People living with dementia in India will triple to 11 million by 2050, says report
India’s burden of dementia will be much higher than what the Global Burden of Disease data shows because the problem is largely underreported in the country, neurology professor Dr Neeraj Jain said on the Lancet report.
MUMBAI: By 2050, 11.44 million people in India are expected to be living with dementia, which is up from 3.84 million in 2019, according to the Global Burden of Disease study published in the Lancet Public Health on Friday. The 197% jump in dementia will primarily be due to population growth and population ageing, but factors like smoking, obesity, high blood sugar, and lack of education of the subject will also play a crucial role, the report states.
Dementia is an umbrella term used for impaired ability to remember, think, or make decisions that interfere with everyday activities. Alzheimer’s disease- a progressive neurologic disorder that causes the brain to shrink and brain cells to die - is the most common type of dementia. Other causes include ageing, hypertension, diabetes, high cholesterol among others. Some reversible causes include side effects of medicines, vitamin deficiencies and thyroid hormone imbalance.
Globally, the cases of dementia are expected to surge by 166%- from 57 million in 2019 to 153 million in 2050. India’s anticipated dementia burden was less than other south Asian countries such as Bangladesh (254%), Bhutan (351%), Nepal (210%) and Pakistan (261%). The highest jump in cases is expected in countries such as Qatar (1926%), United Arab Emirates (1795%) and Bahrain (1084%), while the lowest increase in the burden is expected in Japan (27%), Bulgaria (37%) and Serbia (38%).
The Global Burden of Disease data is pulled from diverse data sets and sources including the censuses, registries, studies and through a network of collaborators. Medical experts from India, however, said the burden of dementia is likely to be much higher than what we know.
According to a 2020 report by the Alzheimer’s and Related Disorders Society of India (ARDSI), an estimated 5.3 million people above the age of 60 have dementia in the country.
“India’s burden would be much higher than what the Global Burden of Disease data shows,” said Dr Neeraj Jain, a neurology professor at the GS Medical College attached to the civic-run KEM Hospital. “The problem is largely underreported in India. In addition to this, the country also lacks large population-based dementia registries or studies, which makes it difficult to obtain accurate estimates of the burden or its projection.”
Dr Annu Aggarwal, a specialist in cognitive and behavioural neurology at Mumbai’s Kokilaben Dhirubhai Ambani Hospital said that the Lancet report shows us that dementia is a “looming pandemic” that is creeping in. “We are a young country and as the quality of life becomes better, people are going to live longer. We are therefore going to have a larger ageing population and an increased number of dementia cases,” she said.
A 2020 Lancet Commission has stated that 40% of dementia cases could be prevented or delayed if exposure to 12 known risk factors were eliminated — low education, high blood pressure, hearing impairment, smoking, midlife obesity, depression, physical inactivity, diabetes, social isolation, excessive alcohol consumption, head injury, and air pollution. “We should focus on these modifiable factors and gear the society and healthcare system to face this dementia pandemic,” said Dr Aggarwal, who also heads a dementia clinic at the hospital.
Dementia is common in people over 65 years but is also seen sometimes in younger people in their 50s. Medical experts say that there is a tendency to ignore early signs of dementia and most patients are brought for medical help when their disease is in advanced stages in India.
“The burden of dementia is already very high in India considering that we are a country with extremely low awareness about the condition as well as limited resources and centres to tackle it,” said Jain. “The interventions to reduce the anticipated burden should start now. Firstly, we need intensive, targeted awareness campaigns and measures to control metabolic diseases like diabetes, hypertension, obesity etc.”
The Lancet study found that improvements in global education access are projected to reduce dementia prevalence by 6·2 million cases worldwide by 2050. But this will be countered by anticipated trends in obesity, high blood sugar, and smoking, which are expected to result in an additional 6·8 million dementia cases.
“To have the greatest impact, we need to reduce exposure to the leading risk factors in each country,” lead author Emma Nichols from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington said in a statement.
“For most, this means scaling up locally appropriate, low-cost programmes that support healthier diets, more exercise, quitting smoking, and better access to education. And it also means continuing to invest in research to identify effective treatments to stop, slow, or prevent dementia.”
Nichols added that the estimates drawn by the study can be used by public health experts, policymakers and governments to make sure resources and support are available for individuals, caregivers, and health systems globally.