Alzheimer's disease, which is primarily an age-related dementia, is still not seen as a public health issue.
The neuro-degenerative disease had many times been interpreted as a mental health problem because of the behavioural changes in a patient. There is no policy on dementia, perhaps, because of the lack of prioritisation, says S. Shaji, president of the Kochi chapter of the Alzheimer's and Related Disorders Society of India (ARDSI).
With demographic transition bringing in negative dividends owing to the rise in the number of elderly as a proportion of the population in Kerala, policies and programmes should have been in place in the public health domain long ago to address age-related ailments such as Alzheimer’s Disease, says Dr. Shaji, who had taken up at least two studies on the subject between 2000 and 2008 for ARDSI.
The causes of dementia are yet to be mapped fully. Studies so far have shown about 140 medical conditions as causative factors, the condition in almost 65% of the affected population being attributed to Alzheimer’s Disease. Vascular dementia, resulting from diabetes and hypertension, comes in second. If a person displays at least seven cognitive problems that affect his or her normal life, the condition is termed dementia.
Scientific information about the disease continues to lag, though the general information level is much higher than it was, say, two decades ago. Prevalence of the disease ranges between 3.5-4.5% of the population and reporting in clinics has increased. The increased case reporting has also brought out the disturbing trend of a 10-15% rise in the incidence of the disease among the younger age group. Late onset of the disease is seldom detected early as most cases come into the clinical ambit when the disease would have reached moderate levels with clear-cut symptoms.
At this stage, management of the patient becomes difficult because of increased forgetfulness, personality changes and confusion about the immediate environment. Hospital-based intervention is also difficult and costly. Home carers are not too many, which means persons with dementia and their families continue to suffer in isolation.