13 Apr 2012

Current estimates put the worldwide dementia prevalence at 35.6 million people for 2010, and its cost at an estimated $604 billion per year. This is according to a report released April 11 by the World Health Organization (WHO) and developed jointly with Alzheimer's Disease International (ADI). If current trends continue, this number is expected to double every 20 years, reaching a universal epidemic. Called "Dementia: A Public Health Priority," the report aims to advise countries in crafting their response. It places special focus on low- and middle-income countries, which are expected to experience the greatest growth in dementia due to their projected demographic shifts.

Prepared by Shekhar Saxena, WHO; Marc Wortmann and Daisy Acosta at ADI, Martin Prince, King’s College London; and Ennapadam Krishnamoorthy, The Institute of Neurological Sciences, Chennai, India, the report draws on working groups that reviewed four main areas. These are epidemiology; national policies, plans, and resources; awareness and the health workforce; and caregivers. The authors also used online surveys in 30 countries and input from major stakeholders, such as spokespeople from public health, academia, and advocacy groups, from 16 countries. The report starts off with an overview, by country, of the prevalence, mortality, costs, and projected surge of dementia. For instance, Europe had a 6.2 percent prevalence in 2010, expected to rise 87 percent by 2050. Africa, on the other hand, had a 2.6 percent prevalence, but projections foresee a 370 percent explosion of that number by 2050. Details about disease subtypes and etiology, as well as known potential prevention measures and risk factors (such as diabetes, obesity, smoking, and hypertension) follow those numbers.

The report showcases plans from more than a dozen countries to deal with dementia. Examples are Denmark's "National Dementia Action Plan" and Korea's "War on Dementia." It calls on other governments to develop similar plans that lay out the problem, bring in interested parties, such as healthcare providers, caregivers, and people with dementia, recognize the necessary areas for action, commit resources, and detail how to implement the overall plan. Further sections emphasize the importance of social and legal protection for aging people and those with dementia, and raise ethical issues that should be considered.

Using examples of services and programs for patients and caregivers in various countries, the report encourages governments to enhance their health and social care systems, as well as their workforces, to cater to people and families with dementia. It outlines benefits associated with early diagnosis, specialist care, long-term care services, community programs, and training of nurses, health workers, and residential care staff. It points out the unique needs of migrant workforces who need help understanding language and culture as they fulfill the rising demand for such positions in higher-income countries.

The report emphasizes the need for countries to prioritize dementia in their public health policy agendas at all levels—from local to international—by investing in measures now that will alleviate the strain brought on later by the looming epidemic. The report is freely available online.—Gwyneth Dickey Zakaib.