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Journalism of Courage
Often data revises our viewpoint on healthy ageing like the new study showing that the number of adults in the US living with dementia could increase from approximately 514,000 in 2020 to approximately 1 million in 2060. This was more pronounced in Afro-American adults.
According to Dr (Prof) M. V. Padma Srivastava, Chairperson, Neurology, Paras Health, Gurugram, the study was not intended to be alarmist but to wake up to the possibilities of preventive health. “If you take preventive steps at the right time, 30 per cent of the dementia cases could be reduced globally,” she says. All you need is to keep your basic lifestyle markers in control like diabetes, hypertension and obesity and pull yourself out of social isolation.
How is this study relevant for India?
Our population density is so high that you have more people being diagnosed with dementia. When you talk about epidemiological factors about dementia per se, we largely look at Alzheimer’s dementia, it being a common neuro-degenerative disease. In India, we have more mixed and vascular conditions like brain stroke.
Two Lancet Commission reports from 2017 and 2024 show that one-third of dementia is preventable. And those factors are largely about fitness and nutrition from the school age. In the middle age, we need to prevent diabetes, hypertension and social isolation. But we don’t give much weightage and often diabetes and hypertension remain uncontrolled, creating conditions for the onset of dementia. Social isolation and depression worsen it.
Have risk factors changed in India?
Statistically we are number three in the dementia population, according to ICMR and Alzheimer’s Association Data.
The risk factors have increased. Apart from bearing the burden of diabetes and hypertension, more and more younger people are suffering from strokes and heart attacks. This group is, therefore, at risk of developing dementia at a later age.
In fact, this is borne out by the incidence of dementia in Blacks, who are economically backward and do not consume healthier food, one of the reasons behind their derailed health parameters. These triggers are there among us too. Besides, our healthcare delivery is dependent on a lot of variables, be it societal, economic or geographical barriers. We have advanced biomarker tests but for this we need money.
What can we do at the policy level to prevent dementia?
If we improve health literacy, basic health parameters, access to clean water, improve nutritional deficiencies like those of B 12 levels, improve thyroid functioning, build social structures so that the elderly do not feel depressed and alone, we can prevent dementia. We also need more geography-specific studies.
How can you diagnose dementia early?
Those with a family history of Alzheimer’s should be on guard and there are ways to pick it up early enough. If your family and relatives feel that you are forgetful, then it’s a red flag. However, if you feel that you are becoming forgetful, it may not be a red flag because you still have insight and it could be just minimum cognitive impairment or it could just be multiple factors like stress or sleep deprivation. But if there is a family history and you do think that you are becoming forgetful, then get yourself checked. There is a kind of preventable dementia.
Apart from memory problems, dementia is discernible from emotional profiles, executive function and language ability. Now we have better ways to pick up dementia early like blood biomarkers, lumbar puncture tests, specific imaging tests like MRI and Pet scan.
