The Caribbean’s alzheimer’s challenge

For many families, it can begin with something seemingly harmless: a grandmother asking the same question several times, a father forgetting a familiar route, or an older relative struggling to remember a name they have known for decades.

It is easy to dismiss these moments as part of getting older. But when forgetfulness becomes persistent and begins interfering with everyday life, it may be something more.

As the world observes World Alzheimer’s Month in September, attention is being placed on a disease that is becoming an increasingly important concern for the Caribbean, where ageing populations are expected to bring a sharp rise in the number of people living with dementia.

Alzheimer’s disease is the most common cause of dementia, accounting for an estimated 60 to 70 percent of dementia cases worldwide. Dementia itself is not a normal part of ageing. It describes a group of conditions that progressively affect memory, thinking, behavior and the ability to carry out everyday activities.

A growing Caribbean concern

The scale of the challenge is significant, although Caribbean statistics generally measure dementia as a whole rather than Alzheimer’s specifically.

A Global Burden of Disease study estimated that approximately 291,800 people across the Caribbean were living with dementia in 2019. By 2050, that number is projected to rise to approximately 744,800, an increase of 155 percent.

Jamaica was estimated to have approximately 17,900 people living with dementia in 2019, with that figure projected to reach more than 40,000 by 2050.

Other countries are facing similar increases. Trinidad and Tobago had an estimated 10,200 people living with dementia in 2019, while the Dominican Republic had approximately 51,700 and Cuba more than 116,000. By 2050, dementia cases in the Dominican Republic are projected to approach 149,000, while Cuba is projected to have almost 260,000.

The projections reflect the region’s changing demographics. Age is the strongest known risk factor for dementia, although dementia can also occur in younger people. Health conditions including high blood pressure, diabetes, obesity and stroke, as well as smoking, physical inactivity and social isolation, can also increase risk.

One of the biggest challenges is recognizing when ordinary forgetfulness has crossed into something requiring medical attention. Warning signs can include repeatedly forgetting recent conversations or events, asking the same questions, getting lost in familiar places, becoming confused about dates or time, struggling to find familiar words, or having difficulty completing tasks that were previously routine.

Changes in personality and behavior can also occur. Someone may become unusually anxious, angry or withdrawn, lose interest in social activities, or experience difficulty making decisions.

The World Health Organization stresses that symptoms vary between individuals and generally become more severe as dementia progresses.

Diagnosis remains a challenge

Doctors may use cognitive assessments, medical histories, physical examinations and other investigations to determine whether dementia is present and whether another condition could be contributing to the symptoms.

There is currently no cure for Alzheimer’s disease, but treatment can help manage symptoms and improve quality of life.

Medications such as donepezil, rivastigmine and galantamine may be prescribed for Alzheimer’s disease, while memantine may be used in more advanced cases. These medications do not reverse the disease but can help manage symptoms for some patients.

Treatment also extends beyond medication. Physical activity, cognitive stimulation, social engagement, rehabilitation and support for caregivers are important components of dementia care. Managing conditions such as hypertension, diabetes and high cholesterol is also important because cardiovascular health is closely linked to brain health.

The message this World Alzheimer’s Month is that persistent changes in memory, thinking or behavior should not automatically be dismissed as ageing.

Early assessment can provide answers, identify other potentially treatable causes, and allow families to plan for care and support.

As the Caribbean grows older, Alzheimer’s will affect more than those diagnosed. It will also affect spouses, children, grandchildren, caregivers and already-stretched health systems.

Recognizing the signs and knowing when to seek help may be one of the most important steps a family can take.