blog

Dementia is a big topic and one that’s become even more important recently. Trouble is, there’s such a lot of information out there, including people writing blogs, it could put you off trying to say anything.

So where’s the best place to start? Deep intake of breath…Personally I think some of the numbers are compelling, so let’s start there. There are about 750 000 people with dementia in the UK at the moment. The number is due to approximately double over the next 30 years. There are almost 700 000 informal carers, by which I mean family/neighbours/friends but mainly family. I’m a bit puzzled as to why the number isn’t the same or even greater than the total number with dementia. There’s an army of people employed as paid carers who provide personal care to people with dementia in their own homes. There are about 400 000 older people living in care homes, of whom at least 2/3 have dementia, and all these homes employ about half a million people. Then we add in that over half of all admissions to hospitals are older people and around half of them have dementia, so there are lots of doctors and nurses seeing patients with dementia every day of the year.

At a rough count that gives about 2 million people who either have dementia or come across it first-hand on a regular basis. This is a very big sector of the economy. Estimates of the cost of dementia range from about £17-23 billion per annum in the UK. The exact figure depends on how you cost for informal care – you can ignore allocating family carers any costs on the basis that they aren’t being paid for their contribution, or you can enter a notional ‘wage’ which varies in some models from the minimum wage to something more realistic. The biggest chunk of the money is spent by local authorities, and most of this is the cost of supporting residential and nursing home places.

But I think it is important to think more widely than just the UK. Dementia is a truly global issue. Alzheimer’s Disease International has produced a series of brilliant annual reports that give a worldwide perspective (e.g. http://www.alz.co.uk/research/world-report-2012). They estimated that in 2010 there were around 36 million people living with dementia, around two-thirds in low or middle income countries, and that this number will almost double  every 20 years, to 66 million in 2030, and 115 million in 2050. The total estimated worldwide costs of dementia are about US$600 billion in 2010. Most of the costs occur in Western Europe and North America because nearly all the care in lower income countries is provided by families and therefore not paid for.

This all sounds very gloomy and indeed dementia has become the most feared illness, knocking cancer off top spot. As our societies get older, that is, the proportion of people living into their 80s and beyond, people talk about tidal waves or tsunamis of old age. So my first rhetorical question is: how can we deliver a balanced message about our ability to cope with rising numbers of people with dementia? Where are the chinks of light?