Looming dementia epidemic in Asia

Yin Jiliang, 73, looked forward to retirement as a time when he and his wife Su Zhiying, 76, could relax and enjoy the fruits of their labour, but instead he has another full-time job--taking care of his wife, who was diagnosed with dementia in 2001. "Every morning I get up at six, and I prepare myself well before waking her up at seven. The first thing to do is to take her to the toilet. She is no longer able to use the toilet alone" says Yin. He also helps Su brush her teeth, have a wash, take a walk, eat a meal. Su is unable to do any of these things independently. "She eats very slowly, about one hour on average per meal. Sometimes I doze off sitting at the table while she has her meal," he explains. "Every night I set the alarm for 3.30 a.m. to wake her up to pee. Afterwards I often can't get back to sleep, making sleep deprivation the most difficult thing for me." Su is fortunate that her loving husband is able to take care of her, and Yin says their adult children, family and friends are sympathetic and supportive. Living in Beijing, the couple can also receive specialist care at the Dementia Care and Research Centre at Peking University's Institute of Mental Health. There Yin can tap into a network of others caring for people with dementia. [ILLUSTRATION OMITTED] "It's nice to get to know and to talk to other relatives and to be able to share experiences with them. Some relatives complain that the partners they take care of are extremely difficult to deal with. In that sense, I am lucky. My wife is the over-happy type and seldom makes any trouble" he says. China's population is ageing fast. Life expectancy in China has gone from 68.4 years in 1990 to 73.8 in 2008; combined with the one-child policy this development will lead to a massive demographic shift in the coming decades. The elderly support ratio, the number of people in the population aged 15 to 64 divided by those aged 65 and above, which was 1:9 in 2010 will become 1:3 by 2050, China's Population Research Bureau predicts. The proportion of over-65s to China's total population is estimated to rise from 7.8% in 2005 to 16.3% in 2030, according to data from the Organisation for Economic Cooperation and Development. China has recognized that dementia will be a significant problem associated with an ageing population, but current initiatives will have to be scaled up fast to meet growing demand. So far there is not even a national estimate of the burden of dementia. "There is a great challenge to get dementia on the health policy agenda, but much has been achieved in the past decade" says Dr Huali Wang, vice chair and vice secretary-general of Alzheimer's Disease Chinese (ADC). This research and advocacy organization is working to get dementia higher up on the health policy agenda. Alzheimer disease is the most common cause of dementia, but it is often used as an umbrella term for several conditions causing dementia. "Dementia care was listed as one of the priorities of mental health services in the Mental Health Plan 2002-2010 and ADC is currently working with the medical community to get it included in the upcoming Major Mental Health Plan" explains Wang. "The government has realized the burden of dementia ... but we need to take action to get a general estimate and we also need more investment in educating the media and government" she says. Chinas experience with this pressing public health issue is just one of several in Asia. Of the 35 million people currently living with dementia globally, 58% live in low- and middle-income countries and by 2050 this figure is projected to reach 71% of the total. Eastern Asia and southern Asia will see dementia growth rates more than double in the coming 20 years, Latin America will see increases of 134% to 146% and North Africa and the Middle East can expect a 125% rise, according to research by Alzheimer Disease International (ADI). …