Challenges to Dementia Care; DOC JIMMY SAYS

Article excerpt

Byline: Dr. jaime T. Galvez Tan

Dementia is a growing public health emergency and a scientific challenge to both developed and developing countries. Experts from 40 countries have recommended to the World Health Organization (WHO) the criteria for determining whether a person has dementia or not.

Each of the following should be present, making independent living difficult or impossible: (a) decline in memory (language, constructional skills, cognitive functions); (b) decline in thinking, planning, organization; (c) initially preserved awareness; and (d) decline in emotional control, motivation, personality or social behavior.

Current worldwide estimates of dementia state that one percent of the population above 60 years old will have dementia. In the Philippine Census of Year 2000, there were 4,565,560 Filipinos above 60 years old or 5.65 percent of the total population. Thus, there would approximately be 45,655 Filipino older persons with dementia.

Other estimation says that the percentage of dementia doubles for every five year cohort after 60 years old. This means that the proportion after 65 years old is two percent and after 70 years old, three percent, and so on. If this parameter is used, the current estimate of Filipino older persons with dementia is 107, 208.

I spoke to the Dementia Society of the Philippines in its First Annual Philippine Conference on Alzheimers Disease and Related Disorders last week. I mentioned to them that these estimates of dementia among Filipino older persons would be their target population. Thus the first challenge to dementia care is to determine the real extent of this condition in the Philippines. While making a survey is very expensive, the cost-efficient alternative is to establish a National Registry of Patients with Dementia.

This could start with the current patients being managed by the present membership of the Dementia Society. Then this could expand to a hospital setting wherein all of the more than 1,600 hospitals in the country can participate, using the standard criteria set by the Dementia Society. Ultimately, a community-based sourcing of patients will bring us closer to the real situation of dementia in the Philippines. A tie-up with the Department of Health, PhilHealth, the Philippine Hospital Association and Local Government Units will be needed to ensure the success of the registry.

The second challenge is to have a multi-disciplinary and multi-sectoral approach to the care of dementia. Currently the Dementia Society is a multi-specialty group of medical doctors who are neurologists, psychiatrists, geriatricians and epidemiologists. …