ADI brings demensia Brunei into the fold

James Kon

Demensia Brunei (dB), a non-governmental organisation (NGO) that promotes dementia awareness and focusses on the rights of persons with dementia in the country, marked a milestone after receiving certification as an exclusive member of Alzheimer’s Disease International (ADI) in April.

The ADI Council unanimously voted for dB to become a full member after evaluating the NGO’s work and efforts on advocacy and raising awareness, engagement, impact assessment, hard work and collaboration.

The NGO was inducted into an 18-month membership development programme in 2018.ADI Regional Director for Asia Pacific DY Suharya congratulated dB for its certification.

In a written response to the Bulletin, DY Suharya said, “dB becoming a full member of ADI, who is in official relations with the World Health Organization (WHO), means all efforts supporting the deliverables of the seven action areas of the global public health responses on dementia will be more integrated. dB has played a significant role in advocacy at the national, regional and global level.”

“ADI’s vision is an improved quality of life for people with dementia and their families throughout the world. We believe the key to winning the fight against dementia lies in a unique combination of global solutions and local knowledge.”

She said the Asia-Pacific region experiences population ageing at an unprecedented pace, with the number of older persons expected to double from 535 million in 2015 to about 1.3 billion by 2050. “ADI supports its member associations through its regional directors. The WHO Asia Pacific region covers the Southeast Asia Region (SEARO) home to 1.8 billion people and the Western Pacific Region (WPRO) with almost 1.9 billion people across 37 countries and areas in the Asia Pacific. This accounts for 56 per cent of all older persons in the region, and 32 per cent of the world. As with ADI’s 102 members, Brunei’s involvement is important to the cause against dementia.”

The ADI Regional Director for Asia Pacific described dB’s efforts as “inspiring and impactful.

“In just less than two years, the hard work and initiatives of dB have led to increased commitments of high level government officials, strengthened partnership in the region (ASEAN) and significant capacity building training programmes in all the seven action areas of global public health responses on dementia.

Touching on the current global situation of dementia, DY Suharya said, “In 2017, the WHO Global Dementia Observatory was developed to monitor and review data on dementia, including reviewing the progress towards targets of the global action plan.

It is three years on from the commitment made by 194 countries at the World Health Assembly, but so far, just 32 WHO member states have national plans for dementia and around 30 are in development, according to ADI’s report From Plan to Impact III launched in June 2020.”

“In the last three years only five countries (Canada, Chile, Spain, Iceland and Qatar) have created plans, meaning at the current rate the 2025 target will not be reached. The report highlights the challenges and opportunities that have been brought on by the COVID-19 pandemic, and calls for governments to take immediate action from the lessons that the outbreak has presented. WHO is still a long way from hitting the target of 146 countries ie 75 per cent of 196 countries. While the reactions have been slow, the action plan has helped raise the issue of dementia that countries urgently need to address,” she added.

Meanwhile, dB Honorary Advisor Datin Jacqueline Wong said that dB was incepted in 2018 with the aim of being the voice of persons with dementia and their carers in Brunei Darussalam.

“One of dB’s objectives is to reduce the risk of dementia. According to the Alzheimer’s Research and Prevention Foundation, regular physical exercise can reduce the risk of developing Alzheimer’s disease by up to 50 per cent. Exercise stimulates the brain’s ability to maintain old connections as well as make new ones.

“Leading a healthy lifestyle and active ageing are highly encouraged and dB goodwill ambassador Wu Chun epitomises health and fitness. We look forward to continued collaboration with policymakers, local corporates, private sector, NGOs, the public and community in promoting dementia awareness, active ageing and encouraging inclusive communities.

“It is a privilege to watch dB grow, contributing efforts and time has demonstrated clear mission to achieve this recognition. Teamwork and individual efforts are commendable – well done and well deserved!” Datin Jacqueline said. “We thank ADI and individuals who volunteered their time, to donors and sponsors supporting our initiatives through funding and in kind, ribuan terima kasih. We hope you will continue to support the cause of dementia and active ageing.”

Commending Brunei’s effort in establishing one of the highest quality public-run healthcare systems in the world, Datin Jacqueline recalled that it has been almost four decades since Brunei gained its sovereignty in 1984, and since then, the people of Brunei have enjoyed better living standards and increased longevity by some 20 years.

Improvements in primary public healthcare such as sanitation, food safety and vaccinations against infectious diseases have contributed to increased life expectancy. She said that the rates of infectious diseases may have reduced, but unfortunately the number of people afflicted with non-communicable diseases such as diabetes, hypertension, obesity and cancer has risen – and more worryingly, continues to rise.

She said that Brunei is ranked as one of the highest in obesity and diabetes as well as one of the highest per cent of people with dementia in Asia.

“One thing is clear from these medical challenges – more Bruneians are living longer in ill health. There may be some spending the last 25 years of their lives having to cope with diabetes and hypertension, and its complications. Some of these illnesses – if not all – lead to dementia. Only a few years ago, dementia was seen as a high-income country issue, whereas now it is a global issue.

“With advances in treatments for non-communicable diseases, life expectancy is higher and as a result dementia is becoming more prevalent.”

“Dementia is one of the most significant global health and social crises in the 21st Century, yet too often diagnosis is made late, or not at all. There is no cure for dementia. Deaths due to dementia have more than doubled between 2000 and 2016, making it the fifth leading cause of global deaths in 2016 compared to the 14th in 2000. In some countries, it is the leading cause of death.

“Despite its prevalence, dementia is a silent killer, as stigma continues to be a major barrier to diagnosis, treatment and care. Moreover, prevalence of dementia is growing rapidly as the global population ages and is the number one cause of dependency and disability for the older population. Besides Japan, Brunei is one of the fastest ageing countries in Asia. The number of older persons is 14.6 per cent for Brunei.”

She noted that, based on ‘Dementia in the Asia Pacific Region, ADI Report, 2014’ there were more than 1,000 persons with dementia in Brunei in 2015. In 2016, there were over 2,000 persons diagnosed with dementia.

“This number will be 11,000 persons with dementia by 2030, amounting to BND65 million per annum in healthcare. I believe there are at least two to three times more people with dementia unrecorded and not diagnosed. Many perceive ‘forgetfulness’ as a normal part of ageing instead of a specific condition eg dementia or cognitive impairment. Due to this lack of awareness and social stigma, advocacy and raising public awareness are of utmost importance. This is where dB comes in. dB offers educational talks to the public on understanding dementia as a disease. This is important for the person with dementia to continue leading a quality of life with respect and dignity as the disease progresses.”

Speaking on reducing dementia, she said, “It is important to educate the public in reducing the risk of dementia by leading a healthy lifestyle and a balanced nutrition. We all have our favourite local meals/dishes rich in carbs and local beverages high in sugar content, but let’s consume in moderation.”

She also advised to take note of the 10 warning signs of dementia and if there are signs to seek early diagnosis. Following this, getting support and understanding the disease is important for the person with dementia, their carer and family.

“dB conducts dementia care skills workshops for better understanding and care for people with dementia. Through fund raising activities, donations & sponsorships from individuals and local corporates our ‘services’ to the community are free of charge,” she added.

CEO of Alzheimer’s Disease International, UK, Paola Barbarino commented on the most pressing common challenges faced by people diagnosed with dementia and their families. She said the most common challenge after diagnosis is the lack of support and information for people with dementia and their families.

“Every diagnosis is different and so are our circumstances. Clear information on how the disease will progress and how to best manage it at every stage will improve the quality of life of those diagnosed and their families.

“From financial arrangements, to modifications in their dwellings that will enable them to live independently for longer, to best practices in care, there is a lot that the government can do in providing information and support. Providing support groups and social care both for carers and for people with dementia immediately after diagnosis can also be immensely helpful.

“I am delighted that the government is acknowledging the great challenge to society that dementia poses and taking action. There is a lot of good practice that can be adopted to make the life of those with dementia and their families better. The people of Brunei should be aware that a lot can be done to make a diagnosis of dementia less challenging,” she said.