Dementia: Facts and Figures

Dementia is a progressive and largely irreversible clinical syndrome that is characterised by a widespread impairment of mental function. Dementia mainly affects older people, although there is a growing awareness of cases that start before the age of 65. After age 65, the likelihood of developing dementia roughly doubles every five years.

Although many people with dementia retain positive personality traits and personal attributes, as their condition progresses they can experience some or all of the following: memory loss, language impairment, disorientation, changes in personality, difficulties with activities of daily living, self-neglect, psychiatric symptoms (for example, apathy, depression or psychosis) and out-of-character behaviour (for example, aggression, sleep disturbance or disinhibited sexual behaviour, although the latter is not typically the presenting feature of dementia).

Dementia is associated with complex needs and, especially in the later stages, high levels of dependency and morbidity. These care needs often challenge the skills and capacity of carers and services. As the condition progresses, people with dementia can present carers and social care staff with complex problems including aggressive behaviour, restlessness and wandering, eating problems, incontinence, delusions and hallucinations, and mobility difficulties that can lead to falls and fractures. The impact of dementia on an individual may be compounded by personal circumstances such as changes in financial status and accommodation, or bereavement (NICE, 2006).

“The societal cost of dementia is already enormous. Dementia is already significantly affecting localised health and social care systems. People with dementia, their families and friends are affected on a personal, emotional, financial and social level and lack of awareness is a problem. A proper understanding of the societal costs of dementia and how these impact upon families, health and social care services and local governments may help address this problem”. (World Alzheimer’s report, 2010) London currently has a relatively young population compared to the country as a whole, with only 11.5% in the 65 and over age group. Lewisham has an even smaller proportion of over 65s, at 9.5% of the total population. Population structures vary substantially across London which explains some of the variation in the number of people with dementia across London. Table 1 highlights the PCTs with the highest and lowest proportions of the 65 and over age group and shows the distinction between inner London and outer London boroughs.

Table 1 Proportion of the population aged 65+ by PCT, 2007

The breakdown of the Lewisham older adult population is listed below in Table 2. The current numbers for older adults are similar to neighbouring PCT areas such as Southwark and Greenwich but are substantially lower than Bromley and Croydon’s older adult population.

Table 2 Populations in the older age groups by PCT, 2007

According to the Healthcare for London (HLF) Dementia Services Guide Lewisham was estimated to have a total of 1,781 people with Dementia in 2007. Lewisham has lower levels of dementia (1.2% of the population over 30 years old) than the London average, with very small numbers of early on-set dementia (48) for over 30’s. Estimates for the expected number of patients in primary care on GP registers with dementia are slightly higher and were 1,956 in 2008/09. This is likely to be because the GP estimates use the actual number of patients registered with GPs in Lewisham rather than population estimates. Numbers of patients registered with GPs tends to be higher than population figures due to patients not being removed from GP’s lists when they die or move out of the area. Of the 1,781 estimated to have dementia by HFL the breakdown below shows the severity:

  • 55% (952) estimated to have mild dementia.
  • 32% (559) estimated to have moderate dementia.
  • 13% (222) estimated to have severe dementia.
  • 1.2% (48) estimated to have ‘early onset’* dementia

* (‘Early onset’ are those aged 30+ to 64) It is forecasted that the number of those that have Dementia in Lewisham by 2021 will be 1,657. This represents a reduction of 124 people from 2007 figures. This is due to forecasted growth of the younger age groups and decrease in the older adult population. In 2005/06 Lewisham had 1.7 places per 100 over 65s registered to take people with dementia compared to a London average of 1.34. Lewisham has a slightly higher proportion of older adults that live alone (45%) compared to the London average. There are more care homes with nursing provision for dementia in the borough than expected, although many boroughs outside of central London ‘import’ older people into residential care homes. The future estimates of provision for care homes with nursing appear to be relatively stable, with an average of 582 nursing places required between 2008 and 2025.

 

 

 

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