Dementia

Dementia
Older People
Healthy People
Cognitive Impairment
Alzheimer’s Disease
Dementia Care
Memory Disorders
Caregiving
Brain Health
Dementia Awareness
Ageing and Cognition
Ageing Well
Ageing Population
Elderly Care
Risk reduction
Delirium
Early/young onset
Vascular dementia
Lewy bodies
Frontotemporal dementia

introduction Introduction

Dementia is an umbrella term that describes the symptoms that occur when the brain is affected by certain diseases or conditions. Symptoms may include memory loss, difficulties with changes in behaviour, thinking, problem-solving or language. It is characterised by a decline in cognitive function that interferes with daily life activities. Dementia has a physical, psychological, social, and economic impact, not only on people with dementia, but also on their carers, families and society at large.1

Dementia is the leading cause of death in the UK with an estimated 850,000 people living with dementia today2. The risk of dementia increases with age, affecting an estimated 1 in 14 people over the age of 65 and 1 in every 6 people over the age of 803. Dementia remains grossly under diagnosed in the UK; between 40-64% of those affected are not formally diagnosed4. At any one time 1 in 4 hospital beds are occupied by people living with dementia5. Although age is the most significant factor and the risk of developing dementia increases with age, dementia can occur in people under the age of 65; this is called early onset dementia and affects 1 in 688 people6. It is estimated that there are approximately 17,000 people living with dementia in Derby and Derbyshire and this will rise to approximately 23,000 by 20307.

There are various subtypes of dementia, the most common are Alzheimer’s disease, vascular dementia, Lewy bodies and frontotemporal dementia. Alzheimer’s disease is the most common, affecting more than 520,000 people in the UK. Vascular dementia is the second most common type of dementia, affecting around 150,000 people in the UK. However, there is increasing evidence that individual cases of dementia are often a mixture of Alzheimer’s disease and vascular dementia. Vascular dementia has the same risk factors as cardiovascular disease and stroke, and so the same preventive measures are likely to reduce risk8.

why is it important to population health Why is it important to Population Health?

Dementia is crucial to population health for several reasons:

High Prevalence and Impact: The prevalence of dementia is increasing. 850,000 people are estimated to be living with dementia in the UK. By 2025 over 1 million people could have dementia in the UK and by 2050 this figure will exceed 2 million9.

The projected number of older people living with dementia in Derbyshire is set to grow by 42.5% from 2019 to 2030. This projected number includes the largest growth for older people living with Severe dementia (58.7%), followed by Mild (30.2%) and Moderate (15.0%)10. The most substantial growth can be seen for those living with severe dementia, which may result in a greater demand for health and social care services in the coming years. As evidence from the impact of the Covid-19 pandemic emerges, we may well see a further growth in the severity of persons living with dementia.

By addressing dementia, population health initiatives can reduce the overall burden on healthcare systems, improve outcomes, and enhance the quality of life for individuals.

Population Health and Ageing: The UK’s ageing population is fuelling the growth in cases of dementia. There are approximately 11.4 million people in the UK over the age of 65, and this figure is projected to rise by over 40% in the next 17 years to over 16 million. 1 in 14 people over 65 have dementia and this rises to 1 in 6 for people over 8011. The projected growth in cases requires further attention on prevention and a greater understanding of how population health efforts can support dementia risk reduction.

Economic Implications: Dementia has substantial economic implications for individuals, families, and society as a whole. The annual cost of dementia to society in the UK is estimated at £26.3 billion by the Alzheimer’s Society (£4.5 billion on state social care, £11.6 billion on unpaid care, £4.3 billion on health care, £5.8 billion on individual social care and £100 million on other costs)12. This corresponds to an average cost per person of £32,250 annually. This is made of a cost of £5,300 in healthcare and £12,500 in social care costs. This is higher than the cost of cancer, heart disease, or stroke13. Population health interventions aimed at preventing dementia can help reduce health and social care costs and alleviate the financial burden on individuals and society.

Quality of Life: Dementia is a degenerative disease characterised by worsening cognition, behavioural disturbance, mood disorder, increased dependency and physical frailty which may lead to institutionalisation14. Although it is possible to live well with dementia; it can still have a profound impact on the quality of life of those living with dementia.

Prevention and Promotion: Although there are treatment options in development, there is not yet a cure for dementia. In the absence of a cure or a treatment that is globally accessible, risk reduction remains the most feasible and proactive way to combat dementia15.

The Dementia prevention, intervention, and care: 2020 report of the Lancet Commission stated that modifying 12 risk factors might prevent or delay up to 40% of dementia. These include: air pollution, depression, diabetes, excessive alcohol, head injury, hearing impairment, high blood pressure, infrequent social contact, less education, obesity, physical activity and smoking16. By emphasising prevention, population health efforts can empower individuals, communities, and healthcare systems to take proactive measures in reducing the risk of dementia.

Overall, addressing the growing prevalence of dementia within an ageing population is crucial for societal wellbeing. Effective population health initiatives can alleviate the burden on healthcare systems, improve outcomes, and enhance quality of life. By emphasising prevention, we empower individuals and communities to take proactive measures against dementia risk factors, fostering a healthier future.

Inequalities: Dementia affects people from all backgrounds and communities. However, there are significant inequalities in dementia risk, incidence, diagnosis and management. Some of these include:

  • Sex: Women are more likely to develop dementia than men, and they are more likely to become a carer for someone with dementia.
  • Socioeconomic status: People in lower socioeconomic groups in the UK are exposed to a higher risk of developing dementia and may face additional barriers such as limited access to healthcare services.
  • Ethnicity: People from Black, Asian and minority ethnic communities living in the UK may be at a higher risk of developing dementia due to increased exposure to dementia risk factors17.

In 2023 the Derbyshire Dementia Support Service developed one of its key aims. The service has increased focus on improving access for currently under-represented groups including ethnic minority communities, young onset Dementia, people with sensory impairments and those with a learning disability18.

the derbyshire population approach The Derbyshire Population Health Approach

The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.

When considering the topic of dementia within The Derbyshire Population Health Approach:

Dementia prevention is one of the eight key strategic priorities of the Derbyshire Well Pathway for Dementia. Dementia prevention efforts in population health involve ensuring the people of Derbyshire have information about dementia and are aware of ways in which they can minimise their risk of developing dementia19. Population health professionals focus on this primary prevention within the pathway, but also work with partners to support secondary and tertiary prevention as the pathway progresses.

Taking a population-centred approach to dementia supports the identification of high-risk populations and enables practitioners to develop targeted interventions to address their specific needs.

A population health approach relies on evidence-informed practices when it comes to dementia prevention. Practitioners utilise research and data to identify effective interventions, evaluate their impact and implement evidence-based guidelines for healthcare providers and community organisations.

Dementia is not a single disease. There are different diseases that can cause dementia20.

Dementia prevention efforts in population health focus on understanding risk factors associated with dementia. This includes looking at the 12 modifiable risk factors that could reduce the risk of or delay the onset of dementia by up to 40%.

Collaboration is essential in the population health approach to dementia prevention. Population health professionals collaborate with healthcare providers, community organisations, local authorities, and other stakeholders to develop coordinated strategies, share resources and expertise, and ensure a comprehensive and multi-sectorial approach to dementia prevention. By incorporating dementia into the population health approach model, practitioners can implement targeted prevention strategies, address the underlying risks associated with dementia, and foster collaboration to reduce dementia prevalence and promote healthier communities. Partners supporting the Derbyshire Well Pathway for Dementia can be found in the Derbyshire Dementia Strategy 2022-2025.

latest derbyshire data Latest Derbyshire Data

Trend Data

Derbyshire Quilt

Prevalence Maps of Derbyshire

The maps below illustrate Lower Super Output Areas (LSOAs) and Middle Super Output Areas (MSOAs) for Derbyshire. LSOAs and MSOAs are geographical divisions used for statistical purposes, allowing for more detailed analysis of local data. In these maps, you can explore various health indicators and data for Derbyshire, providing valuable insights into the area’s health and wellbeing.

In the top right of the map, you’ll find the ‘Layer Control’ icon. This is an easy way to customise what you see on the map visualisation. Click the ‘Layer Control’ to choose which information is displayed on the map. Pick the indicator that interests you the most, and the map will transform accordingly.

Slope Index

This chart illustrates the differences in health and lifestyle factors across areas in Derbyshire, from the most deprived (decile 1, red) to the least deprived (decile 10, green). As you move from left to right on the chart (from more deprived to less deprived areas), the line shows whether these factors are becoming more or less common. Essentially, it’s a way to see how living in wealthier or poorer areas affects the prevalence of these factors.

further analysis and assessments Further Analysis & Assessments

Derbyshire Joint Strategic Needs Assessment (JSNA) involves a thorough examination of a specific health problem, exploring its causes, consequences, and underlying factors. It combines various data sources, collaboration with stakeholders, and rigorous analysis to generate insights for evidence-informed interventions and policy changes.

Coming soon…

more information and resources More Information & Resources

Below is a list of resources and comprehensive information to provide valuable support, education, and guidance on dementia prevention. This will help equip individuals, healthcare professionals, and communities with the tools and knowledge needed within the Preventing Well stage of the Derbyshire Well Pathway for Dementia.

Contributors

Lorraine Stokes, Healthcare Public Health Practitioner, Healthcare Public Health

Phil Wall, Commissioning Manager - Dementia & Sensory Impairment, Adult Social Care