Q How will India effectively address the growing economic and social burden of dementia?

Q         How will India effectively address the growing economic and social burden of dementia?

Ans

Addressing the growing economic and social burden of dementia in India requires a multi-faceted approach focusing on prevention, early intervention, improved healthcare systems, community support, and national policy.

Here are key ways India can work towards effectively addressing this challenge, as outlined in the sources:

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Prioritizing Risk Reduction: Risk reduction is highlighted as the only proven prevention tool currently available, with the potential to delay or avoid nearly 40% of projected dementia cases by addressing risk factors. Governments globally are urged to fund research, education, and support services for dementia risk reduction .

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Promoting Early Diagnosis and Awareness: Early detection is asserted as important for effective care systems. However, dementia is often misunderstood in India due to a lack of awareness and cultural misconceptions, leading to delayed evaluations and diagnosis, which significantly impairs the quality of care. Promoting public awareness is essential to facilitate timely diagnosis. The majority of cases are currently identified only in advanced stages when intervention options are limited and care costs are high.

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Strengthening Healthcare Infrastructure and Training: There is a need for expanded healthcare infrastructure and professional training to address India's growing dementia challenge, including gaps in early diagnosis and treatment Training and capacity-building of health workers at all levels of the health system is essential for promoting dementia care Pre-dementia syndromes like mild cognitive impairment and subjective cognitive decline are often misdiagnosed, underdiagnosed, and undiagnosed, indicating a need for better screening strategies at the community level.

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Developing Community-Based Care and Support: Dementia care requires a holistic, public health approach with a focus on community support. Community-based care systems are needed, potentially through the development of a cadre of community-based health workers focused on the elderly, similar to the ASHA worker model. This is essential to prepare for the rapid growth of the elderly population. Lack of community-based support means public health systems could become overburdened.

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Providing Caregiver Support: Support for caregivers is emphasized as a critical area. The absence of proper support networks for caregivers greatly increases financial, emotional, and physical strain, which can lead to stress, burnout, weakened health, and influence the standard of care provided. Families suffer financially and emotionally with unplanned expenses and the demands of full-time care.

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Integrating Dementia Care into Existing Programs: There is an urgent need to develop programmes and services for dementia care under existing policies and schemes relevant to the elderly. Strengthening the National Mental Health Programme and the National Programme for Health Care of Elderly is suggested to adequately support dementia care.

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Establishing a National Dementia Policy: Experts highlight the need for a comprehensive national dementia policy to address the needs of the older population and their caregivers on a national scale. Such a policy should prioritize prevention strategies, equitable resource allocation, and integrate dementia care into both geriatric and mental health plans  . Establishing this policy requires extensive consultation among stakeholders

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Addressing Stigma and Cultural Misconceptions: Cultural factors, such as the perception that using care facilities is a failure of familial responsibility, contribute to low help-seeking behaviour and are associated with stigma. Addressing these cultural aspects is crucial for improving diagnosis and care quality.

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Creating a National Registry: A national portal or dementia registry could be a valuable resource for researchers, provided it is fully functional, ensures patient and caregiver anonymity, and contains proper medical data.

The sources underscore that India currently lacks adequate infrastructure, resources, and policies to support dementia patients and their families despite the growing crisis. The economic burden on families is substantial and projected to rise dramatically, from an estimated ₹1,18,902 crore annually for 88 lakh people presently to a staggering ₹3,08,395 crore annually for 1.7 crore people by 2036. Dementia is called a public health and economic emergency. Therefore, implementing these comprehensive strategies is seen as vital to effectively manage the challenge.