Why Tackling Inequalities in Dementia Must Be a Priority for the Decade of Healthy Ageing
By Rachelle Doody, Roche/Genentech
There is no doubt that the COVID-19 pandemic has hit the world hard, and compounded many of the health inequalities affecting older people’s lives. From loneliness and isolation, to loss of essential support and reduced access to healthcare, as well as the stress of living alongside a virus that is more likely to cause serious or fatal illness in the oldest — in 2020, no group has been more vulnerable than the older community.[1]
Long before the pandemic, the United Nations (UN) had earmarked 2021–2030 as the Decade of Healthy Ageing. This will be a decade of concerted global action to ensure everyone can lead a long and healthy life. To realise this vision, Alzheimer’s disease (AD) is one of the greatest challenges that the Decade of Healthy Ageing must tackle as part of all of our efforts to reduce health inequalities — particularly given the accelerated ageing of the population.
Worldwide, around 50 million people have dementia and this number is expected to triple to more than 150 million by 2050.[2] AD is the most common form of dementia and accounts for approximately 2/3 of all cases.[3] It induces fear for many people as they age, takes a huge toll on those who live with it, and can overwhelm those who love and support them. It also puts communities, health and social care systems, as well as societies under pressure. These pressures will be dramatically amplified if we don’t take action now.
It’s shocking that as many as ~75% of people with dementia have no formal diagnosis.[4] Behind this number are countless older people whose health issues are being overlooked or dismissed as an inevitable consequence of growing old: ‘she just has normal old-age memory loss’ or ‘his memory isn’t what it was but he still knows who we are’. It’s important that we change the way we talk about dementia and ageing as the words we use can perpetuate stigma and prevent people from seeking help.
With an early diagnosis, people can begin finding new ways to keep mentally, physically and socially active, and start planning for their future. But diagnosis usually relies on cognitive tests and expertise, and a significant number of people are only diagnosed after their disease has already advanced to moderate or severe stages when it is obvious. This means that many older people with undiagnosed AD are left without the care and support which might otherwise allow them to live with the dignity we all deserve.
There is also an urgent need for new and better therapies to enable people living with AD and other forms of dementia to preserve what makes them who they are. Our aim to achieve the Decade of Healthy Ageing’s goals is directly linked to our ability to discover effective diagnostic tools and therapies for AD and to deliver them to the people — all the people — who need them.
Stigma, lack of awareness and the belief that ageing and cognitive decline naturally go hand-in-hand may all play a part in these missed opportunities to diagnose AD earlier. If our goal is healthy ageing, we must increase awareness of dementia, educate ourselves and others about brain health, challenge stigma, and teach each other how to support someone as they age. We must create an environment in which early diagnosis and early intervention are prioritised so that each person has a chance to live a fulfilling life in the decades that remain.
Transforming Alzheimer’s requires unprecedented collaboration, and when one of us makes a step forward, we all step forward. By working together to pursue the goals of the Decade of Healthy Ageing, we can make life better for the old, the young and everyone in between.
Rachelle Doody, MD PhD, is Global Head of Neurodegeneration at Roche and Genentech
References
- COVID-19 and older adults: more support is needed. The Lancet. Vol. 25; 100532. August 2020.
- World Health Organization. Dementia. Available at: https://www.who.int/news-room/factssheets/detail/dementia. Last accessed: June 2021.
- Alzheimer’s Association. What is Alzheimer’s Disease. Available at: https://www.alz.org/alzheimers-dementia/what-is-alzheimers#:~:text=Alzheimer's%20is%20the%20most%20common,%2D80%25%20of%20dementia%20cases. Last accessed: June 2021.
- Alzheimer’s Association. 2020 Alzheimer’s disease facts and figures. Alzheimer’s Dement 2020 16(3):391+
