Closing the treatment gap for dementia in India

There is a rich epidemiological evidence base on dementia in India which shows that this neurodegenerative condition is an important public health problem, particularly in the context of the rapid demographic transition in many parts of the country. Research has shown that most people with dementia, and their caregivers, have significant unmet health and social welfare needs. Due to the great shortage of health care resources and the low levels of awareness about dementia, interventions addressing the needs of the people should be home based and directed at improving quality of life of the person with dementia and the caregiver. In view of the lack of specialists to deal with dementia, a group in Goa developed an alternate model of care which involved training lay health workers to provide home-based care for people with dementia under the supervision of a psychiatrist. This was successfully implemented and evaluated in a randomized controlled trial which showed clear benefits. This article concludes by considering the implication of these findings on strategies for scaling up services and close the treatment gap for dementia in India.