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Mismanagement of dementia costing UK’s health and social care system up to £1 billion a year

A new report by the International Longevity Centre – UK (ILC-UK) demonstrates that a failure to prevent, diagnose, and treat depression, diabetes and urinary tract infections in people with dementia could be costing the UK’s health and social care system up to nearly £1 billion per year.

The report, ‘Dementia and Comorbidities: Ensuring parity of care‘, which was kindly supported by Pfizer, shows that people with dementia are less likely to have cases of depression, diabetes or urinary tract infections diagnosed, and those that do are less likely to receive the same help to manage and treat these comorbidities.

This lack of parity can lead to people’s dementia worsening more quickly leading to greater health and social care costs. ILC-UK demonstrate an annual total net loss of up to approximately £994.4 million for just three conditions:

  • £501.7 million for people with dementia and depression
  • £377 million for people with dementia and diabetes
  • £115.7 million for people with dementia and urinary tract infections

The report also finds that the failure to prevent, diagnose, and treat comorbidities in people with dementia is leading to this group having a reduced quality of life and an earlier death than people who have the same medical conditions, but do not have dementia. It highlights how:

  • Hospital in-patients with dementia are over three times more likely to die during their first admission to hospital for an acute medical condition than those without dementia.
  • Four of the five most common comorbidities people with dementia are admitted to hospital for in the UK are preventable conditions – a fall, broken/fractured hip or hip replacement, urine infection and chest infection.

The ILC-UK identifies six key areas which appear to be leading to the discrepancy in health outcomes for people with dementia and comorbidities:

  1. Atypical symptoms. People with dementia often present atypical symptoms which may lead to carers and medical professionals interpreting these problems as worsening dementia and neglecting other conditions as a potential cause.
  2. Communication difficulties between medical professionals/carers and people with dementia, and between medical professional themselves, leading to lower standards of care.
  3. A failure by the health system to recognise the individual as a whole, instead focussing on the person as a patient with a given diagnosis, leading to the optimisation of care for dementia while the individual continues to deteriorate because of poor management of a comorbid condition or vice versa.
  4. A knowledge gap of hospital staff and carers in caring for people with dementia and comorbidities.
  5. Poor medication management relating to how people with dementia’s medications are prescribed, monitored, administered and/or dispensed.
  6. A lack of support to aid self-management and poor monitoring of comorbidities by health professionals.