What is Total Fertility Rate (TFR)
The average number of children a woman would have at the end of their reproductive period
It is expressed as children per woman.
Total fertility rate is directly calculated as the sum of age-specific fertility rates (usually referring to women aged 15 to 49 years), or five times the sum if data are given in five-year age groups
TFR in India has witnessed a significant decline, dropping from 5.2 in 1971 to 2.0 in 2020, and it is now lower than 2.1, the replacement level.
TFR, has further declined from 2.2 to 2.0 at the national level between National Family Health Survey (NFHS) 4 and 5.
There are only five States in India that are above the replacement level of fertility which is 2.1.
These are Bihar (3.0), Meghalaya (2.9), Uttar Pradesh (2.4), Jharkhand (2.3), and Manipur (2.2), according to NFHS-5, released by the Ministry of Health and Family Welfare
Growing challenge of dementia in India
The steady decline in India’s Total Fertility Rate (TFR) has led to an increase in the proportion of older adults.
As of 2019, India is home to over 139 million people aged 60 and above, accounting for more than 10% of the population
The country is confronting a growing challenge to manage neurodegenerative disorders.
The demographic shift exacerbates several risk factors for dementia including hypertension, obesity, smoking, depression, social isolation, and physical inactivity
Increasing risk factors
The prevalence of obesity has increased in most States in NFHS-5.
At the national level, it increased from 21% to 24% among women and 19% to 23% among men.
The number of individuals at risk of Alzheimer’s and other forms of dementia will increase substantially in India.
A research study conducted in India discovered that older individuals with disabilities were more prone to living alone, exacerbating their sense of social isolation and deprivation
Need reform
Lancet Commission’s 2020 report on dementia prevention, intervention, and care & NFHS 2020, highlights the urgent need for policy reforms and targeted interventions to tackle the growing dementia crisis in India
Public health initiatives aimed at promoting healthier lifestyles, such as regular exercise, a balanced diet, and smoking cessation, can reduce the prevalence of these risk factors and curb the rise of Alzheimer’s disease
India must take a proactive approach to addressing risk factors
Firstly there is air pollution, which can lead to chronic inflammation, oxidative stress, and neuroinflammation, contributing to cognitive decline and an increased risk of dementia
Secondly, addressing hypertension and obesity is critical
Thirdly, the state must implement public safety measures and regulations to reduce the incidence of traumatic brain injury (TBI), focusing on road safety, occupational safety, and sports safety
The government must establish specialised dementia care facilities and train healthcare professionals in geriatric care, with a focus on early detection, intervention, and management
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