Dementia

This report examined the health services usage of people with dementia in their last year of life and the findings have important implications for Australia’s health and aged care systems. The report shows people with dementia who died aged 65 or over generally used health services less in their last year of life than people without dementia. People with younger-onset dementia used health services more than older people with dementia.

This report describes a range of modifiable vascular risk factors for dementia, and estimates their individual and combined contribution to the burden of dementia in Australia. Vascular risk factors in this study include smoking, physical inactivity, mid-life high blood pressure and mid-life obesity, as well as vascular diseases that act as risk factors for dementia—diabetes, stroke, atrial fibrillation and chronic kidney disease. It uses burden of disease estimates from the Australian Burden of Disease Study 2011 and evidence in the literature that shows a link between these vascular risk factors and development of dementia in later life. It shows that about 30% of the total dementia burden in Australia is due to the joint effect of the vascular risk factors examined; highlighting the potential for preventing dementia and reducing dementia-related burden.

Rich and robust data are needed for policy makers and practitioners to facilitate the prevention, early detection, diagnosis and treatment of dementia, as well as improving support for people with dementia and those who care for them. This paper provides an overview of the status of dementia data at the time of preparing the report Dementia in Australia (AIHW 2012a), and suggests ways in which the availability, consistency and quality of these data could be improved.

This report examines the experiences of the 252,700 people aged 50 and over who stayed for at least one night in a New South Wales public hospital in 2006-07. Slightly more than 8% of patients (20,800 people) were identified as having dementia. Even allowing for age and sex differences, people with dementia had much higher hospitalisation rates than those without dementia: 26% compared with 12%. They also tended to stay longer in hospital and were more likely to enter or return to residential care on discharge from hospital, or to die in hospital.

This report describes the methods used for the Hospital Dementia Services Project to derive dementia status, complete hospital stays and post-hospital destination using New South Wales hospital data for 2006-07. Comparisons of estimates using these key variables show that the method used to derive the variables can substantially affect analytical results on use of hospitals. This report demonstrates the importance of using analytical data and methods that match the particular policy or research question being asked.

In 2011, there were an estimated 298,000 people with dementia. This number is expected to increase markedly over time, with projections suggesting it will reach around 400,000 by 2020 and 900,000 by 2050. Dementia is a leading cause of death, accounting for 6% of all deaths in 2010. Total direct health and aged care services expenditure on people with dementia was at least $4.9 billion in 2009-10.

Dementia has become a key issue in aged care. It is estimated that 167,000 Australians had dementia in 2002, leading to dementia being a major cause of disease burden. This publication reports on an investigation of the oral health status of community-dwelling older dentate adults in Adelaide, South Australia with and without dementia. Older adults with dementia had higher levels of dental disease and their oral health deteriorated faster over a one-year follow-up period compared to those without dementia. Older adults with dementia also faced barriers to adequate dental care, identifying the need for improved strategies for the provision of regular oral assessment, oral hygiene care and dental treatment.