Project AMM51

Regional Inequalities and Protective Factors for Dementia

The project aims at examining the regional inequalities in dementia prevalence at tier 2 local authority level using the data from the NHS digital and the office for national statistics (ONS). The project also aims at examining the dementia strategies of England and Essex to identify their existing focus areas and to give recommendations to tackle inequalities.

Background

National Institute for Health and Care Excellence (NICE) estimates a growth rate of 20 per cent for dementia prevalence in the United Kingdom by 2040 for people aged 65 and above, while it would be a stark 114 per cent for people aged 85 and above. Dementia diagnosis rate for persons aged 65 and above is 64.5 per cent as per October 2023 figures. According to the 2019 report of Alzheimer’s Society, the total cost of care for people with dementia is £34.7 billion , and social care comprises the largest proportion of these costs, the other two being healthcare costs and costs of unpaid care. Also, the state bears 40 per cent of the social care costs; the healthcare costs are borne entirely by the state. Considering the current magnitude and projections of number of persons with dementia, it is one of the national public health priority areas. However, England came up with its first national dementia strategy way back in 2009, much ahead of the Glasgow declaration of 2014. In 2012, dementia was identified as a national priority and in 2015, Prime Minister’s challenge on dementia was launched. This challenge was revised in 2020 and it is backed up by an implementation plan. There are decentralised strategies and plans at the levels of local authority to tackle the region-specific challenges of dementia.

One may observe stark regional inequalities both within England as well as within local authorities areas – both in terms of dementia prevalence as well as deprivation. This research aims at examining the regional inequalities and providing for strategies to reduce inequalities and focus on protective / preventive factors for dementia. Using the English Longitudinal Study of Ageing (ELSA), this project also tries to identify the protective factors for dementia.

Project Aims

  • To examine the regional inequalities in dementia prevalence in England and Essex.
  • To understand the focus areas of dementia strategies of England and Essex.
  • To identify the protective factors for dementia.

Project Activity

So far, geospatial maps for tier 2 local authorities of England to examine the regional inequalities using the latest available data on dementia prevalence from Digital NHS are developed. The association with index of multiple deprivation score and health index of deprivation score to get insights into deprivation and dementia prevalence is also undertaken. We plan to identify the regions with dementia prevalence at critical levels (critical levels to be defined), and undertake detailed examination of those areas in Essex. This can help identify the focus areas for informing dementia strategy for Essex.

Dementia strategies of select countries of European Union, England and Essex are downloaded from Alzheimer’s UK and the county council website respectively. Content analysis using the Natural Language Processing methods to understand the focus areas of these dementia strategies, also compared it with the dementia strategies of selected countries of European Union and Global Action Plan of the WHO.

The special licence for accessing the ELSA data, along with the geographical location, is obtained. Now, we have access to the data. A broad list of economic, demographic, psychosocial and behavioural factors is prepared on the basis of variables in the ELSA data. Simultaneously, we are in the process of undertaking a broad review of the studies that identify psychosocial and behavioural factors associated with dementia. We plan to undertake spatiotemporal analysis to identify the protective factors using this data.

Anticipated or actual outputs

  • Robust evidence-based inputs for policy formulation, developing policy briefs based on interdisciplinary approach to study.
  • To inform Essex County Council on protective factors of dementia to help them decide and make investments in addressing the priority areas.
  • Research papers in academic journals.
  • Avenues for collaborative research.

Who is involved?

  • PI and corresponding researcher: Smruti Bulsari
  • Researchers / Collaborators:
  • Robert Stawski, University of Essex
  • Mariachiara Di Cesare, University of Essex
  • Daniel Showell, Essex County Council
  • Lucy Wightman, Essex County Council
  • Kiran Pandya, Uka Tarsadia University (India)
  • Russell Kabir, Anglia Ruskin University
  • Izyani Hashim, Anglia Ruskin University
  • Joseph Kwon, University of Oxford

Principal Investigator/ Lead Investigator email address?

smruti.bulsari@essex.ac.uk

AMM51