A New Path to Dementia Prevention Created by the Community

According to the 2023 dementia epidemiological survey released by the Ministry of Health and Welfare, the number of dementia patients is estimated to reach 970,000 by 2025. It is expected that the number of dementia patients will exceed 1 million in 2026 and 2 million in 2044. As of 2021, the social cost related to dementia was approximately 18.7 trillion won, accounting for 0.91% of GDP.

In this reality, an integrated care system centered on the community is gaining attention. Gwangju Metropolitan City began pilot operation of the 'Gwangju-type Health Care' integrated health center in Dong-gu and Seo-gu starting October 2024. This method integrates services that were previously provided individually at health centers, dementia-friendly centers, and health support centers into one space.

As of October 31, 334 people have registered at the integrated health center, of which 71%, or 235, are seniors aged 65 and older. The center provides comprehensive services such as integrated health assessments, dementia screenings, mental health counseling, smoking cessation support, hypertension and diabetes management, nutritional counseling, and oral health. It serves as a practical health care hub for the elderly, focusing on prevention-centered health management.

Gangseo-gu in Seoul is taking the lead in creating dementia-friendly villages. Starting with Ujangsan-dong in 2019, it designated Gayang 2-dong in 2020, Deungchon 3-dong in 2022, and Banghwa 3-dong in 2024, with Hwagok 1-dong being designated as the 5th dementia-friendly village on October 23, 2024.

The Hwagok 1-dong dementia-friendly village has initiated the creation of a dementia prevention environment through collaboration with local organizations such as the residents' council, community association, and merchants' association. It systematically operates the village based on community participation by establishing a safety net to protect wandering seniors and conducting missing person response training. It particularly emphasizes the importance of oral health management, informing residents that tooth loss can lead to decreased chewing function, which may result in reduced brain activity and cognitive decline.

The Ministry of Health and Welfare plans to complete the installation of dementia-friendly centers in 256 cities and counties nationwide by 2025. As of December 2019, all 256 dementia-friendly centers have officially opened, providing customized services such as counseling, dementia screening and diagnostic tests, cognitive support programs, respite care, the creation of dementia-friendly villages, and public guardianship for dementia.

To enhance accessibility to dementia-friendly centers, the expansion of branch offices utilizing existing infrastructure such as health centers is also underway. The usage time for respite care for mild dementia patients has been extended from the previous 3 hours a day to a maximum of 7 hours, and the usage period can be extended at the discretion of local governments.

According to the 2023 dementia status survey, 45.8% of families of dementia patients living in the community feel a burden of care, and non-cohabiting families spend an average of 18 hours per week on care. The annual management cost per dementia patient was found to be 17.34 million won in the community and 31.38 million won in facilities and hospitals.

Awareness of dementia-friendly centers is 56.2% among community patients and 84.1% among community families, indicating that families have a higher level of awareness. Families of dementia patients have shown a high demand for policy support regarding the economic burden of care.

A community-centered integrated approach is establishing itself as a new model for dementia prevention and management. When a care system that focuses on prevention rather than treatment, shifts from an institution-centered to a person-centered approach, and encompasses not only patients but also families is established, sustainable dementia management becomes possible.

Maintaining healthy personal lifestyle habits along with strengthening community-based integrated care systems is emerging as a key task for dementia management in the aging era.