Yam Bahadur Dura

Anita Loos (1889 – 1981), an American author, who wrote a blockbuster comic novel 'Gentlemen Prefer Blondes' once said, 'Memory is more indelible than ink.'
She is right if someone's memory works well. What happens if a person becomes forgetful and starts forgetting everything?
Studies suggest that people are increasingly getting forgetful worldwide because of dementia. What is it?

Brain Disease
Dementia is a form of brain disease that makes people forgetful. Memory loss is more common as people grow older, which is normal part of aging in general. Although dementia mainly affects older people, it is not a normal part of ageing. It damages brain cells, and creates forgetfulness in a person.
According to National Institute on Aging (NIA), a division of the US National Institutes of Health, dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person's daily activities.
As US National Library of Medicine defines, dementia is a broad category of brain diseases that cause a long-term and often gradual decrease in the ability to think and remember that is severe enough to affect a person's daily functioning.
In the early stage of dementia, a patient experiences increasing forgetfulness, losing track of time, and sometimes gets lost in very familiar places. It most often affects the elderly people above 60 years of age, but lately the people in their early 50s are also showing the symptoms of dementia.
According to the dementia-related reference materials, dementia results from a wide variety of diseases and injuries that primarily or secondarily affect the brain, such as Alzheimer's disease or stroke.

Umbrella Term
It is an umbrella term for around 200 diseases. Cognitive and neuropsychological test, laboratory test, brain scan, psychiatric evaluation, and genetic test are the ways that are used to diagnose dementia.
It becomes more severe in the middle stage with increased memory loss resulting in forgetting recent events, having trouble performing daily tasks including personal care, and difficulty in communication viz. difficulty in finding right words and phrases.
As dementia progresses to its optimum point, a patient forgets everything and everybody even life partner and siblings, and becomes unaware of the time and place depending entirely on others for survival.
Public records say that around 50 million people are suffering from dementia worldwide, and there are nearly 10 million new cases every year. The number of patients is projected to increase to 75 million by 2030. This number will be almost triple by 2050. Nearly 60 percent of patients are living in low and middle income countries.
There is no reliable data on how many people are suffering from dementia in Nepal. The Alzheimer’s Disease International (ADI), a UK based organization, estimates that there were 78,000 people with dementia in Nepal in 2015. Health workers opine that the number is quite higher than estimated, and patients are increasing sharply every year.
Dementia does not care about class, creed and personality of people. High-profile people like former US President Ronald Reagan (1911 – 2004), former British Prime Minister Margaret Thatcher (1925 – 2013), and former Indian Prime Minister Atal Bihari Vagpayee (1924 – 2018) were dementia patients. This means it can attack anyone ranging from people from grassroots to top-notch.
No Reliable Treatment
According to health experts, there is no any reliable treatment system currently available to cure dementia or to stop its progressive course. Experts suggest that we can reduce risk of dementia by keeping oneself mentally active, getting regular exercise, not smoking, controlling weight, eating healthy foods, and maintaining blood pressure, cholesterol and blood sugar levels.
Dementia attacks brain cells paralyzing cognitive functioning. Brain is the headquarters of human beings. If the headquarters remains functionless, then everything goes wrong. It leaves far-reaching impacts in human lives that are socially, culturally, and economically disastrous.
Dementia unknowingly steals happiness and well-beings of family members of patients. For these reason, some people call it 'a quiet thief in the night.' It causes a great degree of human sufferings. Dementia can be painful, especially for the families of affected people and for their caregivers. It puts pressures on physical, emotional and financial aspects of the family.
According to the World Health Organization (WHO), dementia has significant social and economic implications in terms of direct medical and social care costs, and the costs of informal care. The WHO notes, 'In 2015, the total global societal cost of dementia was estimated to be 818 billion US dollars, equivalent to 1.1 percent of global gross domestic product (GDP).'

Important Health Topic
These days, dementia has become one of the important public health topics in Nepal too. On the one hand, the number is aging people is progressively increasing because of improved healthcare system and improved living standards.
On the other hand, absentee population - who are responsible for taking care of their aging parents - is increasing. These days, senior citizens seem to be remained helpless, especially in rural areas.
This kind of scenario demands a robust system that can take care of senior citizens as well as people with dementia. A suitable supportive environment based on internationally accepted medical and human rights standards is required to ensure the highest quality of care for dementia patients.
Policymakers urgently need to develop plans and strategies to cope with this looming crisis of dementia, which can minimize human sufferings and can save human dignity. Let's act upon it, before it gets too late.

(The author is a lecturer)