Dementia (health and wellbeing needs in South Tyneside)
Level of need
National context
Alzheimer's Research UK data highlights that there are approximately 944,000 people in the UK living with dementia; the vast majority of which is LOSD, with the most common type being Alzheimer's disease.
Under 5% or approximately 42,000 people are thought to have EOSD. However, the National Institute for Health estimate this to be around 70,800.
Based on an analysis of ONS statistics, the Alzheimer's Society outlines that 74,261 people died from dementia in 2022, seven per cent more than the 69,178 in 2021. Of this total, more than 48,000 were women. This relates to 1 in 10 of UK deaths.
The Society is seeking the introduction of new drug treatments, this will take time to have an impact on rates and proportions.
The National Institute for Health has outlined a small study undertaken by the National Institute of Neurological Disorders and Stroke (NINDS), where researchers examined the cognitive impact of COVID-19 on people with dementia.
They found that having COVID-19 rapidly accelerated the structural and functional brain deterioration of people with dementia, regardless of the type.
This study also suggests that COVID-19 causes severe neurological complications in people with dementia and appears to accelerate the disease progression in all types of the condition.
Alzheimer's Research UK has highlighted a large research study which looked at health records of people aged 65 +, scientists found that people were at higher risk of developing dementia following COVID-19 infection.
The projections below Alzheimers by the Care Policy and Research Centre (based on 2014 population projections) includes national, regional and local statistics relating to dementia. It should be noted that this is based on no disease modifying treatments, changing the current position over the projection period.
Table 1 below outlines projections in England to 2040, relating to the number of people with mild, moderate, and severe dementia. This suggests an 81% increase in those with dementia in England by 2040 with the growth rates if the most severe cases will be 109%.
| England | 2019 | 2020 | 2025 | 2030 | 2040 | % growth |
|---|---|---|---|---|---|---|
| Mild | 101,700 | 108,300 | 118,900 | 136,100 | 166,700 | 56% |
| Moderate | 206,300 | 198,900 | 210,100 | 235,600 | 276,100 | 35% |
| Severe | 434,600 | 461,900 | 569,400 | 674,400 | 909,600 | 109% |
| Total | 748,000 | 769,200 | 898,500 | 1,046,100 | 1,352,400 | 81% |
Local context
This modelling data also provides projections to 2030 of those regionally and locally with the condition and provides an idea of the associated costs.
Table 2 below projects that by 2030 the number of people with dementia in South Tyneside will have increased by 31.5% to 3,040 (from 2,310 in 2019). This is below both the England and North East average but would be a significant spike in possible care and support demand.
It should be noted that the number of people with dementia in October 2023 in South Tyneside was around 2,000 people and therefore less than the modelling data identified below, however the direction of travel is seen to be increasing based upon the national and regional picture.
| 2019 | 2020 | 2025 | 2030 | %Growth | |
|---|---|---|---|---|---|
| England | 747,960 | 769,200 | 898,470 | 1,046,140 | 39.9% |
| North East | 38,000 | 39,080 | 45,230 | 51,910 | 36.6% |
| South Tyneside | 2,310 | 2,360 | 2,670 | 3,040 | 31.5% |
Table 3 below outlines the total cost of supporting people with dementia, (2015 prices), which for 2020 in South Tyneside was estimated to be around £90 million. However, revised figures using the Bank of England inflation calculator suggest that due to inflation this would be £96m in 2020.
Whilst it is difficult to predict levels of inflation going forward, using a 3% average would suggest that this would be £117m in 2025 and £150m by 2030. This is broken down based on the England average of which 14% is attributable to Health Care, 46% to Social Care, and 40% to Unpaid Care.
| 2019 | 2020 | 2025 | 2030 | % growth | |
|---|---|---|---|---|---|
| England | 29,470m | 31,235m | 39,455m | 50,455m | 71.7% |
| North East | 1,430m | 1,515m | 1,890m | 2,385m | 66.7% |
| South Tyneside | 85m | 90m | 110m | 140m | 59.8% |
Table 4 outlines the projected growth in prevalence rates of dementia in old age.
In South Tyneside it is expected to grow by 4.4% in the period from 2019 to 2030, this is significantly below the England and the regional average of over 10%. Whilst this is welcomed, numbers are still expected to increase, just not at the rate of other areas.
| 2019 | 2020 | 2025 | 2030 | % growth | |
|---|---|---|---|---|---|
| England | 7.2% | 7.3% | 7.7% | 7.9% | 10.8% |
| North East | 7.12% | 7.20% | 7.56% | 7.83% | 10.1% |
| South Tyneside | 7.46% | 7.50% | 7.63% | 7.79% | 4.4% |
Table 5 provides an analysis of the projected growth rate across the various stages of the condition this suggest a growth, as the population ages, of 44.3% in the most severe cases in the period to 2030. This has implications for the types of services that are required.
| 2019 | 2020 | 2025 | 2030 | % growth | |
|---|---|---|---|---|---|
| South Tyneside | 2,308 | 2,358 | 2,669 | 3,036 | 31.5% |
| Mild | 319 | 320 | 338 | 376 | 18% |
| Moderate | 620 | 592 | 615 | 684 | 10.3% |
| Severe | 1,369 | 1,446 | 1,716 | 1,975 | 44.5% |
NHS Primary Care dementia data highlights that in October 2023 there were 1,444 people living with dementia in South Tyneside, with an estimated total prevalence of 2,029 including those undiagnosed.
It is thought that there are 100 people living with EOSD in the Borough, although there is some uncertainty relating to this figure.
Diagnosed prevalence has been increasing steadily, nationally (bar the Covid period).
South Tyneside Council statistics for the end of March 2023 financial year, highlighted that there were 692 South Tyneside local people in receipt of services from Adult Social Care, whom either had a primary support reason (PSR) relating to dementia or a dementia service (21% of those in receipt of services).
427 people have a PSR of Support with Memory and Cognition (dementia), of those:
- 190 also have an active dementia service
- 237 have another service recorded as the primary service
Of these 692, 34 (5%) people had EOSD, with the youngest being 40 years of age. Details of those LSOD are outline below, with the oldest being 101:
- Aged 65 to 70: 28 (4%)
- Aged 71 to 80: 172 (25%)
- Aged 81 to 90: 317 (46%)
- Aged 91+: 141 (20%)
The age groups with the largest number of people with dementia were aged 81 to 90, followed by the 71 to 80 age group.
In terms of sexual orientation of the 692, 46 (7%) identified themselves as heterosexual, 12 (2%) information declined and 634 (92%) not recorded. It has therefore not been possible to provide a detailed breakdown of sexual orientation due to the number of none recorded.
In terms of sex, 68% were female and 325 men, whilst relating to nationality 119 (17.2%) were British, others were unknown, or the groups were too small to be to be recorded without potentially being identifiable.
It has not been possible to develop a clear understanding of the needs relating to LGBTQI+ residents due to a lack of data.
South Tyneside's annual spend on care home placements / home care for older people
At the end of the financial year in March 2023 there were 299 South Tyneside's people with dementia that were in receipt of residential or nursing care (as outlined in their support package).
The average cost of each placement was £1,072 per week or £55,744 per year.
By December 23 there were a higher number of people supported at 408, although the average costs were slightly lower at £911 per week or £47,371 annually.
The total cost of residential and nursing care support for the financial year to March 2023 was £16,667,551. This had risen to £19,327,229 by December 23.
It should be noted that, whilst dementia is highlighted in the care package the person may have multiple support requirements. It should also be noted that these figures do not include those self-funded, details of which are not collected by the Council.
People with dementia, along with the general population, are prone to develop physical conditions as part of living and ageing.
However, those with dementia can have more complex needs which can potentially result in assessment difficulties or a prolonged recovery period. If complex needs are unaddressed, a likely outcome is emergency hospital care, which can also result in an admission to care.
Where people live
An analysis of South Tyneside data on where people live who were accessing services in December 2023 highlighted that of the 677 residents at that time, recorded as having dementia, accessing a service, or requiring PSR of Support with Memory and Cognition (dementia).
Analysis highlights that the Primrose Ward had 10% of the total number of people with dementia living in South Tyneside, whilst Cleadon and East Boldon, Whitburn and Marsden, Fellgate and Hedworth and Simonside and Rekendyke collectively had less than 10% of the overall total.
Feedback from local people and organisations suggest that provision is South Shields centric. 61 or 9% of people with dementia live out of the Borough, with any placement, depending on the needs of the individual (and the family) and the result of any local care home assessment as to whether the individual can be accommodated in the borough.
Reviewing the figure of 677 against the people with dementia of 1,444 (October 23) suggests that approximately 46% of people with the condition are accessing services. Whilst this is only illustrative, this would suggest more than half are not.
In December 2023, there were 5 people whose primary reason for support relates to a learning disability and who had dementia. Three of this group were aged under 65 and therefore have EOSD and two were over 90 years of age. All were female, white British and lived in the Borough.
Discussions with the Admiral Nurses Service suggests that many residents are not able to access third sector activities, in part due to being housebound. Opportunities for one-to-one home-based support would be beneficial, to allow carer breaks and support those that do not wish to attend social activities.
This would help offset any (actual or perceived) South Shields centric view of provision. Exploring opportunities for external funding could help extend the availability of this type of support in the borough.
Age Friendly Communities Survey
Research undertaken in South Tyneside between November 2022 and April 2023 as part of the Age Friendly Communities Survey, and based on World Health Organisation parameters, highlighted that specifically in relation to dementia.
- Public buildings and outdoor spaces - "Need to have more accessible toilets. Public buildings need to have more dementia friendly signage and visual cues."
- Respect and social inclusion - "Very important to build on intergenerational working. Need to practically educate school children in communication skills with older people and people with dementia. Disappointed that we have lost the focus on Dementia Friendly Communities."
- Community and health - "I don't know what services I will need in the future therefore unable to answer with any certainty. As for shops - again internet could provide everything providing its accessible and people know how to use it. There's a distinct lack of services for people with dementia."
More generally issues relating to older people included the need to improve paths and kerbs, too much dependence on online, more community spaces such as chatty cafes, the expensive cost of care, and the need for improved information on social groups.
Feedback loop
Partners are keen to see the opportunity for users and carers to participate in ongoing feedback on progress of the implementation of the findings arising from the JSNAA, recognising the benefits of feedback from carers and people with dementia.