Systemic changes needed to promote better living for people diagnosed with the condition: expert

Improving awareness among patients on their condition, earlier and better diagnosis and improving the quality of health care form a package of solutions that will help persons with dementia, Sube Banerjee, professor of mental health and ageing, Institute of Psychiatry, and Clinical Director, Maudsley, the UK, said here on Thursday.

Showcasing the National Dementia Strategy of the U.K., Prof. Banerjee said the aim was to promote better living for people with dementia. To do this, systemic changes were required as also a vision to look ahead. Investments had to be enhanced and commitment sustained over time. The key to the success of the programme was to drive up the quality of life for those whose quality of life was poor and maintain the standard for those with a good quality of life.

Dementia is a syndrome with multiple causes that impacts daily activities, is progressive and irreversible, Prof. Banerjee pointed out. Cell death in dementia begins 30 years earlier, he said. While the exact cause is not known, it is believed that about 40,000 different interactions between the genes and the environment all contribute in some way.

Prof. Banerjee was delivering the 8th M.V. Arunachalam Endowment Oration organised by the Neurosciences India Group, on ‘Mental health for older people in the 21st century – challenges and solutions in depression and dementia.' According to the World Alzheimer's Report, there are 35.6 million people worldwide with Alzheimer's (used interchangeably with dementia); this was projected to rise to 65.7 million people in 2030 and 115.4 million by 2050. Focussing on depression as another crucial mental health issue among senior citizens, he said about 12-15 per cent of senior citizens were depressed.

“It is not a trivial illness, and yet it is the most not-treated condition.” Depression is associated with suicidal tendencies, non-suicidal deaths, excess health and social service use, profound drop in the quality of life and tremendous increase in the burden on families.

Late-life depression persists, unlike among youth, he stressed, and the chances are that older people do not spontaneously recover from depression.

There were a number of late-life factors that render adults vulnerable to depression, including physical illness, loss of family, health, home, friends, biological factors and higher degree of disability, the expert added.

M.V. Murugappan, chairman, Vellayan Chettiar Trust, and A. Vellayan, chairman, Murugappa Group and trustee of Vellayan Chettiar Trust, both kin of the late industrialist M.V. Arunachalam, in whose memory the endowment has been instituted, felicitated Prof. Banerjee.

E.S. Krishnamoorthy, honorary secretary, VHS, and director, Institute of Neurological Sciences, VHS, said India was on the brink of a demographic shift.

The 100-million strong elderly population in India today was likely to grow to 326 million by 2050.

About a third of the senior citizens have a medical disability and the question is whether the country is prepared to meet this challenge, he said.