Lifting social stigma crucial in dementia fight

James Kon

The number of Bruneians aged 55-64 will reach nine per cent by 2020, while those aged 65 and above is estimated to reach 5.6 per cent. The total number of persons in the ageing group will stand at 14.6 per cent. Aside from Japan, Brunei Darussalam is one of the fastest ageing countries in Asia.

Demensia Brunei Honorary Advisor Datin Jacqueline Wong highlighted this in her presentation ‘The Journey to Age Equality,’ which was the theme for the International Day of Older Persons Symposium (Dementia) at the International Convention Centre (ICC) on Tuesday.

The theme focusses on pathways of coping with future old age inequality.

She highlighted, “It has been over 30 years since Brunei gained its sovereignty in 1984. During this time, we have managed to increase our lifespan by about 20 years. Improvements in primary public healthcare – such as sanitation, food safety and protection against infectious diseases – have contributed to the increased life expectancy. In 1990, the average life span of a Bruneian was 73.5 years. In 2018, the average life span of a Bruneian is 77.7 years.”

Unfortunately, she pointed out, “Living longer has not translated to a better quality of life. The rate of infectious diseases may have gone down, but the number of those afflicted with lifestyle/non-communicable diseases such as diabetes, hypertension, obesity and cancer has risen – and more worryingly, continues to rise.”

She cited that 61 per cent of Bruneians are overweight and obese (the highest rate in ASEAN) with nearly three out of 10 adults found to be obese, according to the 2016 Brunei National Survey on Risk Factors on Non-Communicable Diseases (NCDs) conducted by the Centre for Strategic and Policy Studies (CSPS). The proportion of obesity among adolescents aged 13-17 in Brunei was a staggering 17 per cent.

More worryingly is the trend of the obesity rate increasing one per cent annually for children below 13 years (since 2011), based on findings from health screenings conducted at schools across the country.

The National Health and Nutritional Status Survey 2011 (NHANNS) showed that diabetes prevalence among the population is high (at 12.4 per cent – approxi-mately 37,000 people). The Ministry of Health’s (MoH) latest survey data from 2016 indicated that women in Brunei are at higher risk (10.3 per cent) than men (9.1 per cent).

The survey also found Type 2 diabetes in younger people, some as young as 20. Locally, diabetes is the main cause of kidney failure.

Demensia Brunei Honorary Advisor Datin Jacqueline Wong delivers her presentation on ‘The Journey to Age Equality.’ PHOTO: JAMES KON

Over the past five years, diabetes is the third leading cause of death in the country.

Datin Jacqueline said, “One thing is clear from these numbers – more Bruneians have to live longer in ill health. There may be some spending the last 25 years of their lives having to cope with diabetes and hypertension, and their complications. Some of these illness – if not all – lead to dementia in later years.”

“Between 2017 and 2030, the number of persons aged 60 years or over is projected to grow by 46 per cent (from 962 million to 1.4 billion) globally, outnumbering youth as well as children under the age of 10. Moreover, this increase will be the greatest and most rapid in the developing world.

“Population ageing is poised to become one of the most significant social transformations of the 21st Century. And with ageing, dementia is the number one public health disease and will be the ‘most serious health crisis of the 21st Century’,” she said.

“It is reported that the number of people living with dementia worldwide is currently estimated at over 50 million. This number will double by 2030 and more than triple by 2050. The high global prevalence, economic impact of dementia on families, caregivers and communities, and the associated stigma and social exclusion present a significant public health challenge.

“Two out of every three people have little or no understanding of dementia. The impact of World Alzheimer’s Month is growing, but the stigma that surrounds dementia remains a global problem. The global health community has recognised the need for action and to place dementia on the public health agenda.”

The total number of new cases of dementia each year worldwide is nearly 7.7 million, implying one new case every three seconds. The total estimated worldwide cost of dementia was USD818 billion in 2015. By 2018, dementia will become a USD1 trillion disease, rising to USD2 trillion by 2030.”

In 2016, Brunei reported over 2,000 persons diagnosed with dementia. This amounted to healthcare cost to the tune of BND3.9 million per year. If compared with the MoH’s 2018-2019 budget of BND320 million, this is approximately 10 per cent of total allocation.

Datin Jacqueline pointed out that the main challenges in dealing with dementia in Brunei are lack of awareness and stigma. Regarding awareness, most people in Asian countries like Brunei, perceive dementia as a normal part of ageing, instead of a specific condition that needs to be treated.

Dementia is the number one cause of dependency and disability for the older population. The care needs for a person with dementia are unique and often challenging. Anxiety, paranoia, memory loss, and confusion, along with other chronic conditions, place a difficult emotional and physical burden on the caregiver.

Datin Jacqueline said, “Yes, there is no prevention, and there is no cure for dementia – for now. But, we can all certainly choose and decide to live better, make better lifestyle and meal choices. Granted, we all love our national meal and beverage – the famous nasi katok and teh tarik! But why not, in moderation?