Definition of Dementia
Dementia is an overall term for diseases and conditions characterized by a decline in memory, language, problem-solving and other thinking skills that affect a person’s ability to perform everyday activities. Memory loss is an example. Alzheimer’s is the most common cause of dementia.
There is currently no cure or disease-modifying treatment, but better policies can improve the lives of people with dementia by helping them and their families adjust to living with the condition and ensuring that they have access to high quality health and social care.
In 2018, an estimated 9.1 million people aged over 60 are living with dementia in EU member states, up from 5.9 million in 2000. If the age-specific prevalence of dementia remains the same, ageing populations mean that this number will continue to grow substantially in the future.
The overall number of people living with dementia in EU countries is expected to rise by about 60% over the next two decades to reach 14.3 million in 2040, with the oldest people (those aged over 90) accounting for a growing share.
The prevalence of dementia increases rapidly with age. While only around 1% of people aged 60-64 have dementia, this proportion goes up to nearly 40% among those aged over 90 across EU countries. More women than men also live with dementia at any age group, with the gap increasing at older ages. Overall, around 7% of the population aged over 60 in EU countries have dementia in 2018. This proportion is expected to grow to over 8% by 2040 because of population ageing. Countries that have high shares of very elderly people now generally have a greater proportion of people with dementia. Italy, France, Greece and Spain have around 8% of their population aged over 60 living with dementia now, while this proportion is only around 4% or less in Croatia, the Slovak Republic, Bulgaria, Romania, Poland, the Czech Republic and Hungary.
Over the next two decades, the prevalence of dementia will rise particularly quickly in those countries, where the share of people aged over 80 and 90 years will grow more rapidly. However, there is some evidence that the age-specific prevalence of dementia may be falling in some countries (Matthews et al., 2013) and it may be possible to reduce the risk of dementia through healthier lifestyles and preventive interventions. A recent randomized-controlled trial of a multi-domain intervention, including diet, physical exercise, and cognitive training, found such lifestyle interventions to have a positive effect on cognition (Ngandu et al., 2015). If such efforts are successful, the rise in prevalence may be less dramatic than these numbers suggest.
Nonetheless, dementia will undoubtedly pose a growing challenge to all EU countries.
There has been an international focus on supporting countries to improve the lives of people living with dementia, their families and carers. This includes an increased focus on ensuring patients have access to a timely and accurate diagnosis and adequate post-diagnostic support. The growth of dementia-friendly initiatives across many EU countries – including training social services, businesses, and volunteers to recognize signs of dementia and respond appropriately – may help reduce the stigma around the disease, particularly for those living at home. Nevertheless, further efforts are also needed to improve care co-ordination to help patients and their families navigate complex health and social systems, to develop residential care models adapted to the needs of people with dementia, and to improve the quality of care for people with dementia in hospitals and at the end of life (OECD, 2018)
Matthews, F.E. et al. (2013), “A two-decade comparison of prevalence of dementia in individuals aged 65 years and older from three geographical areas of England: Results of the cognitive function and ageing Study Iand II”,The Lancet, Vol. 382, No. 9902.
Ngandu, T. et al. (2015), “A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): A randomised controlled trial”, The Lancet, http://dx.doi.org/10.1016/S0140-6736(15)60461-5 .
OECD (2018), Care Needed: Improving the Lives of People withDementia, OECD Health Policy Studies, OECD Publishing,Paris,https://doi.org/10.1787/9789264085107-en.Prince, M. et al. (2015),World Alzheimer Report 2015: The GlobalImpact of Dementia, Alzheimer’s Disease International.
OECD/European Union (2018), “Dementia prevalence”, in Health at a Glance: Europe 2018: State of Healthin the EU Cycle, OECD Publishing, Paris/European Union, Brussels. DOI: https://doi.org/10.1787/health_glance_eur-2018-19-en