In 2007, the National Audit Office's (NAO) report "Improving services and support for people with dementia" drew Parliament's attention to the fact that dementia presented a significant and urgent challenge to health and social care in terms of the numbers of people affected (at least 560,000 people in England) and the costs (some £14.3 billion a year, including direct costs to the NHS and social care of £3.3 billion a year). New figures out this month suggest that the challenge is even bigger.

The NAO report noted that dementia suffered historically from poor awareness and understanding; a widely held perception that little can be done and a lack of urgency attached to diagnosing and treating the condition. The NAO drew parallels between dementia and cancer in the 1950s, when there were few treatments, and patients were commonly not told the diagnosis for fear of distress.1

The Department of Health accepted that dementia should be a national priority and in February 2009 published an ambitious, widely supported Strategy - Living well with dementia.2 The Strategy comprised 17 objectives based around three broad themes of improving awareness and understanding, timely diagnosis and living well with dementia. The establishment of the Dementia Action Alliance in 2010 and the Prime Minister's Dementia Challenge in 2012 gave added impetus to the need to improve dementia diagnosis and treatment.

Fast forward to September 2014 and at the Alzheimer's Society's 2014 Conference - Dementia: Today and Tomorrow updated research on the current costs and prevalence of dementia showed that:

  • in 2014 there are now 685,812 people in England with dementia and 815,827 in the UK (62 per cent have Alzheimer's disease) and around 670,000 people act as primary carers for people with dementia.
  • the total cost to the UK economy of dementia is now £26.3 billion or £32,250 per person, comprising £4.3 billion healthcare costs, £10.3 billion social care (44 per cent publicly and 56 per cent privately funded) and the cost of unpaid care is some £11.6 billion3
  • dementia is also estimated to cost UK business £1.6 billion per year with 89 per cent of employers believing that dementia will become a bigger issue for their organisation and their staff
  • two-thirds of people with dementia live in the community with approximately 60 per cent of people receiving home care having some form of dementia. As the symptoms of dementia progress many people need the support of a care home. In 2014 a third of people with dementia were living in care homes and 70 per cent of care home residents had some form of dementia.4

Growth in the prevalence of dementia is driven by population ageing with the oldest at most risk. Findings from the above research suggests that future prevalence predictions for the 65s and over may need to be revised downwards as improvements in education levels and public health, particularly better prevention of cardiovascular risk factors, start to impact on the risk of dementia.

Diagnosis rates are also improving but wide variations still exist both within and between nations (ranging from less than 40 to over 75 per cent). Waiting times for a diagnosis vary considerably depending on where people live with unnecessarily long waits causing undue stress. Once diagnosed many people are left without support. Numerous projects are underway across the UK, focused on making communities easier places for people with dementia to access services, socialise and live well.

The Alzheimer's Society 2014 survey, presented at their annual conference, shows there is still a long way to go. The survey found that only 58 per cent of people with dementia say they are living well and less than half feel part of their community. Sixty-one per cent have felt depressed or anxious recently, largely due to a lack of access to support. Around 40 per cent have felt lonely recently and 10 per cent only leave the house once a month. Forty-three per cent of carers consider they do not receive enough support and are over- worked. Indeed, Seventy –five per cent don't think society is geared up for dementia.5

The international research community is making dementia a global priority with investment in dementia research set to double in the UK alone. The Alzheimer's Society's report - Dementia 2014: Opportunity for change makes 14 recommendations to improve outcomes for people with dementia. Expert opinion, including recent political pronouncements, indicates an agreement on the need for further strategic guidance and direction when the PM's Dementia Challenge ends in 2015.

Here in Deloitte through our support of the Alzheimer's Society, one of our three national charity partners, we have an opportunity to make a contribution. Over the three years to 2016 we are working with the charity to achieve our overarching objective - Care for today, cure for tomorrow. Our five pillars for delivering the partnership objective are Awareness, Volunteering, Fundraising, Pro bono work and the Deloitte Research Programme. There is also an opportunity to get involved in related activities and also to make a personal statement by becoming a Dementia Friend or a Dementia Champion.

The time to act is now – just imagine the national outcry if 50 per cent of people with cancer went undiagnosed.

Footnotes

1. Improving service and support for people with dementia. National Audit Office. 2007. See also: http://www.nao.org.uk/report/improving-services-and-support-for-people-with-dementia/

2. Living Well with Dementia:a national dementia strategy for England (Strategy)

3. Overview document Dementia UK: second edition. 10 September 2014. See also: http://www.alzheimers.org.uk/site/scripts/download_info.php?fileID=2323

4. Dementia 2014: Opportunity for change. September 2014. See also: http://www.alzheimers.org.uk/site/scripts/download_info.php?fileID=2317

5. http://www.alzheimers.org.uk/site/scripts/download_info.php?fileID=1956

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.