Dementia:
Dementia is a general term that describes a pathological state related to the deterioration of the brain functions because of a different set of diseases such as Alzheimer, or exposure to a series of strokes.
Dementia is associated with a wide range of symptoms, such as the decline of memory and thinking skills, in addition to other symptoms so severe that they reduce the individual's ability to perform daily activities.
While dementia is one of the most important reasons which lead to the injury of elderly people with disability and losing their independence all over the world, it is not a natural part of aging. Dementia also has physical, psychological, social and economic effects on care providers, the families, and the societies. This increases the complexity of the process of developing more effective services.
Alzheimer's disease ranges between 50 and 60 percent of the cases of dementia, while vascular dementia (which appears after a stroke) is the second most common form of dementia.
Facts about the disease:
A new case of dementia is diagnosed every three seconds in the world.
There are about 50 million persons suffering from dementia in the world, and 10 million new infections appear every year.
Alzheimer's disease is the most common form of dementia and may contribute to 60 to 70% of cases.
Dementia is one of the most important reasons that lead to the injury of the elderly people with disability and losing their independence all over the world.
Dementia usually affects elderly people, but we are witnessing early awareness of the early symptoms of dementia which appear before the age of 65 years.
Dementia has physical, psychological, and social impacts on people suffering from it, on their caretakers, family members, and the whole society.
Based on the report of the Population Division of the United Nations for the year 2017, it is estimated that the number of people suffering from dementia among those aged 60 years and over in the State of Qatar is more than 4400 persons. It is expected that this number will increase by about ten times, as more than 41,000 persons are expected to develop some form of dementia by 2015 In the event of failure to reach a cure or improve the means of prevention.
Risk factors
Aging is considered the main factor which increases the risk of developing dementia, but dementia does not affect only the elderly people, in addition, it is not considered a part of the natural progression of age (Natural Aging).
Early cases of dementia (when the disease symptoms appear before 65 years of age) represent 9% of the total number of patients.
Some research indicates that cognitive impairment may be caused by common risk factors with some other chronic non-communicable diseases. Some of these factors are the lack of physical activity and obesity, having unhealthy diets, smoking and excessive drinking of alcohol, diabetes, and high blood pressure which begins in the middle of age.
In addition to depression, low level of education, social isolation and cognitive laziness, all of these factors increase the risk of developing dementia, but they are subject to change and can be controlled.
Global Plan of Action to Combat Dementia 2017-2025
Vision
A healthy world helps prevent dementia disease and ensures that the patients with dementia and those who care for them get what they need from support and care to live a decent life, enjoy their abilities and potentials, and respect their dignity, independence and their right to equality.
Target
To improve the lives of persons suffering from dementia and those who care for them and their family members, and reduce the impact of dementia on them, and on the societies and countries in general.
Work Areas of the World Observatory of Dementia
The current status of the disease in Qatar
The working group on Dementia looked over the strength and weakness points (the internal environment), besides the opportunities and risks (the external environment) related to dementia in Qatar.
Strength points:
- A national commitment to design and implement a national plan on dementia.
- National consensus on the necessity of developing an effective and organized pathway for caring for dementia patients.
- The existence of a working group on dementia with a high degree of efficiency and motivation. This contributes to raising public awareness and providing the necessary support to develop a plan on dementia.
Weakness points:
- Diagnosis of dementia and the stigma surrounding it.
- No information is currently available on the infection rates and prevalence of dementia, how the services are used, and the level of requests which have not been met.
- There is a single clinic in Qatar that specializes in memory disorders, while there are other departments in Hamad Medical Corporation and some private sector providers providing diagnostic services of dementia, but they lack coordination and unification.
- The lack of supportive services for the patients and their families such as daycare centers for dementia patients.
Opportunities:
- The early diagnosis contributes to improving the quality of patients' life and their caregivers.
- The State of Qatar is a member of the WHO World Observatory of Dementia.
- Dementia was included in the National Health Strategy 2018-2022.
The risks:
- There are challenges at the level of coordination between the different health and social sectors.
- Coordination challenges between the various health and social sectors.
- Lack of special legislation for Dementia.
- A shortage of trained manpower to deal with Dementia patients.
The Seven Work Areas in Qatar
Although nearly 50 million persons in the world suffer from Dementia, yet only a few countries initiated developing national plans for Dementia. The State of Qatar is one of those few developed countries and the only Arab country which has developed a national plan for Dementia.
The National Plan for Dementia aims to outline the future vision framework of the services provided to the people with dementia, their families and their caregivers, through increasing the public and professional awareness of Dementia, stressing the importance of diagnosis and intervening early, in addition to improving the therapeutic methods and healthcare after diagnosis.
It is expected that the improvement of all services helps enhance the quality of life of people suffering from Dementia, their caregivers and their families in the State of Qatar.
This plan includes the seven work areas which would improve the areas of Dementia patients' care, which will have a direct impact on improving the quality of care.
The Qatar National Plan revolves around these seven areas stipulated in the comprehensive plan of action developed by the World Health Organization for Dementia and the World Observatory of Dementia.
The seven work areas:
Implementation, Monitoring, and Evaluation
This plan will be implemented in the upcoming four years; this will trigger human and financial investments as well as joint planning between different government ministries. The plan includes workers in areas of health care, social care, and civil work institutions, in addition to people with dementia, their families and their caregivers.
The Ministry of Public Health's main role is checking the availability of the necessary resources to implement and push forward the plan, along with continuously monitoring its effectiveness and feasibility. A number of task forces to be appointed will be responsible for the implementation, monitoring, and evaluation, each task force will be appointed one of the areas mentioned.
The National Officer in charge of the population group who is part of "Healthy Aging" initiative (Qatar National Health Strategy 2018-2022) is the main coordinator of the plan, he is keen to implement the communication strategy and the necessary media program.The Task Force working on Healthy Aging, in coordination with the Dementia Task Force (the Global Observatory of Dementia), is responsible for checking that implementation and support take place. Persons affected by the disease, their caregivers, and their family members participate directly in all stages of the implementation of the plan.An external consultant is responsible for conducting the evaluations every six months, he submits the results report to the lead group at the Global Observatory of Dementia and the Ministry of Public Health.
The priorities of the Qatar National Dementia Plan
First and Second years:
- Launching Qatar National Dementia Plan (2019-2018)
- Establishing the national pathway for the care of dementia patients
- Establishing national guiding principles for dementia
- Allocating a budget for national programs and campaigns aimed at spreading awareness of dementia
- Creating educational and training programs about dementia for workers in the health and social care sectors
- Commencing the establishment of a multidisciplinary center for memory assessment (a center with a dedicated budget where a team of physicians work, they specialize in geriatrics and nervous system medicine, the center would have psychiatrists to take care of the elderly, neuropsychiatrists, occupational therapy specialists and social workers)
- Development of a national dementia database
- The establishment of Qatar Society / Association of Caregivers for Dementia Care
- Launching the Dementia Risk Reduction Program in accordance with the strategies of reducing the risk of chronic non-communicable diseases
- Working on establishing units in the hospital's internal department that would be equipped and specialized in dealing with dementia patients
- Establishing care centers for people with dementia, and providing support services for dementia caregivers and caretakers.
- Launching dementia-friendly programs and assets in coordination with the World Health Organization to make Qatar a friendly country for the elderly
- Measuring progress based on specific indications
Third and Fourth years:
- Continuing the creation of an interdisciplinary center for memory assessment
- Making a Legislative framework to support and protect the rights of people with dementia (by forming a group of specialized experts)
- Establishing centers for evaluating the driving ability
- Designing and conducting a comprehensive aging evaluation for all elderly people in health care facilities (in line with the HA-05 Health Aging Initiative as part of the National Health Strategy 2022 - 2018)
- Making dementia research a priority in Qatar.