Reminiscence therapy to cognitive stimulation: Doctors call for a new approach to defuse dementia time bomb in Kashmir

Hirra Azmat

Srinagar: Dementia cases will increase by 197 percent in India and are expected to triple by 2050 globally, according to the latest research study by Lancet.

The number of dementia cases is expected to reach up to 11422692 cases in 2050 in India. In 2019, a total of 3843118 dementia cases were reported in India, the study said.
However, despite the sizeable aging population in Kashmir, there is no study or data to gauge the extent of dementia in elderly people.

“There is no epidemiological study on a geriatric population that can point out an estimation of dementia cases in Jammu & Kashmir but as per the clinical experience we see a good number of old age patients suffering from dementia,” Dr. Sheikh Shoib, Consultant Psychiatrist at JLNM Hospital, Rainawari said.

Dementia or Alzheimer’s, a neurodegenerative disease, most common in people over the age of 65, can majorly impact the quality of life of the person affected.  It is noticed when an elderly person starts misplacing things, forgetting about recent events, conversations, and common places. A person close to the patient may start noticing these changes.

“The disease progresses over time and at later stages, a person may lose the ability to speak and walk. While the onset of Alzheimer’s disease is not before the age of 65 or so, in some cases it may begin at an early age also,” Dr. Shoib said.

Further, he added, the Kashmiri population currently has a very high burden of vascular risk factors, such as diabetes, hypertension, and obesity, which can adversely impact the onset and progression of dementia.“There is no treatment for reversing or stopping the progression of Alzheimer’s, but medicines are available which can symptomatically improve cognition,” he said.

Judging by the state of affairs and the extent of preparations for the same, you would be forgiven for thinking Kashmir is going to be immune to this cataclysmic increase. 
Despite the sizeable elderly population, Kashmir has only a skeletal geriatric healthcare system in place. Besides, the geriatric OPD at JLNM Hospital, Rainawari, and Sher-I-Kashmir Institute of Medical Sciences; ‘Ahata-e-Waqar’ – a daycare recreation center for senior citizens – has been set up in Chanapora, Srinagar.

“Moreover, a geriatric OPD has been established at a public library at Bag-i-Mehtab, Srinagar. While Srinagar can at least boast of this skeletal network, the other districts of the Valley have been left to fend for themselves as no geriatric care facility exists there,” an official at JLNM Hospital, Rainawari, wishing not to be named said.

Dr. Shoib said the treatment approach to tackling the disease has to be multi-dimensional. From the awareness level, where people understand what dementia is, a good number of people are missing out on the diagnosis of dementia at earlier stages due to a lack of awareness. “There is poor awareness of dementia in society as well as among health care professionals. Also, there is a low specialist or trained human resource capacity for the care of those with dementia, and lack of public health priority for dementia is responsible for late referral to hospitals,” he said.

 Dr. Shoib said besides upgrading the health infrastructure for the geriatric population, a long-term approach is key, where not only pharmacological treatment is provided but non-pharmacological treatment is also considered.“Medication, Reminiscence therapy, cognitive stimulation therapy, reality-oriented training along with lifestyle changes are the treatment approaches for patients with dementia,” he said.

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When the world fails to make sense, Hirra Azmat seeks solace in words. Both worlds, literary and the physical lend color to her journalism.
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