The Problems of Dementia in India and the Way Forward

For people over 70, neurological illnesses rank as the second most common ailment. According to estimates, there are 5,000 new instances of dementia per year.

The Problems of Dementia in India and the Way Forward
Photo by Pawel Czerwinski / Unsplash


Growing ageing populations can be attributed to longer lifespans and declining fertility rates in India. For people over 70, neurological illnesses rank as the second most common ailment. According to estimates, there are 5,000 new instances of dementia per year. According to estimates, 3.69 million individuals in India and 51 million people globally have Alzheimer's disease or another kind of dementia in 2020. In order to combat dementia in India, it is necessary to implement policies that assist individuals who are affected and those who are at risk. They are helping the carer and educating the general public and physicians. Community-based therapies that can enhance the quality of life of the carers and persons with dementia are desperately needed.

Introduction to Alzheimer's & other Dementia

From being the fifth most common disease section, neurological disorders have significantly increased to become the second most common disease sector. In India, the lifetime prevalence of neurological illnesses was reported to be 36.3% total weighted, or more than 35000 general cases per 100,000 people. One of the neurological conditions that significantly contributes to older people's disability is dementia. A brain illness called dementia has a significant impact on a person's capacity to do daily tasks. By 2030, the number of persons living with dementia is expected to increase, to almost 1 million. In India, the population over 55 years old would have an average prevalence rate of dementia of 23.7 per 1,000 people in 2021.

Among older persons, Alzheimer's disease (AD) is the most prevalent form of dementia. Dementia instances caused by Alzheimer's disease (AD) range from 50 to 70 percent. Alzheimer's is described as "a brain condition that often begins in late middle age or occurs beyond age 60 and gets worse over time" by the International Classification of Diseases. Memory loss, confusion, difficulties thinking, and changes in language, behaviour, and personality are all symptoms. Young people have early dementia symptoms during their most productive years of life.

Figure. 1. Change In DALYs % Of Neurological Disorders And Alzheimer's And Other Dementia Between 1990 - 2019.

Source: Institute for Health Metrics and Evaluation, 2019.

The early onset form of dementia (EOD) refers to symptoms that typically appear between the ages of 40 and 60, whereas the late-onset form of dementia (LOD) refers to symptoms that appear after the age of 60. (Gauthier et al., 2022).
People may lose their ability to recognise family members or experience difficulty speaking, reading, or writing at a later stage. They might have to recall how to comb their hair or brush their teeth. Later, they can develop anxiety or aggression, or they might escape from their house. They eventually require 24-hour care. Those in the family who have to take care of them may experience a lot of stress as a result. There is no cure for the illness. However for a short time, some medications may prevent symptoms from getting worse.

The Challenge of Dementia in India

India comes in the top 10 Asian countries with a higher prevalence of Alzheimer's and other Dementia. It has the third enormous burden of Dementia. The estimated prevalence of Alzheimer's and other dementias from Asian countries based on the IHME recorded prevalence rate is shown below.

Table 1. The prevalence rate of Dementia for the year 2019

The estimated prevalence of Dementia (Top 10 countries of Asia)












Republic of Korea




Viet Nam






The first step in addressing Alzheimer's in India is to take a deeper look at local issues, such as the disease's impact and risk and protective factors. It also adds to the strain on carers and the high expense of healthcare, making it a public health issue. These all need to be investigated from the perspective of public health (or population-level).

Economic Trends
India's population tripled between 1960 and 2019 and is still growing, with a current estimate of 1.4 billion people. Indians' average lifespan today is 70 years, compared to 63 years in 2000 and 45 years in 1960. Since 1960, the percentage of people over 65 has more than doubled, and it now accounts for 7% of the population, or 94.4 million people in India (World Bank, 2022).
Picture 2 Life expectancy among Indians: From 1990 to 2022, the average age of Indian people is expected to rise by about 18 years. The senior population has expanded, and fertility rates have fallen.

Source: World Bank, 2022

An important and unchangeable risk factor for dementia is age. Growing ageing populations can be attributed to longer lifespans and declining fertility rates in India. The risk of cognitive decline, Alzheimer's disease, and other dementias is anticipated to rise dramatically as the population ages (Kumar CTS, Shaji KS, Varghese M, Nair MKC) (2020).

Risk and protective factors

In a decade, the prevalence of Alzheimer's and other dementias has risen to 89.5%. 3.69 million more Indians with Alzheimer's and other dementias today than there were in 1990. The illness causes 1.38 percent of fatalities and has 265 frequent instances per 100,000 persons. Research suggests that over several years, it may develop as a result of various behavioural and physiological causes. Smoking, high plasma glucose, and a high body mass index are some risk factors that are preventable and changeable. The primary cause of dementias like Alzheimer's and others is smoking (IHME, 2019). According to research, if these risk factors are changed, there is a great chance that Alzheimer's and other dementias will develop differently and that people will live longer.

Nonetheless, India has the second-highest number of diabetics worldwide, according to the Diabetes Atlas, which was published in 2019 by the International Diabetes Federation. According to the "India diabetes report 2000 — 2045," 74.1 million Indian adults (20-79 years of age) have diabetes (2022).

Latest statistics from India's nationally representative household survey, the National Family Health Survey 5 (NFHS-5 2019–21), reveal an alarmingly high frequency of increased blood glucose levels and hypertension. In India, adults over the age of 15 were found to have an increasing majority of blood glucose levels, with 13.5 to 15.6% of them taking medication. According to the Government of India's Ministry of Health and Family Welfare, the higher prevalence of hypertension is expected to be 21.3 to 24% in both men and women who are 15 years of age or older (2022).

Expense and strain on carers

The medical condition dementia is seen as burdensome. According to the severity of the disease, the annual household cost of caring for a person with dementia in India ranges from INR 20,300 to INR 66,025 in rural areas and from INR 45,600 to INR 2,02,450 per person per year in urban areas (Rao GN, Bharath S. (2013); Kumar CT, S., George, S., & Kallivayalil, R. A. (2019). Since that dementia-related diseases are often progressive and permanent, costs rise as the disease process becomes more severe. In India, it is estimated that hospitalisation, medication, and consultations account for between 20 and 35 percent of total costs per sick person per year. Informal home and residential care accounted for more than half of the costs (Kumar CTS, Shaji KS, Varghese M, Nair MKC (2020).

In addition to bearing a heavy financial burden, those who care for a loved one with dementia—be it a spouse, child, or relative—experience high levels of distress from the time spent providing care to the patient. According to research from developing nations, carers spend 3 to 9 hours helping dementia patients with activities of daily living like bathing, dressing, assisting with the toilet, food, and supervision. According to a recent Indian study, dementia patients receive care for 7.4 hours each day on average. However, the caregivers in India have a more negative attitude of shame, perceiving Dementia as madness due to low levels of literacy, lack of awareness and high caregiver needs. It is not seen as a health priority and is thought to be a natural aspect of ageing (Parveen, S., Mehra, A., Kumar, K., & Grover, S., 2022), which results in a significant treatment gap of more than 90% (Alladi, S., Hachinski, V. (2018). Inadequate awareness and attitude cause poor recognition, which causes a delayed diagnosis and can occasionally result in a catastrophe.


The impact of Dementia on individuals, families and society is expected to increase rapidly with the population ageing in India. The article suggests a need to evaluate the attitude of caregivers of people with Dementia to address the prevailing negative attitude and provide them with knowledge and support while performing the caregiver role.