It is estimated that over 3.7 million people are affected by dementia in our country. This is expected to double by 2030. Despite the magnitude, there is gross ignorance, neglect and scarce services for people with dementia and their families. Dementia is not part of aging and it is caused by a variety of diseases. There is range of options to treat the symptoms of dementia and offer practical help to those affected.

The public awareness about dementia in India is low. It was perceived as normal, anticipated as part of aging. There is no special emphasis on dementia diagnosis and management in the training of healthcare professionals. Media interest in dementia and related healthcare issues remain low. This general lack of awareness has serious consequences.

Low awareness and the resultant low demand for services perpetuate the silent suffering of the affected people and their families. It is essential to change these state of affairs by the concerted efforts of all stakeholders with an important role for the Government.

The unprecedented pace of demographic aging of our population demands an urgent need to train our health professionals to look after older sections of the society. Health professionals trained in this country should have basic training to identify conditions like dementia and depression, two common health problems which occur in late life. Health care professionals should have necessary skills to manage common health problems affecting the older people.

ARDSI has been in the forefront to bring the attention of various Government agencies to the needs of people with dementia:

• The need to have dementia recognized as a disability of the elderly, so that they are placed on par with people from other handicaps and resources are reallocated in a more equitable manner.
• Measures to include Alzheimer’s disease and other dementias in Five Year Plan.
• National Dementia Strategy and Dementia Programmes: through Ministry of Health and Ministry of Social Justice and Empowerment
• Memory clinics at district levels for early diagnosis and management
• Grant in aid to support day care, respite care, long term care and home based care for people with dementia
• Training of medical  professionals and para professionals on dementia management

The Dementia India Report brought out by ARDSI in September 2010 was a significant step forward in the dementia care movement in the country. It is coincidental that the Ministry of Health is about to launch the National Health Care Programme for the elderly. Also the Ministry of Social Justice and Empowerment has undertaken the revision of the national policy for older persons. The National Policy on Older Persons (NPOP), which was announced in January 1999 to reaffirm the commitment to ensure the well-being of the older persons, underwent a review in view of the changing demographic pattern in the country. The review committee under the Chairpersonship of Dr. V. Mohini Giri submitted its report and recommendations on 30th March 2011.

In line with the recommendations of the Review Committee, a Sub-Group committee was constituted to view areas of intervention/necessary steps to be taken by Central and State Governments in the XII Five Year Plan (2012-17). ARDSI had the honour by inviting its Chairman Dr. Jacob Roy as a member to the sub group

The working group continued meeting on various issues related with National Policies for Older People discussing priorities for the next FYP. During the series of meetings Dr. Jacob Roy was invited to present papers on concepts and proposals for a policy on dementia - for early identification, treatment and management as well as for new initiatives for training, screening and treating dementia and its sub-groups: facilities proposed in the next FYP of the Health Ministry.

The sub group has submitted the following recommendation on care of Alzheimer’s and dementia disease:

“Dementia due to Alzheimer’s disease and other causes is one of the most serious degenerative diseases that affect the older persons. The loss of memory with advancing age is a common phenomenon. However, dementia, which is a progressive disease of the brain, affects memory, personality and intellect. Of all the dementia, Alzheimer’s disease is the commonest and the severest. Dementia makes social and occupational functioning impossible and when associated with behavioral problems, can cause severe embarrassment to the family and make caring difficult for the caregivers. As the process is irreversible, most dementias have no cure. Early diagnosis and institution of some of the pharmaceutical agents slow down the process of impairment. In view the above fact, the Sub-Group recommended setting up of one National Centre (with special facilities) for the Older Persons suffering from Dementia and Mental Diseases at New Delhi”.

Following this, proposals have been submitted to the Ministry of Health and Ministry of Social Justice and Empowerment for a series of strategies dedicated for the dementia care movement in India.

The specific activities thus designed thus designed essentially includes the following:

• Dementia awareness Camps in all the districts through talks, interactive sessions, radio / TV programmes, wall writings etc.
• Large awareness Programmes at regional level on an annual basis.
  Bi-annual training of doctors on the nuances of dementia and its efficient handling needs.
• Bi-annual training of nurses / para medical staff on the nuances of dementia and its efficient handling needs.
• Setting Up of memory clinics at each district Civil / General Hospitals.
• Setting up of four regional centres of excellence to look exclusively into Dementia related ailments.
• Setting up of a National Alzheimer’s Centre in New Delhi.

We keep waiting for the next……….