In an interview with IndiaMedToday, Ramani Sundaram, Executive Director, Dementia India Alliance highlighted the technological solutions that are improving the quality of life for dementia patients and shared with us the research pipeline for dementia. Sundaram also shared with us the challenges and gaps in the form of inadequate investments, lack of skilled workforce and the absence of a structured policy that has been limiting the progress and expansion of dementia care management.

How do you see the future of dementia care evolving over the next decade, particularly in India, where the ageing population is rapidly increasing?

India’s ageing population is projected to reach 20 per cent by 2050 and with the current dementia prevalence of 7.4 per cent, the number of people living with dementia will rise significantly. The increasing awareness and involvement of various organizations in dementia care will lead to better diagnosis and access to services. Additionally, the Government of India has been focusing on non-communicable disease (NCD) screening and management through programmes like the National Programme for Prevention and Control of Non-Communicable Diseases (NPCDCS) and the National Programme for Healthcare of Elderly (NPHCE). 

Since many NCDs are risk factors for dementia, these programmes can contribute to early risk reduction. Dementia India Alliance (DIA) is actively advocating for state-level dementia policies and action plans. With the World Health Organization (WHO) recommending national dementia plans, India is expected to move towards formulating a comprehensive national dementia policy, which will play a crucial role in shaping the future of dementia care in the country.

Reports state that the prevalence of dementia ranges between 1 to 10 per cent. In addition to this, as per data by NIH, there are 4.1 million dementia cases currently in India, which is expected to double by 2030. Do you see the dementia care market future ready to cater to the needs of the ageing population?

The LASI-DAD study estimates that 8.8 million people in India currently live with dementia, a figure expected to reach 17 million by 2036. However, only one in ten cases is diagnosed, mainly due to low awareness, stigma, lack of trained professionals, and inadequate services. Although awareness is improving slowly and organisations are emerging in the dementia care space, services remain fragmented, inaccessible, and unaffordable for many. There is a critical need for capacity building, integrating dementia care into public healthcare, and making support services widely available.

India’s declining fertility rate and ageing population, as highlighted in The Economic Times article "2050 is just 25 years away, is it time to budget for India’s declining population?” will have a profound impact on dementia care. With over 20 per cent of the population expected to be 60+ by 2050, dementia cases will rise sharply, placing immense strain on families, caregivers, and healthcare systems. A shrinking workforce will lead to fewer available caregivers, escalating the economic burden of long-term care. The time To act is now. 

Despite progress, a multi-stakeholder approach involving the government, private sector, and NGOs is necessary to ensure a sustainable and scalable dementia care ecosystem.

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“With over 20% of the population expected to be 60+ by 2050, dementia cases will rise sharply, placing immense strain on families, caregivers, and healthcare systems.”

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Technology has been harnessed to enhance the quality of living in seniors living with dementia. Could you highlight a few of the recent advancements in this segment?

Technology plays a vital role in enhancing the quality of life for persons with dementia. Some notable advancements include:

• GPS tracking devices to prevent wandering.
• Fall detection systems to improve safety at home.
• Cognitive rehabilitation apps that support memory and cognitive exercises.
• Telehealth and remote monitoring tools that enable virtual consultations and care management.
• AI-based cognitive assessment tools to facilitate early diagnosis.

At DIA, we provide memory screening and teleconsultation through DemClinic, a pioneering initiative utilizing telemedicine to make dementia care accessible across India. Expanding such innovations can significantly improve dementia management.

Research and innovations play a significant role in arriving at interventions and solutions that will not only improve the quality of care but will also reduce the disease burden. How do you see research advancing in neurodegenerative disorders like dementia? Do you see sufficient investment and funding by the government?

Currently, India lacks a dedicated national dementia research agenda. However, dementia research is included under broader themes such as ageing, mental health, neurodegeneration, and NCDs.

Key developments in Indian dementia research include: LASI and LASI-DAD studies, which provide valuable national data on dementia prevalence and incidence. Institutions like NIMHANS, AIIMS, and the Centre for Brain Research (CBR) at IISc Bengaluru, conduct epidemiological and genetic research. Task Force on Brain Health, which promotes research on cognitive ageing and neurodegeneration. Department of AYUSH-backed clinical trials exploring traditional interventions like Ayurveda and Yoga.

However, funding for dementia research remains inadequate. India must increase investments and promote public-private collaborations to drive low-cost innovations, especially in digital technologies for diagnosis and care.

A skilled workforce with expertise in the geriatric segment is questionable in today's scenario with the rest of the healthcare system also grappling with low numbers of skilled HCPs. With dementia cases reaching epidemic proportions, what recommendations can you offer to ensure capacity building in the geriatric care segment?

India faces a severe shortage of trained dementia care professionals. Some key recommendations for capacity building include. Creating a certified cadre of professional caregivers through accredited training programmes. Ensuring fair wages and career growth opportunities to reduce attrition among caregivers. Integrating dementia education into medical and nursing curricula to equip healthcare professionals. Expanding government-supported skill development programmes under initiatives like the National Skill Development Corporation (NSDC) to train caregivers in dementia care. Promoting dementia caregiving as a viable career by offering structured training and certification programmes.

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Providing tax exemptions on medical expenses, home care services, assistive devices, and medications for dementia patients can encourage families to seek early diagnosis and quality care.

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Dementia care involves a heavy financial burden on the family and caregivers. Quality care is available mostly at private healthcare facilities, making affordability a major concern. How are you at DIA addressing this concern?

Dementia care is financially challenging, especially since quality care is often limited to private healthcare facilities. Key strategies to reduce costs include: Early diagnosis and intervention, which significantly lowers the long-term care burden. Integrating dementia screening into existing national health programs such as NPCDCS and NPHCE.Leveraging Ayushman Bharat’s Health and Wellness Centres (HWCs) to provide community-level dementia screening and support.Training primary healthcare providers to offer dementia care at the grassroots level.

DIA is actively advocating with the government to build capacity at various levels and develop cost-effective community-based care solutions.

As a leader in dementia care, what policies or initiatives do you believe are essential to improving the care ecosystem for individuals with dementia and their families?

Key policy recommendations for strengthening dementia care in India: Developing a National Dementia Policy, in line with WHO guidelines, involving both government and non-governmental stakeholders. Raising public awareness about dementia to reduce stigma and encourage early help-seeking. Implementing WHO’s Dementia-Friendly Initiatives, adapted to India’s socio-cultural context. Standardising care pathways and expanding services to rural areas. Incorporating dementia training in medical curricula to equip healthcare professionals.Creating dementia-friendly hospitals based on NABH guidelines developed by DIA.Expanding Ayushman Bharat (AB-PMJAY) to cover dementia-specific services.Establishing government-supported respite care, daycare, and long-term care centres to support families.

Should Dementia be included under the tax exemption category, especially for a dependent patient and their caregivers?

Yes, dementia care places a significant financial burden on families. DIA strongly advocates for: Tax exemptions for dementia caregivers to ease financial strain. Inclusion of dementia care expenses under Section 80DDB of the Income Tax Act, similar to other chronic illnesses (Is already happening) .Increased tax benefits for senior citizens to help them access better healthcare and caregiving services.

Given the high cost of quality dementia care, a substantial tax exemption can provide financial relief to families, making care more accessible. 

We are also hopeful that Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) will expand to cover treatments for conditions like Alzheimer's, dementia, heart failure, and cancer in the elderly. DIA also advocates for insurance coverage of regular memory screenings, cognitive assessments, home nursing care and therapies without hospitalization clauses.

What are your thoughts on tax benefits for senior citizens, given that quality dementia care comes at a cost and a substantial tax exemption can benefit hugely?

Given the high cost of dementia care, tax benefits for senior citizens and their caregivers would provide much-needed financial relief. Dementia is a long-term, progressive condition that requires continuous medical care, home modifications, professional caregiving, and sometimes institutional care—all of which place a significant economic burden on families.

Providing tax exemptions on medical expenses, home care services, assistive devices, and medications for dementia patients can encourage families to seek early diagnosis and quality care. Additionally, caregivers—both family members and professional caregivers—should be eligible for tax deductions on expenses incurred while supporting a person with dementia.

India can take inspiration from countries where dementia-related expenses are covered under health insurance schemes and tax rebates. Expanding Section 80D and 80DD of the Income Tax Act to include dementia-related medical and caregiving costs is a step in the right direction. Extending income tax deductions for families caring for persons with dementia, similar to those available for dependents with disabilities will also be a welcome move.