Not unlike my friends who traveled to foreign locales and researched various subjects impacting global health, I spent the summer in the exotic, scenic waterfront city of…Baltimore…working on memory disorders research. My project focused on developing a numerical rating scale for assessing and quantifying dementia severity. The current standard clinical rating scales rely heavily on memory, where Alzheimer’s commonly reveals itself first; however, there are a whole host of functional domains – orientation, behavior, language, judgment – that commonly manifest descriptive symptoms of cognitive decline. By measuring the disease progression in some objective way, we can record the natural history of disease and develop further therapeutic or management strategies.
How is this relevant to global health, you may ask.
Well, as Atlas and Axis’s self appointed geriatrics correspondent and honorary senior citizen, I wanted to draw your attention to a recent study on the global cost of dementia, “The World Alzheimer Report 2010” issued by Alzheimer’s Disease International. The study features staggering statistics for the global economic and epidemiologic impact of dementia over the next 20 years.
Alzheimer’s is the most common and most well-known form of dementia, though there are numerous types of dementia that affect memory, executive function and comportment. Fatal and progressive, dementias can cause cognitive deficits that come to interfere with daily life and functioning, such as the ability to make simple decisions, to recognize family members or to dress oneself. In the moderate to severe stages of disease, patients become completely dependent on caregivers, leading to stress and depression for patients and caregivers alike.
In 2009, there were an estimated 35.6 million people living with dementia global, and this number is expected to double by 2030. (Americans account for 5.3 million of these patients). Alzheimer’s and other dementias are not simply diseases of high income countries; these diseases are prominent in such low and middle income countries as Cuba, Dominican Republic, Mexico, India, China, and Peru.
Not surprisingly, the societal burden of disease is matched by an economic burden. This year, the global cost of dementia is estimated to exceed $604 billion, surpassing the annual revenue of Walmart ($414 billion), for example. On an individual level, the average cost of caring for an Alzheimer’s patient is anywhere from $18,000 to 77,500 per year. Though many scientist, healthcare practitioners and physicians have devoted themselves to the study of the disease, there is currently no cure for Alzheimer’s disease.
Sadly, the impact of dementia is often unnoticed and its onset attributed to “old age” or “senility.” With worldwide life expectancies increasing and the 65 and over population rising sharply in the next few years, the elderly are becoming an underserved and overlooked population. I know that my miniscule research project will not remove the social and economic difficulties of dementia, nor will it move us closer to a cure, but I hope that, in some small way, we can gain a better understanding of the global picture of dementia.
