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The Rising Cost of Dementia |
| Paper ID: |
609 |
Last updated: 18/05/2011 14:35:55
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Summary  |
| Rates of dementia will increase steadily in line with increasing rates of longevity of the general population. This will have a major impact on family carers, and their mental health, and on health and social services. Financially, the cost of dementia to the UK at the end of 2008 was £17 billion per year. This could increase to over £50 billion per year over the next thirty years. |
Discussion |
Progressive organic diseases of the brain (dementia) are common, with senile dementia currently affecting 5% of people aged over 65 and 20% of those aged over 80. [1], [2]
The term dementia is used to describe a collection of symptoms, including decline in memory, reasoning and communication skills, and a gradual loss of skills needed to carry out daily activities. The most common type of dementia is Alzheimer’s disease. Many factors can be associated with dementia [1] including age, genetic background, medical history and lifestyle, and these can combine to lead to the onset of dementia.
Dementia is most common in older people. The proportion of deaths attributable to dementia increases steadily from 2% at age 65 to 18% at age 85–89 in men, and from 1% at age 65 to 23% at age 85–89 in women. [3] The prevalence of both young onset and late onset dementia increases with age, doubling with every five-year increase across the entire age range from 30 to 95 and beyond.
It is estimated [3] that at the end of 2008 there were about 700,000 people with dementia in the United Kingdom, and this number is forecast to increase with the demographic shift in the age of the population, with more people surviving beyond 80 years. In particular, over the next thirty years the total could double to 1.4 million people, with the numbers of men and women affected increasing at a similar rate. Dementia currently costs the UK economy £17 billion a year, and this could treble to over £50 billion a year over the same period.
This increase is due to a combination of two factors: first, the proportion of people who experience dementias rises rapidly with age; and secondly, the age of the population is rapidly increasing: the number living beyond 80 could nearly double to 5.4 million by 2031, and more than treble to 9.5 million by 2071366.
The increases in the numbers of people with dementia under 80 years of age will be relatively small. Numbers of people with young onset dementia are projected to remain relatively stable over time.
The PSSRU (Personal Social Services Research Unit) has built a model to project the likely future demand for long-term care for older people and its costs. [4] A wide range of scenarios has been examined for a variety of purposes, including for the Wanless Review of social care [5]. A variant of the model has been constructed to make projections of the numbers of older people with cognitive impairment (a good proxy for dementia) and the associated costs of their support. [6] The number of older people with cognitive impairment in England is projected to rise by more than two-thirds from 468,000 to 855,000 between 2002 and 2031, faster than the increase in numbers of older people with functional disability only. Over the same period, expenditure on long-term care services for older people with cognitive impairment in England is projected to rise from £5.4 billion to £16.7 billion equivalent to an increase from 0.60% to 0.96% of projected GDP. This figure does not include any imputed cost for informal care. Under present arrangements for the financing of long-term care, a sizeable proportion of this total would be publicly funded. [3]
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Implications |
In old age, mental health problems can often lead to expensive admissions to nursing homes or hospital. However, while this attracts considerable attention of policy makers, overall a bigger impact is often felt in the family. Although it is difficult to put an economic value on informal care, there is no doubt that the cost for this is also high: arguably, insufficient emphasis is given to the financial burden on the family in discussions of policy and practice. [7] However, the recently published Dementia UK report offered new estimates of the overall cost of dementia. [3]
Total annual UK costs of dementia amounted to £17 billion: accommodation accounted for 41% of the total, health services 8%, social care services 15% and imputed costs for informal care support and lost employment 36%. (This last element is sensitive to the value placed on informal care, and different studies have used different methods. However, the consistent finding across studies is of a high cost of informal care). [2]
Other impacts include:
• more of the working population staying at home to look after the old;
• the possibility of increased prioritisation of healthcare for the elderly, squeezing, healthcare for the young;
• More opportunity for crime against the elderly (e.g. swindling vulnerable people out of life savings)
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Early indicators |
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Drivers & Inhibitors |
Drivers: The demographic shift is the main driver.
Inhibitors: Current medications used in the treatment of Alzheimer’s disease (cholinergic enhancers) bring about limited improvement in cognitive function in some patients, but do not affect the fundamental course of the disease. There is a good chance that at some point in the next 20 years, the current large amount of research into biological mechanisms underlying the disease and potential drug treatments will result in medications which do have preventive or true disease-modifying effects. These could have major effects on prevalence, survival and costs, with increased health service cost for medications, but also possibly substantial savings on social care. One area of particular innovation in this field is biomarkers. And with raised understanding it may be possible for individuals to underake activities to reduce their chances of some age related mental problems.
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| The contents of this paper were provided by the Outsights-Ipsos MORI Partnership. Any views expressed are independent of government and do not constitute government policy. |
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