There might have been a time when people in the Caribbean viewed Alzheimer’s disease and other age-onset dementias as problems associated only with North America and Europe, simply because these are the continents where they have been recognised for what they are for years. There is still some amount of ignorance about dementia in this part of the world – to the detriment of elderly citizens many of whom would have served their countries well while in their prime and to whom are owed a wealth of care.
In a report issued on Tuesday to coincide with the global observation of Alzheimer’s Day, Alzheimer’s Disease International (ADI) estimated that the worldwide cost of dementia for this year will hit US$604 billion. Some 35.6 million people in the world are said to be stricken with Alzheimer’s disease or one of the several other forms of dementia. The Caribbean accounts for 327,825 people, according to statistics compiled by the World Health Organisation (WHO), but which are nowhere near the true figure. This is because, overwhelmingly in the Caribbean, despite the presence of non-governmental Alzheimer’s associations in Barbados, Jamaica, Trinidad and Tobago, dementia is viewed not as a disease, but as a natural part of ageing. This is in spite of evidence that not all elderly persons develop dementia and not all persons stricken by dementia are elderly. In fact, recent research has seen the disease manifested in middle-aged people – below the age of 60 – when previously people over 65 years were mainly victims of the disease.
Dementia is a mental health disease because in all its forms it impairs cognitive skills. However, in low income countries such as Guyana the general practice has been to brand elderly people with dementia as mad, thereby attaching to them the stigma still associated with insanity. No doubt some of our old folk living on the street are there as a result of their dementia never being properly diagnosed and the resulting lack of recourse to treatment.
In extreme cases, elderly persons have disappeared and died after having left home because their illness might have militated against them finding their way back. In one of two recent examples, last year June, a 66-year-old Guyana-born US citizen who had come back here for a funeral disappeared, practically into thin air, after going to visit his family home at Buxton, East Coast Demerara. Kwame Rumel Jobronewet also known as Romie Johnston of California, had only arrived in Guyana hours before he disappeared and to date has not been found. Mr Jobronewet’s medical history was not revealed by his relatives, but it was surmised that he might have been afflicted with some form of dementia which might have caused him to wander off. Less than a month later in July 2009, 84-year-old Albert Van Vieldt died at the Georgetown Public Hospital after he was found naked and barely alive on a dam at the back of Mocha, East Bank Demerara. Reports had revealed that this elderly man was afflicted with dementia and would periodically leave home and return days later.
Projections are that cases of dementia will rise significantly worldwide because life expectancy rates are up. And according to President of the Alzheimer’s Association Harry Johns, “the developed world is currently where the bulk of the problem is. The developing world will be a place where the problem grows dramatically later.” In Guyana’s case, these words are almost prophetic as migratory trends reveal that to some extent the younger generation leaves for greener pastures while older folk return after retirement.
If systems are not put in place now, elderly care could become a real burden on families and on the state or a huge social embarrassment if ignored.
The ADI, in its report “calls on governments to make dementia a health priority and develop national plans to deal with the disease… to fund and expand the implementation of the WHO Mental Health Gap Action Plan, including the packages of care for dementia, as one of the seven core disorders identified in the plan…” and that new investments in chronic disease care always include attention to dementia.
