Page 95

Commonwealth Health Partnerships 2015

and other social services. Attitudinal barriers, such as discrimination and stigma, cause social exclusion (particularly for women, who often face double discrimination). These barriers can compromise the capacity of people with disabilities to self-determine their own needs and care – an essential part of social equity and a key part of safeguarding human dignity in all stages of life (WHO and WB, 2011). Environmental protection: Environmental factors – including rapid urbanisation, air pollution and natural disasters – can increase the risk of health conditions, such as NCDs, that lead to disability and impairment. Unplanned urban design and other unsustainable environmental practices create physical barriers that limit or N C D s , d i s a b i l i t y a n d a g e i n g eliminate access to health, rehabilitation and education. And in the wake of natural disasters, people with disabilities and older persons are often left behind in the response (ibid). This was recognised in the Sendai framework for Disaster Risk Reduction 2015–30, which has explicit references to the rights and needs of persons with disabilities and older persons (UN, 2015). Ensuring equitable access to health: A rights-based approach A range of international declarations, including the Universal Declaration of Human Rights, acknowledge the rights of all people Among chronic disease conditions, dementia has a uniquely profound effect upon disability and needs for care, making it vital to consider the impact of the condition not only on the persons affected but also on their carers. All over the world, the family remains the cornerstone of care for older people who have lost the capacity for independent living. Household living arrangements and characteristics of the main caregiver for people with dementia at 11 sites in Latin America, China and India. 10/66 dementia Number Household living arrangements (%) Characteristics of the main caregiver (%) research group Alone Spouse Adult One or more Spouse Child or Non- Female study site only children children under child-in-law relative Cuba 316 6.3 10.2 54.7 33.7 17.3 67.7 5.8 80 Dominican Republic 235 8.5 10.2 48.5 39.9 21.4 44.6 11.6 81.3 Venezuela 140 5.7 4.9 68.1 53.8 13.7 68.4 2.8 80.7 Peru (urban) 129 1.6 9.4 54.3 27.1 13 41.6 30.1 83.7 Peru (rural) 36 13.9 8.3 63.9 38.9 16.7 58.4 2.8 86.1 Mexico (urban) 86 14 9.3 55.8 38.4 5.8 79.1 3.5 83.7 Mexico (rural) 85 16.5 11.1 55.3 31.8 12.9 68.2 2.4 76.5 China (urban) 81 2.5 34.5 38.3 7.4 36.1 47.3 13.9 66.7 China (rural) 56 3.6 8.9 75 60.7 42.9 57.1 0 35.7 India (urban) 75 4 13.3 72 49.2 26.7 40 0 69.3 India (rural) 10 15.1 5.7 67 52.8 23.3 70 0 80.2 Source: ADI, 2009; 10/66 Dementia Research Group, 2004 Commonwealth Health Partnerships 2015 93 Caregivers Scope of the issue 16 years Age is the largest non-modifiable risk factor for dementia. Genetic mutations account for about three per cent of cases, generally persons whose symptoms present under the age of 65 years. The number of people living with dementia worldwide in 2013 is estimated at 44.35 million, reaching 75.62 million in 2030 and 135.46 million in 2050. Most of the growth in the number of persons with dementia in the next 20 years will be in LMICs. Updated estimates of the number of people living with dementia in different regions and as a percentage of world total Region People with dementia Proportionate increase Millions (% of world total) (%) 2013 2030 2050 2013–30 2013–50 G8 14.02 (32%) 20.38 (27%) 28.91 (21%) 45 106 G20 33.93 (76%) 56.4 (75%) 96.61 (71%) 66 185 OECD 18.08 (41%) 27.98 (37%) 43.65 (32%) 55 142 High income 17 (38%) 25.86 (34%) 39.19 (29%) 52 131 Low and middle income 27.84 (62%) 49.76 (66%) 96.27 (71%) 79 246 World 44.35 75.62 135.46 71 205 Source: ADI, 2013


Commonwealth Health Partnerships 2015
To see the actual publication please follow the link above