Dementia
Dementia is a syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities. It is a major cause of disability and dependency among older people worldwide, affecting individuals, caregivers, families, communities and societies. Dementia is not a normal part of ageing. People with dementia often live for many years after their symptoms begin, requiring long-term care and support.
Dementia can be overwhelming not only for those who have it, but also for their caregivers and families. When resources are limited, especially in low- and middle-income countries, delegating dementia-related tasks and responsibilities to community workers can improve the quality of life of people with dementia and their caregivers. With the growth of ageing populations around the world, the number of people living with dementia is rising rapidly.
Dementia is a syndrome characterized by deterioration in cognitive function, with Alzheimer’s disease as the most common form of dementia. While age is the most common risk factor for dementia, other diseases or injuries that affect the brain also increase the risk for developing dementia. Currently, it is the seventh leading cause of death among all diseases and is a major cause of disability and dependency among older people globally. Family members are often burdened with the cost of care due to the lack of trained professionals and access to programmes and services. Prevention and early intervention is key to improving health outcomes.
The signs and symptoms of dementia are divided into 3 stages, although the exact presentation of dementia may vary across individuals depending on the underlying cause and specific circumstances.
Early stage of dementia is often subtle, and include symptoms such as forgetfulness, losing track of time, and becoming lost in places that are familiar.
Middle stage is when the signs and symptoms of dementia are clearer and may include, forgetting recent events or people’s names, becoming confused while at home, difficulty communicating, needing assistance in personal care, and behavioural changes such as wandering and repeated questioning.
At the late or final stages of dementia, individuals living with this condition are nearly or entirely dependent on others. They may exhibit unawareness of time and place, having difficulty recognizing friends and family, increased need for assisted care, difficulty walking or moving, and behaviour changes that may include aggression.
WHO recognizes dementia as a public health priority. The Global action plan on the public health response to dementia provides a comprehensive blueprint for action across 7 areas:
- making dementia a public health priority,
- increasing dementia awareness, inclusion and friendliness;
- reducing the risk of dementia;
- improving diagnosis, treatment and care;
- supporting dementia carers;
- enhancing health information systems for dementia, and
- fostering research and innovation.
The Regional Framework for the Future of Mental Health in the Western Pacific calls for a systems approach to promoting and protecting mental health, including addressing dementia and its risk factors.