病の時限爆弾　中国の高齢化とアルツハイマー病患者

【北京ＡＦＰ＝時事】陳韶華さん（６８）が出掛けたきり帰って来ず、警察に初めて保護された時、家族は、陳さんは混乱していたのだろうと考えた。（写真はアルツハイマー病を患う陳韶華さん。ＡＦＰの取材が行われた中国・北京にある娘の自宅で）
　もう一度同じようなことが起き、ようやく陳さんの具合がかなり悪いことに気付いたが、もう遅かった。
　「初期の兆候を見逃しました」と娘の陳媛媛さんは話す。「母はここ数年、父がうそをつくと、こぼしていました。（中略）私たちはずっと親元を離れていたので、どういうことかよく分からなかったんです」
　診断は、アルツハイマー病だった。
　脳の神経変性疾患で、効果的な治療法がいまだ見つかっていないこの病気の診断を受けている人は、中国では、およそ１０００万人に上り、世界全体の患者数の約４分の１を占めている。
　英ロンドン大学衛生熱帯医学大学院の研究によると、中国では高齢化が急速に進んでおり、アルツハイマー病の患者数は２０５０年までに４０００万人に達するとみられている。それに伴う医療費支出と家族の介護離職による生産性の低下で、中国の経済損失は年間１兆ドル（約１１０兆円）に及ぶと研究は警鐘を鳴らしている。
　アルツハイマー病の問題は世界中で深刻化しているが、中国の環境は整備されていないと専門家は指摘する。
　６２０万人のアルツハイマー病患者がいるとされる米国の場合、専門的な治療施設の病床数は７万３０００床だが、中国は２００床に満たない。
　中国では数百万人が都市部に移住し、農村部で暮らす年老いた親たちは「取り残され、病気が深刻化しやすい」と国家老年疾病臨床医学研究センターのホー・ヤオ氏は言う。
　家族が認知症に気付かず、患者は適切な治療を受けられないまま、何年も過ごすことになる。「早期に治療すれば、病気の進行を遅らせることができるのだが」とホー氏は付け加えた。
　中国政府が昨年発表した「健康中国２０３０」と銘打った行動計画は、アルツハイマー病などの認知症を早期に発見するため、地域単位で検診を実施し、この病気への理解を深めることを目標にしている。
　しかし、医師の養成や専門介護施設の建設、公立病院での認知症患者の受け入れ体制の強化といった具体策には踏み込んでいないという批判の声もある。

■行方不明の高齢者を捜すボランティア団体
　陳さんは、かつては人民解放軍の音楽隊のメンバーで、数種類の伝統的な楽器を演奏していた。体力はあり、数十年前の記憶ははっきりしているが、過去と現在の出来事を混同して語ることがある。
　陳さんの息子は物流会社で多忙な職に就いている。だが、地域に介護施設がないため、陳さんを勤務先の倉庫に連れて行き、自身はフルタイムの仕事をこなしつつ、父親に目を配らなければならない。
　陳さんがいなくなった時、家族は行方不明の高齢者を捜し出すボランティア団体を頼った。
　北京の志援応急救援サービスセンターの１０人以上のボランティアが、最後に陳さんが目撃された場所に駆け付け、手掛かりを得るために街頭の防犯カメラの映像を警察と一緒に何時間もかけて確認した。
　同団体が捜索に協力して家に送り届けたアルツハイマー病患者は、２０１６年以来、約３００人に上るという。
　「行方不明になった親を捜す家族の電話が、ほぼ毎日、全国からかかってきます」と蘇学代表は説明した。
　「とても危ないのは、お年寄りが建設現場跡地に迷い込んで出られなくなったり、露天掘りの穴に落ちたり、悪天候にさらされることです」と話した。【翻訳編集ＡＦＰＢＢＮｅｗｓ】
〔ＡＦＰ＝時事〕（2021/09/30-12:47）

The first time Chen Shaohua went missing and was picked up by police, the 68-year-old's family put it down to confusion.
When he disappeared a second time, they realised he was deeply unwell -- but it was already too late.
We missed the early signs, daughter Chen Yuanyuan explained, adding: For several years our mother complained he was lying... but we couldn't judge because we haven't lived with them for years.
Doctors diagnosed Chen with Alzheimer's Disease, the most common form of dementia, where people suffer impaired cognitive function including memory loss, eventually needing full-time care.
Approximately 10 million people have been diagnosed with the degenerative -- and incurable -- brain disorder in China, which accounts for approximately a quarter of the world's cases.
As the country's population is rapidly aging, this figure is expected to soar to 40 million by 2050, according to a study by the London School of Hygiene and Tropical Medicine.
The report warned this surge in cases would cost the economy $1 trillion each year in medical expenses and lost productivity as caregivers drop out of the workforce.
The World Health Organisation says that while dementia is not an inevitable consequence of biological aging, the strongest risk factor for getting it is age.
And while this is a growing problem worldwide -- experts say China is poorly prepared for the challenge.
The United States has 6.2 million Alzheimer's patients and 73,000 beds in specialist treatment centres, while China has double the cases but fewer than 200 beds.
No healthcare problem looms larger in China than Alzheimer's Disease, said Wei Shouchao, a neurologist from Guangdong medical university.
It is the fastest-growing major illness on the mainland, and we are not at all equipped to deal with it.
- 'We never suspected' -
When Chen started misplacing his keys or wallet, his family thought it was just forgetfulness.
The first time he went missing, it took 40 hours to find him. Police picked him up after someone reported an attempted break-in.
(It) looked like the place where we used to live. Dad was confused. He forgot we are now in Beijing... luckily no one assaulted him, his daughter told AFP.
Uncertain of what to do next, they bought him a watch that could help them track him via an app, but when he went missing again after taking it off, they realised he needed medical help.
We never suspected Alzheimer's because we didn't have a family history and he is so young, said Chen Yuanyuan.
As millions migrate to cities, old parents in rural China are left behind and left vulnerable, said He Yao, from the National Clinical Research Center for Geriatrics Diseases.
Lack of awareness among families means patients go without access to proper medical care for years, he said.
This is a missed opportunity because early interventions can slow the progression of the disease, he said.
Last year, Beijing announced the Healthy China 2030 action plan that aims to roll out community-level screening programs for the early detection of Alzheimer's or dementia and raise public awareness of the disease.
However, critics say the proposals do not include details about training doctors, building dedicated care facilities or increasing the capacity of public hospitals to treat dementia patients.
Rural doctors aren't trained for early diagnosis, said Wei.
Even Beijing has only one care home with staff trained to handle Alzheimer's patients.
- Missing parents -
Chen is a former army musician who plays several classical Chinese instruments including the bamboo flute.
He is physically fit and has a clear memory of things that happened decades ago. On the surface, the only indicator that something is amiss is when he talks of past events as if they are happening now.
Chairman Mao attended one of our performances, he told AFP, referring to a concert in the central city of Wuhan in the 1960s.
Dementia patients often need round-the-clock care, and the physical and mental toll on caregivers can be significant, particularly if there is little professional help.
Chen's son Chen Yunpeng has a busy job at a logistics company but as there are no community facilities he must instead bring his father to the warehouse where he juggles full-time work with keeping his father safe.
And when he disappeared, the family had to rely on a volunteer group that helps find elderly people reported missing.
Over a dozen people -- including retired civil servants, teachers and housewives -- rushed to the site where Chen was last seen and helped police pore over hours of CCTV footage from public cameras to find clues about where he went.
The team says it has helped find about 300 missing Alzheimer's patients since 2016.
We get calls almost every day about missing parents from families across the country, said Su Xiao, head of Beijing Zhiyuan Emergency Rescue Services Center.
The real danger is of the elderly being trapped in abandoned construction sites or falling into open pits or being out during bad weather.