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Dementia from a Global Perspective

How Do Developing Countries Approach the Disease?

May 17, 2009 Jeffrey Donaldson

Dementia is a neurological disease which annually affects more than 24 million people globally. This article explores the challenges of treatment in developing countries.

This article reviews a section from a 2006 World Health Organization (WHO) report entitled "Neurological disorders: public health challenges."

For more information regarding the general phenomenology of Dementia, see "Dementia: Risk Factors, Difficulties, and Treatment" at Suite101.com.

Scarce Resources Become Scarcer

In developing countries, such as India and Latin America, WHO has found that health services generally are not well prepared to deal with Alzheimer's Disease or other forms of Dementia. Neurologists, Psychiatrists, Gerontologists, and Psychologists are rare in these countries, leaving the General Practitioners (GP). GPs at government operated clinics are focused on providing care for acute illnesses and injuries, and do not treat long term, chronic illnesses such as Dementia.

As a result of the relative unresponsiveness in government clinics , individuals seeking treatment for their elderly parents suffering Dementia rely increasingly on private medical services. These private services are far more expensive, and medications are often difficult to access for all but the richest families.

Challenges Resulting from Increasing Education for Women

As more women in developing countries such as India pursue higher education and more frequent employment outside the home, elderly parents will receive less direct care from their family members.

Challenges Resulting from Increased Migration

In such countries as Ghana, where two million citizens have left the country to seek better economic opportunities in foreign countries, 63% of elderly parents lost their primary means of support. After a war or a natural disaster (such as an earthquake or typhoon), elderly people are particularly vulnerable.

Challenges Resulting from Declining Fertility

In countries such as China which restrict birth to one child, more elderly parents are left with little support, as traditionally the daughters care for the parents of their husbands rather than their own parents.

Challenges from Increased Morbidity and Mortality

In regions such as Sub-saharan Africa, deaths from HIV/AIDS has resulted in many elderly parents losing their only means of support, as orphaned children would.

How Can Doctors in Developing Countries Become Better Trained to Treat Dementia?

WHO recommends that GPs in developing countries shift the focus of their training. They recommend that the doctors spend more time in their curricula learning about diagnosis and needs based assessment of brain diseases.

WHO also suggests a shift in focus from care which is strictly oriented toward immediate, acute illness and injury to a focus which includes long term support and management of chronic diseases. WHO also recommends that countries develop outreach care, so that individuals may receive treatment in their own homes.

Without a reorientation of priorities and a development of strategies and policies, the health care systems of these countries will necessarily devote an ever-increasing proportion of their budgets to caring for the elderly, as the elderly will develop far more acute illnesses and injuries without better care for their immediate Dementias.

The copyright of the article Dementia from a Global Perspective in General Medicine is owned by Jeffrey Donaldson. Permission to republish Dementia from a Global Perspective in print or online must be granted by the author in writing.

Dementia is a worldwide problem