GP dementia targets based on old data that overestimates prevalence

NHS primary care targets for dementia are based on outdated information and should be re-evaluated, say experts who found that prevalence of the disease is falling in the UK.

Dementia: GP targets based on out-of-date information
Dementia: GP targets based on out-of-date information

A study comparing the incidence and prevalence of dementia in four western European countries – the UK, Spain, Sweden and the Netherlands – over the past two to three decades suggests that occurrence of dementia is stabilising, not rising, across Europe – and that numbers have dropped in the UK.

GPs have come under pressure to boost dementia diagnosis in recent months as estimates suggested swathes of the population remained undiagnosed, culminating in a controversial DES that incentivised GPs to identify more patients with the disease at £55 per diagnosis.

GPonline revealed that tens of thousands more patients were diagnosed with dementia following introduction of the DES, but diagnosis rates still fell short of NHS England’s high targets.

But the present study, published in the Lancet, suggests that estimates for current dementia numbers are calculated using 30-year-old data that overestimates prevalence of the disease in the UK.

‘The first epidemiological investigations of dementia in western Europe were started in the 1980s and had a discernible effect on policy 10 years later,’ the authors said.

Dementia diagnosis

‘These studies are still affecting policy development nowadays and continue to provide an estimate of the size and distribution of dementia within European countries, and are used at both national and local levels, [including] the UK’s NHS primary care targets.

‘Projections of the findings from these old studies support the idea of a continuing so-called dementia epidemic.’

They added that current estimates are 'out of date' because they failed to take into account changes in life expectancy and living conditions over the past few decades.

But despite the possible fall in cases, co-author Yu-Tzu Wu, from the University of Cambridge, stressed that dementia care will remain a challenge.

‘It is important to remember that the number of people over age 85 is the fastest growing age demographic, with about 40% currently estimated to be affected by dementia,’ Wu said.

Fellow author Professor Brayne added: ‘Our up-to-date evidence suggests a relatively optimistic picture of possible future trends in dementia occurrence and strengthens the need to shift more of our societal and research focus to primary prevention across the life-course, with a rebalancing from what could be seen as the current overemphasis on diagnostics and drug interventions for dementia.’

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