A “growing number” of refugees and migrants are living with dementia as people compelled to move get older, health chiefs warned on Monday.
Experts said people with dementia are “often forgotten in a crisis” as war, poverty and climate change push millions of people to flee their homes. They also struggle to get health care in a foreign country and often lack understanding of their condition.
The number of over-60s living outside their home countries has almost doubled in the past three decades, from 25.5 million in 1990 to 48.2 million in 2020, a report by the World Health Organisation said. That means more migrants are at risk of a disease that typically affects people in their sixties and older.
That increase has been “particularly rapid” in areas including western Asia – a term the UN uses for the Middle East. About a third of the world's refugees come from Syria and Afghanistan.
Although there is no cure for dementia, according to some estimates almost half of cases could be prevented by addressing risk factors such as smoking, diabetes and air pollution. While evidence is patchy on whether migrants are at particular risk, the WHO says these prevention strategies are made harder when people have to upend their lives.
Dementia has been estimated to affect more than 55 million people and cost the world economy more than $1 trillion. Although exact figures are missing, the money needed to look after unwell migrants is often a political sore point raised by anti-immigrant parties in rich countries.
“Broader shifts such as population ageing, food insecurity, climate change and conflict are leading to more refugees and migrants, including those of older age. Sadly, many of these older migrants also have dementia,” said Jerome Salomon, an assistant WHO director general.
“People living with dementia are often forgotten in crisis. They also face discrimination and a struggle to access health care services in their new countries.”
The WHO's 146-page report said the issue of migrants with dementia was one of “growing scientific interest”. It said it was “increasingly evident” that migrant and forced displacement could affect “many aspects” of dementia care.
“The available evidence confirms that, due to global ageing, a growing number of refugees and migrants live with dementia in host countries,” it said. “The health needs of refugees and migrants living with dementia in emergency situations should be recognised and addressed.”
While some patient registers showed migrants at lower risk of dementia, clinical trials revealed the opposite – suggesting not enough cases are spotted, said Marco Canevelli, from the department of human neuroscience at Sapienza University, Rome, at a WHO briefing on Monday.
“This discrepancy likely reflects an under-diagnosis of dementia, and poor access to health care resources for migrants and refugees,” he said.
“There is increasing evidence that a lack of knowledge and poor health literacy concerning dementia are significant barriers to accessing services and obtaining a diagnosis,” said Mr Canevelli. “Evidence shows that several barriers within services and health care systems can hinder access to diagnosis and care for migrants and refugees with dementia.
“Care-givers of migrants and refugees with dementia encounter specific and significant challenges in providing care. These challenges arise from language barriers, limited understanding and knowledge of dementia, difficulties in navigating the HC system in a new country, and a lack of resources and specialised professionals such as interpreters and cultural mediators.”
