Experts in Oman call for early action to check increasing cases of dementia

Muscat: With the prevalence of dementia increasing, experts in the Sultanate and wider region MENA have called for early action.

Dementia prevalence in the MENA region is increasing at alarming rates, but progress to tackle the neurodegenerative condition is far too slow, according to Alzheimer’s Disease International (ADI), the global federation for 105 Alzheimer’s and dementia associations across the world.

The MENA region currently has almost 3 million people living with dementia, with cases set to rise by 367 percent across the region to over 13.8 million cases by 2050 according to the latest estimates, the highest regional increases in the world.

Dr Hamad Al Sinawi, Chairman of the Oman Alzheimer’s Society, and Consultant and Psychiatrist at the Department of Behavioural Medicine at the Sultan Qaboos University Hospital in Muscat, says “The statistics provided by ADI and WHO are concerning, and we need to start acting now. However, the issues faced by MENA countries regarding dementia differ greatly to other regions, which is why national dementia plans need to be localised and tailored to these specific issues.”

“The root-cause problems, which we need to focus our efforts and energy on, are a lack of proper health education and health care services. We are still dealing with a stigma around memory loss being considered a normal part of the ageing process,” explains Dr Al Sinawi.
Furthermore, insufficient diagnostic and screening tools result in many people with dementia remaining undiagnosed without access to treatments and support. Those who are diagnosed, then face a lack of aged care services which is why at-home caregiving is a go-to option, however often an unaffordable and in some countries culturally unacceptable approach.
“In most parts of the world health care and social care are joining together, but specifically in the Middle East very few countries manage to merge these services. A national dementia plan will have to consider accessibility as a major issue. Most people will appreciate an update of healthcare services, care homes, and recruitment first,” Dr Al Sinawi continues.

“Tackling dementia now for some nations is like climbing Mount Everest – there is so much to do, but all nations need to start somewhere,” says ADI Chief Executive Officer, Paola Barbarino. “Time is running out to implement national dementia plans by the WHO deadline of 2025, which is why it’s even more important for MENA countries to start educating and spreading awareness about the seriousness of dementia and the oncoming wave of dementia cases.”

The latest dementia prevalence statistics show that the number of people living with dementia worldwide will rise to 139 million by 2050, according to the WHO. Forecasts show increases of almost 2,000 percent in some countries by 2050, especially those in the MENA region.

Ageing populations, lifestyle and environmental risk factors are contributing to these spiraling numbers. “Risk factors like diabetes and obesity are common in our region. In addition, social isolation during the Covid-19 pandemic arose as a new risk factor. We are used to visiting the Mosque for prayers up to 5 times a day which wasn’t possible over the last couple of years,” says Dr Al-Senawi.

“Covid-19 has an impact on forecast numbers in different ways. We also have serious concerns that the neurological impact of the virus on the brain may spark a future wave of people developing dementia – driving prevalence up even higher,” says Barbarino.

ADI’s latest report ‘From Plan to Impact’ found that only a fifth (39 out of 194) of all World Health Organization (WHO) Member States have followed through with their promise to create a national dementia plan by 2025, a commitment made during the 2017 World Health Assembly.

Dr Al Sinawi concludes, “Before we talk about dementia-friendly communities, we must first focus on education, awareness building and early diagnosis. I believe a more collaborative plan between countries is the way to go for the MENA region.”

“This plan should focus on sharing expertise and knowledge. WHO, for example, has developed online education programmes in video format. We don’t need to reinvent the wheel, but sharing resources that translate between different areas could work in the Middle East and North Africa with similar cultures and values. ”

“ADI is committed to supporting governments to develop country-specific plans which, for MENA countries, will include sharing of knowledge and expertise through in plan development and expert working groups, advice on prioritisation, sharing of best practice, courses for caregivers, support groups, translating material, and updated care services,” continues Barbarino.

Encouragingly, but with identifiable barriers, the first prescription based, potential disease modifying treatment for Alzheimer’s disease, is being made available in the region, the first area outside of the US.  

“Having a prescribed drug can certainly help tackle stigma around dementia not being a serious condition, but awareness is still very low. Even if the drug is available, eligibility criteria are strict and cost will be an issue”, says Dr Al Sinawi.

Barbarino says, “The drug is certainly a step in the right direction, but successful implementation is yet very far away and therefore a reason to keep focusing on ADI’s Plan to Impact timelines.”