1 The prevalence and cost of dementia
and the development of a Departmental strategy diagnosis and early
intervention
1. Dementia is a term for a range of progressive,
terminal organic brain diseases. Symptoms include decline in memory,
reasoning and communication skills, and ability to carry out daily
activities, and loss of control of basic bodily functions caused
by structural and chemical changes in the brain. Alzheimer's disease
is the most common form of dementia. Age is the main risk factor
in dementia. Official statistics show dementia was the cause of
3% of all deaths in 2005, and may have contributed to up 13% of
all deaths.[2]
2. In 2006-07 there were around 560,000 people with
dementia in England. Prevalence increases with age and the number
of people with dementia is set to increase by over 30% over the
next 15 years. Figure 1 shows the expected rise in prevalence
over the coming 50 years.[3]
Figure 1: The number of people with dementia in England is increasing
and is estimated to reach 1 million by 2031 and 1.4 million by 2051[4]
Year
Source: C&AG's Report Figure 5 (adapted from
Dementia UK: Report to the Alzheimer's Society, King's College
London and London School of Economics and Political Science, 2007)
3. Dementia costs the health and social care economy
more than cancer, heart disease and stroke combined.[5]
In total the estimated economic burden of late-onset dementia
in England is £14.3 billion a year (on average £25,000
per year for each affected person).[6]
The contribution made by informal carers is estimated to save
the taxpayer over £5 billion per year. The biggest component
of cost relates to care home accommodation, which totals almost
£6 billion per year. Costs of NHS services and social services
total £3.3 billion a year. Figure 2 provides a breakdown
of the different cost components relating to dementia.[7]
Figure 2: Breakdown of economic burden of dementia in England (2006-07)[8]
Source: C&AG's Report , Figure 8
4. Despite the significant human and financial costs
of dementia, the disease has not been a priority for the Department
or the NHS. It was not until 2005 that the Department developed
policy specifically directed towards older people's mental health
issues. Dementia services, and older people's mental health services,
have not benefited from the National Service Frameworks for older
people, mental health or long-term conditions.[9]
Following publication of the C&AG's report on dementia services,
the Government identified dementia as a national priority and
the Department has since established a Working Group to develop
and deliver a national dementia strategy within the next year.[10]
5. By October 2007, the Working Group had met three
times and identified three key themes to focus on in developing
its strategy: improving public and professional attitudes and
understanding; enabling early identification and early treatment
for people with dementia; and improving the quality of care for
people once they are diagnosed (from diagnosis to end-of-life).
Following development of a national dementia strategy, the working
group intends to generate an implementation plan.[11]
6. Whilst the Chief Executive of the NHS has overall
responsibility for dementia care, there is no-one with the specific
responsibility for improvements in dementia service, as there
is for cancer. The Department confirmed that the strategy will
consider whether there might be merit in appointing a Senior Responsible
Officer to drive through the development and implementation of
the dementia strategy and take overall responsibility for dementia
care in England.[12]
2 Q 68; C&AG's Report, paras 1, 1.3 Back
3
Qq 2, 39, 68-71; C&AG's Report, para 1.2; Back
4
C&AG's Report, Figure 5 Back
5
Lowin et al (2007) Alzheimer's disease in the UK. Comparative
evidence on costs and illness and volume of health services research
funding, International Journal of Geriatric Psychiatry,
Vol 16, 1143-1148 Back
6
Dementia UK: Report to the Alzheimer's Society, King's
College London and London School of Economics and Political Science,
2007 Back
7
Qq 41-42, 46; C&AG's Report, paras 1.3, 1.10 Back
8
C&AG's Report, Figures 8 and 9 Back
9
Q 2; C&AG's Report, para 1.6; Back
10
Qq 2-7, 84-87, 114-123 Back
11
Qq 2, 5, 84 Back
12
Qq 89-98, 114 Back
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