Dementia is now emerging as a leading mental health challenge among older Cook Islanders says Te Marae Ora (TMO), Ministry for Health Dr Rangiau Fariu.

Dr Fariu who is currently part of TMO’s mental health team spoke at the second day of the Primary Care Psychiatry Course for Frontliners and Volunteers event at Sinai Hall yesterday.

Dementia is increasingly becoming a significant health challenge, particularly among older adults. It is not a single disease, but rather a syndrome caused by various underlying brain disorders.

Dr Fariu said that in the 1960s and 70s, we rarely encountered dementia. However, thanks to modern medicines and technology, we are now living longer, which has a downside: a rise in dementia cases.

Many people in Aitutaki, and likely other islands too, have never been assessed for dementia, he said.

“It’s becoming more prevalent everywhere.”

Dementia is a general term used to describe a group of symptoms that affect memory, thinking, behaviour, and the ability to perform everyday activities.

Memory loss is one of the most common early symptoms, especially short-term memory. Other symptoms include difficulty with language, problem solving, attention, judgment, and changes in mood or behaviour.

Dementia is progressive, meaning symptoms gradually worsen over time.

There is no cure for most types of dementia, but some treatments and support strategies can help manage symptoms and improve quality of life.

Among adolescents and young adults, substance abuse was identified as a major trigger for long-term mental illness.

Meanwhile, Dr Fariu emphasised that the main mental health problems in youth are caused by alcohol, marijuana, and other substances. Prolonged use can lead to chronic conditions like schizophrenia.

The Cook Islands carries one of the highest rates of non-communicable diseases (NCDs) in the Pacific, such as diabetes, hypertension, high cholesterol, and heart disease - all of which contribute to the rising incidence of dementia.

Mamatiare George, a nurse from Mangaia, said their island population stands at 504, and 252 people live with an NCD.

The island has six known mental illness cases - ranging from schizophrenia and psychosis to dementia and severe anxiety.

George says there have been incidences when they have to rely on the Police for help to deal with patients.

Due to lack of funding, Dr Fariu and his team have not been able to visit Mangaia since 2021. Previously, the mental health team visited once or twice a year when specialists were available.

“The last doctor to our island was four years ago. It would be nice to have a visit from the Te Marae Ora Mental Health team,” said George.

Health workers from the Pa Enua (Outer Islands) have raised concerns about patients being sent from New Zealand by their families back to the islands without adequate support.

Some arrive diagnosed and on medication, yet travel to live in the Pa Enua without prior coordination with local mental health services.

“We only hear about some when the nurses (in the Pa Enua) refer them - usually when it’s urgent and the patient is in a psychotic state. And by then, they can't deal with it, they don't have medicines there,” said Dr Fariu.

“So it depends on the families who come across to let us know. At least we can support.”

He added, “It’s happening more often.”

The course is facilitated by Te Kainga O Pa Taunga (TKOT) - the Cook Islands’ leading provider of mental health care - highlighted growing concerns around mental illness across age groups and in the country.