Researchers at the Cambridge Institute of Public Health say the UK is not heading for a dementia epidemic of the scale initially feared, after all. In an article published in the Lancet Neurology Journal they said that the number of dementia sufferers is actually stabilizing in some European countries, including the UK, and that the data and figures typically cited for the proportion of people with dementia are ‘out of date’ and inaccurate.
The figures quoted by the NHS and other health and social care bodies (including the Alzheimer’s Society) are based on old studies conducted in the 1980s. ‘These old studies support the idea of a continuing ‘dementia epidemic,’ but are now out of date because of changes in life expectancy, living conditions, and improvements in health care and lifestyle,’ said lead study author Carol Brayne, a professor of public health medicine at the Cambridge Institute of Public Health.[i]
Might this explain the 400,000 or so people said to be still undiagnosed? And could the publicizing of the real figures lift the pressure off GPs to meet NHS diagnoses targets, whose underlying data has been thought to be questionable?
Researchers from Cambridge University in the UK, Stockholm, Madrid, Bonn andGothenburg analysed the findings of five large studies carried out across Europe, all of which compare both the numbers of people with dementia and the number of people who have being diagnosed at two different points in time.
They found that four out of the five studies showed no increase in the number of people with dementia (prevalence), or the number of newly diagnosed cases over the past 20 or 30 years (incidence). In fact, the study in the UK showed a drop in the numbers, with 22 percent fewer people aged over 65 being diagnosed in 2011 than had been predicted in 1990.
According to Professor Brayne, the dip in numbers coincides with improvements in living standards and education, factors thought to protect against dementia. “Incidence and deaths from major cardiovascular diseases have decreased in high-income countries since the 1980s,” she said. “We are now potentially seeing the results of improvements in prevention and treatment of key cardiovascular risk factors, such as high blood pressure and cholesterol, reflected in the risk of developing dementia.”
While the findings are good news, they don’t reduce the impact of dementia on the NHS and social care, said Jeremy Hughes, Chief Executive of the Alzheimer’s Society. ‘People aged 85 and older are the fastest growing age demographic, and about 40 percent of this group are estimated to be affected . So while it’s good news that there are fewer people in particular age groups developing dementia, the overall number of people with the disease is still set to increase as more people live into their 80s and 90s.’ He added that with no cure and few effective treatments, the serious economic impacts of dementia still exceed those of cancer and heart disease, making it the most critical social and health care challenge in the UK.
While not ignoring the 85s and older, the authors suggest a “fairly optimistic” view of the future in terms of dementia trends. They recommend that effort and resources should be put into preventing it through health across the life course. ( http://www.medicaldaily.com/dementia-epidemic-improved-health-care-and-lifestyle-lead-fewer-diagnoses-growing-349044 )
The Cambridge study follows those presented at the Alzheimer’s Association International Conference in Copenhagen in July 2014. (http://www.alzheimers.org.uk/site/scripts/press_article.php?pressReleaseID=1156)
[i] Source: Brayne C, et al. Dementia in western Europe: epidemiological evidence and implications for policy making. The Lancet Neurology. 2015.