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The level of need in the population

Adults :: Dementia :: The level of need in the population

Local prevalence

In the Medway local authority area in 2012, there were estimated to be 2,587 people living with dementia with 2,523 being over 65 years old. The number estimated for the registered population for Medway CCG is 2,783. Data from the Quality and Outcomes Framework primary care dementia registers in 2012/13 have only identified 1,332 patients in Medway as having dementia. The estimated prevalence of dementia for Medway CCG population is 47.87%, which is higher than the Kent and Medway average of 42.94% and the South of England average of 45.65%.

Figure 1: Estimated prevalence of Dementia in people aged 65 years and over.
Figure 1: Estimated prevalence of Dementia in people aged 65 years and over [1] Notes: Age-sex prevalence estimates have been taken from Dementia UK 2007 report produced for the Alzheimer’s society by King’s College London and the London School of Economics. [2]

The prevalence rates have been applied to ONS population projections of the 65 and over population to give estimated numbers of people predicted to have dementia in 2012. These numbers are shown above the bars.

Severity of need

The severity of dementia is normally classified as mild, moderate or severe. At any one time about 55% of the population who have dementia will have mild dementia, 32% moderate dementia and 13% severe dementia. [2] The table below shows this in more detail broken down by age group. Applying the estimates in the first column to the Medway population numbers the second column shows the estimated total number of people in 2012 with mild, moderate and severe dementia.

  Mild.num Mild.pc Mod.num Moderate.pc Sev.num Severe.pc
65-69 101.0 62 52.0 32 10.0 6
70-74 157.0 63 75.0 30 17.0 7
75-79 244.0 57 133.0 31 51.0 12
80-84 349.0 57 196.0 32 67.0 11
85-89 318.0 54 194.0 33 77.0 13
90+ 226.0 47 158.0 33 91.0 19
Table 1: Measures of subjective wellbeing in Medway compared with the southeast and England 2012.
Source: Office for National Statistics

Level of need for care

Many of those with severe dementia, especially those over 85, have a combination of mental and physical problems. [3] On average, people with dementia live for seven or eight years after the problem has been first diagnosed, although there are wide individual variations [3]

The Dementia UK 2007 report [2] estimates that 63.5% of people with late onset Dementia (aged 65 years and over) live in private households (the community) and 36.5% live in care homes. Applying these percentages to current Medway estimates, suggests that about 1,590 people with dementia are living in the community and 932 in care homes.

Figure 2: Estimated number of people with dementia in Medway by residence type.
Figure 2: Estimated number of people with dementia in Medway by residence type [2]

Another way of understanding the level of need for care is to use the concept of “interval of care” [4] developed for use with older people.

Using these classifications the table below shows the number of people in Medway aged 65 and over currently in these groups.

  Care interval/ndescription Requirement Proportion of/npeople/nwith dementia Number of/npeople/nin Medway
1 critical (critical interval) constant care or supervision needed 34% 858
2 substantial (short interval) care needed at regular intervals during the day for dressing, meals etc 48% 1,211
3 moderate (long interval) care needed once a week 11% 278
4 low (independent) care considered 6% 151
Table 1: Care intervals [5]

Carers needs


• Many of the carers of older people with dementia are themselves fairly old.
• Carers of people with dementia generally experience greater stress than carers of people with other kinds of need, nearly one-half having some kind of mental health problem themselves

As can be seen above the majority of people living with dementia live at home. Supporting carers needs is essential if this situation is to continue especially as number of people with dementia increase.


References

[1]   Institute of Public Care and Oxford Brookes University. Projecting Older People Population Information System 2010;
[2]   Emiliano DA, Banerjee PS, Dhanasiri S, et al. Dementia UK: The Full Report 2007; Alzheimer's Society. http://alzheimers.org.uk/site/scripts/download.php?fileID=2 .
[3]   The Audit Commission. Forget Me Not: Developing Mental Health Services for Older People in England 2000; The Audit Commission.
[4]   Melzer D, Pearce K, Cooper B, et al. Healthcare needs assessment: the epidemiologically based assessment reviews - 1st Series, 2nd edition 2004;
[5]   London Centre for Dementia Care. London Borough of Sutton Older People with Dementia Service Redesign 2008; University College London. http://www.dhcarenetworks.org.uk/_library/Sutton_Borough_dementia_needs_assessment.pdf .