Estimates such as World Alzheimer Report 2009 expected approximately 5.5 million people in China to suffer from some form of dementia by 2010. While these figures were adopted by the World Health Organisation (WHO) in its
2012 dementia report, they show a striking deviation from the 9.2 million dementia sufferers estimated by Igor Rudan and co-authors in a study published in The Lancet in June 2013. According to Rudan, the number of Alzheimer’s Disease and other dementia cases has more than doubled over the past 20 years (from 3.7 million in 1990).
The numbers become even more staggering when fed into the projections used by the 2009
. Extrapolating the findings, China could expect to have 19.9 million citizens suffering from dementia by 2030 and 37.8 million by 2050. The World Alzheimer Report, compiled by Alzheimer’s Disease International (ADI) and providing the most recent data prior to the work of Rudan and colleagues, estimates 11.9 million in 2030 and 22.5 million in 2050. World Alzheimer Report
The difference can, in part, be explained by the methodology and breadth of information reviewed. ADI’s conclusions were based on 25 studies conducted between 1980 and 2004. For the current study, information was taken from cross-sectional studies conducted between 1990 and 2010 using consistent methods for its multi-disciplinary analysis. Of the 12,642 reports that met the exclusion criteria, 8,477 abstracts were screened, 175 full-text articles were assessed for eligibility and 89 were included in the findings.
However, there are other factors, such as growth, demographic change and the general lack of awareness and understanding of dementia. In China,
93% of dementia goes undetected, which was found to be directly linked to a person’s socioeconomic status and whether they were urban or rural dwellers. Characteristic of low- and middle-income countries, mental and neurological disorders are not on the political agenda in China. 20% MORE THAN EXPECTED
Epidemiology of Alzheimer’s disease and other forms of dementia in China, 1990–2010: a systematic review and analysis, funded by the Bill & Melinda Gates Foundation, University of Melbourne, the National 12th Five-Year Major Projects of China and others, is the first large-scale systematic analysis of the epidemiology of dementia in a low- or middle-income country.
September is celebrated as World Alzheimer’s Month
Giving national Alzheimer associations and likeminded groups an opportunity to raise awareness, September is celebrated as World Alzheimer’s Month with this year’s focus on the care required by people with dementia. Alzheimer’s Disease International plans to publish its
the same month. World Alzheimer Report 2013
Earlier estimates in such regions have been based on few, often biased, reports. Given the lack of data, the authors suggest that the prevalence of dementia in low-income and middle-income countries is higher than previously assumed. Earlier findings might need to be revised upwards by at least five million cases, or almost 20%.
Dementia may pose the single-largest challenge to health and social care systems – both at home and in healthcare facilities. During a landmark High-Level Meeting on Non-Communicable Diseases held in 2011, the United Nations
officially recognized dementia as a significant cause of death worldwide, putting it on a par with diabetes, cancer, lung disease and cardiovascular disease. The estimated that, with global population aging, dementia is likely to have a larger economic effect than cancer, heart disease and stroke combined. World Alzheimer Report 2010
The aim of the research was “to improve estimates of the burden of disease, analyse time trends and inform healthy policy decisions relevant to China’s rapidly aging population,” Rudan and colleagues write. The authors recommend that public awareness campaigns such as World Alzheimer’s Month (see breakout box), which takes place every September, “be used to counteract common misconceptions about dementia.”
Sadly, dementia has become a normal part of the aging process. The typically long and devastating progression of the disease and long-term care required places a personal, emotional, financial and social burden on families and society alike.
A FEMALE DISEASE
The report’s findings that Alzheimer’s is more prevalent among Chinese women than men has considerable policy implications. Most dementia patients are cared for at home and women, typically the caregivers, make up 75% of the population aged 85 and older in China (UNDP). According to the study, the problem may be exacerbated by China’s “one-child policy and large internal migration, with fewer adults of working age available to provide continuing care to the millions of people with dementia, particularly in rural regions.”
These figures are daunting when one considers the requirements and economic impact of long-term institutional care for the “large number of elderly people, especially women, in rural regions living alone. Those who develop any form of dementia will be at an increased risk of becoming vulnerable and isolated, requiring community support and being dependent on government-supported care programs.
“Dementia has become one of the main causes of disability in later life. Governments need to be prepared to monitor its spread and be proactive in developing a national dementia strategy, particularly in low- and middle-income countries,” Professor Igor Rudan (University of Edinburgh’s Centre for Population Health Sciences) told PROJECT M.