2009 World Alzheimer's Report
21 September 2009
The number of people with dementia and Alzheimer’s will nearly double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050, according to the 2009 World Alzheimer’s Report prepared by researchers at King's. More than 35 million people worldwide will have dementia in 2010. The new report is released on 21 September, which is World Alzheimer’s Day.
The 2009 report, published by Alzheimer’s Disease International (ADI), was prepared by a research team headed by Professor Martin Prince from the Institute of Psychiatry at King’s College London. It covers the global prevalence of dementia, the impact of dementia worldwide, and a detailed analysis of the challenges faced by governments and healthcare systems worldwide.
The updated figures for the numbers of people with dementia worldwide represent a 10 per cent increase over the previous global dementia prevalence reported in 2005 in The Lancet. This change is driven mainly by new information from recent studies in low and middle income countries. The proportions of older people affected are now significantly higher than previously estimated for three world regions: South Asia (5.7 per cent vs. 3.4 per cent), Latin America (8.5 per cent vs. 7.3 per cent) and Western Europe (7.3 per cent vs. 5.9 per cent). The proportion in East Asia is lower (4.98 per cent vs. 6.46 per cent) and in North America effectively identical.
Increases over the next 40 years in the number of people with dementia will be much steeper in low and middle compared with high income countries. As a consequence, while the researchers found that 57.7 per cent of people with dementia in 2010 live in low and middle income countries, this will rise to 70.5 per cent by 2050.
The costs of caring
The report highlights that, among older people, dementia makes the largest contribution of any of the chronic diseases to disability and needs for care. The need for long term care is the main driver for the societal cost of dementia, estimated at $315 billion per year worldwide. In high income countries, the cost of community care and of supporting people in care homes accounts for a large proportion. In all world regions family carers subsidize society through their unpaid contributions, while themselves incurring costs due to lost opportunities to work, and hiring additional paid carers.
Professor Martin Prince comments: ‘Caring is a full time job – an average of around eight hours per day for a relative with moderate to severe dementia. In all parts of the world, carers, who are most commonly female and the spouses or children of the persons with dementia, often experience high levels of strain. Studies reviewed in the new report suggest that half to three quarters of carers have significant psychological illness, while up to a third have clinical depression. While these numbers are staggering, the current investment in research, treatment and care is actually quite disproportionate to the overall impact of the disease on people with dementia, their carers, on health and social care systems, and on society.’
Marc Wortmann, ADI’s Executive Director, adds: ‘The crisis of dementia and Alzheimer’s can no longer be ignored. Unchecked, Alzheimer’s will impose enormous burdens on individuals, families, health care infrastructures, and the global economy. There is hope yet, if action is taken now to fund improvements in dementia care services, and to increase investment in research. Australia, France, Korea and England have developed national Alzheimer’s action plans, and several more are currently in development.’
In order to tackle the challenges faced by governments and healthcare systems worldwide, the report offers eight global recommendations based on the findings. Crucially:
The World Health Organization, and governments worldwide, need to declare dementia a global health priority.
Awareness raising is needed worldwide.
High income countries should be aiming for comprehensive, integrated, high quality services, meeting the needs of patients and carers at all stages of the illness.
In low and middle income countries the focus should be upon first strengthening the capacity of primary care to diagnose and treat dementia, and to provide long term advice and support to carers.
Full 2009 World Alzheimer’s Report: http://www.alz.co.uk/research/worldreport/