Dementia

Summary

Dementia is not a disease, but a collection of symptoms caused by a number of different conditions which affect the brain and the vascular system. There are many different types of dementia although some are far more common than others, with Alzheimer's disease accounting for the majority of cases, followed by vascular dementia.

Other common forms include mixed dementia, dementia with Lewy bodies, dementia with Parkinson's disease and frontotemporal dementia (Pick's disease). Some of the less common forms of dementia include alcohol-related dementia, Creutzfeldt-Jakob disease (CJD), and Korsakoff's syndrome. Currently there is no cure for Alzheimer's disease and other dementias, but medication can slow down the progression of the condition, allowing the symptoms to be managed for some people.

The cause of most dementias is unknown but is likely to be due to an interaction of a number of factors. It is important to understand having the risk factors does not mean a person will develop dementia, and conversely the absence of the risk factors does not guarantee a person will not develop the condition. Some of the risk factors include:

  • age;
  • cardiovascular disease, such as hypertension and stroke;
  • depression;
  • diabetes;
  • environmental factors; 
  • excessive alcohol consumption;
  • genetic susceptibility;
  • midlife obesity;
  • poor diet/nutrition;
  • psychosocial stress (increased hormones such as cortisone); and
  • smoking.

Key findings - prevalence

Figures from the 2016/17 Quality and Outcomes Framework (QOF) indicate that there are 15,649 known cases of dementia accounting for 0.90% of the registered population across the Lancashire and South Cumbria Sustainability and Transformation Plan (STP) area. Four of the eight clinical commissioning groups (CCGs) record a prevalence significantly above the England average (0.76%), these are NHS Blackpool (1.04%), NHS Fylde and Wyre (1.31%), NHS Morecambe Bay (1.04%) and NHS West Lancashire (0.95%).

Dementia is an area that is considered to be under reported by the QOF disease registers, due to the disparity between the recorded prevalence and prevalence estimates taken from research studies and the difficulty in diagnosing the disease at an early stage. Using the latest methodology, developed by NHS England, which combines the findings of the Cognitive Function & Ageing Study (CFAS ii) and the research by the Alzheimer's society (Delphi 2014), and the April 2017 GP registered population figures it is estimated that there could be as many as 22,186 persons (aged 30+) living with dementia across the Lancashire & South Cumbria STP area. This highlights the need for more work around increased diagnosis levels and patient awareness of the risks and symptoms of dementia.

Further key facts and figures around dementia are available in the dementia local intelligence data tables, July 2017 update (XLSM 4.1 MB). 

The National Institute for Health and Care Excellence (NICE) also provides comprehensive guidelines around health and social care needs for people with dementia.

Young onset dementia

Young onset dementia is dementia that affects people under 65 years of age. In August 2016 we published a needs assessment for young onset dementia in Lancashire-12 looking at the current prevalence, future projections, causes, risk factors and the impact of the syndromes on younger people and their carers. The report should influence the way we support people with dementia in Lancashire. The findings and recommendations will be used for the creation of a new dementia strategy for Lancashire. Below are some key points from the analysis.

  • Younger people with dementia have a unique set of difficulties and opportunities compared to older people with dementia.
  • Learning disabilities are a risk factor for young onset dementia, and many other risk factors relate to lifestyle and the effective management of existing conditions.
  • It is difficult to establish an accurate prevalence of YOD but this report has highlighted that there is a substantial gap between estimated and diagnosed prevalence. There could be more than 800 people in Lancashire-12 with YOD and around 470 of these could be undiagnosed.
  • Prompt diagnosis can help people with YOD to manage their condition and achieve a better quality of life, while, in some cases, appropriate treatment and lifestyle changes can help slow the progression of the underlying disease.
  • Working and volunteering are known to promote positive mental wellbeing. Many people with YOD are still able to be economically active, so it is important to support these individuals to obtain work and remain in work for as long as they desire.

Further analysis and data

Young onset dementia in Lancashire-12.pdf (PDF 884 KB)

Dementia local intelligence data tables, July 2017 update (XLSM  4.1 MB)

Page updated November 2017