Introduction
Background Information
Aging of the world’s population, along with the fast-growing life expectancy, results in increased expenditures spent on health care services.
Older age is closely associated with high rates of chronic diseases. In this respect, dementia is considered to have had a serious impact on the quality of life, as well as on the economic burden that family should take. At the current moment, dementia treatment refers to advanced medicine and novel approaches to cope with the increasing number of cases. However, the ineffectiveness of treating dementia has a negative impact on life expectancy in aging societies.
The global trends in aging undergo significant changes due to the influence of external factors, including economic, political and social challenges. This is of particular concern to the evident difference in the distribution of adults with dementia in developing and developed economies.
The recent explorations of the problem have indicated the tangible impact of environmental factors on dementia development (Prince, 2000). In particular, because the mental disorder is considered a significant problem in the developed world with increased rates of aging population, it has considerably higher rates in the developing economies. The evident distinctions, as well as demographic transitions, have negative consequence for the dementia spread among the developing world’s population.
The research studies by Wang et al. (2008) have recently discovered that dementia is the core reason for economic burden among the aging population in developing countries. Such a situation is explained by insufficient education, as well as poor health care services tailored to the patients’ demands. Attention should also be given to the cross-cultural survey of people with dementia in the third world.
Research studies in such developing regions as Latin American, Africa, China, and Southeast Asia are indispensible to define how lack of education, poor health care network, and community perception affect dementia diagnosing (Prince et al., 2003). Considering culturally and economically sensitive environments of the developing countries is vital for evaluating the differences in incidence and prevalence of the disease among the identified populations.
Purpose of the Research
Although the developed world recognizes dementia as a serious threat to the aging population and overall demographics, little comparative analysis has been done on the assessment of the situation in both developing and developed worlds to define what external and internal processes influenced the lifespan of adults with dementia.
This is of particular concern to such issues as cultural diversity, economic impact, political situation and education serving as the comparative tools of the analysis. Therefore, the purpose of the research lies in defining what underpinnings influence greater lifespan of people with dementia in developed region, as compared to the developing world.
Main Discussion
Influence of Dementia on Life Expectancy
Numerous researches have been dedicated to the analysis of the connection between dementia and life expectancy. In this respect, Xie (2008) states,
People with dementia have markedly decreased survival rates compared with those without dementia and are two to four times more likely to die at a given age than those of the same age without dementia (p. 259).
Even minor cognitive disorders can have a negative impact on the survival mechanisms of individuals and, therefore, it has direct relation to the risk of mortality. The degrees of mortality of people suffering from dementia are largely predetermined by such characteristics as sex, age, demographic characteristics, type of dementia, and genetic information. Higher risks of mortality are observed among older people (Xie, 2008).
Gender characteristics are considered less important in defining the impact of dementia on life expectancy. The studies produced by Routree et al. (2012) have also provided evidence concerning the strong dependence between greater probability of dementia disorder among males of older age and slower pre-progression rate.
The evident connection between the age of the patients and survival rates explains the survival mechanisms and the necessary health care assistance. Within this context, the lifespan rates among the patients will largely depend on economic and political realms within which these patients are placed (Waring et al., 2005). In this respect, the overall impact of dementia is closely associated with the quality of health insurance, economic and social conditions under which the individuals are treated.
Analysis of Economic Aspects Influencing the Lifespan of People with Dementia in Developing and Developed Countries
On the one hand, the previously discussed studies point to the direct influence of age on life of people with the disease. On the other hand, the survival probability can significantly be increased with the introduction of advanced technologies, medication, and quality of health care delivery. In this respect, Kalaria et al. (2008) have defined that, although mortality rates predetermined by poverty, communicable diseases, and human conflicts, number of individuals with dementia have augmented in the developing world.
The current evidence suggests that age-predetermined dementia observed in individuals under the age of 65 is higher in such developing regions as Latin America and Asia than in India and sub-Saharan Africa (Kalaria et al, 2008). Moreover, education is considered the decisive factor in development of the disease because illiteracy increases the potential risk for dementia emergence.
Rapid expansion of patients with dementia in the developing countries is strongly associated with the financial resources invested in treatment and prevention schemes. In particular, the costs spent on treating dementia in the developing countries reach about $ 73 billion annually (Kalaria et al, 2008).
However, the actual care demands for social protection are much higher than the actual budgeting. Therefore, lack of sufficient financing in developing economies constitutes the core reason for the increased rates of dementia among patients, as well as their shorter level of life expectancy (Rooij et al., 2011). As a result, greater demand for residential care should be introduced in the future to prevent the expansion.
In contrast to the economic environment in developing countries influencing dementia treatment, the developed world manages to spend significant part of financial resources to cope with the problem (Rooij et al., 2011; Xie, 2008).
However, provided aging has become the major challenge for dementia development, the prosperous economies can face serious problems in dealing with the patients suffering from the disorder. Greater ratios of older people in the developed world, therefore, can prevail in number over the ratio of older people in the developing countries.
To enlarge on the issue, Wehling and Groth (2011) have introduced the statistics counting, “…number of people aged 65 years and above will grow from 600 million to 2 billion (increase of 330 %) and the 80+ generation will increase by more than 400 % from 105 million to 400 million” (pp. 275-276). Therefore, the increase in life expectancy levels presupposed by the socioeconomic progress explains the ratio of older people in the developed world. However, these improvements contrast with the rapid decrease in birth rates.
In case the established pace of life expectancy continues growing in the course of the 21st century, most children born in 2000 are likely to reach the age of 100 (Wehling & Groth, 2011). Such statistics is worsened by the decline of the youth ratio. For instance, Japan has one of the highest rates of life longevity in the world.
Education as the Threshold Identifying Lifespan of Individuals with Dementia in Developing and Developed Countries
According to Prince et al. (2003), “low levels of education, literacy, and numeracy can result in cognitively unimpaired people screening positive for dementia” (p. 909). In educational terms, sensitive screening techniques do not allow to define arithmetical ability, as well as the level of writing and reading skills.
However, the screening instruments can be applied to various cultural circumstances. For example, it is possible to introduce interview formats that do not relate to educational realm. It should also be stressed that lack of education in developing region does not indicate the higher risk of dementia.
Rather, the low indices of educational activities do not contribute to appropriate diagnosing of the disease. Therefore, the developing region should be more concerned with the development of new technological devices that can improve the situation.
With regard to the above-presented research studies, developing economies should give specific attention to education as a decisive factor in determining the quality of diagnosing, which later complicates to define advanced from of the disorder. Such a situation can also be a reason for shorter lifespan of people with dementia.
In particular, the research evidence shows that Shanghai citizens defined that the mortality levels for dementia, particularly for people over the age of 75, had similar mortality indices as people suffering from cancer (Kalaria et al., 2008).
In India, the average rate for survival among the patients equals to 3.3 years in developing countries, which is much lower than in developed regions where the lifespan of adult individuals with dementia reaches 9 years (Kalaria et al., 2008). In addition, high mortality rates have been identified in African region; in particular, the relative risk ratio amounts to less than 3 years.
The studies by Kalaria et al. (2008) have been defined that Asian ad Latin American regions are the leading ones in terms of the dementia prevalence.
However, aging groups of population reveal lower ratio of adults with dementia in Sub-Saharan Africa and India. In this respect, it can be concluded that this region demonstrates the lowest life expectancy, which is partially predetermined by depressive illnesses and illiteracy that contribute to the development of disease.
In addition, Kalaria et al. (2008) have discovered, “…increasing frequency of vascular disease and global tends in modernization will add to the burden of AD within the developing countries” (p. 826). Indeed, the globalization process and mobilization provide a new outlook on the treatment techniques of patients. Therefore, much concern relates to the problem of the aging population among which the ratio of adults with dementia is lower in the developing countries than in the developed ones.
Introducing Costs Spent on People with Dementia in Developing and Developed Countries
Understanding the importance of expenditures spent on treating dementia is vital to promote future health case, as well as improve the overall socio-economic policy. The government needs to gain evidence for establishing firm policies for the fast-growing numbers of adults with dementia.
Low social awareness, underestimated attitude to the problem, and maltreatment does not contribute to the efficiency of the introduced strategies. In this respect, social protection and security are among the major challenges in the developing countries because of such factors as urban migration, conflict situations, and deployment of HIV/AIDs (Kalaria et al., 2008). The circumstances also point to the older people as the most vulnerable segment of the population living in the third world.
Apart from weak social environment, the developing countries face race discrimination, which is also another reason for the decline in lifespan of people with dementia. Moreover, the aging process of people with dementia provides greater costs and, as a result, this category is considered the economic burden, particularly for the developing world.
In this respect, Wang et al. (2008) have discovered that China is among the leading countries that enters the aging era due to the high level of health care delivery. At the same time, the patients with dementia need constant care with regard to the level of disease severity (Wang et al., 2008).
Therefore, despite the fact that the longevity of the patients increased, the economic burden imposed on hospitals and caregivers has been increased as well. Dias et al. (2008) support the idea of enhancing the home care support that can ensure longer life expectancy in India. In fact, the Indian region lack sufficient budgeting of the health care services, particularly people suffering from dementia and, therefore, longevity of their lives is much shorter than in other regions.
Rapid demographic aging can result in the rise of adults suffering in dementia in the developing countries and, therefore, specific attention should be given to health care arrangement in this particular region. According to the studies by Prince (2004), older individual living in developing countries are not isolated from their younger relatives. However, significant levels of family stress create certain disadvantages in terms of lifespan of people with dementia.
Moreover, in contrast to the developed countries, adults with dementia in the developing world usually live in extended families composed of three-generation households. Older people suffering from the disease cannot be regarded as a separate category in the developing societies. As a result, this group experiences significant psychological strain and increase costs influencing all family members as well. Further complications can affect education, impoverishment levels, and gender discrimination.
Therefore, Prince (2004) argues, “dementia is a development issues, and as such a proper concern for proper concern for policymakers in developing countries” (p. 176). Because people in the developing countries are under the stress of family bonds, their lifespan is unlikely to be higher as compared to the lifespan of adult living in the developed world.
Despite the fact that developing world has higher ratio of people with dementia among elder population, the aging phenomenon is still more typical of the developed countries. In fact, greater life expectancy in the developed economies is explained by the greater attention given to the quality of health care services.
At the same time, Asian, African, and Latin American regions also witness significant rise of the aging population rates, although their services are less advanced (Shaji, 2009). As a result, because their rates of dementia disease are higher, the aging process poses a significant challenge to this region.
Despite the fact that the biological phenomenon of aging is a global problem, the life of senior members of society varies greatly due to the difference in cultural and economic contexts (Shaji, 2009). Health care and aging, therefore, are predetermined by social and cultural factors, including social status and attitude to elder people as accepted in various countries (Prince, 2004). Traditional support systems are unlikely to have a potent impact on economic changes and social restructuring.
Conclusion
In conclusion, the research studies have discovered that the life expectancy of people with dementia in developed countries is much higher as compared to that of people with dementia in the developing countries due to a number of economic, cultural, and political factors.
To begin with, the globalization can be considered as the underpinning for the highlighting the aging process in the world due to the technological and scientific progress. Due to the fact that innovation is more associated with the developed world, this region has higher level of aging population.
Although the developing region, including Asia, Africa, and Latin America, has lower quality of health care services, the social support of elder generation is ensured by cultural aspects and traditions. As a result, because both face the aging process, the developing economies are under the threat of having lower rates of longevity among people with dementia. Education and economic costs also relate to the risk factors influencing the rapid growth of the patients.
References
Dias, A., Dewey, M. E., D’Souza, J., Dhume, R., Motghare, D. D., Shaji, K. S., & … Patel, V. (2008). The Effectiveness of a Home Care Program for Supporting Caregivers of Persons with Dementia in Developing Countries: A Randomised Controlled Trial from Goa, India. Plos Clinical Trials, 5(6), 1-7.
Kalaria, R. N., Maestre, G. E., Arizaga, R., Friedland, R. P., Galasko, D., …& Antuono, P. (2008). Alzheimer’s Disease and Vascular Dementia in Developing Countries: Prevalence, Management, and Risk Factors. Lancet Neurology, 7(9), 812-826.
Prince, M. (2000). Dementia in developing countries. A consensus statement from the 10/66 Dementia Research Group. International Journal Of Geriatric Psychiatry, 15(1), 14-20.
Prince, M. (2004). Care arrangements for people with dementia in developing countries. International Journal Of Geriatric Psychiatry, 19(2), 170-177.
Prince, M., Acosta, D., Chiu, H., Scazufca, M., & Varghese, M. (2003). Dementia Diagnosis in Developing Countries: A Cross Cultural Validation Study. The Lancet, 361, 909-917.
Rooij, A., Luijkx, K. G., Declercq, A. G., & Schols, J. (2011). Quality of Life of Residents with Dementia in Long-Term Care Settings in the Netherlands and Belgium: Design of a Longitudinal Comparative Study in Transitional Nursing Homes and Small-Scale Living Facilities. BMC Geriatrics. 11(20), 20.
Routree, S. D., Chan, W., Pavlik, V. N. Darby, E. J., & Doody, R. S. (2012). Factors that Influence Survival in a Probable Alzheimer Disease Cohort. Alzheimer’s Research & Therapy, 4(16), 1-6.
Shaji, K. (2009). Dementia care in developing countries: the road ahead. Indian Journal of Psychiatry, 51, 5-7.
Wang, G., Cheng, Q., Zhang, S., Bai, L., Zeng, J., Cui, P., & … Chen, S. (2008). Economic impact of dementia in developing countries: an evaluation of Alzheimer-type dementia in Shanghai, China. Journal of Alzheimer’s Disease: JAD, 15(1), 109-115.
Waring, S. C., Doody, R. S., Pavlik, V. N., Massman, P. J., and Chan, W. (2005). Survival among Patients with Dementia from a Large Multi-ethnic Population. Alzheimer Disease and Associated Disorders, 19(4), 178-183.
Wehling, M., & Groth, H. (2011). Challenges of longevity in developed countries: vascular prevention of dementia as an immediate clue to tackle an upcoming medical, social and economic stretch. Neuro-Degenerative Diseases, 8(5), 275-282.
Xie, J. (2008). Survival Times in People with Dementia: Analysis from Population Based Cohort Study with 14 Year Follow-Up. British Medical Journal. 336, 258-262.