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Mental care for senior citizens 'faces challenges'

Updated: 2012-10-11 00:35
By Wang Qingyun and Shan Juan ( China Daily)

Mental healthcare for the elderly faces a number of challenges if it is to meet government targets, a senior health official said on Wednesday.

About 13 percent of the population are at least 60 years old.

A 40 percent detection rate for the first stage of mental illness is set out in the 12th Five-Year Plan (2011-15) but a lack of standard procedures means this will be difficult to meet, Kong Lingzhi, deputy director of the bureau of disease control and prevention at the Ministry of Health said on Wednesday, World Mental Health Day.

China's health authorities have not yet set standard procedures for screening early-stage dementia, she said.

Cost is also a factor that needs consideration, Kong said. "Early-stage diagnosis is, obviously, important. The more people screened the better. However, it can be costly," she said. "We have to consider which age groups are suitable for screening."

In research carried out in 1997, Zhang Zhenxin, a neurologist at Peking Union Medical College Hospital, found that of the 34,000 people older than 55 screened in Beijing, Xi'an, Shanghai and Chengdu, 1,141 had dementia.

The survey interviewed families and caregivers of 405 dementia sufferers, and found only 93 had sought medical treatment after showing symptoms. Only 25 had been correctly diagnosed. The majority believed that there was no need to treat dementia as they considered it a natural phase of life for the elderly, the survey showed.

Lack of screening facilities for grassroots healthcare providers is to blame for the "rather low " rate of early dementia diagnosis in China, according to Tang Zhe, a professor of gerontology at Beijing's Xuanwu Hospital.

"Usually people go to hospital only because they have severe dementia," Tang said. "We need to develop simple methods for preliminary examination for community healthcare centers, and train specialists to do the regular screening there, so that patients can find out about their condition in time."

He also warned that dementia is an illness that requires early treatment.

"Families of elderly people tend to mistake dementia for a natural state of aging, particularly in the early stages," said Shang Lan, a specialist in elderly mental healthcare at Beijing's Huilongguan Hospital.

According to the 12th Five-Year Plan (2011-15), the number of people aged 60 or older will increase to 16 percent of the population in 2015.

"Psychiatric departments in China offer 1.58 beds for every 10,000 people, while the global average is 4.36 beds per 10,000 people," said Kong. "Also, our specialists are in short supply. We now have only just over 20,000 psychiatrists and 35,000 nurses."

In order to tackle the problem, "central and local governments have invested 15.4 billion yuan ($2.45 billion) from 2010 to 2012 to expand 548 mental health institutions and to help 608 mental health institutions obtain basic equipment," Kong said. "From 2011 to 2012, the government spent 6 million yuan on training medical workers in mental healthcare."

According to Shang, dementia, which inhibits cognitive ability far beyond the aging process, is a major mental health disorder afflicting the population.

Shang said that most of dementia patients are at least 60, but in recent years, "we've detected a rising number of younger sufferers, some even in their 40s''.

Apart from the elderly, those at major risk are people with cardiovascular disease and those who had less education opportunities.

Statistics from the regional epidemiology study showed 4.2 percent of those aged 60 or above on the mainland suffered dementia.

"For those aged 85 and older, the prevalence might reach 30 percent," said Shang.

One form of dementia, Alzheimer's disease, accounts for 50 to 80 percent. "It starts with frequent memory loss and sufferers end with zero ability to live independently," Shang noted. "The process, on average, takes 10 years."

"A patient is like a baby and is extremely hard to take care of,'' she said.

Given treatment can only slow the process rather than reverse it, long-term care, particularly within the family, is a growing social concern, she added.

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