Dementia sufferers must not be left behind
China's advances in public health have resulted in a significant increase in life expectancy, which has gone from under 60 years in the 1950s to 73 today. However, this improvement has also resulted in increasing numbers of senior citizens - and a corresponding rise in some of the diseases prevalent in that age group, such as different kinds of dementia, notably Alzheimer's.
It has been estimated that there are more than 35 million people worldwide living with dementia. Those figures are expected to double in 20 years and hit 115million by 2050. According to a 2009 report, China had 5.3million people living with Alzheimer's. Such figures make Alzheimer's and other kinds of dementia one of the most significant health and economic crises of the 21st century.
The economic impact of dementia on countries is not sufficiently appreciated. According to statistics from Alzheimer's Disease International, the estimated worldwide total cost of dementia was US$604billion in 2010. Those costs will soar in the next few decades. The organisation estimates that, by 2030, costs will increase by 85per cent, based on the predicted numbers of dementia sufferers.
The China Alzheimer's Project estimates that 75per cent of urban patients have not been diagnosed properly. The proportion in rural areas is probably higher. At present, only top hospitals can provide comprehensive diagnosis and treatment of Alzheimer's.
The Chinese organisation reports that there are too few physicians experienced to deal with this kind of disease, and estimates that China is short of 10million caregivers for the elderly. Several situations hinder more rapid progress, among them the low level of public health education and the lack of state health-research projects.
Access to affordable health care is a serious problem, particularly in rural China. It is compounded by a lack of care by relatives, many of whom have to migrate to urban areas in search of jobs.
The government is now educating the public about dementia, and big cities like Shanghai have developed plans to build new facilities. However, there are still challenges. A main one is who will pay for professional care; the social safety net is weak and commercial insurance does not cover the disease or non-hospital nursing care.
Alzheimer's Disease International recommends that every country have a national dementia strategy, promoting early diagnosis and intervention, while at the same time developing primary care services to be able to make a provisional diagnosis. In China, with one of the fastest ageing populations, the sooner the challenge is faced, the better.
Dr Cesar Chelala is an international public health consultant