Dementia is a general term that refers to a collection of progressive, degenerative brain syndromes that affect a person’s memory, thinking, behavior and emotions. Among the specific causes of dementia, Alzheimer’s Disease is the most common, representing 60 – 80% of all cases, while vascular dementia is the second most common cause at 20 – 30%. Others diseases that cause dementia include Dementia with Lewy Bodies and Fronto-Temporal Dementia, both of which occur less frequently.
Alzheimer’s Disease International (ADI) estimates that approximately 36 million people worldwide have dementia. This number is expected to double every twenty years as people age and as diagnostic techniques and protocols improve. For rapidly aging societies such as China, where it is currently estimated that more than ten million people have dementia and six million have Alzheimer’s, this will increase more rapidly. China’s population over the age of 60 today is approximately 135 million, an amount that is expected to increase to 336 million by 2030.
In terms of care, China is not currently prepared for this increase, either with respect to facilities or trained professionals. Indeed, there is a marked shortage of trained health services professionals across the board, beyond those specialized in the treatment of dementia. It is estimated that in China dementia and its constituent diseases are misdiagnosed in urban settings more than 75% of the time. Moreover, only 15% of those with diagnosed mild dementia, and only 26% with moderate dementia, are under the ongoing treatment of a doctor.
Complicating the landscape is China’s former one-child policy, which is leading to a shortage of available primary caretakers, while the ongoing de-emphasis of filial piety in Chinese society doesn’t help.
ADI estimates that the total worldwide cost of dementia was approximately US$ 604 billion in 2010, of which 16% comes from direct medical costs, 42% from community care, and 42% from informal care (e.g., family caretakers). Indeed, as ADI observes, if the cost of dementia care represented the GDP of a standalone country, it would represent the 18th largest country on the globe. The cost of dementia in China has not yet been reliably determined.
In April 2010, the U.S.’ National Institute of Health published an Evidence Report on the prevention of Alzheimer’s Disease and cognitive decline. In brief, active cognitive training was found to be correlated with a decreased risk in the development and the progression of Alzheimer’s Disease. Physical activity, particularly at high levels, also appears helpful in lowering the incidence of the disease. However, it is still not fully known what the underlying cause is, despite a significant amount of work occurring around the beta amyloid plaques that tend to occur in the brains of Alzheimer’s patients.
Across all of Greater China, much remains to be done in addressing these trends, particularly around preparing caretakers and professional healthcare workers on the frontline, even in more developed markets such as Hong Kong. Whether we as a society, and our public health officials, can address this trend remains to be seen.
July 16, 2013
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