Understanding Dementia: Addressing the Global Failure in Care

2023-09-21 12:19:00

Has the world failed people with dementia? The summary of what the Director-General of the World Health Organization said may be a realistic result of what dementia patients are experiencing in the world and the region, as he admitted in a previous statement that “the world is failing people with dementia, and this hurts us all. Four years ago, governments agreed on a clear set of goals to improve care for people with dementia.” Dementia, but goals alone are not enough.

Dementia deprives millions of people of their memories, independence and dignity, as memories become merely scattered pieces that are difficult to reassemble into a clear image. Many may consider this disease not a priority like other diseases, but its impact is equal in difficulty and pain to other diseases, especially when you look at the faces of those you love who do not know you.

According to the World Health Organization, more than 55 million people in the world have dementia. The largest percentage belongs to women (8.1 percent compared to 5.4 percent for men). This number is expected to rise to 78 million by 2030 and to 139 million by 2050.

As for Lebanon, according to a study – which was the first of its kind on the spread of dementia and access to health care – conducted in 2017 in the Beirut and Mount Lebanon regions, the prevalence of dementia reached 7.4 percent. Note that the prevalence of dementia in the Middle East and North Africa region ranges between 5 to 8 percent, and thus Lebanon is considered close to the highest rates in the world.

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There are many reasons responsible for the increase in dementia cases, the most important of which are increased rates of aging and prolonged lifespan, chronic diseases such as cardiovascular disease, diabetes, smoking, lack of physical activity, lack of social life, genetic factors, etc.

On World Alzheimer’s Day, the most important question was raised: What is the reality of dementia in light of crises, psychological pressures, and declining health care capacity?

Professor of Epidemiology at the Faculty of Health Sciences at the American University of Beirut, Dr. Monique Chaaya, explains to An-Nahar the details of two new studies that are underway to find out the influencing factors, to prevent them, mitigate the effects of the occurrence of the disease, or control it.

We begin with the first study conducted by the Faculty of Health Sciences at the American University of Beirut entitled “The Health of Our Elderly.” It addresses all health issues related to the elderly (over 60 years) and will include about 3,000 people residing in the Beirut and Zahle regions.

According to Chaaya, the study will collect information related to mental, mental and physical health. Based on the answers, we can know whether the person suffers from dementia. It is not possible to shed light on the disease without looking for its causes, the first of which is living more and extending life, which inevitably necessitates the emergence of greater health challenges, including Alzheimer’s disease, as 60 percent of dementia diseases are of the Alzheimer’s type.

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But what do we mean by dementia?

Chaaya explains that dementia is a group of symptoms that affect memory, thinking, and social abilities, and thus indicates a decline in the six functions of the brain, which are memory, emotions, behaviors, language, and task execution… Decline or loss of memory is considered one of the basic symptoms that accompany the disease. Alzheimer’s is the most common type of dementia.

Accordingly, the goal of the first study is to know the level of mental health of older people and how they receive health care, in addition to their social and economic status and life experiences. This will be a long-term study and will follow participants in the coming years to compare them and see how they are affected by the changes.

The study, which will be randomized, will also follow up on participants not only verbally but also physically by monitoring blood pressure, diabetes, physical measurements, walking balance, and conducting a comprehensive blood test.

As for the second study, it is titled “The Effects of Education in Old Age on Mental Ability” and its goal is to compare people who receive education or follow-up in stimulating mental ability with uneducated people or people who did not have the opportunity to learn after they grew up.

Chaaya confirms that what we need today is “more knowledge about the causative factors and how to change the mental ability of the elderly and the possibility of drawing blood from these people, which is considered an important procedure because of the indicators and evidence it carries that help diagnose the disease. We hope that the two studies will help understand the reality of dementia in Lebanon and thus raise awareness.” “On how to deal with it and contribute these experiences abroad.”

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She points out that people “do not know much about Alzheimer’s disease and have misconceptions about it, so we need to increase education and awareness and distinguish between natural mental decline as a result of aging and Alzheimer’s disease and its impact on daily life. Studies have proven that early diagnosis of the disease helps in controlling it.” The patient’s condition does not deteriorate quickly.

It is important to know that memory decline does not necessarily mean that the person has Alzheimer’s disease, but rather it must also be confirmed that there is a change in another mental function, both of which affect his daily life. Therefore, if the caregiver or the person himself is able to prevent the influencing or responsible factors (15 factors), this reduces the risk of dementia, and the most important thing is to maintain social contact for the elderly to avoid dementia or a rapid deterioration of their condition.

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