Mismanagement of dementia costs health care system £1bn each year

A failure to prevent, diagnose and treat depression, diabetes and urinary tract infections in people living with dementia could be costing the UK’s health and social care system up to £1bn per year, according to research published by the International Longevity Centre – UK (ILC-UK).

The ‘Dementia and Comorbidities: Ensuring parity of care’ report, supported by Pfizer, reveals 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, leading to greater health and social care costs.

Sally Greengross, chief executive of the ILC-UK said: “It is an absolute scandal that doctors, nurses and health care workers are too often failing to see people living with dementia as more than simply this disease.

“Our health system is too often failing to prevent, diagnose, and treat comorbidities among people with dementia. This failure has a devastating impact on quality of life, and results in earlier deaths. A failure to prevent adds avoidable financial pressures to our cash-strapped health service.”

The report found that hospital in-patients with dementia are over three times more likely to pass away during their first admission to hospital for an acute medical condition than those without dementia.

Furthermore, 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:

• 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;

• Communication difficulties between medical professionals/carers and people with dementia, and between medical professional themselves, leading to lower standards of care;

• A failure 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 co-morbid condition or vice versa;

• A knowledge gap of hospital staff and carers in caring for people with dementia and comorbidities;

• Poor medication management relating to how medications are prescribed, monitored, administered and/or dispensed;

• A lack of support to aid self-management and poor monitoring of comorbidities by health professionals.

Jeremy Hughes, chief executive of Alzheimer’s Society, said: “The reality for many people with dementia is that they have to contend with other long-term conditions, all of which greatly impact their quality of life.

“As this report highlights, to view dementia in isolation not only makes poor economic sense, but can cause unnecessary suffering. While initiatives to integrate health and social care services are a step in the right direction, it is clear Government plans need to go much further to truly meet the needs of people with dementia and other health conditions.

“Alzheimer’s Society is working with the All Party Parliamentary Group on dementia to better understand the experiences of people living with dementia and other conditions. Our report is due later this month.”

Roz Schneider, global patient affairs lead at Pfizer added: “This report clearly highlights disparities in care and health outcomes that are associated with people living with dementia who also have co-morbid illnesses.

“Patients and their caregivers, as well as others in their support community, can provide subtle yet critical insights about medical changes that affect these patient’s lives.

"Such a collaborative approach could lessen or avoid the progression of some co-morbid conditions. That is why this expanded care community stand ready to partner with health care teams in order to advance these important health care conversations and care decisions.”