Governments need to take action on delaying the onset of Alzheimer's disease and other dementias, argues Associate Professor Lesley Russell.
The high rates of dementias in Aboriginal and Torres Strait Islander communities require urgent attention as part of Closing the Gap.
Currently 14 per cent of Australians are aged 65 and over and by 2050 these older Australians will make up a quarter of the population. This "grey tsunami" is propelling the number of cases of Alzheimer's disease and other dementias on a trajectory to triple by 2050 with a consequent impact on the healthcare budget and the economy as a whole.
Australia has a higher prevalence rate for dementias in people aged 60 and over compared to Western Europe and the United States and new prevalence estimates released last week are around 12 per cent higher than those made in 2009. But even as the Abbott government expresses concern about growing healthcare and aged care costs and pushes for people to stay longer in the workforce, it deliberately rejects actions that would ameliorate the adverse impacts of dementia on our society.
Almost one in 10 Australians aged over 65 has dementia and the risk doubles every five years; at age 85, approximately one person in four has this condition. That means there are currently about 340,000 Australians living with dementia and that number is expected to triple by 2050. It's the single greatest cause of disability in older Australians aged 65 or older and the second leading cause of death. Two-thirds of older Australians with dementia are women, perhaps because they live longer than men. Indigenous Australians experience rates of dementia that are three to five times that of the general population and get the disease earlier.
There are no cures, but the onset of Alzheimer's disease and related dementias can be delayed and perhaps even prevented. It has been estimated that if the age at which people got dementia could be pushed back by five years, this would save $60 billion in cumulative costs by 2050. This goal is quite achievable with a concerted national campaign to change health and lifestyle choices and promote physical and cognitive activity, healthy diet, tobacco and alcohol control along with efforts to reduce head injuries, high blood pressure and high cholesterol.
These are already defined as 'best buys' in prevention – actions that will not just reduce the prevalence and delay the onset of dementias, but will reduce the societal impacts of obesity, heart disease, stroke and diabetes. Dementias alone currently cost the health and aged care systems $12.89 billion. By 2050 dementia costs are predicted to outstrip those of any other illness and rise to $83 billion unless effective interventions are taken. Currently 1.2 million people are involved in the care of people with dementia. Meeting the demand for carers in 2050 will be a struggle given that there will be one person with dementia for every 20 or 30 working adults.
So where is the response from a government which constantly tells the nation that the pressure of the aging population on the budget and the delivery of services cannot be sustained and requires urgent action? The problem lies in the fact that this government has no appetite for health prevention and promotion. Instead it has waged an ideological campaign against agencies and activities it identifies with the 'nanny state'.
The Australian National Preventive Health Agency, the Alcohol and Other Drugs Council of Australia, and the National Partnership Agreement on Prevention with the states and territories have all been axed and millions of dollars clawed back from preventive programs as crucial as cutting smoking rates in Indigenous communities. The monies saved have gone to the Medical Research Future Fund with the promise that the research funded will find a cure for Alzheimer's disease.
But there's unlikely to be a silver bullet to prevent or cure dementias and in the meantime there is no concerted federal leadership on interventions that will certainly slow the rate of diagnosis of these conditions from the current one every six minutes. The high rates of dementias in Aboriginal and Torres Strait Islander communities require urgent attention as part of Closing the Gap.
Prime Minister Tony Abbott has previously served as Minister for Health and Treasurer Joe Hockey was Opposition Minister for Health and Ageing but apparently they learnt nothing about the social and economic impacts of dementias during their terms. There appears to be little awareness that the total costs (direct and indirect) of dementias today are estimated at around 1 per cent of national GDP and are predicted to rise to 3 per cent of GDP in 2050. That's hardly an economic can that can be kicked down the road or left to the serendipity of biomedical research.
Dr Lesley Russell is adjunct associate professor at the Menzies Centre for Health Policy at the University of Sydney.
This article was first published in Fairfax Media
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