Dementia

Dementia has become an increasingly significant issue in health and social care services because of the high and increasing numbers of people with the condition and the resulting costs to the UK economy.

What is dementia?

Dementia describes a set of symptoms that include loss of memory, mood changes and problems with communication and reasoning. It is caused by a number of diseases, most commonly Alzheimer’s disease, which leads to changes in the brain that cause the death of brain cells.

The likelihood of getting dementia increases with age though a small proportion of sufferers is aged under 65.

The extent and cost of dementia

There were an estimated 750,000 people with dementia in the UK in 2010, according to Alzheimer’s Society figures, at a cost to the economy of over £20bn a year. Numbers with the condition are expected to rise to 1.7m by 2050.

The large majority of the cost comes in unpaid care and social care.

Problems with dementia care

Besides its high and rising cost, dementia care has long been beset by problems, including:

• Failure to diagnose: Just 40% of people with dementia receive a diagnosis, according to figures produced in 2011 by Alzheimer’s Society. It predicted that half a million people would live undiagnosed in the UK with dementia by 2021, without improved rates of diagnosis. This is linked GPs having a lack of training in diagnosing dementia, the impact of stigma on preventing people coming forward to be diagnosed and lack of information and advice for families on dementia.
• High use of residential care: The 2007 Dementia UK report found that one-third of people with dementia lived in residential care. This is linked to a failure to intervene early to support people with dementia.
• High use of antipsychotic drugs to control the symptoms of dementia: A review for the Department of Health in 2010 found that, of 180,000 people treated with antipsychotics in England each year, just 36,000 derived some benefit from them.
• Poor quality of care in care homes and hospitals: This has been identified by a number of reports.

Policy: dementia strategies

Governments of all four countries of the UK have responded to the concerns over dementia with strategies to improve care and support.

The national dementia strategy for England

The national dementia strategy for England was published in January 2009, setting out a range of objectives to improve care by 2014. The coalition government has prioritised three of these objectives in a revised action plan, published in September 2010: good-quality early diagnosis and intervention for all; improved quality of care in general hospitals and living well with dementia in care homes. It has also set a fourth objective, reducing the use of antipsychotic medication for people with dementia.

Early progress on the strategy was criticised in a 2010 report by the National Audit Office. Progress on the strategy is being captured through a national audit of dementia services, overseen by national clinical lead for dementia Alistair Burns.

Scottish dementia strategy

The Scottish government published its first national dementia strategy in June 2010. It set our basic standards of dementia care, which providers will be assessed on, and a new skills framework to ensure all staff are appropriately trained. A progress report was published in June 2011.

Wales and Northern Ireland

A national dementia action plan for Wales was published in 2009, including proposals to improve information for people with dementia, training for staff and support for carers.

A draft dementia strategy for Northern Ireland was issued for consultation in 2010.

Dementia research

Dementia affects more people than cancer or heart disease but has traditionally been underfunded in comparison with these areas. The Dementia 2010 report, commissioned by the Alzheimer’s Research Trust (now Alzheimer’s Research UK) found that for every £1m in care costs relating to the disease, £130,000 was spent on cancer research and just £5,000 was spent on dementia research.

Yet experts have said research could limit the future cost of dementia to the state by developing better treatments and care.

In June 2011, the UK government pledged up to £20m over five years to boost spending on dementia research in England.  Boosting spending on research is also a priority in Scotland and Wales.

More information on dementia

Alzheimer’s Society

Alzheimer Scotland

Alzheimer’s Research UK