Despite a growing older population, the incidence of dementia is declining around the world – and this offers opportunities for providers to develop new services.

The number of new cases of dementia is falling in Australia and overseas – and this could have a big impact on future planning for retirement living and aged care.

This article is part of a special eight-part SATURDAY project on dementia that we will be running for the next four months – stay tuned for the next instalment on how building design can enhance the experience of people living with dementia.

Ask anyone on the street and they will likely tell you that dementia is a ‘normal’ part of ageing.

A 2019 survey of 70,000 people by Alzheimer’s Disease International (ADI) found two-thirds of respondents thought that dementia was an inevitable part of getting older. Almost all of those surveyed – 95% – thought they would themselves develop dementia in later life.

But while the prevalence of dementia – or the number of people living with dementia – around the world is still increasing, the incidence of dementia – so the number of new cases every year per thousand – is declining.

Improvements in health reducing dementia risk

“There’s no evidence to say there are 450,000 people living with dementia in Australia today,” Dr Stephen Judd, who for 25 years was the CEO of Not For Profit HammondCare – widely regarded as a specialist in dementia care – told SATURDAY.

“This figure is purely an extrapolation based upon population increases and increases in the ageing of the population.”

Stephen points instead to a longitudinal study of people aged over 65 in England and Wales completed in the mid-1990s which determined there were 183,000 new cases in the UK every year.

The research team forecast that this would increase to 251,000 cases in 20 years’ time – but when they returned to evaluate the numbers 2015, new cases were still sitting at 210,000.

Their conclusion? A reduction in smoking in men – interestingly, not women – and an improvement in people’s cardiovascular health had reduced the incidence of dementia.

“Brain health is improving significantly in the UK across generations, particularly among men … the so-called dementia tsunami is not inevitable,” said study author, Professor Carol Brayne.

Another report published in The Lancet in 2020 concluded that there were 12 modifiable risk factors – or lifestyle choices – which accounted for around 40% of global dementia cases, which could potentially be prevented or delayed. They are:

• less education
• hypertension
• hearing impairment
• smoking
• obesity
• depression
• physical inactivity
• diabetes
• low social contact
• excessive alcohol consumption >21 units a week
• traumatic brain injury
• air pollution

Provider and Government focus should be on dementia prevention

This is good news, not only for ageing Australians but for village and aged care providers.

At the individual level, we can all take steps to minimise our risk of dementia.

But at the strategy and policy level, the focus should be on dementia prevention.

Again, there is positive news. In 2021, the Federal Government announced that it would commit funding to establish the National Centre for Monitoring Dementia – as part of the Australian Institute of Health and Welfare (AIHW) – to help calculate the true incidence of dementia in Australia.

With accurate data, Government and providers should be able to have the true figures on the number of Australians living with dementia – and plan accordingly.

Of course, there will still be a need for dementia-specific residential aged care into the future.

But there will also be an important role for providers to support people living with dementia in their homes.

Demand for dementia respite and healthy ageing services to grow

Here is where the opportunity lies for village and aged care operators.

There is already an increasing demand for dementia respite services, which can help meet consumer preferences to live at home for longer and save the taxpayer money.

Stephen notes a 2019 study funded by HammondCare that surveyed families using its cottage respite which found that dementia respite services delayed admission into permanent residential aged care by over 12 months.

Case in point: innovative dementia care provider Group Homes Australia (GHA) founded by Tamar Krebs has launched a new personalised short-stay dementia respite program, Respite Reimagined (R&R), which is seeing high demand.

There will also be a growing requirement for services that aimed at promoting healthy ageing and good brain health – think seniors’ gyms, exercise classes, dieticians, social activities and more.

As we report in this issue, NSW aged care provider Scalabrini has piloted a new Social Hub which is providing a source of social connection for older people living in the community.

Should operators be strategising now about how they can develop services aimed at both dementia prevention plus dementia support for people living at home?