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The world’s population is aging.

Improvements in health care in the past century have

contributed to people living longer and healthier lives.

However, this has also resulted in an increase in the

number of people with noncommunicable diseases,

including dementia. Although dementia mainly affects

older people, it is not a normal part of ageing. Dementia

is a syndrome, usually of a chronic or progressive nature,

caused by a variety of brain illnesses that affect memory,

thinking, behaviour and ability to perform everyday activities.

 

 

Dementia is overwhelming not only for the people who have it, but also for their caregivers and families. It is one of the major causes of disability and dependency among older people worldwide. There is lack of awareness and understanding of dementia, at some level, in most countries, resulting in stigmatization, barriers to diagnosis and care, and impacting caregivers, families and societies physi- cally, psychologically and economically. Dementia can no longer

be neglected but should be considered a part of the public health agenda in all countries.

The objective of this report is to raise awareness of dementia as a public health priority, to articulate a public health approach and to advocate for action at international and national levels based on the principles of inclusion, integration, equity and evidence.

 

Burden of dementia

 

We have a growing body of evidence on the global prevalence and incidence of dementia, the associated mortality and the global economic cost. Most of the information is from high-income coun- tries with some data becoming increasingly available from low- and middle-income countries (LMIC).

Prevalence and incidence projections indicate that the number of people with dementia will continue to grow, particularly among the oldest old, and countries in demographic transition will experience the greatest growth. The total number of people with dementia worldwide in 2010 is estimated at 35.6 million and is projected to nearly double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050. The total number of new cases of dementia each year worldwide is nearly 7.7 million, implying one new case every four seconds.

The total estimated worldwide costs of dementia were US$ 604 billion in 2010. In high-income countries, informal care (45%) and formal social care (40%) account for the majority of costs, while the proportionate contribution of direct medical costs (15%) is much lower. In low-income and lower-middle-income countries direct social care costs are small, and informal care costs (i.e. unpaid care provided by the family) predominate. Changing population demo- graphics in many LMIC may lead to a decline in the ready availability of extended family members in the coming decades.

Research identifying modifiable risk factors of dementia is in its infancy. In the meantime, primary prevention should focus on targets suggested by current evidence. These include countering risk factors for vascular disease, including diabetes, midlife hypertension, midlife obesity, smoking, and physical inactivity.