World failing to address dementia challenge : WHO
According to the WHO's "Global status report on the public health response to dementia," just a quarter of countries have a national policy, strategy, or plan for helping individuals with dementia and their families. Half of these countries are in the European Region of the WHO, with the rest spread over the other Regions. Even in Europe, though, many plans are about to expire or have already expired, signalling that governments must renew their commitment.
According to the report, the number of persons living with dementia is increasing at the same time: More than 55 million individuals (8.1 percent of women and 5.4 percent of men over 65 years) are estimated to have dementia, according to the WHO. By 2030, this number is expected to climb to 78 million, and by 2050, to 139 million.
Dementia is caused by a range of brain disorders and accidents, including Alzheimer's disease and stroke. Memory and other cognitive processes, as well as the capacity to conduct daily chores, are all affected. Dementia-related impairment is a major source of expenditures connected with the disease. The expense of dementia was expected to reach US$ 1.3 trillion in 2019. By 2030, the cost is expected to rise to US$ 1.7 trillion, or US$ 2.8 trillion when care costs are factored in.
“Dementia takes away millions of people's memories, freedom, and dignity, but it also takes away the individuals we know and love,” said World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus. “The world is failing dementia patients, and this hurts us all. Governments agreed on a clear set of goals to improve dementia care four years ago. However, goals by themselves are insufficient. We need to work together to ensure that all persons living with dementia have the support and dignity they deserve.”
The report emphasises the critical need for increased national assistance, both in terms of dementia care and support for those who offer that care, in both formal and informal settings.
Primary health care, specialist care, community-based services, rehabilitation, long-term care, and palliative care are all needed for people with dementia. While the majority of countries (89%) reporting to the WHO's Global Dementia Observatory claim they have some community-based dementia services, high-income nations have more than low- and middle-income countries. In high-income nations, dementia medication, hygiene products, assistive technologies, and household changes are also more available, with a higher level of reimbursement, than in low-income ones.
The level of informal care, which is mostly supplied by family members, is determined by the type and level of services offered by the health and social care sectors. Informal care contributes for roughly half of the worldwide dementia cost, while social care costs account for more than a third. The majority of dementia care costs in low- and middle-income nations are due to informal care (65 percent ). In affluent nations, informal and social care costs account for roughly 40% of total costs.
In 2019, carers spent an average of five hours per day providing daily living assistance to the person they were caring for with dementia, with women accounting for 70% of that care. Access to information, training, and services, as well as social and financial assistance, is especially crucial for carers because of the financial, social, and psychological burden they suffer. Currently, 75% of countries claim that they provide some form of assistance to carers, however these are mostly high-income countries.
A string of failed clinical trials for dementia treatments, along with costly research and development expenses, has resulted in a drop in interest in future initiatives. However, dementia research funding has recently increased, mostly in high-income nations such as Canada, the United Kingdom, and the United States of America. From US$ 631 million in 2015 to a predicted US$ 2.8 billion in 2020, the latter has increased its annual spending in Alzheimer's disease research.
"Dementia research activities need to have a clear direction and be better organised to have a higher chance of success," said Dr Tarun Dua, WHO's Head of the Brain Health Unit. “This is why WHO is working on the Dementia Research Blueprint, a worldwide coordination mechanism to structure research activities and spur new initiatives.” The inclusion of people with dementia, as well as their carers and relatives, should be a major emphasis of future research efforts. People with dementia are involved “rarely” or not at all in two-thirds of nations responding to the Global Dementia Observatory.
More positively, with strong civil society leadership, countries in all regions have made significant success in establishing public awareness programmes to raise public understanding of dementia. Awareness-raising efforts have been carried out in two-thirds of the nations reporting to the Observatory. Two-thirds have taken steps to increase the accessibility of physical and social surroundings for individuals with dementia, as well as to provide training and instruction to groups outside of the health and social care sector, such as volunteers, police, fire departments, and first responders.