N o n - c ommu n i c a b l e d i s e a s e s a n d d i s a b i l i t i e s symptoms of dementia and manage stress. The public must similarly be educated in order to lower stigma and to increase health care seeking by those affected. Non-physician ‘clinicians’ should be trained to provide community-based services with the supervision of medical professionals; and physicians should assume training, supervision and quality-control roles for members of the multi-disciplinary community and home outreach teams. Training programmes and resource centres that increase the number of medical professionals with specialised knowledge of dementia must also be created or supported. These measures provide a comprehensive approach to long-term care that will require a multi-pronged approach. Co-operation between caregivers, health services, multiple areas and levels of government, civil society and not-for-profit organisations will be necessary. Approaches must be evidence based. Programmes and policies will need to be changed, and legislative changes may also be necessary. Dementia is no longer an issue for high-income countries alone; LMICs need to prepare now for the coming decades when need for care will increase exponentially. References Akinyemi, R. O., Mukaetova-Ladinska, E. B., Attems, J., Ihara, M. and Kalaria, R. N., 2013. ‘Vascular risk factors and neurodegeneration in ageing related dementias: Alzheimer’s disease and vascular dementia’. Current Alzheimer Research, 10 (6), pp. 642–653. Dias, A. and Patel, V., 2009. ‘Closing the treatment gap for dementia in India’. Indian Journal of Psychiatry, 51 (Suppl. 1), pp. S93–97. Dias, A., Samuel, R., Patel, V., Prince, M., Parameshwaran, R. and Krishnamoorthy, E. S., 2004. ‘The impact associated with caring for a person with dementia: A report from the 10/66 Dementia Research Group’s Indian network’. International journal of geriatric psychiatry, 19 (2), pp. 182–184. Etgen, T., Sander, D., Bickel, H. and Forstl, H., 2011. ‘Mild cognitive impairment and dementia: The importance of modifiable risk factors’. Deutsches Ärzteblatt International, 108 (44), pp. 743–750. Ferri, C. P., Prince, M., Brayne, C. et al., 2005. ‘Global prevalence of dementia: A Delphi consensus study’. Lancet, 366 (9503), pp. 2112–2117. 84 Commonwealth Health Partnerships 2015 Graff, M. J., Adang, E. M., Vernooij-Dassen, M. J. et al., 2008. ‘Community occupational therapy for older patients with dementia and their care givers: Cost effectiveness study’. British Medical Journal, 336 (7636), pp. 134–138. Lund, C., Breen, A., Flisher, A. J. et al., 2010. ‘Poverty and common mental disorders in low and middle income countries: A systematic review’. Social Science and Medicine (1982), 71(3), pp. 517–528. Prince, M., Acosta, D., Ferri, C. P. et al., 2012. ‘Dementia incidence and mortality in middle-income countries, and associations with indicators of cognitive reserve: A 10/66 Dementia Research Group population-based cohort study’. Lancet, 380 (9836), pp. 50–58. Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W. and Ferri, C. P., 2013. ‘The global prevalence of dementia: a systematic review and metaanalysis’. Alzheimer’s and Dementia, 9 (1), pp. 63–75. Scazufca, M., Menezes, P. R., Araya, R. et al., 2008. ‘Risk factors across the life course and dementia in a Brazilian population: Results from the Sao Paulo Ageing and Health Study’. International Journal of Epidemiology, 37 (4), pp. 879–890. Sousa, R. M., Ferri, C. P., Acosta, D. et al., 2009. ‘Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: A 10/66 Dementia Research Group population-based survey’. Lancet, 374 (9704), pp. 1821–1830. Whitmer, R.A., Sidney, S., Selby, J., Johnston, S. C. and Yaffe, K., 2005. ‘Midlife cardiovascular risk factors and risk of dementia in late life’. Neurology, 64 (2), pp. 277–281. CAROLINE KIM is a faculty member for the International Diploma in Mental Health, Human Rights and Law offered by the ILS Centre for Mental Health Law and Policy in Pune, India. She is a lawyer and resides in Canada. SOUMITRA PATHARE is a psychiatrist and co-ordinator of the ILS Centre for Mental Health Law and Policy in Pune, India. He is also course co-ordinator of the International Diploma in Mental Health, Human Rights and Law offered by the centre. He has served as a Member of the Mental Health Policy Group, appointed by the Ministry of Health and Family Welfare, Government of India to draft India’s first national mental health policy.
Commonwealth Health Partnerships 2015
To see the actual publication please follow the link above