Health literacy in the context of Dementia in Malta.

Abstract

As a consequence of global ageing and demographic changes, neurodegenerative disorders amongst older adults are leading to an ever increasing impact on public health (Chapman, D.P. et al. 2006). In 2015, there were 46.8 million people worldwide with dementia (Alzheimer's Disease International, 2015). The same report estimated that there would be a projected increase to 74.7 million cases in 20 years time, and to 131.5 million cases in 50 years' time.. It is therefore important to invest in good public health knowledge in order to increase the level of health literacy on dementia with the aim of increasing the likelihood of having earlier diagnosis rates that will secure better treatment outcomes. Health literacy is defined as the capability of a person to understand and process basic health information in order to be able to make appropriate health decisions (Peerson and Saunders, 2009). Dementia is a syndrome of the brain resulting in a disturbance of memory, thinking process, learning capacity, language and judgment (World Health Organisation, 2012). Dementia is usually subdivided into three main stages; early (symptoms include forgetfulness and difficulty in communicating), middle (increase in forgetfulness, difficulty managing daily tasks and disorientation of time and place), and late (unable to recognise relatives, agitation and unaware of the things around them). Dementia is devastating, not only to the affected individuals, but also to relatives who, in the majority of cases, act as main carers. To care for an individual with dementia requires time, money and support from a myriad of sources including governmental and non-governmental organisations. There is still lack of awareness on dementia in the Maltese Islands. For a significant number of individuals, memory loss is still considered as part of normal ageing and therefore no medical advice is sought in time. Thus, the aims of this study were to investigate the level of knowledge of the Maltese general adult population regarding dementia (focusing mainly on Alzheimer's disease (AD)); and to study the potential for increasing awareness through the organisation of public seminars. In tum the objectives of this study were; to analyse the knowledge among the general adult population by relating to four demographic variables (age, gender, level of education and location) and analysing an improvement in dementia knowledge following the delivery of seminars on the subject. The methods chosen for the study were two. For phase 1, the target population was the adult general population of the Maltese Islands. During this phase the general public's knowledge about dementia, in particular AD was analysed by conducting 400 telephone interviews. Following completion of phase 1, statistical analysis was carried out to evaluate topic areas where the public mostly lacked knowledge, and formulated a questionnaire that was used as the measurement tool during phase 2. The target population for the second phase of the study were individuals who attended a number of day centres in Malta ("Zurrieq", "B'Kara" and "Mosta"). Results from the survey in phase 1 indicated that the majority of the participants (mean age: 75.6 years) mostly feared of getting cancer and AD. The survey revealed that more work needs to be done in order to increase the awareness about the availability of a reliable test to diagnose AD (being the most common form of dementia), and the availability of a medical treatment that will aid the person with AD to slow down the progression of the disease. Initiatives need to be devised in order to increase the public's knowledge about the different symptoms of AD, especially the severe symptoms which include hallucinations and anger. On a positive note, the majority of the participants agreed that they will seek medical advice either for themselves or a family member if they become aware of symptoms related to AD. Since dementia is a public concern, the findings from this study can be a source of information for both policy makers and health care professionals in formulating new policies and agendas in this sector. Such initiatives will surely aid persons with dementia and their carers in enhancing their quality of life whilst reducing stigma that is normally associated with dementia.