A recent study in The Lancet Public Health revealed some contradictory shifts in dementia rates in England and Wales. From 2002 to 2008, the number of new cases dropped by almost 29 percent. Initially, this appeared promising. However, the trend took an abrupt turn with cases growing more than 25 percent from 2008 to 2016 in the same population.
University College London (UCL) researchers analyzed data from the English Longitudinal Study of Ageing (ELSA), a large-scale survey focusing on people aged 50 and older in private households in England. They applied standard criteria based on cognitive and functional impairment to identify cases of dementia among the participants. They also linked the ELSA data to the mortality register to account for deaths that might have occurred before dementia diagnosis.
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Widening Gap
It’s not clear why there was a decline in dementia over a six-year period. Researchers speculated about some possible factors including improvements in cardiovascular health, education, and living standards, as well as changes in diagnostic practices and awareness.
Likewise, the reasons for the spike in cases was also not entirely understood. The global financial crisis, changes in lifestyle and environmental factors, and increased survival rates among people with chronic conditions that elevate dementia risk could potentially explain the spike. An aging population also appeared to be a major driver of the trend. with an increasing percentage of people within the older age groups contributing to the rise in the neurodegenerative condition.
Lower educational attainment was tied to a higher risk of dementia over the study’s entire 18 year period. For example, those with lower levels of education saw a quicker rise in dementia rates after 2008. In other words, there was a slower decline in 2002-2008 and a faster increase after 2008 among people who had less schooling. According to the researchers, this suggests that socioeconomic inequalities in dementia risk may be widening over time.
Trouble Ahead
The study’s projections aren’t just a numbers game. If the upward trend continued at a pace of 2.8 percent increase per year as observed in the final six years of the study, the researchers predicted that the number of people with dementia in England and Wales will top 1.7 million by 2040 – approximately twice the number it is now.
Lead author, Yuntao Chen MD, of the UCL Institute of Epidemiology & Health Care, said that he found it shocking to think that estimates may be 70 percent higher in 2040 than if the dementia incidence had continued to decline.
“Not only will this have a devastating effect on the lives of those involved but it will also put a considerably larger burden on health and social care than current forecasts predict,” he commented in a statement.
Chen warned that the unexpected rise in dementia cases signals a looming challenge for healthcare systems and underscores the need for ongoing surveillance and effective policy planning. It portends a more urgent policy problem than previously recognized — even if the current upward trajectory continues for just the next few years.
A Worldwide Problem
England and Wales are certainly not the only countries to carry the heavy and growing burden represented by dementia. According to the World Health Organization, there are currently more than 55 million people living with dementia worldwide. If estimates are accurate, it will rise to 139 million by 2050. At nearly 55 cases per 100,000 people, Finland has the highest rate for the diagnosis in the world.
The United States ranks eighth globally, with 33 out of every 1,000 citizens anticipated to develop dementia annually. Dementia incidence is also climbing in the US. The number is expected to double to 13.8 million Americans by 2050.
