Dementia Cases Set to Surge as India Lags in Preparedness

India Spends 1.9% of GDP on Healthcare, Far Less on Dementia

April 29, 2025

India faces a sharp rise in dementia cases, with around 340 million people aged 60 and older expected by 2050 and 5.3 million already living with dementia since 2020, according to a report published in The Lancet Psychiatry. Yet there are still major gaps in public knowledge, available services, and trained staff.

The actual number of people with dementia in India, particularly in rural areas and lower-income populations where healthcare access is poor and awareness is low, is likely much higher than official estimates.

Studies by the Dementia India Alliance and others suggest the true figure could be at least 20–30% higher. Cultural misconceptions, stigma, and the mistaken belief that memory loss is a normal part of ageing often prevent families from seeking medical help, leading to widespread underreporting.

Warnings about the scale of the problem were issued as early as 2010 by the Alzheimer’s and Related Disorders Society of India, which called for better care systems, public awareness drives, and investment in research and training, according to the report titled “India’s need for a national dementia policy.” A follow-up report in 2020 stressed the need for early detection, greater awareness, and stronger systems of care.

Government spending on healthcare remains low, at just 1.9% of GDP as of 2023–24. Out of a 48.21 trillion-rupee budget, only 16.14 billion rupees—or 0.033% of the healthcare budget—was allocated for mental health and elderly care, reflecting its low priority in national planning, the report’s authors note.

China spends about 5–6% of its GDP on healthcare—significantly more than India’s 1.9%—and has been expanding its focus on elderly care as its population ages. And Japan has a dedicated long-term care insurance system, which covers dementia care among other services. In 2021, government spending on long-term care amounted to around 2.2% of Japan’s GDP. Dementia care forms a significant part of this system.

The Longitudinal Aging Study in India (LASI) reported in 2023 that about 7.4% of people aged 60 and older have dementia, with higher rates among women and rural populations. The number of cases is expected to quadruple by 2036.

Some states have started taking action, the report acknowledges.

Kerala launched the State Initiative on Dementia in 2014 in partnership with private organisations, offering awareness programmes, caregiver training, memory clinics, and residential care facilities. In Delhi, the Longitudinal Cognition and Aging Research project began in 2015 to study stroke and dementia, aiming to develop risk prediction tools, though results remain unclear due to study challenges.

Karnataka launched the Karnataka Brain Health Initiative in 2023 with NIMHANS and NITI Aayog, aiming to set up specialist clinics for brain diseases. The Centre for Brain Research is also conducting studies on ageing and brain health in urban and rural settings. While still evolving, these efforts mark an important shift towards addressing dementia.

Dementia is a group of conditions that damage the brain and gradually impair thinking, memory, and daily functioning. Symptoms worsen over time. Early signs include memory loss, difficulty thinking clearly, problems with language, and disorientation, such as getting lost in familiar places. Changes in mood and behaviour are common, with individuals becoming confused, anxious, suspicious, withdrawn, or unusually aggressive. In later stages, people may struggle to recognise loved ones, lose speech and mobility, and experience hallucinations.

Symptoms vary depending on the type of dementia. Alzheimer’s disease is the most common cause. Vascular dementia mainly affects thinking speed, decision-making, and concentration. Lewy body dementia leads to severe fluctuations in attention and alertness, often with hallucinations and movement issues. Frontotemporal dementia causes major changes in personality, behaviour, and language, often before memory loss appears.

There is no cure for dementia, but treatment can help manage symptoms and improve quality of life. Medicines such as donepezil, rivastigmine, and memantine are used to ease memory loss, confusion, depression, or agitation, although they do not halt the disease. Non-drug therapies—including cognitive stimulation, music therapy, physical exercise, and occupational therapy—play a key role in helping people maintain independence. Counselling for individuals and families is vital for emotional support.

In advanced stages, full-time care may be needed at home or in professional facilities. Families are encouraged to create safe, predictable environments to reduce confusion and distress. Digital tools like mobile apps, reminder systems and brain-training games are being developed to support early-stage dementia management, although they cannot replace personal care.

For India to confront its growing dementia crisis, a national strategy focused on prevention, care, and equitable support is urgently needed. Building such a strategy requires collaboration among government officials, healthcare professionals, researchers, people living with dementia and their families. Existing studies and reports already provide a strong starting point.