1. Changing demographics and the impact on dementia
Fiona Matthews
MRC Biostatistics Unit, Cambridge
Institute of Health and Society, Newcastle University

2. Population change

3. Population change

4. Background
Number of cases of dementia worldwide projected to triple by 2050
Europe a doubling of AD (approximately 60% of dementia) to 15.9 million by 2040
Models suggest primary prevention rather than treatment most likely to delay onset
Some suggested that up to 50% of dementia is caused by modifiable risk factors

5. Risk factor changes Factors expected to increase dementia prevalence
Physical inactivity
Obesity
Diabetes
Longer survival after stroke
Shift in age distribution
Inequalities in health across lifespan
Factors expected to decrease dementia prevalence
Prevention of heart disease
Early life education
Reduction in stroke

6. Modifiable risk factors
Norton et al 2014

7. Impact of risks
Norton et al 2014

8. CFAS I and CFAS II
Originally set up in six areas– sampling from whole population geographically
Three taken forward for new study
Cambridgeshire (Ely and surrounding area)
Newcastle
Nottingham
Equal numbers in and 75+ year age groups
Complete population (including care homes)
CFAS I
7640 individuals interviewed (80% response) in
Two stage – screen then assessment
1457 individuals with diagnostic assessment
CFAS II
7796 interviews (56% response) in
One interview (screen and assessment combined)
All individuals with diagnostic assessment

9. Changes over last 20 years

10. Men
Women

11. Men
Women

12. Care settings

13. Care settings

14. Projections 1991 prevalence 7.2%, total number 664,000
Apply 2011 age structure
Estimate 2011 prevalence
Projected prevalence 8.3%, total 884,000
Undertake new study
CFAS II prevalence 6.5%, total 670,000
Significant reduction of dementia (OR=0.7, 95% CI )

15. Conclusions Dementia prevalence has declined over the last 20 years
Number with dementia in UK remained constant despite more older people
Large variability still seen
Between men and women
With deprivation
Future work to investigate risk factor profiles and population risk

16. CFAS I and CFAS II