Improved healthcare and the increasing availability of successful treatments means many of us are now leading longer, healthier lives. But it also means that the world population is ageing – within the next five years, the number of adults aged 65 and over will outnumber children under the age of five. And with ageing populations come some serious challenges, one being the significant increase in the number of people with Alzheimer’s disease and related dementias.
Dementia is a broad term that describes a set of symptoms caused by a gradual loss of brain function. Symptoms include memory loss, mood changes, problems with communication and an inability to perform everyday activities. Alzheimer’s disease is the most common type of dementia and develops as a result of changes in the structure of the brain. Dementia mainly affects older people. After the age of 65, the likelihood of developing dementia roughly doubles every five years.
The global prevalence of dementia is shocking and the current situation of this devastating disease is one of under-diagnosis and late diagnosis. Alzheimer’s disease International estimates that there were around 36 million people living with dementia worldwide in 2010. This is expected to rise to a staggering 66 million by 2030 and 115 million by 2050. The sharpest increases in numbers are set to occur in low- and middle-income countries, as elderly populations continue to grow.
According to a report by the World Health Organization (WHO), there were around 7.7 million new cases of dementia in 2010; that’s around three times as many as HIV/AIDS (2.6 million per year). By 2050, the incidence of dementia will have increased to almost 25 million new cases annually, unless massive movements in treatment and prevention are made.
Dementia expertise, public awareness of dementia and how symptoms are perceived vary greatly in different parts of the world and explain why so many people go undiagnosed and untreated. Some countries or populations consider dementia a normal part of ageing; others consider it a mental illness, or something linked to supernatural or spiritual beliefs. In April this year, the WHO declared that dementia must become a global public health priority. Australia was the first country to make dementia a national health priority back in 2004, and National Dementia Strategies have been launched in Australia, Denmark, Finland, France, South Korea, England, Scotland, Norway and the Netherlands. There are also a number of non-Government National Dementia Strategies, for example, in Ireland, Canada, India and New Zealand.
Although many people believe that low public awareness of dementia and a lack of dementia expertise is far more prevalent in low- and middle-income countries, there are similar challenges in Western parts of the world. For example, in the UK, it’s been found that people typically wait three years before reporting symptoms of dementia to their doctor.
Dementia experts have highlighted that stigma and false beliefs, such as that dementia is a normal part of ageing and that nothing can be done, are key factors to under-diagnosis and the lack of people seeking help. One report found that only a third to a half of people with dementia ever get a formal diagnosis.
Considering these findings, a sense of poor practice starts to unfold, and it’s clear that further research into high-risk groups, how best to case-identify, then screen and diagnose, as well as better public awareness, is desperately needed to tackle the rising epidemic of dementia.