The prevalence of dementia in Eastern Mediterranean countries

The prevalence of dementia in Eastern Mediterranean countries

Literature Review

Prevalence, Comorbidity, and Gender

The prevalence of dementia in Eastern Mediterranean countries is 13% of the adult population (Yahgmour et al., 2019). Alkhunizan et al. (2018) found the prevalence in Saudi Arabia to be 6.4%. In India, 10% of the older population experiences dementia and mild cognitive impairment. Dementia has been found to affect women more than men. El-Metwally et al. (2019) and Konda et al. (2019) found rates of dementia to be twice as high in women. Dementia is associated with a variety of comorbidities including diabetes, hypertension, cardiovascular conditions, and depression (Yahgmour et al., 2019; El-Metwally et al., 2019; Abd Elaaty et al., 2019; Albugami et al., 2018).

Culture and Religion

The Eastern Mediterranean and Islamic culture put the responsibility of caring for individuals with dementia on the family (El-Metwally et al., 2019). Placing the elderly in care facilities is discouraged (Yahgmour et al., 2019), so families must bear the burden. Caregivers face stigma from the community as a result of their caring for a person with dementia (Werner and AboJabel, 2019; Yahgmour et al., 2019). Stigma arises from a lack of understanding of dementia in the region (Bhalla et al., 2018), and cultural misconceptions regarding the condition. Some believe it is transmittable, while others believe it is a punishment from God (Werner and AboJabel, 2019a).

Recognition and Tools

There is a general lack of dementia awareness in the Eastern Mediterranean region (Bhalla et al., 2018; Werner and AboJabel, 2019b, Algethami et al., 2019), making recognition challenging. Elmahdy et al. (2020) note poor dementia knowledge in aetiology, diagnosis, and medication. A lack of culturally-appropriate diagnostic tools has also been identified. Yahgmour et al. (2019) note that the current assessment instrument used in the region is not valid due to low literacy levels. Karam et al., 2019 and Feghali et al., 2019 tested Arabic versions of dementia diagnostic tools, and found them to be valid, reliable, and internally consistent.

Workforce Issues

Healthcare personnel in the region lack adequate knowledge and training on how to support people with dementia (Albugami et al., 2018; Manee et al., 2019). Elmahdy et al. (2020) note there is a clear gap in medical education and training, as 80% of the medical students, they surveyed reported to have received no dementia care training. Yahgmour et al. (2019) state that geriatric and dementia care have only been recently incorporated into nursing and medical training in Saudi Arabia. Almari (2020) further notes that geriatric research in the region has been low and has failed to address common conditions such as dementia.

Conclusion

Dementia is prevalent in Eastern Mediterranean countries, with researchers estimating the prevalence rate to be between 6.4% and 13%. Women are at higher risk of developing the condition, which is linked to numerous comorbidities, including hypertension, diabetes, and cardiovascular conditions. These conditions also function as risk factors for developing dementia. Low levels of awareness and understanding in the general and medical populations make the recognition and treatment of dementia in the region much harder. Caring for individuals with dementia is the responsibility of family members, and caregivers experience stigma for their role due to cultural and religious misconceptions regarding the condition. Culturally-appropriate diagnostic tools and enhanced training on dementia care for health professionals is required in the region to improve recognition and treatment.