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The Hindu
26-05-2025
- Health
- The Hindu
Dementia — the urgent need for India to invest in elder care
India's population is rapidly ageing. The share of individuals aged 60 or older is expected to touch 20 crore by 2031. Estimates indicate it is then projected to increase to nearly 20% of the total Indian population by 2050. With age being a major risk factor for dementia - an umbrella term for several diseases affecting memory, other cognitive abilities and behaviour that interfere significantly with a person's ability to maintain their activities of daily living - India faces an alarming potential increase in the number of people with age-related cognitive decline. In 2023, the Longitudinal Aging Study in India (LASI) and LASI-Diagnostic Assessment for Dementia reported that the prevalence of dementia in India among individuals aged 60 and older was 7.4%, with higher rates in women and rural regions. The study estimated that by 2036, the number of cases would quadruple, touching 1.7 crore. The World Health Organization (WHO) declared dementia a public health priority in 2012 and launched a Global Action Plan on the public health response to dementia (2017 – 2025) which emphasises critical areas such as dementia awareness, risk reduction, diagnosis, treatment, caregiver support, and research. As India grapples with the challenges of a rapidly growing elderly demographic, the need for specialised elder care has never been more urgent, experts say. Currently, India has a severe shortage of resources, trained caregivers, and comprehensive healthcare systems to adequately address the needs of those suffering from dementia. The first steps: risk reduction, early diagnosis Despite advances in drug development, risk reduction remains the only proven prevention tool, Alzheimer's Disease International (ADI), the global federation of over 100 Alzheimer's and dementia associations, has warned. Calling on governments around the world to urgently fund dementia risk-reduction research, education, and support services, ADI has said that nearly 40% of projected dementia cases can be delayed or potentially even avoided by addressing risk factors. While 40 governments worldwide have so far developed national dementia plans, the proposal is yet to gain momentum in India. Asserting the importance of early detection, awareness and effective care systems, Thomas Gregor Issac, associate professor at the Centre for Brain Research (CBR) at the Indian Institute of Science (IISc) in Bengaluru, said there is a need for expanded healthcare infrastructure, professional training, and a national dementia policy. This will help address India's growing dementia challenge, which includes early diagnosis and treatment gaps, he said. Pointing out that dementia is often misunderstood in India, he said this was due to a lack of awareness and cultural misconceptions, which led to delayed evaluations and diagnosis. This in turn considerably impairs the quality of care. 'A large chunk of pre-dementia syndromes like mild cognitive impairment and subjective cognitive decline is often misdiagnosed, underdiagnosed and undiagnosed. While the thrust should be on better screening strategies at the community level, a national portal or dementia registry that is fully functional, ensuring patient and caregiver anonymity, but with proper medical data, blood test reports and neuroimaging data can be a wonderful resource for all researchers in the country working on different angles of this problem,' he said. A previous global survey by ADI revealed that a shocking 80% of the public still incorrectly believes that dementia is a normal part of ageing rather than a medical condition. 'In a value-driven society such as India, where intergenerational support and family ties are strongly embedded in cultural norms, help-seeking behaviour for dementia remains low. The idea of using care facilities or depending on care homes is often perceived as a failure to fulfil familial responsibilities and is associated with stigma. The absence of proper support networks for caregivers greatly increases the financial, emotional, and physical strain, which frequently results in stress, burnout, and weakened health, all of which influence the standard of care given to people with disabilities or chronic illnesses,' Dr. Issac explained. Community-level care P. T. Sivakumar, professor of psychiatry, and head of the Geriatric Psychiatry Unit at the Department of Psychiatry, NIMHANS, Bengaluru, said dementia care requires a holistic, public health approach with a focus on prevention, early diagnosis, comprehensive post-diagnostic support, daycare, long-term care and caregiver support. Promoting public awareness to facilitate timely diagnosis, and a dementia-friendly community with adequate resources to support care were essential, he said. Dementia care should be community-based through the development of a cadre of community-based health workers, with a primary focus on integrated health and social care for the elderly population, he said. 'Increasing the investment to promote community-based healthcare of the elderly and long-term care systems is essential to prepare for the rapid growth of the elderly population in the next two decades. The development of the cadre of ASHA workers at the community level two decades ago was one of the biggest healthcare reforms for maternal and child healthcare. It is time to develop a similar cadre of health workers with a dedicated focus on the elderly population, including for dementia care,' he said. Asserting that training and capacity-building of health workers at all levels of the health system to promote dementia care was also essential, Dr. Sivakumar said there was an urgent need to develop programmes and services for dementia care under the existing policies and schemes relevant to the elderly. 'The National Mental Health Programme and the National Programme for Health Care of Elderly should be strengthened adequately to support dementia care. States with high proportions of elderly population like Kerala, Tamil Nadu, Karnataka, Himachal Pradesh, etc. need to focus on this area,' he said. NIMHANS has launched a pilot study for Amyloid PET imaging to diagnose Alzheimer's disease, the most common form of dementia which can impair memory and significantly lower quality of life. 'A public health emergency' Ramani Sundaram, executive director of Dementia India Alliance (DIA), said despite its impact, a majority of dementia cases are identified only in the advanced stages when intervention options are limited, care costs are high, and the quality of life for individuals and their families is severely compromised. Pointing out that dementia is a public health and economic emergency, she said without early detection and intervention, India's already stretched healthcare infrastructure will bear the brunt of rising hospitalisations, emergency admissions, and long-term institutional care. Late-stage dementia care is significantly more expensive than early interventions. DIA president Radha S. Murthy said public health systems would soon be overburdened due to a lack of community-based support. 'Families suffer financially and emotionally with unplanned expenses and the demands of full-time care,' she added. According to a study published in the Indian Journal of Public Health in 2013, the cost of dementia care in India in 2010 for 37 lakh people was ₹23,300 crore annually. It was estimated that at present, families of 88 lakh people with dementia would be spending about ₹1,18,902 crore annually to take care of their kin. Based on current projections, the economic burden on households to take care of 1.7 crore people with dementia by 2036, would be a staggering ₹3, 08,395 crore annually, experts pointed out. Despite this growing crisis, India continues to lack adequate infrastructure, resources, and policies to support dementia patients and their families. Also Read: Indian Institute of Science researchers highlight India's need for national dementia policy with focus on cultural factors Need for a comprehensive policy A recent paper by researchers from CBR highlighted the need for a comprehensive dementia policy in India to address the needs of the older population and their caregivers on a national scale. This policy should prioritise effective dementia prevention strategies and equitable allocation of resources, incorporating evidence-based approaches. The policy should also integrate dementia care into both geriatric and mental health plans, stated the paper published in The Lancet Psychiatry in January this year. Establishing such a policy, the paper noted, required extensive consultations among various stakeholders and organisations, including government bodies, healthcare professionals, researchers, and individuals living with dementia and their caregivers.
Economic Times
21-04-2025
- General
- Economic Times
Passenger offers seat to elderly man on bus, walks away with a life-changing lesson
A Reddit user shared a touching story about offering his bus seat to an elderly man, who later revealed he hadn't spoken to anyone in four days. The encounter sparked deep reflection on loneliness and human connection. The story resonated widely online, prompting healthcare workers and others to share similar experiences of how simple gestures can profoundly impact lives. Tired of too many ads? Remove Ads A Conversation That Changed Everything Tired of too many ads? Remove Ads Shared on Reddit, the story sparked heartfelt responses about loneliness, empathy, and the quiet struggles many elderly people face daily. The Internet Responds: 'This Happens More Than We Know' A Glimpse into Lives We Overlook More Than Just a Seat Tired of too many ads? Remove Ads A Silent Crisis: The Hidden Scars of Elder Abuse Type of abuse among older adults in India (n=1,002), Longitudinal Aging Study in India wave 1, 2017-2018 ( Originally published on Apr 19, 2025 ) It was just another ordinary commute home for a worn-out officegoer. Drained from the day's chaos and barely in the mood for small talk, the individual boarded a crowded city bus, eyes scanning for a place to sit. Fortune favored them—one empty seat beckoned, and they sank into it the stillness of that moment was soon interrupted when the bus stopped again. An elderly man boarded, frail and tired, barely managing to steady himself amidst the jostling crowd. The writer of a now-viral Reddit post on r/self didn't hesitate—they stood up and offered the old man their seat. He accepted with a smile that spoke happened next, however, was far more impactful than the seat elderly gentleman, perhaps moved by the kindness or simply grateful for a moment of human connection, began to speak. It started off light—questions about work, life, the usual polite exchange. But somewhere between stops and stories, the conversation took a deeply human turn.'I haven't spoken to anyone for four days,' the man confessed, his voice quiet but clear. 'I just needed someone to listen to me.'That single sentence hit the young commuter like a wave. Silence fell between them, but not the awkward kind. The kind that held weight. The kind where listening was more powerful than any he stepped off the bus, the young commuter simply listened. Not because they didn't know what to say—but because they realized that maybe, that was all the man really story resonated deeply across Reddit. Healthcare workers and audiologists chimed in with their own encounters with the elderly—people who booked appointments not for treatments, but simply to talk. As one former audiologist shared, 'I'd check the hearing aid, find it working fine within five minutes, and then spend the rest of the session listening to them talk about life, love, and loss.'Another healthcare worker noted how older patients often become the most expressive, craving laughter and attention because they're often starved of both. 'They may not see anyone else the entire day,' the comment read. 'So I always try to make them laugh at least once.'A more philosophical Redditor summed it up poignantly: 'We're pack animals taught to survive in isolation. It makes for a lonely world full of lonely people.'One especially moving comment described a conversation with a woman nearing 100. She had outlived her friends, her family was distant, and her body was slowly giving up. Blind in one eye, losing grip strength, barely able to move from bed to chair to toilet—she had only one wish left: to be done with it all. Yet, despite her physical decline, her mind remained sharp, her wit stories like these that reveal how age often strips away the social scaffolding people once leaned on. What remains are minds full of memories and hearts still yearning for wasn't a grand act of heroism. No medals were handed out. But for one elderly man and one weary commuter, a few minutes on a city bus became a life lesson in a world moving at lightning speed, where conversations are replaced with scrolls and likes, a moment of old-school humanity—offering a seat, lending an ear—can be next time you're in a hurry, or just tired from the day, remember: sometimes, the smallest gestures reveal the biggest truths. And sometimes, giving up your seat on a crowded bus might just open the door to a story you'll never acts of kindness toward the elderly warm the heart, a deeper, disturbing reality often goes unnoticed. According to a 2018 study published in the National Library of Medicine, 5.2% of Indian adults aged 60 and above reported experiencing abuse in the year prior to the survey, with 3% suffering mistreatment within their own households. Verbal abuse was the most prevalent, while neglect afflicted nearly half—47.5%—within homes. Emotional abuse was also alarmingly high, affecting over one-third of elderly individuals. These findings underscore a grim truth: loneliness is only one of many battles our seniors quietly endure.
