‘Dementia isn’t seen as a medical condition but a normal problem of ageing – No, it isn’t. It is devastating – not only to victims but also to family and friends.’ – World Alzheimer’s Report 2010
In 2010, the total estimated worldwide costs of dementia were $604 billion (US dollars). This figure placed it as the 18th largest in the world economies. The costs included informal care (provided by family and others); direct costs of social care (provided by community care professionals and in residential home settings) and the direct costs of medical care (the costs of treating dementia and other conditions on primary and secondary care).
In 2010 there were an estimated 35.6 million people living with dementia worldwide; this is set to increase to 65.7 million by 2030 and 115.4 million by 2050 (figures from Alzheimer’s Disease International). In South Asia, this figure currently stands at around 4.5 million and is expected to increase by 108 per cent to 9.3 million in 2030.
The World Alzheimer’s Report 2013 says that globally, 13% of people aged 60 or over require long-term care. Between 2010 – 2050, the total number of people with care needs will nearly treble from 101 million to 277 million. Long term care is mainly about care for people with dementia; around half of all older people with care needs have dementia and 80% of older people living in care homes are living with dementia. The worldwide cost of dementia care is currently over $US600 billion or around 1% of global GDP.
What is dementia?
It is often referred to as a syndrome that can be caused by a number of progressive disorders affecting memory, thinking, behaviour and the ability to perform everyday tasks.
There are four main types:
– alzheimer’s disease
– vascular dementia
– dementia with Lewy bodies
– frontotemporal dementia.
There are over 100 variations of the condition under these four main types. Dementia mainly affects older people but there is growing awareness of cases that start before the age of 65 – for instance, there are cases of people developing the condition in their forties.
Professor Martin Prince, co-author of the World Alzheimer Report 2010, believes that there are ways of tackling this situation:
“Empowering older people; promoting lifelong physical health; social protection and age appropriate health care are all important,” he says. “There are opportunities for prevention in early life by good nutrition and neurodevelopment; in mid-life by cutting the risks of developing cardiovascular (heart) disease and other conditions by tackling smoking and diabetes; in later life by tackling under-nutrition that is linked to poverty and older people and can lead to anaemia, yet another risk factor for developing dementia.” Professor Prince says that cigarette smoking in early life is a significant factor in developing dementia in later life.
Alzheimer’s Disease International has put forward a number of recommendations that include a non-means tested universal social pension; access to disability benefits for people with dementia; caregiver benefits; incentivised family care; provision of basic information, training and support for care givers in the community.
There is a call for governments across the world to wake up to the costs that they are incurring in trying to deal with the effects of dementia – costs that are set to rise significantly as the number of sufferers increases.
Around 70 per cent of the total costs of dementia occur in Western Europe and North America. The majority of dementia care provided in these parts of the world come through informal care by family members and others and care homes. But any notion by governments that families can continue to provide the necessary care “needs to be disabused” says Professor Prince because the projected increase in numbers of dementia sufferers will make this untenable – families just won’t be able to cope. And this doesn’t take account of people who don’t have children or other family members to provide such care, or whose children may have moved away or have their own health problems making them unable to perform an informal caring role.
Governments across the world are also reminded of their obligations under the UN Convention on the Rights of People with Disabilities and the Madrid International Plan for Action on Ageing to ensure access to healthcare. Also for governments to fund and expand the implementation of the World Health Organisation’s Mental Health Gap Action Plan, including the packages of care for dementia as one of the seven core disorders identified in the plan.