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Zhang Qi Xia, resident of the Beijing First Social Welfare Institution affiliated nursery home, stands in a reminiscence room, which is a reproduction of a house set in the 1950s in China and aids with the residents' emotional health by evoking memories from their past, in the facility in Beijing March 1, 2013. The nursing home is one of the prestigious care centres for the elderly in China and accommodates about 1,000 seniors. China's elderly population will hit 360 million by 2030, from about 200 million in 2013. REUTERS/Kim Kyung-Hoon
Reuters/Kim Kyung-Hoon
COMMENTARY

In China, 93% of dementia cases go undetected

By Lily Kuo in China

By some estimates, China has the largest population of people suffering dementia—9.2 million people, as of 2010. That stands to reason given that China has the largest population on earth.

What’s alarming, though, is that only a tiny fraction of those people have been diagnosed. Some 93% of cases of dementia went undiagnosed, according to a study published this week in the British Journal of Psychiatry. By comparison, in England about 55% of dementia cases go undetected; in most developed countries, the rate is about 60%. The new study also found that 92% of those with late-life depression were undiagnosed.

This says a couple of things worth noting. First off, China’s aging population may pose even more problems than policy planners anticipate. By the end of the year, China will be home to 200 million people over the age of 55. This demographic change is already going to dent economic growth in the long term as the size of the workforce shrinks in comparison to the number of dependents. Worse, the mental healthcare needs of that growing elderly population will be much greater—and more expensive—than what the current social welfare system provides. They will also strain the younger populations, many of whom suffer from a lack of awareness of the symptoms of dementia and Alzheimer’s, and of how to care for loved ones with those conditions.

But while China’s dementia rate might sound shocking, it’s consistent with the country’s staggeringly widespread neglect of people of all ages suffering from mental illness. That’s even though China has what some estimate to be one of the highest rates of mental illness in the world.

Untreated mental illness is already taking its toll on Chinese society in very public ways. Unfortunately for the general population of mentally ill, most of that is associated with violence. Attacks often on primary school students in China have been occurring with some regularity over the past three years—an alarming trend that officials have attributed to the country’s poor treatment and awareness of mental illness. Almost 20 Chinese children have been killed and more than 50 others wounded by often middle-aged men wielding knives, cleavers and hammers. In May, a middle aged man with a cleaver attacked six primary schools students on their way home from school in Guangdong province. This week, a Chinese man in Guangxi province killed two government workers with a machete.

Earlier this year, authorities instituted the country’s first mental health law to rectify abuses in the system in which authorities were forcibly putting away activists, criminals, and those seen as general nuisances under the guise of mental illness.

That signifies how the government is at least acknowledging China’s problem diagnosing mental illness. But funding healthcare providers and educating society about how to care for elderly with mental illness is different from straightening out whom to lock up. This latest study is evidence that China has a long way to go on that score.