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The looming dementia threat

The first skin patch delivering a drug to treat dementia has just got U.S. Government approval. This, and recent signs of a potential breakthrough in diagnosing Alzheimer’s disease — the most common form of dementia among older people — by means of a blood test even before its symptoms become discernible, mark significant steps in the quest for managing better the cruel, brain-destroying disorder causing progressive deterioration in memory and in thinking and everyday abilities. It is indeed a development that governments and health policy planners need to take note of. Dementia is a general term for more than 70 conditions. Worldwide, 24 million people have dementia. The figure could rise to 42 million by 2020 and 81 million by 2040, with China and South Asian countries witnessing a tripling of cases by 2040. A report commissioned by Alzheimer’s Disease International says the Asia-Pacific region is facing an epidemic, with the number expected to reach 65 million in 50 years, marking a five-fold increase. It seems plausible that the most striking increases may occur in China and India. In India, the numbers are projected to grow from 3.2 million to 16 million. Given the pattern of demographic transition, the proportion of people in the 60-plus age group will rise from under 10 per cent of the regional population today to 25 per cent by 2050.

Since the disease primarily shows up in the 60s, as more people live longer the absolute numbers affected by it will increase. Governments should make dementia and the development of care facilities a policy priority. They need to create a widespread awareness about it and develop care services that are equipped to be responsive. Compared with some of the killer diseases, Alzheimer’s is far behind in terms of numbers and receives relatively little research funding. But the current economic costs of the disease in the 15 Asia-Pacific countries are an estimated $60 billion. The costs will rise both in terms of the financial burden to health systems and the toll on families. It has been estimated that if the onset of dementia could be delayed by five years through preventive measures and pharmacological interventions, the number of sufferers would fall by half. Lifestyle changes may be important: smoking, obesity, diabetes, and high blood pressure could be pre-disposing factors. Mental activity and a diet rich in fruit and vegetables appear to have a protective effect. Some people appear to be genetically more susceptible than others. Detailed plans need to be drawn up to tackle the crisis and the health-care systems geared to face up to the challenges.

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