The project aimed 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 aimed 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
- Understood the focus areas of dementia strategies of England.
- Examined regional inequalities in dementia diagnosis in England and its association with the extent of deprivation.
- Identified the psychosocial and behavioural modifiable risk factors for dementia, and develop a model to estimate the dementia risk, given these factors.
Project Activity
Activity 1
- Examined dementia strategies of England over time.
- Undertook a comparative analysis of dementia strategies of European countries in the context of Glasgow Declaration and The WHO’s Global Action Plan.
Outcomes:
- Poster of dementia strategies of England over time (Abstract can be accessed here).
- Read the paper titled, 'A comparative analysis of dementia strategies of seventeen European Countries in the context of Glasgow Declaration and WHO’s Global Action Plan'
- The findings were also presented at the in non-technical terms and a general talk format at the Dementia Open Forum of the University of East Anglia (https://www.youtube.com/watch?v=Ihkyxa-rmQM).
Activity 2
- To examine regional inequalities in dementia diagnosis and examining its association with regional deprivation.
Outcomes:
- Ongoing work presented at NCRM Seminar on “Researching Deprivation” (YouTube Link to the presentation). Working on the manuscript, results could be of interest to policymakers.
Activity 3
- Examining the modifiable psychosocial and behavioural risk factors for dementia.
- This research is ongoing and is being coproduced with Essex County Council.
Planned outcomes:
- A manuscript based on umbrella review to understand modifiable psychosocial and behavioural risk factors for dementia.
- To develop a model based on the outcomes of (1) to estimate the risk of dementia based on given psychosocial and behavioural risk factors.
- To develop and policy brief with recommendations to invest in the most crucial psychosocial / behavioural risk factor for dementia.
Next Steps
The scope of our research has expanded to include project aims, Activity 4 and Activity 5. Activity 4 is yet to commence from 01 April 2025 and Activity 5 has recently commenced.
Activity 4
- To examine the Financial, Psychological and Physical Health Implications on people living with dementia (PLwD) and their carers.
- A qualitative study involving PLwD and their carers will be undertaken to understand the issue in detail.
Planned outcomes
- Academic paper and a policy brief to Essex County Council.
Activity 5
- Developing DEcision-Making support Model for whole-pathway dementia workforce COMMissioning (DEMM-COMM) (Funded by Alzheimer’s Society). Abstract can be found by clicking here and then scrolling down. I am a co-investigator on this project.
Outputs
- Robust evidence-based inputs for policy formulation, developing policy briefs based on interdisciplinary approach to study.
- Informed 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 was involved?
PI and corresponding researcher: Smruti Bulsari
Researchers / Collaborators:
- Mariachiara Di Cesare, University of Essex
- Sara Jalai-Farahani, University of Essex
- Daniel Showell, Essex County Council
- Joseph Kwon, University of Oxford
- Ting Cai, University of Oxford
- Pippa Collins, Dorset Healthcare University NHS Foundation Trust and University of Southampton
- Sujin Kang, Imperial College London
- Kiran Pandya, Sarvajanik University (India)
- Robert Stawski, Utah State University (USA)
- Russell Kabir, Anglia Ruskin University
- Izyani Hashim, Anglia Ruskin University
