By Sharon Atieno
Despite the rise in cases of dementia, support for such cases is still low globally with only one in four countries having a national policy, strategy or plan for the condition, a new report reveals.
The World Health Organization (WHO) report on the Global public health response to dementia notes that Europe accounts for half of this support yet in some parts of the region some plans are expiring or have already expired, indicating the need for renewed commitment.
Dementia- a disease that affects memory and other cognitive functions as well as the ability to perform everyday tasks- is the seventh leading cause of death (1.6 million mortalities), accounting for more than 55 million cases globally. The number is expected to rise to 78 million by 2030 and 139 million by 2050, according to the report.
“Dementia robs millions of people of their memories, independence and dignity, but it also robs the rest of us of the people we know and love,” said Dr Tedros Adhanom Ghebreyesus, Director-General, WHO in a statement.
“The world is failing people with dementia, and that hurts all of us. Four years ago, governments agreed on a clear set of targets to improve dementia care. But targets alone are not enough. We need concerted action to ensure that all people with dementia are able to live with the support and dignity they deserve.”
According to the report, support in terms of caring for people with dementia and those who provide that care must be strengthened at national levels in both formal and informal settings. This includes community-based services as well as specialists, long-term and palliative care.
While 89 per cent of countries reporting to WHO’s Global Dementia Observatory (GDO), say they provide some community-based services for dementia, high-income nations provide medication, hygiene products, assistive technologies and household adjustments, with a greater level of reimbursement.
The report observes that the type and level of services provided by the health and social care sectors also determines the level of informal care, which is primarily provided by family members.
Informal care accounts for about half the global cost of dementia, while social care costs make up over a third. In low- and middle-income countries, most dementia care costs are attributable to informal care (65%) while in richer countries informal and social care costs each amount to approximately 40%.
In 2019, the global cost of dementia was estimated to be US$ 1.3 trillion, most of the costs occurring in high-income countries despite a majority of people with dementia living in Low and middle income countries. The report estimates that with the increased numbers, the cost could increase to US$ 1.7 trillion by 2030.
Additionally, the report notes that in 2019, carers spent on average five hours a day providing support for daily living to the person they were caring for with dementia; 70% of that care was provided by women.
Given the financial, social and psychological stress faced by carers, access to information, training and services, as well as social and financial support, is particularly important, according to the report. But only 75% of countries report that they offer some level of support for carers, although, these are mainly high-income countries.
Despite a decline for research due to unsuccessful clinical trials for treatments for dementia, coupled with high costs of research and development, the GDO shows that funding has increased recently in the United Kingdom, United States, Canada and other high-income countries, including an annual investment in US Alzheimer’s disease research from $631 million in 2015, to an estimated $2.8 billion in 2020.
“To have a better chance of success, dementia research efforts need to have a clear direction and be better coordinated,” said Dr Tarun Dua, Head of the Brain Health Unit, WHO in a statement. “This is why WHO is developing the Dementia Research Blueprint, a global coordination mechanism to provide structure to research efforts and stimulate new initiatives.”
The report calls for meaningful inclusion of people with dementia, their carers and families in the entire research process, including conceptualization and priority setting, decision in funding allocation as well as evaluation of research outcomes. Currently, only two-thirds of countries reporting to the GDO involve people with dementia “rarely” or not at all.
The report also notes that across WHO regions, countries have made good progress in implementing public awareness campaigns to improve public understanding of dementia, with strong leadership by civil society.
“Of all GDO countries, approximately two thirds reported running awareness raising campaigns. Similarly, two thirds of GDO countries reported implementing initiatives to improve the accessibility of the physical and social environment for people with dementia,” the report reads.