Dementia in Australia

Dementia is a term used to describe a group of conditions characterised by gradual impairment of brain function, which may impact memory, speech, cognition (thought), personality, behaviour, and mobility.

There are many forms of dementia, the most common being Alzheimer’s disease – a degenerative brain disease caused by nerve cell death resulting in shrinkage of the brain. It is also common for an individual to have multiple types of dementia, known as ‘mixed dementia’. While the likelihood of developing dementia increases with age, dementia is not an inevitable or normal part of the ageing process. Dementia can also develop in people under 65, referred to as younger onset dementia, and in children, which is known as childhood dementia.

Dementia is a significant and growing health and aged care issue in Australia that has a substantial impact on the health and quality of life of people with the condition, as well as their family and friends. As the condition progresses, the functional ability of an individual with dementia declines, eventually resulting in the reliance on care providers in all aspects of daily living. There is currently no cure for dementia but there are strategies that can assist in maintaining independence and quality of life for as long as possible.

How common is dementia?

In 2022, it was estimated that there were 401,300 (AIHW estimate) Australians living with dementia. Based on AIHW estimates, this is equivalent to 15 people with dementia per 1,000 Australians, which increases to 84 people with dementia per 1,000 Australians aged 65 and over. Nearly two-thirds of Australians with dementia are women.

With an ageing and growing population, it is predicted that the number of Australians with dementia will more than double by 2058 to 849,300 people (533,800 women and 315,500 men) (Figure 1).

Figure 1: Australians living with dementia between 2023 and 2058: estimated number by sex and year

In 2021, the Organisation for Economic Co-operation and Development (OECD) estimated that the prevalence of dementia in Australia was 15.1 cases per 1,000 population, close to the OECD average of 15.7 per 1,000 population and ranking 19th lowest out of 38 countries (OECD 2021).

See Prevalence of dementia for data by age, sex, geographic and socioeconomic area.

Risk factors

A range of factors are known to contribute to the risk of developing dementia and may affect the progression of symptoms. Some risk factors can’t be changed, such as age, genetics and family history. However, several are modifiable, and can be altered to prevent or delay dementia.

High levels of education, physical activity and social engagement are all protective against developing dementia, while obesity, smoking, high blood pressure, hearing loss, depression and diabetes are all linked to an increased risk of developing dementia (Livingston et al. 2017).

See What puts someone at risk of developing dementia? for more information about risk factors.

Impact

Dementia is the second leading cause of death in Australia

In 2020, dementia was the second leading cause of death in Australia, accounting for 14,500 deaths (or 9.6% of all deaths). Dementia was the leading cause of death for women and the second leading cause for men, after coronary heart disease.

The number of deaths due to dementia increased from 9,200 deaths in 2010 to 14,500 deaths in 2020. The age-standardised rate, which accounts for differences in the age and sex structure of a population, rose between 2010 and 2020, from 35 to 38 deaths per 100,000 Australians (Figure 2).

For more information, see Deaths due to dementia.

Figure 2: Deaths due to dementia: number and age-specific rates, by age and sex, 2020

Impact of COVID-19 on people with dementia

People with pre-existing chronic conditions, such as dementia, have a greater risk of developing severe illness from COVID-19. Fatal COVID-19 outbreaks have involved many people with dementia. Pre-existing chronic conditions were reported on death certificates for 8,871 deaths due to COVID-19, registered by 30 November 2022 in Australia. Of these deaths, over 30% had dementia (including Alzheimer’s disease) recorded (ABS 2022). COVID-19 was an associated cause of death for a further 511 deaths due to dementia (including Alzheimer’s disease).

The indirect effects of COVID-19 on people with dementia – including reduced uptake of preventative healthcare services leading to delayed diagnoses, as well as spikes in mental illness, such as loneliness and depression – are not well understood but are thought to be substantial.

See COVID-19 Mortality in Australia: Deaths registered until 30 November 2022 for more information on COVID-19 deaths released by the Australian Bureau of Statistics.

Dementia is a leading cause of burden of disease

Burden of disease refers to the quantified impact of living with and dying prematurely from a disease or injury and is measured using disability-adjusted life years (DALY). One DALY is equivalent to one year of healthy life lost.

Dementia was the second leading cause of burden of disease in Australia in 2022, behind coronary heart disease. However, it was the leading cause of burden for women as well as for Australians aged 65 and over. The total burden of dementia was just under 242,000 DALY, with 59% of burden attributable to dying prematurely and 41% from the impacts of living with dementia (Figure 3).

Figure 3: Leading 10 causes of disease burden (DALY) in Australia, by sex and age, 2022

Around 43% of the overall dementia burden in 2018 could have been avoided if exposure to 6 lifestyle risk factors (overweight including obesity, physical inactivity, tobacco smoking, high blood pressure in midlife, high blood plasma glucose levels, and impaired kidney function) were reduced.

See Burden of disease due to dementia for detailed information on burden attributable to specific risk factors.

Treatment, management and support

GP and specialist services

Services provided by general practitioners (GPs) and other medical specialists are crucial in diagnosing and managing dementia. If a GP suspects dementia, they typically refer the patient to a qualified specialist, such as a geriatrician, or to a memory clinic for a comprehensive assessment (Dementia Australia 2020).

Data on GP and specialist services across Australia are a major enduring gap for dementia monitoring. However, recent advancements in data linkage have enabled the examination of these services – see GP and specialist services overview.

In 2016–17, about half (49%) of all services claimed under the Medicare Benefits Schedule (MBS) by people with dementia were for GP consultations, with an average of 20 GP consultations per year, per person with dementia.

Consultations with medical specialists, other than GPs, accounted for 12% of all MBS services used by people with dementia. On average, a person with dementia had 5 specialist services in 2016–17.

The types of specialist services used varied by age, with psychiatrists and neurologists most frequent among people with younger onset dementia (aged under 65), and specialists treating age-related conditions, such as geriatricians and ophthalmologists, increasing in frequency with age.

For more information about patterns of health service use among people with younger onset dementia see Younger onset dementia: new insights using linked data.

Dementia-specific medications

Although there is no cure for dementia, there are 4 medicines, subsidised through the Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme, that may alleviate some of the symptoms of Alzheimer’s disease.

In 2019–20, there were over 623,000 prescriptions dispensed for dementia-specific medications to just under 64,600 Australians with dementia aged 30 and over. There was a 43% increase in scripts dispensed for dementia-specific medications between 2012–13 and 2019–20.

People with dementia may experience changed behaviours, such as aggression, agitation and delusions, commonly known as behavioural and psychological symptoms of dementia. Non-pharmacological interventions are recommended to manage these symptoms, but antipsychotic medicines may be prescribed as a last resort.

In 2019–20, antipsychotic medications were dispensed to about one-fifth (21%) of the 64,600 people who had scripts dispensed for dementia-specific medication.

For information on medicine types, see Prescriptions for dementia-specific medications.

Hospitalisations

In 2020–21, there were more than 11.8 million hospitalisations in Australia (AIHW 2022). Of these, dementia was the main reason for admission for about 25,500 hospitalisations, which is equivalent to 2 out of every 1,000 hospitalisations.

For people with dementia, the average length of stay was almost 5 times as long as the average for all hospitalisations (13 days and 2.6 days, respectively). Of the hospitalisations due to dementia, 62% of patients were aged 75–89 (Figure 4).

Figure 4: Hospitalisations due to dementia, by age and sex, 2020–21

Data presented in this section refer to hospitalisations due to dementia, that is, when dementia was recorded as the principal diagnosis. However, understanding hospitalisations with dementia, that is, all hospitalisations with a record of dementia, whether as the principal and/or additional diagnosis, also provides important insights into the wide-ranging conditions that can lead people living with dementia to use hospital services.

See Hospital care for information on hospitalisations with dementia, as well as data by state, and by dementia type.

Aged care services

Aged care services are an important resource for both people with dementia and their carers. Services include those provided in the community for people living at home (home support and home care), and residential aged care services for those requiring permanent care or short-term respite stays.

Among people with dementia in Australia, 1 in 3 people live in cared accommodation. In 2019–20, there were over 244,000 people living in permanent residential aged care, and more than half (54% or about 132,000) of these people had dementia.

See Aged care and support services used by people with dementia for detailed information on the services and initiatives available.

Health and aged care expenditure on dementia

Australia’s response to dementia requires economic investment across health, aged care and welfare sectors. It is estimated that almost $3.0 billion of health and aged care spending in 2018–19 was directly attributable to the diagnosis, treatment and care of people with dementia.

Residential aged care services accounted for the largest share of expenditure (56% or $1.7 billion), followed by community-based aged care services (20% or $596 million) and hospital services (13% or $383 million) (Figure 5).

Figure 5: Health and aged care spending directly attributable to dementia by broad service area, 2018–19

For detailed information of spending on aged care, health, hospital and support services, see Health and aged care expenditure on dementia.

Carers

The level of care required for people with dementia depends upon individual circumstances, but likely increases as dementia progresses. Carers are often family members or friends of people with dementia who provide ongoing, informal assistance with daily activities.

The AIHW estimates that in 2021 there were between 134,900 and 337,200 informal primary carers of people with dementia. Among primary carers of people with dementia, 3 in 4 were female and 1 in 2 were caring for their partner with dementia.

Caring can be a rewarding role with 38% of primary carers of people with dementia reporting feeling closer to the care recipient.

Caring can also be physically, mentally, emotionally, and economically demanding. According to the Australian Bureau of Statistics (ABS) Survey of Disability, Ageing and Carers (SDAC) 2018, among carers of people with dementia:

• 1 in 2 provided an average of 60 or more hours of care per week.
• 3 in 4 reported 1 or more physical or emotional impacts of the role.
• 1 in 4 reported that they needed more respite care to support them.
• 1 in 2 experienced financial impacts since taking on the role.

Further findings from this survey can be found in Carers and care needs of people with dementia.

Dementia data gaps

Australia’s dementia statistics are derived from a variety of sources including administrative data, survey data and epidemiological studies. As each data source has incomplete coverage of people with dementia, it is difficult to accurately report how many Australians are living with dementia. This limits the ability to examine impacts of dementia on individuals with the condition, their carers and support networks, as well as the community and national health and aged care systems more broadly (see Dementia data gaps and opportunities).

Where do I go for more information?

• Visit Dementia for more AIHW reports on this topic.
• See chapters of Dementia in Australia for detailed dementia statistics.
• For information on ageing and carers from the Australian Bureau of Statistics, see Disability, Ageing and Carers, Australia: summary of findings, 2018.