As India’s older population share is projected to grow to nearly 20% of the total population by 2050, a pan-Indis study reveals an alarming increase in the number of people with dementia.
The study says that at present, there are about 8.8 million people living with dementia, which is projected to reach 16.9 million by 2036. The jump is calculated on the basis of the growth of people who are 60 years of age or older. It also associates the rapid rise in risk factors like cardiovascular diseases with the jump in dementia cases.
The study
Titled, “Prevalence of dementia in India: National and state estimates from a nationwide study”, the study was published in the Journal of the Alzheimer’s Association. It states that the estimated dementia prevalence among individuals aged 60 and older in India is 7.4 per cent. “Using nationally representative data collected in India between 2017 and 2020, we found that an estimated 7.4 per cent of people aged 60 years and older live with dementia (8.8 million individuals). Dementia prevalence was found to be higher among females than males (9.0 per cent vs. 5.8per cent) and higher in rural than in urban areas (8.4 per cent vs. 5.3 per cent).”
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Lowest in Delhi, Highest in J&K
Its lowest prevalence is in Delhi at 4.5 per cent and highest in Jammu and Kashmir at 11.0 per cent. “For India as a whole, this calculation suggests an increase from 8.8 million individuals aged 60 and older with dementia in 2016 to 16.9 million in 2036,” the study says.
The prevalence of dementia among women is almost double that among men. “It is also much higher in rural than in urban areas. Finally, dementia is considerably more prevalent among individuals with lower education,” says the study.
Education and Dementia
The study finds that different levels of educational attainment across states could contribute to cross-state differences in various dementia risk factors, such as undernutrition, uncontrolled cardiovascular disease, and exposure to indoor air pollution. If prevalence stays the same, the number of people with dementia is projected to reach 16.9 million in 2036 due to the growth in the older Indian population.
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“Particularly noteworthy is the large fraction of individuals without any formal education (60 per cent), which is a known correlate of dementia,” says the study. The study was led by researchers from the University of Southern California and AIIMS-Delhi in collaboration with 18 other health and medical institutions in the country which reveals that the prevalence of dementia varies from state to state.
The study recommends that a top priority for future dementia research in India is a nationwide study of dementia incidence and its association with risk factors. It also calls for future epidemiological studies on dementia. An algorithmic classification of dementia based on neuropsychological test performance and informant reports, which have been used in other epidemiological studies of dementia, was also cited as an alternative approach to be adopted.
In 2010, the Alzheimer's and Related Disorders Society of India estimated that 3.7 million Indians had dementia and projected that this number would double by 2030.
An Urgent Need To Understand Dementia
The number doubled a decade earlier, reaching 8.8 million in 2019. “Therefore, the need to scale up policies to prevent and manage dementia in India is urgent." Researchers found significant heterogeneity across states, meaning that the burden of dementia cases is unevenly distributed across states and requires different levels of local planning and support.”
It also talks about the rapid rise in risk factors for cardiovascular disease in India that may increase dementia risk.
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“Our preliminary investigation based on cross-sectional data confirmed the existence of a strong association between education and dementia, consistent with prior literature," the study said. Researchers also emphasize the lack of education, known to be significantly associated with several other risk factors, such as uncontrolled cardiovascular disease with dementia. Therefore, the study suggests further investigation accounting for potential confounding factors is required to better understand the relationship between education and dementia.
