Editorials

Addressing dementia prevention

The government has compiled a draft outline of new measures to address the growing problem of dementia among the elderly, placing emphasis on preventive steps to curb the increase in the number of patients. The draft features the first-ever numerical targets to contain the disease — cutting the incidence rate among patients in their 70s by 6 percent over six years and delaying the onset of dementia in that age bracket by a year within the next decade.

While exploring effective steps to prevent the disease — for which there is yet no established cure — will be important, the feasibility of the targets may be in doubt since steps often recommended to reduce the risk of dementia, such as adequate physical exercise, social interaction and a healthy diet, reportedly lack solid scientific evidence. Concern has also been raised that too much emphasis on preventive measures could lead people to think dementia patients are to blame because they did not make enough effort to prevent its onset. The new focus on preventing the disease should not detract from the need to create an environment in which people who have developed it can continue to live comfortably — a key objective in the government’s earlier policy in dealing with dementia.

The problem is anticipated to grow more serious with the rapid aging of Japan’s population. According to the Health, Labor and Welfare Ministry, 1 out of every 7 Japanese 65 or older is estimated to suffer from dementia. The number of patients, which stood at some 5.2 million as of 2015, is forecast to reach 7 million, or 1 out of 5 of the elderly population, in 2025. By beefing up measures aimed at preventing and delaying the onset of the disease, the government hopes to curb the anticipated rise in social security expenses caused by the increase in dementia patients.

The World Health Organization meanwhile estimates the number of dementia patients worldwide at 50 million — with about 10 million more people developing the symptoms each year. The WHO warns that unless countries take adequate steps against the disease, the number of dementia patients could reach 152 million by 2050. In a recently crafted guideline on efforts to reduce the risk of dementia, the organization cited regular physical activity, stopping smoking, eating a healthy diet and avoiding harmful consumption of alcohol among its recommendations for averting cognitive decline.

The government’s draft outline also includes physical exercise and social interaction as possible measures that could prevent or delay the onset of dementia. However, many of these recommended preventive steps are said to lack sufficient scientific grounds, leaving the feasibility of the numerical targets to cut the number of patients or delay the onset of the disease unclear.

Groups of dementia patients, their families and supporters have expressed concern that placing the emphasis on preventing the disease may breed a misunderstanding that the patients suffer from the disease because they neglected to make sufficient efforts to prevent its onset. Last week, some groups of patients and their families petitioned the Health, Labor and Welfare Ministry for the government to take steps to eliminate misunderstanding or prejudice against the patients and build a society in which people with the disease can live together with those without it. Specifically, members of the groups called for measures to enable people who develop the symptoms to keep working with the help of medical advice or to help stop company employees from having to quit to care for relatives who suffer from dementia.

The draft outline of the new measures calls for beefing up efforts to develop possible cures for dementia. A key pillar of such efforts will be building a system to encourage the participation of people with the risk of developing dementia in clinical trials for potential medical solutions. The government hopes to promote research into the mechanism of how people develop the symptoms in order to contribute to early stage diagnosis of dementia and possible development of measures to prevent the disease.

These efforts are important and need to be promoted. But equally important are the efforts to help enable dementia patients to lead decent lives in their communities — as the patients and their families are seeking. In devising and carrying out measures to address the growing problem of dementia, the government needs to listen sufficiently to the patients themselves and their supporters, so that their views will be reflected in the new policy.