Dementia in Australia

In 2018:

• there were an estimated 219,000 Australians with dementia, a 12.7% increase from the 194,400 with the condition in 2015.
• Females, with a prevalence of 1.0%, were more likely than males to have the condition (0.8%).

The World Health Organisation [1] describes dementia as a syndrome in which there is “deterioration in cognitive function (i.e. the ability to process thought) beyond what might be seen with normal ageing”. It is usually chronic or progressive in its nature and affects memory, thinking, orientation, comprehension, language, and judgement. A decrease in emotional control, social behaviour or motivation can often be seen with the decline in cognitive functioning.

Dementia results from a variety of diseases and injuries that primarily or secondarily affect the brain, such as Alzheimer's disease or stroke. The condition affects each person in a different way, depending upon the impact of the disease and the person’s personality before becoming ill. It is also a condition that can come on slowly, so people in the early stages of the condition may not realise they have a problem, or may dismiss their difficulties as a normal part of ageing [2].

This article uses results from the 2018 Survey of Disability, Ageing and Carers (SDAC) to present an analysis of the prevalence of dementia in Australia, and the impact the condition has on the everyday lives of those affected by it.

There is variation in the prevalence of dementia across age groups, with the condition being very rare in those under 65 years of age (0.1%), increasing to over one quarter (27.5%) of those aged 95 years and over.

Most people with dementia are living with multiple long-term health conditions. In 2018 95.1% of people with dementia had at least one additional long-term health condition and more than one in six (17.8%) had nine or more long-term health conditions. This high level of co-existing health conditions means people with dementia experience a range of impairments, including:

• memory problems or periods of confusion (71.6%);
• slow at learning or understanding things (54.4%);
• loss of hearing (35.4%); and
• chronic or recurring pain or discomfort (43.1%).

In 2018, among all people with dementia, 83.8% (183,600) reported having a profound or severe core activity limitation, that is, they always or sometimes need some help or supervision with at least one of the following three activities: communication, self-care and mobility. It should be noted however, the SDAC does not provide a link between the severity of disability and the long-term health conditions a person has. As noted above, most people with dementia have co-existing long-term health conditions and these additional conditions will also be contributing to a person’s level of impairment.

Just over half (51.6%) of people with dementia and a profound or severe core activity limitation reside in a health care establishment.

A person with dementia may need assistance with a range of activities. The 2018 SDAC found that the highest level of need were in the areas of health care tasks (84.1%), moving around away from the residence (67.4%) and reading, writing and paperwork related activities (63.1%).

Not everybody with dementia living in households needed assistance with specific activities. Of those who didn’t need assistance, a small number reported having difficulties with these activities.

There were 28,900 people with dementia living in households who did not receive any assistance with at least one activity of daily living, that they need help with.

People with dementia living in the community may receive assistance from a range of providers depending on their needs.

Notably, the bulk of care was provided by informal carers (relatives or friends), with informal care being the only care received for many of the activities. For example, of those needing help with reading and writing, 89.2% received only informal assistance with the activities. Similarly, of those needing assistance with meal preparation, this need was only met by informal sources for 81.1% of the people affected.

The 2018 SDAC found that of the 105,900 people with dementia receiving informal support from family and friends, most of the assistance was coming from their children (52.7%) and partners (48.3%). Children were more likely to be the source of assistance with mobility (48.0%) and property maintenance (53.2%).