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The world cannot cope with the challenge of dementia

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Only a quarter of the world’s countries have a national policy, strategy or plan to support people with dementia and their families, according to the ‘World Health Report on the Global Health Response to Dementia’ published today. Half of these countries are located in the WHO European Region, and the rest are divided among other regions. Yet, even in Europe, many plans are running out or have already expired, indicating the need to renew government commitment.

At the same time, the number of people living with dementia is growing according to the report: the WHO estimates that more than 55 million people (8.1% of women and 5.4% of men over the age of 65) live with dementia. It is estimated that this number will increase to 78 million by 2030 and to 139 million by 2050.

Dementia is caused by a variety of diseases and injuries that affect the brain, such as Alzheimer’s disease or stroke. It affects memory and other cognitive functions, as well as the ability to perform everyday tasks. Disability-related disability is a key driver of the costs associated with the condition. In 2019, the global cost of dementia is estimated at $ 1.3 trillion. Expenditures are projected to increase to $ 1.7 trillion by 2030, or $ 2.8 trillion if adjusted for increased care costs.

“Dementia takes away memories, independence and dignity from millions of people, but also from the rest of the people we know and love,” said Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “The world is falling apart for people with dementia, and it hurts us all. Four years ago, governments agreed on a clear set of goals to improve dementia care. But goals alone are not enough. We need to work together to ensure that all people with dementia can live with the support and dignity they deserve. ”

Greater support is needed, especially in low- and middle-income countries

The report emphasizes the urgent need to strengthen support at the national level, both in terms of care for people with dementia and in support of those providing that care, in both formal and informal settings.

Care needed for people with dementia includes primary care, specialist care, community services, rehabilitation, long-term care, and palliative care. While the majority of countries (89%) reporting to the World Health Observatory for Dementia say they provide some services in the dementia community, the supply is higher in high-income countries than in low- and middle-income countries. Remedies for dementia, hygiene products, assistive technologies, and household adjustments are also more affordable in high-income countries, with higher levels of compensation, than in lower-income countries.

The type and level of services provided by the health and social sector also determines the level of informal care primarily provided by family members. Informal care accounts for about half of the global cost of dementia, while social care costs account for more than a third. In low- and middle-income countries, most of the costs of dementia care are attributed to informal care (65%). In richer countries, the cost of informal and social care is approximately 40%.

In 2019, caregivers spent an average of five hours a day providing support for the daily life of a person caring for dementia; 70% of that care was provided by women. Given the financial, social and psychological stress faced by carers, access to information, training and services, as well as social and financial support, is particularly important. Currently, 75% of countries report that they offer a certain level of support to carers, although again these are primarily high-income countries.

A new initiative to better coordinate dementia research

A series of failed clinical trials of dementia treatment, combined with high research and development costs, has led to a decline in interest in new efforts. Recently, however, there has been an increase in funding for dementia research, mainly in high-income countries such as Canada, the United Kingdom, and the United States. The latter increased its annual investment in Alzheimer’s disease research from $ 631 million in 2015 to an estimated $ 2.8 billion in 2020.

“To have a better chance of success, dementia research efforts need to have a clear direction and be better coordinated,” said Dr. Tarun Dua, head of the WHO’s Department of Brain Health. “That is why the WHO is developing a dementia research project, a global coordination mechanism that ensures the structure of research efforts and encourages new initiatives.” An important focus of future research efforts should be to include people with dementia, their carers and families. dementia includes people with dementia “rarely” or none at all.

Good progress in awareness campaigns

More positively, countries in all regions have made good progress in implementing public awareness campaigns to improve public understanding of dementia, with strong civil society leadership. Two-thirds of the countries applying to the Observatory have run awareness-raising campaigns. Two-thirds have taken measures to improve the accessibility of the physical and social environment for people with dementia and to provide training and education to populations outside the health and social care sector, such as volunteers, police, fire services and emergency services.

Editor’s notes

The “Global Health Report on Public Health Response to Dementia” analyzes the progress made so far in achieving the global dementia goals for 2025 set out in the WHO “Global Action Plan for Dementia” published in 2017. Uses data from the 2019 World Health Assessments and Global study of the burden of disease in 2019, as well as from the World Health Observatory for Dementia (GDO). So far, 62 countries have provided data to the GDO, of which 56% are high-income and 44% are low- and middle-income. Together, these countries represent 76% of people over the age of 60. Data on issues ranging from national policies and diagnostics, treatment and care, to carer support, and research and innovation are included.

The work of the WHO on the ‘Global Action Plan for Dementia’, including the Global Dementia Observatory, is supported by the Executive Agency for Consumers, Health, Agriculture and Food (CHAFEA, Executive Agency of the European Union), the governments of Germany, Japan, the Netherlands, Switzerland and the United Kingdom and the Canadian Public Health Agency.

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2/ https://www.who.int/news/item/02-09-2021-world-failing-to-address-dementia-challenge

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