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An encouraging feature of health care in India is how life expectancy has increased from 32 in 1947 to 68 today. However, this has led to new health problems, including cancer and dementia. Dementia refers to the deterioration of a person's mental faculties that frequently affects memory, behavior and thought. It is serious enough to affect the patient's daily life. Although there are many causes of dementia, the majority of which can not be treated, the most common is Alzheimer's disease. It affects about 46.8 million people worldwide, with about 9.9 million new cases a year. In India, four million people are suffering from a form of dementia, a number that is expected to triple by 2050.
We know what is going on in Alzheimer's disease, but we do not know why this is happening. Alzheimer's disease can occur in families, but it is unclear whether the trigger is its lifestyle, environment, genes, or a combination of these factors. People with cardiovascular disease are more likely to develop Alzheimer's disease. No specific test defines Alzheimer's disease; it's a diagnosis based on the clinical evaluation and exclusion of various other causes. There is an insidious and progressive decline in mental functions. These are characterized by memory loss, longer routine tasks, difficulty in planning / solving problems, lack of judgment leading to bad decisions, loss of time, difficult conversation, changes in skills, lack of judgment, lack of judgment, lack of judgment. mood and personality and an abandonment of social activities. These patients must be evaluated and studied by a neurologist and the type of dementia characterized. Although there is no cure for Alzheimer's disease, it is important to detect the disease early and take certain steps. These include the examination of structured behavioral characteristics, the establishment of routines for mundane tasks and certain medications for the management of behavioral symptoms and others. Efforts are needed to optimize their physical health, maintain their hydration and nutrition and reduce the risk of falls and infection.
Deep-rooted costs
The disease has high personal and social costs. From an economic point of view, the main cost factor is home and hospital care. Indirect costs include the loss or reduction of the patient's income and the family members who have to take care of them at home. The direct cost increases as the disorder progresses and a formal caregiver is required. These patients are frail and subject to multiple medical morbidities requiring hospitalization and expensive treatment. With further progression, the patient may need to be placed in an institution permanently (in a hospital or an institution for the elderly). The economic burden of Alzheimer's disease is estimated at $ 1 trillion (which is more than 1% of global GDP). According to a 2010 report, the economic burden of dementia in India amounted to £ 147 billion, a figure that is expected to triple by 2030. The annual cost of caring for a person with Alzheimer's disease is between £ 45,600 and £ 2,250 in urban areas and between $ 20,300 and $ 107,025 in rural areas. The cost increases with the increasing severity of the disease.
In the past, a common family structure was the backbone of social security for the elderly in India. With changing social norms, this is being replaced by nuclear families. In addition to this, government social security is minimal or non-existent and well-managed retirement homes are rare. The worsening of dementia and Alzheimer's disease is a serious threat to our social development agenda. Primary care physicians must be involved in the daily care of these patients. The role of neurologists is important in the initial diagnosis, the treatment of the patient as well as in the training and supervision of primary care physicians. A home-based caregiver workforce is needed to manage these patients optimally. Specialized institutions (other than retirement homes) providing basic care to affected people need to be developed to avoid repeated hospitalization and overload of existing health care institutions.
Health care for dementia patients must be continuous, holistic and integrated. Innovative, specific and cost-effective care models for the Indian scenario need to be developed. Copying Western models (organized rehabilitation, retirement homes and welfare institutions) would be impractical as there is no social security and no resources to meet the needs of a population as large as the population. 'India. Addressing this health problem (this impending but inevitable epidemic of dementia) will require Herculean efforts that must be undertaken now. Providing comprehensive health care for people with dementia is a social necessity. It will require the political will and sustained efforts of public health decision-makers in conjunction with health and social services professionals.
Dr. V. P. Singh is Chairman of the Board, Neurosciences, Medanta – The Medicity
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