The prevalence rate of dementia among seniors over 65 is known to increase twofold every 5 years. Considering the recent rapidly aging population trend, it is inevitable that we will face an abrupt rise in dementia patients. As of 2010, the total population of Seoul is approximately 10,186,556 and elderly people 65 years or older, comprise around 969,055, which accounts for 9.5%.
Assuming dementia prevalence, of elderly people 65 years or older, as approximately 8.2%, there are 79,462 dementia patients in Seoul. The number of those patients will be at least over 120,000 by 2020 since the elderly population is supposed to be doubled by then. Although it is merely an arithmetic calculation, super-aged seniors will surely increase more, so the actual rise of the dementia population is likely to be much greater than this.
Today, the vast majority of senile dementia, excluding dementia due to other causes, show chronic or undergoing progress that cannot be completely cured.
Moreover, dementia patients have difficulty carrying on independent lives due to the decline of daily life necessity functions. During the course of the disease, dementia patients are crippled by serious psychological and physical pain. These difficulties also affect their families with economic burden. More seriously, as the social unit of a family moves towards a more nuclear structure and women take more jobs in society, the support that a traditional family structure may provide, is diminishing. In summary, the burden is increasing beyond an individual patient or family’s capacity, and is the reason the government has taken action.
Due to chronic or undergoing progress, dementia requires different types of services for each stage of the disease. In the stages prior to incidence, preventive efforts that focus on control of vascular risk factors are needed along with regular checkups for early discovery of disease. In early stages of dementia, the relative importance of medical services such as precise diagnosis of causes and timely treatments are stressed, and additional weekly support services, cognitive rehabilitation programs would also be helpful.
During the mid-stages, diverse forms of home care support services such as family education & support programs, weekly & short term protection measures. along with medical services including drug treatments are required. For some patients, long term nursing home care should be considered.
In the last stages, the importance of welfare service including long term nursing home care becomes greater, along with medical care for the physical illness related to the disease. Recently, early discovery and intervention for dementia is being emphasized in terms of cost-effectiveness. 10~15% of dementia which is detectable in the beginning stages, have reversible causes of illness. They have great possibility for recovery. Vascular dementia that comprises approximately 20~30% of total patients, can be prevented through active management on vascular risk factors such as hypertension, diabetes, hyperlipidemia, obesity, and smoking. Moreover, as it is recently known that vascular factors are greatly involved with the incidence of Alzheimer's disease, there is a greater emphasis placed on inhibition or delay of dementia incidence through management of risk factors. Although there is no verified drug proven to prevent the incidence of Alzheimer's disease until now, drugs that will slow down the progress of the disease are undergoing clinical trials. If dementia can be delayed for approximately 2 years through many different measures, it is expected that the prevalence of dementia will reduce by approximately 30% 20 years later.
Therefore, to effectively solve the issue of dementia on a social level, beyond the fragmentary facility care level, "Dementia Integrative Management System" is required, as it provides awareness in improvement of illness, in-advance preventive programs, early diagnosis, and proper medical & welfare services according to the stage of progress.