By Chioma Obinna
While Nigeria is still struggling with recent reports that ranked the country 6th among miserable people in the world, the country has again, scored another negative point with regards to its already battered health indices.
The country has again broken another unenviable record with the number of dementia cases growing by 400 percent.
Dementia is a brain disorder that affects communication and performance of daily activities. It is an umbrella term for a set of symptoms including impaired thinking and memory. It is often associated with the cognitive decline of ageing.
In Nigeria, sadly, little or no attention is given to mental health disorders. Dementia victims are labelled witches or mentally derailed. The level of awareness on mental health issues is poor and fraught with lots of misconceptions.
The culture of stigma and discrimination fuels access to care as mental disorders are linked to supernatural causes including witchcraft, demonic possession, and even punishment from gods or ancestors. In this part of the world, in most cases, these patients are abandoned to their fate.
Currently, over 7 million Nigerians suffer from depression, according to the World Health Organisation 2015 estimates. The same report estimates that West Africa has about 4.8 million people with anxiety disorders. These scary statistics may not be unconnected with the fact that Nigerians are becoming more stressed due to economic hardship and other stressful life events.
Nigeria is rated among top 10 countries that are over depressed and ranks among countries with the highest number of drug addicts, depression and dementia among others.
Statistics by WHO show that an estimated 47.5 million people have dementia and there are 7.7 million new cases every year. Developing countries like Nigeria account for 57.7 percent of the problem. According to the Federal Ministry of Health, about 20-30 per cent of Nigerians suffer from mental illness.
The Permanent Secretary of the Ministry of Health, Abdulaziz Abdullahi, had at a Mental Health Action Committee and Stakeholders’ Workshop in Abuja disclosed that with a population of about 200 million, Nigeria had a high rate of mental illness. This implies that Nigeria has about 60 million persons with mental illnesses.
However, as Nigeria battles with the mental disorders challenge with no policy on mental health in place, a study by the Journal of Global Health Reports published by the University of Edinburgh has revealed that dementia, a clinical syndrome caused by neurodegeneration has increased astronomically in Nigeria over the last two decades.
It is estimated that about 47.5 million people are living with dementia globally, with over two-thirds residing in Low and Middle-Income Countries, LMICs, including Africa, where there is very limited access to social protection, and relevant care, services and support.
This first national comprehensive study also revealed that several communities in Nigeria still link dementia to a normal process of ageing, with many patients stigmatised and abandoned in the belief that their condition is beyond any medical intervention. Thus, many of those affected delay seeking medical care and endure poor outcomes. However, the situation is exacerbated by poor mental health service access which partly results in high out-of-pocket expenses that few can afford.
It has been estimated that the number of dementia cases increased by over 400 percent over a 20-year period, from 63,500 in 1995 to 318, 000 in 2015 among persons aged 60 years.
Prevalence was highest in North-central; followed by North-west and South-west while the prevalence was also higher in urban settings compared to rural settings. Alzheimer’s disease, one of the subtypes of dementia, had the highest prevalence while other dementia subtypes had prevalence rates less of than 1 per cent
In the views of the Lead Researcher, the Centre for Global Health Research, University of Edinburgh, Dr. Davies Adeloye some of the factors responsible for the prevalence of this disease include genetic, cultural, and nutritional variation in the country. He urged the government to provide comprehensive care and support institutions for people living with dementia as this is currently lacking in the country.
Adeloye advocated for a bill broadly focused on protecting the rights of individuals with mental disorders and setting standards for mental health practice in the country. It is therefore important for policymakers to direct efforts at ensuring adequate infrastructure, personnel, training and research that focus on dementia, among other important mental health needs, in Nigeria.
Adeloye who noted that 318,000 persons were affected as at 2015 regretted said to prevent the disorder there is need for Nigerians to maintain a healthy lifestyle by eating a healthy, balanced diet, maintaining a healthy weight, exercising regularly, keeping alcohol to a minimum level, stopping smoking and keeping blood pressure at a healthy level.
Reacting to the findings, a Clinical Psychologist, Lagos University Teaching Hospital, Dr Juliet Ottoh who also described dementia as a general term for a massive decline in mental ability said when is severe, it can interfere with an individual’s life activity.
She said lack of mentally stimulating activities, not exercising and not eating healthy and balanced food could predispose an individual to dementia.
Ottoh urged Nigerians to quit smoking and embrace regular medical checkup for early detection and treatment.
“There are many different mental disorders, with different presentations. They are generally characterised by a combination of abnormal thoughts, perceptions, emotions, behaviour and relationships with others.
“Mental disorders include Depression, bipolar affective disorder, schizophrenia and other psychoses, dementia, intellectual disabilities and developmental disorders including autism. Stigma is a big problem in Nigeria.
It prevents people from seeking treatment; nobody wants to be seen entering a psychiatric hospital,” she counselled.