Dementia challenge in India

Addressing risk factors could reduce dementia cases by 40%: report

The steady decline in India’s Total Fertility Rate (TFR) has led to an increase in the proportion of older adults. As of 2019, India is home to over 139 million people aged 60 and above, accounting for more than 10% of the population. By 2050, the percentage of elderly people is projected to double to 19.5%, with 319 million individuals over 60. 

Demographic Shift and Public Health Challenge

• Aging Population: India has over 139 million people aged 60 and above, accounting for more than 10% of the population. This number is projected to double by 2050 to 319 million (19.5% of the population).
• Decline in Total Fertility Rate (TFR): TFR has decreased from 5.2 in 1971 to 2.0 in 2020. The replacement level of fertility (2.1) is exceeded only in five states: Bihar (3.0), Meghalaya (2.9), Uttar Pradesh (2.4), Jharkhand (2.3), and Manipur (2.2).

Growing Risk Factors for Dementia

• Modifiable Risk Factors: Air pollution, hypertension, traumatic brain injury (TBI), and obesity.
• Prevalence Increase: Obesity rates have increased from 21% to 24% among women and 19% to 23% among men nationally between NFHS-4 and NFHS-5.
• Social Isolation: Older individuals with disabilities are more prone to living alone, exacerbating social isolation and deprivation.

Policy Reforms and Interventions

• Lancet Commission’s Recommendations: Up to 40% of dementia cases may be preventable by addressing modifiable risk factors.
• Public Health Initiatives: Promoting healthier lifestyles, early detection, and timely intervention.

Key Strategies to Address Dementia

1. Air Pollution: Implement stringent air quality regulations, sustainable urban planning, cleaner transportation alternatives, renewable energy promotion, and air quality monitoring.
2. Hypertension and Obesity: Nationwide awareness campaigns, regular exercise, balanced diet, weight management, and strengthened primary healthcare services for early detection and treatment.
3. Traumatic Brain Injury (TBI): Public safety measures, road, occupational, and sports safety, and awareness of TBI’s long-term consequences.

Investment in Healthcare Infrastructure

• Specialized Dementia Care: Establish facilities and train healthcare professionals in geriatric care focusing on early detection, intervention, and management.
• Research: Invest in understanding the links between risk factors and dementia to develop effective interventions and treatments.
• Public Awareness: Increase understanding of dementia and its risk factors, encouraging proactive cognitive health measures and creating a supportive environment for those affected.

Government Initiatives

• National Programme for Health Care of the Elderly (NPHCE)
• Health and Wellness Centres (HWCs) under Ayushman Bharat
• National Policy for Senior Citizens 2011

Significance for UPSC Preparation

• Prelims Focus: Understand demographic trends, public health challenges, and government initiatives related to the aging population and dementia.
• Mains Focus: Analyze policy measures, the role of public health infrastructure, and strategies to mitigate risk factors for dementia. Evaluate the effectiveness of current government programs and suggest improvements.

Important Points for Essays and GS Papers for UPSC Exam: 

• Essay Topics: “Aging Population and Public Health Challenges in India,” “Preventive Strategies for Dementia: A Public Health Perspective,” “The Role of Public Health Initiatives in Managing Age-Related Diseases.”
• GS Paper I (Society): Demographic trends, impact on society, and social issues related to the elderly population.
• GS Paper II (Governance): Government policies and programs for elderly care, public health initiatives.
• GS Paper III (Science and Technology): Role of technology and innovation in healthcare for the elderly, research in neurodegenerative diseases.
• GS Paper IV (Ethics): Ethical considerations in elderly care, societal responsibility towards aging population.

Conclusion

A comprehensive and proactive approach addressing the demographic shift, modifiable risk factors, and enhancing healthcare infrastructure is essential to mitigate the impending dementia crisis in India. Effective implementation of government programs and increased public awareness are crucial steps towards ensuring the well-being of the aging population.