Cecilia Van Cauwenberghe from Frost & Sullivan’s TechVision Group, focuses on China, in terms of how to deal with dementia during the COVID-19 pandemic
According to World Health Organization (WHO) estimates, the number of Disability Adjusted Life Years (DALYs) lost due to neurological diseases is expected to rise from 95 million worldwide in 2015 to 103 million in 2030. DALYs lost in connection with Alzheimer’s disease and other forms of dementia will rise in the main part by around 28%. Equivalent years lost due to infectious neurological diseases are expected to fall by 37%.
In particular, China accounts for the largest population of patients with dementia in the world (Jia et al., 2020). Indeed, dementia constitutes one of the most notable reasons for disability in people older than 65. This situation led the Chinese Government to issue new health policies that enhance care systems, including new facilities, for citizens older than 65. In fact, the Chinese 13th Five-Year Plan was specifically designed to manage dementia by increasing the access of patients with dementia to healthcare services, including the availability of neuroimaging technologies, as well as, to educate doctors and caregivers.
Double pandemic: Dementia + COVID-19
With dementia emerging as a pandemic illness in an ageing society, the onset of the COVID-19 pandemic has generated a significant concern for people living with dementia, particularly in China (Wang et al., 2020). From inconveniences in remembering precaution procedures, including wearing masks and washing hands, to difficulties in the understanding of the public health information provided to them, people suffering from dementia may be exposed to a higher likelihood of infection.
Furthermore, lockdown and other preventive measures implemented to prevent the broad spread of the outbreak have affected patients with dementia even more adversely by being isolated from their regular support healthcare systems and caregivers (Canevelli et al., 2020).
Diagnostic and therapeutic aspects for dementia in China
The early detection and management of dementia before their onset is being facilitated through a variety of diagnoses and treatment methods. Positron Emission Tomography (PET) imaging of certain protein tangles in the brain, using new PET tracers, is playing an important role in early diagnostics, as well as, in assessing clinical trials for disease-modifying therapies. Artificial intelligence (AI) and deep learning (DL) approaches have started empowering neuroimaging solutions by perceiving complex patterns. Moreover, DL is projected to constitute a useful tool in the current search for biomarkers (Lal, 2018).
Regarding therapeutics, China utilises medication approved by the U.S. Food and Drug Administration (FDA) and the Chinese National Medical Products Administration (NMPA). Cholinesterase inhibitors, including donepezil and rivastigmine, both FDA approved, and the receptor antagonist memantine, NMDA approved, represent the first line of medication administered (Jia et al., 2020).
Final remarks
Beyond local new policies attempting to help people with dementia in China, prolonged self-isolation due to the COVID-19 pandemic has profoundly impacted the access of patients to healthcare systems. Moreover, lockdown has contributed to adverse effects including feelings of loneliness, behavioural modifications and routine disruptions, in addition to acute events that would require hospitalisation. Important modifications in the delivery of care in the post-emergency phase are crucially necessary in China for people with dementia.
Acknowledgements
I would like to thank all contributors from industry involved with the development and delivery of this article from Frost & Sullivan.
Further reading
Canevelli, M., Valletta, M., Blasi, M.T., Remoli, G., Sarti, G., Nuti, F., Sciancalepore, F., Ruberti, E., Cesari, M. and Bruno, G., 2020. Facing Dementia During the COVID19 Outbreak. Journal of the American Geriatrics Society.
Jia, L., Quan, M., Fu, Y., Zhao, T., Li, Y., Wei, C., Tang, Y., Qin, Q., Wang, F., Qiao, Y. and Shi, S., 2020. Dementia in China: epidemiology, clinical management, and research advances. The Lancet Neurology, 19(1), pp.8192.
Lal, U. 2018. Global Diagnostic Neuroimaging Markets and Emerging Applications, Forecast to 2022. Frost & Sullivan Research Service. Industry Research Analysis, P9B6, Healthcare.
Wang, H., Li, T., Barbarino, P., Gauthier, S., Brodaty, H., Molinuevo, J.L., Xie, H., Sun, Y., Yu, E., Tang, Y. and Weidner, W., 2020. Dementia care during COVID-19. The Lancet, 395(10231), pp.1190-1191.
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