September is World Alzheimer’s Month, and in Bangladesh, the country is undergoing a significant demographic shift. With declining fertility rates and increased life expectancy, the population in South Asia is rapidly aging. However, the focus of the national health system remains primarily on infectious diseases, maternal and child healthcare, and basic cardiovascular health, overlooking the growing crisis of Alzheimer’s disease and related dementias.
Recent epidemiological studies conducted in 2019 by icddr,b, the Directorate of Health Services, and the National Institute of Neurosciences and Hospital revealed that around 8% of individuals aged 60 and above in Bangladesh are living with dementia. The rates are even higher among women, surpassing 12% in regions like Rajshahi and Rangpur. It is projected that by 2025, more than 1.3 million older adults in the country could be affected by cognitive impairment, a number that could rise to over 2.4 million by 2041 without timely intervention.
Dementia poses a significant challenge for Bangladeshi households, as over half of those affected also have other non-communicable conditions such as hypertension and clinical depression. The lack of cognitive screening tools and geriatric training at primary healthcare facilities results in delayed recognition of symptoms, leading families to seek care at overwhelmed tertiary hospitals in urban centers, incurring substantial financial and logistical burdens.
In Bangladesh, where out-of-pocket health spending comprises over 79% of total healthcare expenses, chronic neurodegenerative diseases like dementia can push families into financial hardship. The cost of managing dementia escalates significantly from $590 annually in mild stages to over $25,500 in severe stages, driven by the need for continuous care, advanced palliative services, and long-term medication.
Moreover, the economic burden of dementia in low- and middle-income countries is largely shouldered by families through unpaid caregiving, with women bearing the brunt of this responsibility in Bangladesh. This hidden cost not only impacts household incomes but also exacerbates gender disparities and reduces the national workforce.
Preventing and detecting Alzheimer’s early requires increased public investment. Addressing modifiable risk factors such as hypertension, diabetes, smoking, physical inactivity, and untreated hearing loss can potentially prevent or delay nearly half of all dementia cases globally. By investing in preventive measures and early detection, Bangladesh can reduce the economic burden associated with end-stage dependency and ensure better outcomes for affected individuals.
To address this challenge effectively, a collaborative effort across multiple government ministries is necessary. The Ministry of Health and Family Welfare should incorporate cognitive screening tools into existing healthcare facilities, while the Ministry of Social Welfare can enhance support for households caring for dementia patients. Additionally, the Ministry of Local Government, Rural Development, and Co-operatives can establish community programs to provide respite care for caregivers, enabling them to maintain employment.
Dementia should not be a silent burden borne by families alone but a public health and economic priority demanding urgent government intervention. By investing in prevention, early detection, and comprehensive social support, Bangladesh can safeguard its elderly population, support its workforce, and ensure dignity for all its citizens.
Dr. Imdadul Haque Talukdar, an adjunct assistant professor of psychology at North South University specializing in public mental health, emphasizes the importance of addressing dementia as a pressing public health issue that requires immediate action.