Dementia is set to rapidly escalate in India but awareness remains low

India has a serious and growing problem with dementia, but it it is neglected due to various reasons, the main one being a lack of awareness. According to recent published figures, over four million Indians above 60 have the condition, which is around 3.7 percent of that population. Approximately, one out of every 16 households with an elder has someone with dementia. Yet, dementia remains a neglected area in healthcare, and many families do not seek or get suitable diagnosis or treatment for dementia symptoms. The 19th national conference of the Alzheimer’s & Related Disorders Society of India (ARDISI), recently held at Mumbai, advocated the need for more attention to the condition, given that the number of people with dementia is expected to rise to about 7 million by 2020 and rapidly escalate to reach 13 to 14 million by 2050. The conference stressed the need to create awareness, and to advocate with the government for better facilities for persons with dementia. [caption id=“attachment_2560384” align=“alignleft” width=“380”]  Representational image. Reuters[/caption] In a presentation at the conference, Swapna Kishore, a Bangalore-based resource person for dementia care, talked about the poor dementia awareness and support in India. She said that most efforts to spread awareness or to support dementia care do not reach people who are less literate, of poorer economic status, or in smaller cities and rural areas. Given the demographics of India, this very limited reach of various campaigns is a major problem. Poor awareness about dementia means that elders who experience problems like forgetfulness, confusion, or difficulty doing tasks do not consult doctors. “Often people who forget things or start getting disoriented cover up their mistakes out of shame or they think it’s just part of growing older,” Kishore told Firstpost. “But while some problems are normal with age, others may be because of dementia or other medical conditions. So, some of these elders may benefit if the medical reason is identified and if treatment is possible for their condition.” Most people only think of Alzheimer’s Disease when dementia is mentioned, but dementia symptoms can be caused by many diseases. While most types of dementia are irreversible and cannot be fully cured, medication can provide some relief in the symptoms in some cases. Also, sometimes dementia symptoms happen due to reversible problems like vitamin or hormone deficiencies. Treatment is available for these. Not consulting a doctor means the person cannot get diagnosis or treatment. Also, a major problem is that general practitioners may not take the symptoms reported by elders seriously. A common refrain is telling the person that he or she is fine for his or her age. Doctors may not check for possible medical problems. They may not refer the person to specialists for further investigations. There seems to be an assumption that such problems do not matter. But, as Kishore said, “Someone who feels confused and disoriented and is finding it increasingly difficult to handle normal tasks is definitely having a poorer quality of life. The person is probably feeling insecure and agitated and may even withdraw. So it is worth trying to understand and reduce the problems. Also, if the family gets a dementia diagnosis, they can plan for the stage when dependence is much higher and the person needs constant attention and care.” Lack of diagnosis means the family does not know that the person has a medical condition. So family members may react to the patient’s forgetfulness with irritation, even anger, instead of understanding that the person can’t help being forgetful. And when the patient cannot do some task properly, they may get angry and think the patient is not trying hard enough. The 2011 World Alzheimer Report said that while there is evidence that early interventions are effective, an astonishing 28 million of the world’s 36 million dementia patients remain undiagnosed. Early diagnosis will help people to plan to handle the condition later in life. It will also help them plan for future care while they still have the capacities to make important decisions. Early therapy can improve cognitive functions and retain them for a longer time. The lesson seems to be is that if an elder in the family is getting increasingly forgetful or is finding it very difficult to perform daily living tasks, and if your physician says everything is normal, you should still look for further medical advice. Try consulting specialists such as neurologists, psychiatrists, psychologists, or geriatricians. Or visit a memory clinic or a geriatrics clinic. Hospitals like NIMHANS, Bangalore are an excellent resource for getting dementia treatment and care. Not all forms of dementia can be treated or reversed, but the ones that are need to be caught early if the patient must have a chance to live a better life.