The Scenario of Dementia in Bangladesh
The ageing population is a growing concern of the world in particular to the increasing social burden and challenges of cost associated with dementia epidemic. For Bangladesh, bearing the world’s eighth-largest population of more than 160 million, the expected number of people over 60’s is projected to be increased to 9% by 2025 and 21% by 2050.The burden of people with dementia is presumed to enhance dramatically.
It is estimated that there are about 4,60,000 people with dementia in Bangladesh in 2015 while the number will rise to 8,34,000 in 2030 and 21,93,000 in 2050 respectively. This scenario is not widely known as earmarked among the country’s population. Though WHO has given first line priority to dementia treatment and care, our government did not mention it as a health care problem at all. We hope that Bangladesh government will soon accept the reality, recognize the problem, come forward with required budget and establish specialized hospitals and build up trained physicians with support services so that dementia patients will be served best one day.
There is very little awareness and knowledge regarding dementia among the people of Bangladesh. In addition, there is stigma regarding dementia and for this reason, people with this disease do not get proper care and are isolated from the society at large.The country is facing a big challenge and everyone should come forward to address this issue in mitigating its sufferings.
Numbers of people with dementia worldwide:
As of 2013, there were an estimated 44.6 million people with dementia worldwide. This number will nearly double every 20 years, to a estimated 76 million in 2030, and 135.4 million in 2050. Much of the increase will be in developing countries. Already 62% of people with dementia live in developing countries, but by 2050 this will rise to 71%. The fastest growth in the elderly population is taking place in China, India, and their south Asian and western Pacific neighbours.
Demographic ageing is a worldwide process that shows the successes of improved health care over the last century. Many are now living longer and healthier lives and so the world population has a greater proportion of older people. Dementia mainly affects older people, although there is a growing awareness of cases that start before the age of 65. By 2050, people aged 60 and over will account for 22% of the world’s population, with four-fifths living in Asia, Latin America or Africa.
There are 7.7 million new cases of dementia each year, implying that there is a new case of dementia somewhere in the world every four seconds.
ADI’s World Alzheimer Report 2009 presents the most comprehensive global prevalence study of dementia to date and looks at levels of mortality, disability, strain on carers and dependency. The report includes estimates of the number of people with dementia in each world region.
Economic impact of dementia
The total estimated worldwide cost of dementia was US$604 billion in 2010. About 70% of the costs occur in Western Europe and North America. This figure includes costs attributed to informal care (unpaid care provided by family and others), direct costs of social care (provided by community care professionals, and in residential home settings) and the direct costs of medical care (the costs of treating dementia and other conditions in primary and secondary care).
Costs of informal care and the direct costs of social care generally contribute similar proportions of total costs, while the direct medical costs are much lower. However, in low and middle income countries informal care accounts for the majority of total costs and direct social care costs are negligible.
These costs are around 1% of the world’s gross domestic product, varying from 0.24% of GDP in low income countries, to 0.35% in low middle income countries, 0.50% in high middle income countries, and 1.24% in high income countries.
If dementia care were a country, it would be the world’s 18th largest economy, ranking between Turkey and Indonesia. If dementia care were a company, it would be the world’s largest by annual revenue exceeding Wal-Mart (US$414 billion) and Exxon Mobil (US$311 billion).
Costs of informal care (unpaid care provided by families and others) and the direct costs
of social care (provided by community care professionals and in residential home settings)
contribute similar proportions (42%) of total costs worldwide, while direct medical care costs
are much lower (16%).
Low income countries accounted for just under 1% of total worldwide costs (but 14% of the
prevalence), middle income countries for 10% of the costs (but 40% of the prevalence) and high
income countries for 89% of the costs (but 46% of the prevalence). About 70% of the global
costs occurred in just two regions: Western Europe and North America.
These discrepancies are accounted for by the much lower costs per person in lower income
countries – US$868 in low income countries, US$3,109 in lower middle income, US$6,827 in
upper middle income and US$32,865 in high income countries.
In lower income countries, informal care costs predominate, accounting for 58% of all costs
in low income and 65% of all costs in lower middle income countries, compared with 40% in
high income countries. Conversely, in high income countries, the direct costs of social care
(professional care in the community, and the costs of residential and nursing home care)
account for the largest element of costs – nearly one half, compared with only one tenth in
lower income countries.
Worldwide, the costs of dementia are set to soar. There is a tentative estimate of an 85%
increase in costs to 2030, based only on predicted increases in the numbers of people with
dementia. Costs in low and middle income countries are likely to rise faster than in high income
countries, because, with economic development, per person costs will tend to increase
towards levels seen in high income countries, and because increases in numbers of people
with dementia will be much sharper in those regions.
The World Alzheimer Report 2010 provides the clearest, most comprehensive global picture yet of the economic impact of Alzheimer’s disease and dementia.
Research shows that most people currently living with dementia have not received a formal
diagnosis. In high income countries, only 20-50% of dementia cases are recognised and
documented in primary care. This ‘treatment gap’ is certainly much greater in low and middle
income countries, with one study in India suggesting 90% remain unidentified. If these
statistics are extrapolated to other countries worldwide, it suggests that approximately 28
million of the 36 million people with dementia have not received a diagnosis, and therefore do
not have access to treatment, care and organised support that getting a formal diagnosis can
The World Alzheimer Report 2011 shows that earlier diagnosis and early intervention are important mechanisms by which the treatment gap can be closed.