KKN Gurugram Desk | Dementia, a progressive neurodegenerative condition, is becoming a global health challenge, with its prevalence expected to rise significantly in the coming decades. A recent US study on dementia in Afro-American adults has revealed insights that could be crucial for India’s battle against the condition. According to two Lancet Commission reports (2017 and 2024), one-third of dementia cases are preventable if timely interventions are made.

This article explores the key takeaways from the study and examines their implications for India, offering actionable strategies to lower dementia risk factors at an individual and policy level.

The Global Rise of Dementia

A US study projects that dementia cases in the country could double, from 514,000 in 2020 to approximately 1 million by 2060, with a disproportionately higher impact on Afro-American adults. Dr. M. V. Padma Srivastava, Chairperson of Neurology at Paras Health, Gurugram, emphasizes that the findings highlight the importance of preventive healthcare.

Dr. Srivastava explains, “If you take preventive steps at the right time, 30% of dementia cases could be reduced globally. Controlling diabetes, hypertension, obesity, and addressing social isolation are key factors.”

Why This Study Matters for India

India ranks third globally in dementia prevalence, according to data from the Indian Council of Medical Research (ICMR) and the Alzheimer’s Association. With a high population density and a growing number of lifestyle-related diseases, India faces unique challenges in managing dementia.

Key Epidemiological Insights for India

1. Mixed and Vascular Dementia: Unlike the US, where Alzheimer’s dementia is more common, India sees a higher prevalence of mixed and vascular dementia, often caused by strokes.
2. Rising Lifestyle Diseases: Younger Indians are increasingly suffering from diabetes, hypertension, and strokes, all of which contribute to dementia risk in later years.
3. Healthcare Inequities: Socioeconomic disparities and limited access to advanced diagnostics, like biomarker tests and imaging, hinder early diagnosis and intervention.

Preventable Factors: Lessons from Lancet Reports

The Lancet Commission reports highlight that one-third of dementia cases are preventable by addressing lifestyle factors across different life stages:

• Early Life: Focus on nutrition and fitness from a young age.
• Midlife: Control diabetes, hypertension, and maintain social connections.
• Late Life: Prevent social isolation, manage depression, and ensure cognitive engagement.

Changing Risk Factors in India

India’s burden of dementia is compounded by the rise of risk factors such as:

• Diabetes and Hypertension: Uncontrolled blood sugar and blood pressure levels are major contributors to cognitive decline.
• Younger Onset of Strokes: Increasing stroke cases among Indians aged 30-40 years raise the risk of dementia in older age.
• Poor Nutrition: Deficiencies in Vitamin B12 and other essential nutrients exacerbate brain health issues.
• Social Isolation: Elderly individuals often face loneliness and depression, both of which accelerate dementia progression.

These risk factors mirror the triggers identified in the Afro-American community, where poor access to healthy food and healthcare leads to derailed health outcomes.

Early Diagnosis of Dementia

Early detection of dementia is crucial for effective management. Here’s what you need to know:

When to Seek Help

• Family History: Individuals with a family history of Alzheimer’s should be vigilant.
• Memory Concerns: If others notice forgetfulness, it could be a red flag. However, if you are aware of forgetfulness yourself, it might indicate stress or mild cognitive impairment.

Other Warning Signs

• Emotional instability or unusual behavioral changes.
• Difficulty with decision-making, language, or executive functions.

Diagnostic Tools

Advances in medical technology have made early detection easier:

• Blood Biomarkers: Indicators of brain health found in the bloodstream.
• Imaging Tests: MRI and PET scans can identify structural and functional changes in the brain.
• Lumbar Puncture: Spinal fluid analysis for specific proteins linked to dementia.

Preventing Dementia: What Can Be Done?

Individual-Level Strategies

1. Maintain a Healthy Lifestyle:
   • Eat a balanced diet rich in fruits, vegetables, and omega-3 fatty acids.
   • Exercise regularly to improve cardiovascular and brain health.
   • Avoid smoking and excessive alcohol consumption.
2. Control Chronic Conditions:
   • Monitor and manage diabetes and hypertension.
   • Address thyroid issues and other metabolic disorders.
3. Stay Socially Active:
   • Engage in community activities or hobbies that involve social interaction.
   • Prevent isolation by maintaining relationships with friends and family.
4. Engage Your Brain:
   • Challenge your mind with puzzles, reading, or learning new skills.

Policy-Level Recommendations

1. Enhance Health Literacy:
   • Educate the population about dementia risk factors and preventive measures.
2. Improve Access to Diagnostics:
   • Make biomarker tests and imaging facilities more affordable and accessible.
3. Tackle Nutritional Deficiencies:
   • Address common deficiencies, like Vitamin B12, through public health campaigns.
4. Strengthen Social Structures:
   • Build support systems for the elderly to reduce depression and loneliness.
5. Geography-Specific Research:
   • Conduct localized studies to understand dementia patterns in different regions of India.

The insights from the US study on dementia among Afro-American adults are a wake-up call for India. With a rapidly aging population and increasing lifestyle-related diseases, India must prioritize both preventive and curative strategies to tackle dementia effectively.

By taking timely steps to address modifiable risk factors such as diabetes, hypertension, and social isolation, individuals and policymakers can significantly reduce the burden of dementia. Early diagnosis and awareness campaigns are critical to ensuring better outcomes for those at risk.