MPs are calling on the government and heath and social care watchdogs to “urgently” link care for people with dementia and co-morbidities, as the habitual treatment of concurrent illnesses in isolation is disjointing care.
According the All Party Parliamentary Group (APPG) on Dementia, 70% of dementia patients are living with at least one other long-term health condition, such as high blood pressure (41 percent), depression (32 percent), heart disease (27 percent) and diabetes (13 percent).
However, its inquiry found that the current health and care system is fragmented and does not have the capacity to manage the complexity of these multiple illnesses. This is not only having a significant detrimental effect on patients but also has significant financial consequences; the International Longevity Centre-UK estimates that the cost of mismanaging dementia and diabetes, depression, and urinary tract infections is nearly £1 billion per year.
Dementia patients are less likely to receive a diagnosis for other health conditions, but untreated co-morbidities, such as diabetes, can actually also fuel progression of dementia - on average one to two years faster - as well as increase the risk of hospitalisation, highlighting the complexities.
To help address the key issues, the APPG says multiple reviews for separate conditions must be consolidated into one holistic, annual health review, to be coordinated by a GP. Revising the Quality Outcomes Framework - which currently incentivises separate reviews of conditions - will help to deliver this in practice, and accelerate the detection of any health issues by a GP.
Also, the medicines management for people with dementia and co-morbidities is a significant issue for clinicians, the Group notes, calling on the Royal Pharmaceutical Society to develop guidance that addresses the needs of such patients “as soon as possible”. It’s also crucial that the Care Quality Commission inspects care pathways, to improve understanding of the patient experience and service integration, it said.
“Without a radical change in focus and priority, we will consign many more thousands of people to substandard care and a poor quality of life, wasting hundreds of millions of pounds in the process. It is therefore essential that these recommendations are taken forward by decision makers,” the APPG stressed.
Meanwhile, a study published online in Nature Communications has found that the incidence of dementia in the UK has dropped 20% in the last two decades, driven by a reduction in cases in men at all ages.
Their findings suggest that there are just under 210,000 incident cases per year, 74,000 men and 135,000 women, representing a far smaller rise than previously expected.
“It’s encouraging to see research showing that the rate of new cases of people with dementia in the UK has fallen, indicating that lifestyle factors, such as better heart health, are helping to reduce the risk of dementia,” said James Pickett, head of Research at Alzheimer’s Society.
“However, people are living for longer and with other risk factors such as diabetes and obesity on the rise, there will still be over 200,000 new cases of dementia each year. That’s still an enormous number of people who require better information and health and social care support,” he notes.
Dr Pickett also points out that given that there have been significant advances in the understanding of dementia and and many people are now being diagnosed at an earlier stage of the condition, it’s possible that not all of these people would be identified using the methods of this study, “leading to an underestimate of people with dementia”.