By 2050, nearly 150 million are expected to be living with dementia. At present 58% of people with dementia live in low and middle-income countries (LMICs), but by 2050 this will rise to 68% (ADI). Improved access to basic healthcare, decreasing fertility rates, and increasing life expectancy are some of the factors which are contributing to an aging population in countries that have had youthful populations, for the most part of their history. While aging does not cause dementia, it remains the biggest risk factor.
High-income (HI) countries such as Sweden, Australia, and Japan have had the chance to build comprehensive care programs through years of skill and knowledge development as an aging population is not a new phenomenon in these countries. While funding in research still remains a challenge to be addressed, the government is able to channel resources into ensuring that the person living with dementia is able to access high-quality care. Well-developed care programs also take the wellbeing of the caregiver into account.
The case is not the same for LMICs. In lower-income countries like Zambia, dementia is largely a taboo and social structures to support a person affected by dementia are underdeveloped. In middle-income countries like India, the World Health Organization finds that nearly 65% of healthcare expenditures are out of pocket due to a lack of welfare provisions from the state. This is not the case for all countries within this category. For example, Indonesia is one of the 27 WHO Member States which has adopted a national plan to address the economic and societal challenges of dementia. However, in general, the lack of good dementia care is largely prevalent in LMICs.
How can governments prepare to ensure that citizens are able to age well and continue to live an active and healthy life after a diagnosis?
To find an answer, SCI spoke with Dr. Alexandre Kalache, a medical epidemiologist specializing in the study of aging. A former director of the World Health Organization, he is currently the President of the International Longevity Centre-Brazil and co-President of the Global Alliance of International Longevity Centres. Dr. Kalache has worked extensively in the field of aging and related issues from both an academic and policy perspective. Together with Dr. Louise Plouffe, Dr. Kalache developed the WHO Global Age-Friendly Cities project and subsequently the Global Age-Friendly Cities Guide in collaboration with other partners. The research protocol was implemented in 33 cities around the globe (WHO).