Alzheimer’s disease is rapidly becoming a major public-health concern in India as the population ages and lifestyle risks increase. The condition now affects millions of families and will place growing pressure on caregivers, health services, and social systems.
Recent national research estimates that roughly 8.8 million Indians aged 60 and above currently live with dementia. If prevalence remains the same, demographic ageing alone will push that number up to about 16.9 million by 2036. These figures point to a doubling of the dementia burden within a little more than a decade, driven mainly by population ageing.
A GROWING PUBLIC-HEALTH CHALLENGE
Globally, dementia already affects tens of millions of people and is expected to rise sharply over the coming decades, with most of the increase occurring in low- and middle-income countries. This global trend underlines the urgency for India to prepare systems for diagnosis, care, and support.
Several connected trends explain the rising numbers in India. First, life expectancy has increased, which naturally raises age-related diseases. Second, the prevalence of vascular and metabolic conditions such as diabetes, hypertension, obesity, and heart disease has risen in recent decades.
These conditions are important risk factors for cognitive decline and dementia, and they are common across urban and rural India. Third, changing lifestyles, poor sleep, physical inactivity, stress, and diets high in processed foods also contribute to the growing risk.
The disease profile in India shows regional and gender differences. Some states report higher prevalence than others, and women appear to have a higher age-standardised prevalence than men in several studies.
Rural-urban disparities exist too: limited awareness, delayed diagnosis, and poor access to specialist care mean many cases go unrecognised or are diagnosed late.
WHY INDIA’S NUMBERS ARE RISING
Alzheimer’s is primarily a disease of old age, but a large minority of cases are early-onset, affecting people under 65. Early-onset cases are often missed or misdiagnosed because symptoms can be mistaken for stress, mood disorders, or work-related problems.
Estimates suggest that a small but meaningful share of Alzheimer’s patients fall into this category and deserve focused clinical attention.
On the diagnostic and treatment front, the landscape is changing. Improved brain imaging, biomarker testing, and AI-assisted tools are enabling earlier detection than in the past. Disease-modifying therapies that target amyloid plaques have received regulatory approvals abroad in recent years, and one such drug gained FDA approval for early Alzheimer’s in 2024.
EARLY DETECTION, TREATMENT AND PREVENTION
These therapies are relevant for carefully selected patients with early disease, but they require specialised testing and carry risks that need close monitoring. Regulatory decisions in other jurisdictions have been mixed, highlighting both the potential and the caution needed in adopting new treatments.
Despite scientific advances, the most powerful immediate tools remain public health measures. Controlling hypertension and diabetes, promoting physical activity, improving sleep, reducing smoking and excessive alcohol, maintaining social engagement, and encouraging lifelong learning all reduce dementia risk or delay its onset. Health systems must prioritise awareness campaigns, training for primary-care providers, and community support for caregivers.
If India acts now to scale prevention, expand early diagnosis, and strengthen care pathways, the worst economic and social impacts can be reduced.
If the country delays, millions more families will face long and costly periods of caregiving and disability. The coming two decades are the critical window to build capacity, spread awareness, and integrate new diagnostic and treatment options in an evidence-based, ethical way.
(The article is written by Dr Kunal Bahrani, Clinical Director and Head of Department of Neurology at Marengo Asia Hospitals, Faridabad.)
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