pneumonia, and blood clots due to reduced mobility.
- Diagnosis: Involves medical history, physical exams, neurological tests, and brain imaging.
- Treatment: Medications include cholinesterase inhibitors and memantine.
- Non-pharmacological options include cognitive therapy, behavioural interventions, assisted living, and caregiver support.
- Advanced treatments like aducanumab (FDA-approved) can cost millions.
Impact:
- Personal Impact: Dementia affects not only the individual but also their family and caregivers.
- Economic Impact: The global cost of dementia care is substantial, with significant contributions from informal caregivers.
Government and Policy Initiatives:
- The National Mental Health Programme focuses on elderly mental care, including early detection.
- Dementia India Alliance: DemClinic, a platform by the DIA, provides free memory screening and virtual assessments through telemedicine and expert care.
- Ministry of Social Justice supports dementia care initiatives, while public-private partnerships fund specialised centres and research.
- Strengthening Responses to Dementia in Developing Countries (STRiDE): This project, led by the LSENIMHANS, aims to understand the current dementia care context in India and develop policies and programs to improve the quality of life for those living with dementia
Challenges:
- Expertise shortage: India faces a shortage of trained professionals and specialised care infrastructure.
- Care Costs: The cost of dementia care varies widely, with urban households spending between Rs 45,600 and Rs 2 lakh annually, and rural households spending between Rs 20,300 and Rs 66,025.
- Care Options: Include medications, cognitive therapy, behavioural interventions, and assisted living facilities are unevenly distributed across India, exacerbating the need for more comprehensive care networks.
Way Forward:
- The existing healthcare model is largely hospital-centric; there is an urgent need for integrated community-based care models that involve primary healthcare providers.
- Experts call for national dementia-specific policies and community-level interventions to address the growing dementia burden.
