DEVELOPMENT OF DEMENTIA

IN BOSNIAN SOCIETY AND

NEW WAY OF CALCULATION

OF AFFECTED PEOPLE

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Author: Osman Kučuk

Center for dementia Sarajevo; Bosnia and Herzegovina

Alzheimer association A&R; Bosnia and Herzegovina

April 2017.

32. International Conference of ADI – Kyoto; Japan

Bosnia and Herzegovina is country in the developing. State, which was part of the Ottoman Empire 450 years to 1898., as a border territory opposite Europe.

Period of 1898.-1918. B&H was part of the Austro-Hungarian Empire.

After that period Bosnia entered in the community of Slavic nations in the Kingdom of SCS and SFR Yugoslavia until 1992.

After attaining independence and establishment of the separate state, in the period from 1992.-1995. B&H has gone through the period of aggression on the Bosnian territory.

Since 1996. B&H has peace in independent state and build new state.

FROM THE GIVEN DATA WE CAN CONCLUDE THAT THIS IS THE COUNTRY FOUR BIGGEST RELIGIONS WITH INFLUENCE OF DIFFERENT CIVILIZATIONS, CULTURES AND TRADITIONS – BRIDGE BETWEEN WEST AND EAST.

ABOUT BOSNIA and HERZEGOVINA – history, geographical location

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Dementia, according to our research, has taken on the character

an epidemic in Bosnian society. As risk factors we will take:

Age,

Education,

Accumulated stress,

Difficult social situation of the whole society.

The problem of dementia in Bosnian society, we will follow through three stages:

1. Period of socialism until 1992, period uniform social rights,

2. Period of aggression 1992-1995, period transitions to another social arrangement,

3. Period since 1996 - today, a new social arrangement with uneven

social rights.

DEMENTIA THROUGH THE PRISM OF AGE, LEVEL OF EDUCATION,

STRESS AND SOCIAL SITUATION IN THREE PERIODS OF NEW HISTORY

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- - 1.1. Period of socialism until 1992, period

uniform social rights

- Traditional society,

- Families are composed of three generations in

a common houshold,

- Stable life with activities planned for the future,

- Social and health insurance for all citizens,

- The average age of dead is 61 years.

4.7

6.1

6.6

0 1 2 3 4 5 6 7

71.

81.

91.

% of population 65+

%

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Characteristics of that period in relation with dementia :

There is no reliable data on the number of patients,

Very small number of diagnosed cases,

Diagnosis difficult because knowladge about disease and

symptoms are not eough,

Therapy is limited due to the small selection of drugs,

Low education of medical staff,

Low education of caregivers,

Low level public awareness on disease,

Ignorance about the hereditary factor disease,

Shame because of illness in the family

- 1.1. Period of socialism until 1992, period uniform social rights

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Rural

population

[PERCENTA

GE]

townsfolk

[PERCENTA

GE]

RELATIONSHIP BETWEEN RURAL

POPULATION AND TOWNSFOLK

rural population townsfolk

illiterate

[PERCENTA

GE]

University

degree

[PERCENTA

GE]

Third and

four degree

[PERCENTA

GE]

EDUCATION OF THE POPULATION

illiterate

university

degree

third and four

degree

- 1.1. Period of socialism until 1992, period uniform social rights

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Population 6,5% - 65+ 65-75 80% 3% PwD >75 20% 20% PwD Total PwD

4,3 M 279.500 223.600 6.708 55.900 11.180 17.888

Number of People with Dementia in B&H – calculation/presupposition – 1992.

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- 1.2. Period of aggression 1992.–1995. is and period of

transitions to another social arrangement

- - The war brought the modified nutrition - quantitatively and

qualitatively,

- - Military activities are implemented in urban areas or near urban areas.

- - fear for his lifes and for the life of loved ones,

- - the struggle for food and water,

- - life without electricity, water and heating,

- - destroyed, half destroyed or damaged homes.

- - people forced to use food derived through the programs of humanitarian aid,

- - the great migration of population,

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- 1.2. Period of aggression 1992.–1995., period transitions to

another social arrangement

- Conditions of care PwD

- Persons with dementia are nurtured at home.

- Families gather in one house because ease of the functioning, so

that patients never are not alone.

- Because of the war situation, peoples are connected among

themselves and helps each other, so that caregivers have

reduce stress

- The great problem was medications which have not been and

food which composed mostly of carbohydrate, food of dubious

quality and hygienic safety.

- the person with dementia placed in temporary organized

psychiatric unit so-called "happy center.

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1.3 Period since 1996 – today, a new social arrangement with

uneven social rights; census 2013

The population of Bosnia and Herzegovina has been reduced

for about 800,000 residents on 3,5 million inhabitants.

New communities have changed structure of the population, different habits, different needs.

Especially come to the fore social and educational

differences within the community.

0 10 20 30 40 50 60

agriculture

non-agricultural activities

service activities

Employement

% of employed

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elementery school

secondary school

high school

0 10 20 30 40 50 60

% educated people

% obrazovanih

without elderly person

one elderly person

two elderly person

0 10 20 30 40 50 60 70 80

changes in lifestyle habits- % of elderly

persons per household

1.3 Period since 1996 – today, a new social arrangement with uneven

social rights; census 2013

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0 10 20 30 40 50

1981.

1991.

2004.

2013.

Average age of population

the average age

0 10 20 30 40 50 60 70

1991.

2014.

Percentage according to place of life

urban population rural population

1.3 Period since 1996 – today, a new social arrangement with uneven

social rights; census 2013

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63.1

66.5

69

73

58 60 62 64 66 68 70 72 74

1996.

2000.

2006.

2014.

Average age of death

age at death

8.9

5.9

0.7

-1.5

-4 -2 0 2 4 6 8 10

1991.

1996.

2004.

2014.

Population growth

%

1.3 Period since 1996 – today, a new social arrangement with uneven social

rights; census 2013

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4.7

6.1

6.5

11.8

14.22

0 5 10 15

1971.

1981.

1991.

2004.

2013.

Percentage of population

over 65 years

% 65+

6

15

22

42.75

14.22

0 10 20 30 40 50

0-5 year

06 - 18 year

19-34 year

35-64 year

65+

Percentage of population by age

group

%

1.3 Period since 1996 – today, a new social arrangement with uneven

social rights; census 2013

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65 - 69 153,569 6% 9,200

70 - 79 257,722 14% 36,000

80 - 84 62,636 20% 12,500

85+ 28,069 35% 10,000

Geriatric case 15,000 50% 7,500

Total 75,200

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Number of affected people per AGE

Year/level of

school

No. of

persons

-16,8%

elderly p.

65+

70% 50% 45% 10%

0 146,078 24,500 17,000

<8 274,036 46,000 23,000

8 640,724 107,500 54,000

14 1,525,161 256,000 115,000

VI 94,204 16,000 1,500

VII+ 285,622 48,000 5,000

2,965,825 498,000 17,000 77,000 115,000 6,500

total 215,500

Social case 62% 133,500

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NUMBER OF AFFECTED PEOPLE – BASIC PARAMETERS

Social status and level of education

research of Center for dementia Sarajevo in two years on 1.400 subjects - result is 62% social

cases has symptoms of dementia

3%

OF THE TOTAL B&H POPULATION HAS

SYMPTOMS OF DEMENTIA

PwD per age 75,200

PwD per level of school and

social status

133,500

Total 208,700

AVERAGE 105,000

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This data is confirmed and accepted from Federal government and it is base for making National

dementia strategy which bearer is Alzheimer association A&R Sarajevo.

The recommendation WHO about number of affected people is 48.000 , but our presupposition is

that B&H has cca 150,000 affected people.

We shall not be satisfied until proven our presupposition!

MINIMUM NUMBER OF AFFECTED PEOPLE

WHO recomandation

48,000

18000 105000

4300000

3500000

0

500000

1000000

1500000

2000000

2500000

3000000

3500000

4000000

4500000

5000000

1991. 2013.

Comparison about Number PwD and number of

population

PwD Total of population

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From the above text we can conclude that B&H in the period 1991. to 2015.

gone through an amazing period in which the dementia as a disease with

relatively small share of the overall population of 0.7% has become a

disease with share of almost 2.9% in the overall population.

Furthermore, the country is confronted with the problem of a large aging

population (60% of the population is older of +35 year). Permanent outflow

of young people which go in countries of the EU and the USA worsens total

balance.

This is a huge change, and the country is not ready to face the problem of

these proportions. Therefore, the State is, in the first moment, turned a head

from the problem and did not wanting to accept it. The government is

aware that it will be faced with huge material expenditures for: help for

persons with dementia, help for their families and carers, as well as fees for

employers of people with dementia, in order to form a friendly environment

for people with dementia.

CONCLUSION www.demencija.org

THANK YOU ON YOUR ATTENTION

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Author:

Osman Kučuk ; Center for dementia Sarajevo