The WHO Issues Wake-up Call: Dementia Cases Will Triple by 2050, More Family Caregiver Support Needed

Dementia - A Public Health Priority - 2012 Report issued by WHO and Alzheimer's Disease International The World Health Organization (WHO) on April 11 issued a substantial new report showing that, with populations aging, cases of dementia are expected to more than triple worldwide by 2050. The report calls upon nations to address this pandemic-size public health issue now by developing programs that “focus on improving early diagnosis; raising public awareness about the disease and reducing stigma; and providing better care and more support to caregivers.”

The new report, Dementia: a public health priority, was issued jointly by the WHO and Alzheimer’s Disease International, along with a news release on April 11, 2012.

The Burden of Dementia

“Dementia is a syndrome, usually of a chronic or progressive nature, caused by a variety of brain illnesses that affect memory, thinking, behaviour and ability to perform everyday activities. Dementia is overwhelming not only for the people who have it, but also for their caregivers and families,” the WHO explains in its report. The most common form of dementia is Alzheimer’s Disease, accounting for 60–70% of the cases, according to the report.

“The total number of people with dementia worldwide in 2010 is estimated at 35.6 million and is projected to nearly double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050. The total number of new cases of dementia each year worldwide is nearly 7.7 million, implying one new case every four seconds,” the WHO report states.

In the United States alone, over 15 million Americans are now caring for someone with Alzheimer’s dementia, 5.4 million Americans are living with Alzheimer’s, and every 69 seconds someone in the U.S. now develops Alzheimer’s, which is the 6th leading cause of death in the U.S., and the only one among the top 10 causes of death that cannot yet be prevented, cured or even slowed, according to a recent report by the Alzheimer’s Association.

“The total estimated worldwide costs of dementia were US$ 604 billion in 2010. In high-income countries, informal care (45%) and formal social care (40%) account for the majority of costs, while the proportionate contribution of direct medical costs (15%) is much lower,” according to the new WHO report.

A Call for Public Policies to Address the Impending Crisis in Care

“The estimated annual worldwide cost to society of dementia, US$ 604 billion [in 2010], highlights the enormous impact that dementia has on socioeconomic conditions worldwide. If dementia care were a country, it would be the world’s 21st largest economy,” the UN report states.

Yet, the report points out that so far, “only eight countries worldwide currently have national programmes in place to address dementia.”

These eight countries include Australia, Denmark, France, Japan, Korea, the Netherlands, Norway and the United Kingdom. The United States, under legislation signed by President Barack Obama in January, 2011, has begun the formulation of a National Alzheimer’s Disease Plan, and the President has recently announced an increase in funding for Alzheimer’s research and family caregiver support.

In an introduction accompanying the WHO report, Dr. Margaret Chan, Director-General of the WHO, said, “The need for long-term care for people with dementia strains health and social systems, and budgets. The catastrophic cost of care drives millions of households below the poverty line. The overwhelming number of people whose lives are altered by dementia, combined with the staggering economic burden on families and nations, makes dementia a public health priority. The cost of caring for people with dementia is likely to rise even faster than its prevalence, and thus it is important that societies are prepared to address the social and economic burden caused by dementia.”

“A broad public health approach is needed to improve the care and quality of life of people with dementia and family caregivers. The aims and objectives of the approach should either be articulated in a stand-alone dementia policy or plan or be integrated into existing health, mental health or old-age policies and plans,” the WHO report advocates.

“The priority areas of action that need to be addressed [by public policies and programs] include raising awareness, timely diagnosis, commitment to good quality continuing care and services, caregiver support, workforce training, prevention and research,” according to the WHO report:

  • Improving early diagnosis. “We need to increase our capacity to detect dementia early and to provide the necessary health and social care. Much can be done to decrease the burden of dementia,” says Dr. Oleg Chestnov, Assistant Director-General, Noncommunicable Diseases and Mental Health at WHO. “Health-care workers are often not adequately trained to recognize dementia.”
  • Raising public awareness and reducing stigma. “Public awareness about dementia, its symptoms, the importance of getting a diagnosis, and the help available for those with the condition is very limited. It is now vital to tackle the poor levels of public awareness and understanding, and to drastically reduce the stigma associated with dementia,” says Marc Wortmann, Executive Director, Alzheimer’s Disease International.
  • Providing more support to caregivers. “In every region of the world, most caregiving is provided by informal caregivers – spouses, adult children, other family members and friends,” the WHO release notes. A large part of the WHO’s new report is devoted to emphasizing the importance of providing additional support for family caregivers.

Urging More Support for Family Caregivers

The WHO report notes that “Dementia has an immense impact on the lives of the family, and particularly the person who takes the primary role in providing care. Most care is provided by family and other informal support systems in the community and most caregivers are women.” “However, changing population demographics may reduce the availability of informal caregivers in the future,” the WHO notes.

“The provision of care to a person with dementia can result in significant strain for those who provide most of that care. The stressors are physical, emotional and economic. A range of programmes and services have been developed in high-income countries to assist family caregivers and to reduce strain. The beneficial effects of caregiver interventions in decreasing the institutionalization of the care recipient have been clearly demonstrated,” the WHO states.

Among the specific suggestions advocated for caregiver support are:

  • Strengthening Care. The report calls for increased community-based services and “home-based support” along with further research focusing on how best to implement locally-based home care services and related resources and make them available on a broader scale.

    The report notes that people who care for a person with dementia are themselves particularly prone to mental disorders, such as depression and anxiety, and are often in poor physical health themselves. Family caregivers are in need of care-help, as well as resources to provide them respite from the caregiving role.

    “Community-based services can provide valuable support to families caring for people with dementia in both high- and low-income countries – delaying the need for people to enter into high-cost residential care. At the same time, health workforce training needs to pay closer attention to dementia, and the skills required to provide both clinical and long-term care,” the WHO states.

  • Increased Information and Education Programs for Family Caregivers. Increased information and education is needed to help family caregivers become aware of available services and resources, to develop skills needed in the caregiving role, and to develop understanding to help overcome stigma that has too often attached to dementia out of ignorance and impeded family caregivers from reaching out for the help they need. “Information and education campaigns for the public – including people with dementia, their caregivers and families – can improve service utilization by raising awareness, improving understanding and decreasing stigmatizing attitudes,” the report states.
  • Programs to Help Overcome Cultural, Language and Financial barriers. Such barriers can and do impede access to and utilization of needed care assistance, or lead to poor experience with services. “Many caregivers also suffer economically as they may be forced to stop working, cut back on work, or take a less demanding job to care for a family member with dementia,” the WHO’s release points out. Additional financial resources are needed to support family caregivers and help to compensate them for their caregiving role.
  • Involving Existing Caregivers in Designing Programs to Better Support People with Dementia and their Caregivers. “People with dementia and their caregivers often have unique insights to their condition and life. They should be involved in formulating the policies, plans, laws and services that relate to them,” the WHO states as a “key message” of its report.

“Support is needed to enable informal caregivers to be able to continue in their role for as long as possible. Support includes information to aid understanding, skills to assist in caring, respite to enable engagement in other activities, and financial support,” the WHO report concludes.

More Information

The entire new WHO report, Dementia: a public health priority, is available for download as a 112 page PDF document from the WHO’s website.

See related HelpingYouCare™ reports on:

Nearly 15 Million Americans Are Now Caring for Someone With Alzheimer’s Disease – A Number Rapidly Growing

Women Bear Heaviest Burden of Alzheimer’s Worldwide, New Survey Shows

Obama Administration Increases Funding for Alzheimer’s Research & Caregiver Support

Legal and Financial Issues for People with Alzheimer’s Disease: A NIA Resource List

September is World Alzheimer’s Month; September 21 is Alzheimer’s Action Day

New Guidelines for Diagnosis of Alzheimer’s

Stepping In for a Parent With Alzheimer’s

For more information on Alzheimer’s and dementia, see the HelpingYouCare™ resource pages on Alzheimer’s/ Dementia, including:

See also the HelpingYouCare™ resource pages on How to Deal with Difficult Elderly Behavior, including Classic Sources and more sources (continually updated) on:

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