by Elsabe Brits
Alzheimer’s disease is the most common cause of dementia. Dementia is a general term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life. Alzheimer’s is the most common cause of dementia.
Recently ,the The Lancet Public Health published the first comprehensive analysis which forecasts dementia prevalence in 204 countries and territories. By 2050, 153 million people are expected to be living with dementia worldwide, up from 57 million in 2019, largely due to population growth and population ageing.
Dementia cases will rise in every country, with the smallest estimated increases in high-income Asia Pacific (53%) and western Europe (74%), and the largest growth in north Africa and the Middle East (367%) and eastern sub-Saharan Africa (357%).
South Africa’s figures do not look promising – the estimate is a rise of 181% by 2050, which is not so far in the future.
However, it is suggested that up to 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.
Apart from these 12 risk factors – all of which needs addressing, South Africa is currently lacking enough affordable dementia and frail care facilities for those who need them. it is worth remembering how we take care of the most vulnerable in our society speaks volumes of who we are. We often focus much attention on the other phases of life and neglects old age and its diseases, as if we will miraculously escape it.
Globally, more women are affected by dementia than men. In 2019, women with dementia outnumbered men with dementia 100 to 69. And this pattern is expected to remain in 2050.
It’s not just because women tend to live longer. There is evidence of sex differences in the biological mechanisms that underlie dementia. It’s been suggested that Alzheimer’s disease may spread differently in the brains of women than in men, and several genetic risk factors seem related to the disease risk by sex.
In a very insightful article in BMC Geriatrics the researches states that South African elder care policy places a strong emphasis on ageing in the community rather than institutional settings, but the primary healthcare system is not geared to address the health needs of older people living in community settings. They interviewed focus groups of older patients to hear their experiences. See https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-019-1116-0
South Africa has the highest proportion of elderly people in its population in the African region (8.7%) and the number of people over 60 is expected to increase from 4.1 million in 2011 to over 15 million in 2030.
For older people to remain functional and active participants in their communities, their specific health needs need to be considered by the healthcare system. This study above has shown that the healthcare system in Cape Town (and likely the rest of the country) underserves older persons, who have negative perceptions of the care they receive.
Care is heavily focused on ‘processing’ patients and patient’s individual needs and concerns are overlooked, leading to non-compliance with treatment. This leads to sick patients.
We need to take better care of the elderly.