Dementia overtakes heart disease as leading cause of disease burden for over-65s

Australia’s ageing population, and better prevention and treatment of heart disease, has seen dementia become the number one burden of disease for the nation’s over-65s, a new report finds.

One in 12 Australians aged 65 and over has dementia, along with two in five people aged over 90, the AIHW report, Dementia in Australia, says.

Dementia has overtaken heart disease as the greatest burden among those older than 65 on the nation’s health system, with the ageing population driving the surge.

A study from the Australian Institute of Health and Welfare finds more than 400,000 people have dementia, a number expected to more than double to almost 850,000 over the next 35 years.

One in 12 Australians aged 65 and over has dementia, along with two in five people aged over 90, the AIHW report, Dementia in Australia, says.

Dementia is the second leading cause of death in Australia behind heart disease, accounting for almost 10 per cent of deaths in 2020, the report says, and it is the leading cause of death for women.

In terms of burden of disease, it sits higher than heart disease for those above 65, accounting for almost 230,000 years of healthy life lost among people aged 65 and over in 2022, a 62 per cent increase since 2011.

“Dementia was responsible for 4.4 per cent of Australia’s disease burden in 2022, which includes both the impact of living with the condition (the non-fatal burden of disease) and dying prematurely (fatal burden),” AIHW spokeswoman Melanie Dunford said.

There is some good news behind the bleak numbers, she said: “(Dementia) is an increasing cause of disease burden largely due to our ageing population but also from declines in burden from other leading causes such as coronary heart disease.”

Dementia is an umbrella term for a broader group of conditions that impair brain function and affect memory, speech, cognition, personality, mobility and other physical impairments.

Types of dementia include ­Alzheimer’s disease, vascular dementia and Lewy bodies dementia. There is no known cure.

 

While risk factors such as family history are inherent, others can be avoided or reduced, including physical inactivity, excessive alcohol consumption, smoking and social isolation.

The report also looked at the behaviours and psychological symp­toms of dementia (BPSD) including aggression, insomnia and anxiety, and how it affected not just the person with dementia but their loved ones as well. “BPSD can have a significant impact on people with dementia, carers and family, and has been associated with early admission to residential care, increased hospitalisation, distress for carers and reduced functional ability for the person with dementia,” Ms Dunford said.

The report notes that Dementia Support Australia, which provides support services for people reporting issues with behaviour associated with dementia, found agitation was the most reported primary behaviour during the year to June 2022, accounting for almost 35 per cent of referrals.

This was followed by physical aggression (25 per cent), verbal ­aggression (11 per cent) and anxiety (6 per cent).

DSA head of dementia professional services Marie Alford said the rising prevalence of dementia was having an impact on carers, their families, the health system and residential aged-care homes. “With two in three people living with dementia being in the community, there were up to 354,200 unpaid carers supporting them last year, often working 60 or more hours a week,” she said.

“It’s important we provide options for respite for these carers and support them with necessary skills to continue to provide care at home through programs like DSA’s Staying at Home program.”

The report confirmed an extremely high prevalence of dementia in residential aged-care settings, the report notes, due to the advanced age of residents.

Among Indigenous Australians, the rate of people with dementia is estimated to be 3–5 times as high as the Australian population overall, the report said.