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Dementia in Developing Countries

dementia in developing countriesThough dementia is traditionally thought of as being prevalent only in the developed world, it is now occurring at higher rates in developing countries. Currently, 67% of people with dementia worldwide reside in low- and middle-income nations, and researchers predict that number will reach 75% by 2050 in tandem with these nations’ aging populations. Because health and social care services in these countries are already strained or non-existent, dementia in developing countries poses a unique set of challenges.

Dementia and Alzheimer’s

The most common cause of dementia is Alzheimer’s Disease. But as with nearly all forms of dementia, there is progressive brain cell death, so as its symptoms progress, cognitive functions become severely impaired. As early as the second stage of mild dementia, individuals may require intensive care and supervision from others with tasks in their daily life. However, healthcare systems are stretched thin in many developing countries. Often, their frontline providers may not be adequately trained in providing the long-term care needed for these conditions. Even when assisted-living arrangements in a medical facility are an option, people with dementia have limited autonomy over their care because there are few systems in place to monitor the quality of dementia care in poorer nations.

Treating Dementia in Developing Countries

Due to the lack of formal care, people with dementia in the developing world tend to rely upon systems of “informal” care by family, friends, or other community members. These support mechanisms are under great strain due to the economic, emotional and physical demands of unpaid, and often unsubsidized, caregiving. Caring for someone with dementia can demand up to 74 hours a week and cost around $4600 a year. Furthermore, symptoms associated with the later stages of dementia, such as aggression, depression and hallucinations can have distressful psychological effects for these caregivers. In fact, 45% of family caregivers report experiencing distress, and 39% have feelings of depression.

Social Stigmas Surrounding Dementia

The social stigma associated with mental health diagnoses as well as general health illiteracy and unfamiliarity with dementia also contributes to inequities within the quality of dementia care. A study conducted in India suggested that 90% of dementia cases in low and middle-income nations go undiagnosed. Even healthcare professionals may lack the awareness to identify early signs of dementia. The wide-spread myth that dementia is not a medical issue in developing countries can mislead providers to dismiss dementia’s symptoms as characteristics indicative of normal aging.

Furthermore, in some parts of Sub-Saharan Africa, such as rural Kenya and Namibia where knowledge of dementia is not widespread, people may associate dementia with witchcraft or punishment for previous wrongdoings. Such beliefs further entrench the stigma surrounding it into the broader culture, discouraging people with dementia from seeking an official diagnosis. Organizations like the Strengthening Responses to Dementia in Developing Countries (STRiDE) Project have worked specifically towards reducing this stigma.

Understanding Poverty and Dementia

The immense prevalence of undiagnosed cases is particularly detrimental, considering poverty may increase one’s risk of dementia. Poverty is linked with many risk factors for dementia — one of which is stressful experiences like financial insecurity and education difficulties. Incidence of dementia has also been linked to lower levels of education since early development of neural networks can help the brain combat damages to its pathology later in life. A study on the rural Chinese island of Kinmen, where the median level of education is one year, showed dementia rates rising as people turned 60. This trend is earlier than in developed nations, and implies that illiteracy and lack of education can bring on dementia sooner.

Looking Forward

It remains unclear whether there is a correlation or direct causation between education level and the likelihood of dementia later in life. But one thing, however, is clear — low education levels serve as a frequent marker for other socioeconomic issues that are more common in developing nations, such as poverty, malnutrition, and toxic environmental exposures. Furthermore, the most commonly recommended strategy for reducing the risk of Alzheimer’s is maintaining overall health, which is more difficult in poorer countries due to malnutrition and unequal access to health care.

Moving forward, we must expand the support available to informal care systems, while ensuring healthcare providers receive dementia-specific training and health literacy. Women often the ones left to provide the majority of dementia care, but their efforts largely go ignored by their governments. Incentives, like universal social pensions, disability benefits and carer’s allowances, could support family and friends who house and care for people with dementia. Still, formal health systems too need to be bolstered to supplement and eventually substitute the role of informal carers. Policy-makers worldwide need to prioritize and anticipate the growing number of people with dementia as it remains the only leading cause of death still on the rise.

– Christine Mui
Photo: Flickr

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5 Facts to Raise Awareness About Dementia in Africa

Dementia in AfricaDementia is universally feared and stigmatized because it is mistakenly viewed as a gradual part of aging. There has been no research found to treat these symptoms, but there are ways to care for and uplift those in need to reduce the risk of dementia around the globe — including Africa.

5 Facts to Raise Awareness About Dementia in Africa

  1. Dementia is an umbrella term under which Alzheimer’s disease can fall. Dementia is categorized as a syndrome and does not have a definitive diagnosis. It is a group of symptoms that affect mental cognitive tasks such as memory and reasoning, Health Line reported. According to Health Line, as dementia progresses with age, it can have an impact on the ability to function independently, placing an emotional and financial burden on families.
  2. Dementia currently affects more than 47 million people worldwide. More than 75 million people are expected to be living with dementia by 2030. Dementia in Africa will rise over the next decades due to an aging population, an increase in noncommunicable diseases and the effects of the HIV pandemic. Even though there has been a reduction in HIV contractions, the disease still leaves its mark as a conduit for dementia. According to The Conversation, South Africa accounts for 17 percent of the global burden of HIV infection. HIV is linked with cognitive decline and leads to HIV-associated dementia (HAD). The Conversation stresses that health care and social care systems are a crucial step toward getting society involved and aware. The World Health Organization (WHO) had a conference in 2015 to discuss global action against dementia. The committee stated that raising generational awareness was essential for encouraging action from younger generations. There is a need to search for disease-modifying therapy, improve care and quality of life and reduce the risk of dementia in Africa.
  3. The WHO emphasized that people must embed a rights-based approach in all interventions. Specifically, the WHO’s committee illustrated the importance that people living with dementia deserve empowerment. The goal is to provide support to exercise their rights and have access to enhanced autonomy to reduce the risk of dementia in Africa. Margaret Chan, director-general at the WHO, offered her view on the conference and its goals.“I can think of no other disease where innovation, including breakthrough discoveries to develop a cure, is so badly needed,” Chan said.
  4. The First WHO Ministerial Conference on Global Action Against Dementia sought to promote a better understanding of dementia, raise public awareness and engagement, demand respect for the human rights of people living with dementia, reduce stigma and discrimination, and foster greater participation, social inclusion and integration. The approval of the WHO Global Action Plan on Dementia in May 2017 allowed Alzheimer’s Disease International to put greater pressure on governments to take the issue with urgency and reduce the risk of dementia in Africa. In the African continent, there is a need for new studies to evaluate dementia prevalence, incidence, mortality and to monitor changes over time. According to WYLD Network, these studies are crucial to emphasize to governments, local and international organizations the necessity to target health policies for older people and the development of strategies for dementia care in sub-Saharan Africa.
  5. As the WHO progresses toward awareness to reduce the risk of dementia in Africa, it instilled an international surveillance platform, the Global Dementia Observatory. The WHO established this for policy-makers and researchers to facilitate monitoring and sharing of information on dementia policies, service delivery, epidemiology and research.

While there is no cure for dementia, several plans like the Global Action Plan on Dementia pave the way for successful care of those developing dementia. Updated research to reduce the risk of dementia in Africa is essential to inform officials of the development and empowerment for the most vulnerable.

– Carolina Chaves
Photo: Creative Commons

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10 Facts About Dementia in the Developing World

Dementia in the Developing WorldDementia is the deterioration of mental capability, specifically concerning things such as memory, that most typically occurs in the elderly. The word “dementia” itself is not a disease, but rather a term used to describe a variety of symptoms associated with the condition. Alzheimer’s disease is a form of dementia, and in 2015 it was the seventh most common cause of death worldwide. Here are 10 facts about dementia in developing nations:

  1. Two thirds of dementia cases occur in the developing world, yet only 10 percent of research on the disease is conducted there.
  2. Incidences of Alzheimer’s and dementia are just as prevalent in the developing world as the developed world, if not even greater.
  3. A 2005 Alzheimer’s disease international study claimed that there was a lower incidence of Alzheimer’s and dementia in undeveloped countries than in the developed world. This has since been found to be untrue and researchers have re-assessed the variables at play in diagnosing memory-related illness.
  4. Women in both the developing and developed world have statistically higher rates of dementia than men of the same age.
  5. Socioeconomic factors, such as education and literacy, are directly linked to lowering the rates of Alzheimer’s and dementia in the developing world.
  6. Dependency has a very strong link to poverty, and as the incidence of late stage dementia cases increases with aging populations in the developing world, there will be an increased economic strain on families of dependents.
  7. If methods of screening for dementia were homogenous worldwide, it would provide vastly more accurate data on the prevalence of dementia globally.
  8. Assisted living and long term care facilities are sparse in the developing world, due in part to the importance of home-based care and rehabilitation in many cultures.
  9. There is a lack of funding for dementia care facilities and memory centers in the developing world, only exacerbating the growing rate of memory-related illness in these countries.
  10. The best way to ensure long term care for those with dementia in the developing world is to push policy makers to fund social programs to protect the elderly. We need to push for policy which integrates home-based care and generalized healthcare.

Dementia is not curable, but access to proper healthcare can help provide long lives to those afflicted with the condition. If the international aid community were to pool their support for this issue, we could ensure proper care for those suffering from dementia worldwide and radically improve the lives of those affected, their loved ones and even future generations.

– Tyler Troped

Photo: Flickr