By JULIUS BARIGABA

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One in five people in Uganda aged 60 and above, has Alzheimer’s disease or related forms of dementia, prevalence studies show, supporting World Health Organisation’s latest data, showing that two-thirds of people with dementia worldwide live in low and middle-income countries.

According to the WHO Global Status Report on the Public Health Response to Dementia 2021, there are 55 million people with dementia worldwide.

This figure is projected to increase to 78 million by 2030 and 139 million by 2050, by which time an estimated 71 percent of new cases will be in the low and middle-income countries where all East African countries fall.

Alzheimer’s is a disorder that causes the brain to shrink and brain cells to die, slowly destroying memory and thinking skills, and eventually the ability to carry out activities of daily life; it is the most common form of dementia and may contribute to 60 to 70 percent of cases.

Experts say Alzheimer’s and dementia-related illnesses have remained in the bracket of neglected diseases in Uganda, partly due to funding.

During a national symposium on quality mental healthcare in Uganda in 2019, experts said the government allocated 9.8 percent of its gross domestic product to the sector, or $146 annually per person. The experts added that less than one percent of this budget goes into mental healthcare, compared with 10 percent for many other countries.

Support mechanisms

According to Nathan Kakongi, a lecturer at the Department of Biochemistry, Mbarara University of Science and Technology, dementia burden of care doubles every 7.2 years in sub-Saharan Africa, while in the developed world it doubles every 20 years.

The rising cases amidst dwindling funding have seen resort to private measures to address the prevalence, care and support to victims.

On September 25, non-profit Uganda Alzheimer’s Association held the first-ever memory walk in the country, in support of Alzheimer’s victims, and in recognition of the rising cases and a need for a national dementia strategy that will address data gaps, diagnosis and care for patients.

According to its chief executive, Dr Paul Kiwanuka-Mukiibi, the association was established in 2017 by affected caregivers, medical professionals and supporters to raise awareness and provide support to those affected by Alzheimer’s disease and related dementias.

The walk took place just four days after World Alzheimer’s Day passed without any activity by the Ministry of Health to mark the day or articulate a strategy to address the rising cases, under-diagnosis and funding plan.

The Health ministry did not immediately respond to our request for comment, but Rwanda, Uganda and Tanzania are ranked first, second and third, as having the highest death rates among people with Alzheimer’s disease.

The disease remains among the top 10 killer diseases globally, according to a WHO 2019 study.

The study, published in December 2020, shows that globally, Alzheimer’s disease and other dementias rank seventh among the most causes of death – killing nearly two million people annually.

Late diagnosis

In the East African Community, Rwanda ranks poorest, with a death rate of 28.26 per 100,000 people, the WHO says.

Uganda and Tanzania lose 26.65 and 26.52 people per 100,000 persons respectively, while South Sudan is at 22.52 persons and Burundi at 23.21 deaths.

Kenya is best ranked, with the lowest death rate of 19.65 per 100,000 people, WHO data for 2018 shows.

The WHO study also revealed that Alzheimer’s disease and other forms of dementia are ranked seventh leading cause of death, adding that women are disproportionately affected.

Dr Kiwanuka-Mukiibi said other problems, in addition to poverty, that deter diagnosis and treatment include stigma, discrimination, illiteracy and lack access to healthcare, while lack of awareness and understanding of the disease exacerbates the stigmatisation and barriers to diagnosis and care.