Dementia is a significant global health challenge, impacting cognitive function and overall well-being. The World Health Organization (WHO) addresses this challenge by developing strategies and providing guidance worldwide. This effort aims to improve the lives of individuals affected by dementia and their families.
What is Dementia?
Dementia is a syndrome characterized by a decline in cognitive function beyond typical age-related changes. This decline affects various abilities, including memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgment. It is caused by brain diseases and injuries that destroy nerve cells and damage the brain over time.
The symptoms of dementia are progressive, eventually interfering with daily life and independent function. Common types include Alzheimer’s disease, which accounts for 60-70% of cases, vascular dementia, Lewy body dementia, and frontotemporal dementia. While age is the strongest known risk factor, dementia is not an inevitable part of biological aging.
The Global Burden and WHO’s Commitment
Dementia carries a substantial worldwide burden, placing significant demands on health systems and societies. In 2021, an estimated 57 million people globally were living with dementia, with over 60% in low- and middle-income countries. Projections indicate this number will rise to 78 million by 2030 and 139 million by 2050.
Dementia is the seventh leading cause of death globally and a major contributor to disability and dependency among older individuals. It also imposes a considerable economic burden; in 2019, the total global societal cost was estimated at US$1.3 trillion. This financial impact, coupled with the profound physical, psychological, and social effects on individuals and their caregivers, highlights its status as a global public health priority for the WHO.
WHO’s Initiatives and Guidelines
The World Health Organization has developed frameworks to address dementia. In May 2017, the 70th World Health Assembly adopted the Global Action Plan on the Public Health Response to Dementia 2017-2025. This plan provides a comprehensive blueprint for action across seven key areas:
- Public health leadership and governance
- Dementia awareness and friendliness
- Dementia risk reduction
- Diagnosis, treatment and care
- Support for dementia carers
- Information systems for dementia
- Fostering research and innovation
A significant component of this plan is the Global Dementia Observatory (GDO), a web-based platform launched in December 2017. The GDO monitors and collates data from WHO Member States on 35 key dementia indicators, strengthening countries’ ability to respond to the needs of people with dementia and their families. The GDO also serves as a knowledge bank, offering country and regional dementia profiles, global reports, policy guidance, and toolkits on prevention and care.
The WHO also develops evidence-based guidelines to support countries in their response to dementia. The “Guidelines for risk reduction of cognitive decline and dementia,” released in 2019, provide recommendations on lifestyle behaviors and interventions to delay or prevent cognitive decline. Guidelines also cover various aspects of dementia care, including identification, diagnosis, post-diagnostic support, non-pharmacological approaches for distressed behaviors, grief, and palliative care.
Promoting Brain Health and Care
Based on WHO recommendations, various strategies can promote brain health and reduce dementia risk. These include engaging in regular physical activity, adopting a healthy diet such as the Mediterranean diet, avoiding harmful alcohol use, and not smoking. Managing existing conditions like hypertension, diabetes, and obesity also contributes to reducing dementia risk.
The WHO emphasizes providing appropriate care and support for people living with dementia and their caregivers. This involves fostering dementia-friendly communities that empower, support, and include individuals with dementia and their caregivers. These initiatives aim to raise awareness and understanding of dementia, helping to reduce stigma and discrimination. For caregivers, the WHO has developed resources like iSupport, an online training program offering advice on care management, dealing with behavioral changes, and maintaining their own health.