Malaysia facing dementia 'time bomb'

KUALA LUMPUR: Malaysia is fast heading towards becoming an aged society, with 14 per cent of the population expected to be over the age of 65 by 2044.

Despite the imminent rise in the number of elderly citizens, DY Suharya, Asia Pacific Director of Alzheimer’s Disease International (ADI) noted that Malaysia has yet to implement a national dementia plan.

Failure to tackle this health matter in the near future would result in major economic and societal costs, she warned.

“It is a trillion dollar disease, there are other economic matters intertwined with it,” she said. “There is a crisis in the care sector and it is not acknowledged.”

The World Health Organisation’s global action plan on the public health response to dementia targets at least 75 per cent of its 194 member states to have implemented a national dementia plan by 2025.

According to the ADI’s latest report, an estimated 453,900 Malaysians are predicted to be living with dementia by 2050. These forecasts do not account for the accelerated risk of dementia or other cognitive impairments that could occur as a consequence of COVID-19.

“We need the attention of the government and Health Ministry to step up on this matter because people around the world are really putting dementia as a priority.

“It’s an invisible disability and it also affects the mental health of families,” said DY, adding that Putrajaya must look into risk reduction and begin campaigning to raise awareness and reduce stigma associated with the condition.

Better funding, policies to protect the elderly

Dr Yau Weng Keong, National Head of Geriatrics Services at the Health Ministry, said there are around 270,000 people living with dementia in Malaysia.

But the country is only home to 33 geriatricians in the public and private health sector combined, with none stationed in Terengganu.

“We know that the number of patients will double every 20 years and that someone in the world develops dementia every three seconds.

“So it is actually a time bomb and we need to be prepared,” he said.

Speaking to Astro Awani, Dr Yau said civil societies and advocates had been pushing for Malaysia to acknowledge the growing issue of dementia, but funding for elderly care remained inadequate.

“There is this tendency to think that elderly healthcare, long-term care (LTC) and so on are very costly, but it would actually be beneficial and bring returns of wellbeing, workforce and consumption. We need to invest in healthy ageing.”

A 2019 audit report by the National Audit Department found that the emergency and trauma department at Malaysian hospitals were understaffed, underfunded, overcrowded and lacked equipment to provide proper levels of care.

Health Director-General Tan Sri Dr Noor Hisham also previously tweeted that the Health Ministry was “underpaid, overworked, overstretched and overcrowded with patients”.

Along with more funding, Dr Yau said it was also important to enact a holistic act to safeguard the rights of the elderly.

“If they have problems with their cognitive function, they may not be able to make good decisions. In that process, sometimes they may be scammed or cheated off their finances.

“So there must be a means for us (to act) if they get into trouble,” he added.

Such a law was first proposed by former Deputy Prime Minister Datuk Seri Dr Wan Azizah Wan Ismail under the Pakatan Harapan-led government in 2019.

It was supposed to be based on a 15-month study by Universiti Malaya to look at the content, approach and scope for a special law that catered to senior citizens.

Meanwhile, Universiti Kebangsaan Malaysia had also been appointed to conduct a study on LTC which was to be completed by November 2020.

Among the expected outcomes of the study would have been a proposal for an LTC model for Malaysia that covered the human resources required, sustainable financing and proposed locations to conduct pilot projects

The way forward for Malaysia’s ageing population

Dr Azlina Ahmad Annuar, Associate Professor in Neurogenetics at University of Malaya told Astro Awani that the deterioration of brain cells begin up to 20 years before symptoms of dementia become evident.

As such, the country should shift its approach and mindset surrounding the condition.

“By the time you are treating the patient in the clinic, you are 20 years too late. So rather than thinking of dementia as an elderly issue, we should think of it as a youth or mid-life problem,” she said.

Dr Azlina added that Malaysia must also look into expanding its awareness programmes in order to educate the public on caring for their brain health. Current healthcare programmes, she noted, often focused on more “common” conditions such as diabetes and cancer.

“Using our smartphones at night, lack of sleep, chronic stress, diet, exercise and even social interaction–all those play a major role in impacting our brain health.”

Meanwhile, Emily Ong from ADI’s Board of Directors called for countries to implement better infrastructure for the elderly.

“You need to ensure that all infrastructures like hospitals and public spaces are inclusive and enabling for all ages and abilities.”

Having been diagnosed with young-onset dementia in 2017, Ong also said it was crucial to promote health literacy to empower future generations to make appropriate decisions regarding their health and treatment.