Projections of Dementia Prevalence and Incidence in Victoria 2010 – 2050: State Electoral Districts
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Projections of dementia prevalence and incidence in Victoria 2010 – 2050: State Electoral Districts 6 April 2010 Report by Access Economics Pty Limited for Alzheimer's Australia Vic State Electoral Districts Contents Executive Summary .........................................................................................................................i 1 Background ......................................................................................................................... 1 2 Modelling methodology ...................................................................................................... 2 3 Dementia projections by State Electoral Districts .............................................................. 5 4 Mapping of dementia prevalence ..................................................................................... 28 Appendix A .................................................................................................................................. 34 References ................................................................................................................................... 37 While every effort has been made to ensure the accuracy of this document and any attachments, the uncertain nature of economic data, forecasting and analysis means that Access Economics Pty Limited is unable to make any warranties in relation to the information contained herein. Access Economics Pty Limited, its employees and agents disclaim liability for any loss or damage which may arise as a consequence of any person relying on the information contained in this document and any attachments. i State Electoral Districts Executive Summary Australia is currently facing a dementia epidemic. The prevalence of dementia in Australia is expected to increase from 257,000 in 2010 to over 1.1 million in 2050 (Access Economics, 2009). This growth will primarily be driven by increased population numbers and demographic ageing, although modifiable risk factors (such as a reduction in physical activity) will also play a part. In line with the projected increase in dementia prevalence, there will be a strong increase in the demand for dementia care services. Our modelling has found that on the basis of current policy settings, there will be shortages in the supply of care for people with dementia (Access Economics 2009a). Thus planning a policy response now, to accommodate demand for services in the future, is essential for delivering cost effective and appropriate dementia care in Victoria. Access Economics has been commissioned by Alzheimer’s Australia Vic to provide up‐to‐date estimates and projections of dementia prevalence and incidence in Victoria. Using updated age and gender specific prevalence rates derived from a recent study for Alzheimer’s Australia (Access Economics 2009), and population projections using our in‐house demographic model (AE‐DEM), dementia prevalence and incidence has been estimated for 2010 and projected to 2050 for each State Electoral Division (SED). Summary of results It is estimated that there are almost 66,000 people with dementia in Victoria in 2010 which is projected to increase to 246,000 people by 2050. This represents a 275% growth in prevalence between 2010 and 2050. Similarly, it is estimated that there are approximately 20,000 new cases of dementia in Victoria in 2010. Incidence is projected to increase by 400%, reaching 94,000 new cases by 2050. Projections of dementia prevalence and incidence in Victoria are shown in Chart i Chart i: Dementia prevalence and incidence in Victoria : Incidence Prevalence 100 90 300 80 250 70 (000s) 60 (000s) 200 50 People 40 People 150 30 100 20 10 50 0 2010 2020 2030 2040 2050 0 2010 2020 2030 2040 2050 Males Females Persons Males Females Persons Source: Access Economics calculations. For each decade between 2010 and 2050, the prevalence of dementia prevalence is expected to increase at a faster rate than those aged 70 years and older in Victoria. The most rapid growth in dementia prevalence is expected in the next decade from 2010 to 2020 with around i State Electoral Districts 50% growth projected. Table i shows the projected growth in dementia prevalence and the 70 years and older Victorian population. Table i: Percentage change in dementia prevalence and 70+ population per decade in Vic 2010‐20 2020‐30 2030‐2040 2040‐2050 age 70+ in Victoria 40% 35% 24% 15% dementia prevalence 50% 44% 38% 26% Source: Access Economics calculations. Dementia prevalence throughout State Electoral Districts (SEDs) is highly variable. In 2010, the SED with the highest estimated number of dementia cases is Nepean (Eastern Victoria) with over 1,250 cases. The SED with the lowest estimated number of dementia cases is Yuroke (Western Metropolitan), with around 400 cases. Our projections show that in 2050 the highest number of dementia cases is expected to be in Bass (Eastern Victoria), with over 5,000 cases, while Brunswick (Northern Metropolitan) is expected to have the least number of cases with fewer than 1,600 cases. The growth of dementia prevalence between 2010 and 2050 is expected to range between 97% (Pascoe Vale – Western Metropolitan) and 734% (Melton – Western Victoria). The average prevalence growth across all SEDs is estimated at 290%. The SEDs with the highest estimated dementia prevalence in 2010 and 2050 are shown in Chart ii. Chart ii: Dementia prevalence, by top 10 SEDs 2010 2050 60 60 50 50 40 40 30 30 (00s) (00s) 20 20 10 10 People 0 People 0 Hill East East East Vale Bass West Lowan Box Melton Barwon Barwon Preston Nepean Nepean Brighton Bellarine Bellarine Narracan Pascoe Mornington Mornington Bendigo Ballarat South South Gippsland Gippsland Source: Access Economics calculations. Overall, the top ten SEDs, ranked by dementia prevalence, are concentrated in the Eastern and the Western Victoria regions. In 2010, both regions each contributed three of the top 10 SEDs, while in 2050, Eastern Victorian regions contributed five of the top 10 SEDs, with the Western Victorian region contributing four of the remaining top five SEDs. It should be noted that the overall prevalence estimates in this report differ from those in Access Economics (2009) due to subsequent changes to population estimates. These changes arise from mortality and annual migration updates, which alter the age distribution and total numbers in the population projections, both in the near and distant future. All the age‐gender prevalence rates in this report are the same as in Access Economics (2009). ii State Electoral Districts 1 Background Access Economics has completed a number of projects detailing the impact of dementia in Australia. More recently, Access Economics (2009) provided dementia prevalence and incidence estimates and projections for 2009 to 2050 to Alzheimer’s Australia, based on updated population and prevalence rates, and expected trends in physical activity. The report found that dementia prevalence will be greater than first thought, with projections for the year 2050 increasing to 1.13 million (from 731,000 previously estimated in 2005). The year 2010 is significant in Victoria’s demographic ageing. It represents the first year that the baby boomers start turning 65 years of age. The baby boomer bulge is on the cusp of working its way through those age brackets that are at greater risk of dementia. This is the main driving factor in the expected increase in dementia prevalence and incidence. However, there will be an uneven ageing distribution across regions within Victoria, with younger people generally located in Melbourne and other metropolitan regions and older people located outside these areas. Older adults also represent a growing proportion of the population outside the Melbourne metro region. Dementia remains a growing concern for health and aged care service provision. Combined with Australia’s and Victoria’s ageing population, modifiable dementia risk factors continue to increase in Australia. For example, diabetes mellitus is known to increase the risk of Alzheimer’s disease and vascular dementia. Obesity is a risk factor for vascular dementia through its effect on coronary heart disease and stroke, while physical inactivity has also been linked to an increase in dementia through its impact on cardiovascular disease, stroke, and Type 2 diabetes (DoHA 2006; DCRC 2007). The Australian Institute of Health and Welfare (AIHW) has noted significant increases in these risk factors over the past decade that is likely to continue into the near future (AIHW, 2008). This report identifies the key areas in Victoria that are expected to experience the greatest increase in dementia cases. This research can then be used to assist government agencies in planning the provision of future dementia services, with the aim of improving the quality of life for all people in Victoria living with dementia, including their families and carers. 1 State Electoral Districts 2 Modelling methodology The methodology used to estimate and project dementia prevalence and incidence in Victoria was based on population growth, demographic ageing and projected changes in physical inactivity, a known modifiable risk factor for dementia. Age and gender specific prevalence rates were derived from a recent study for Alzheimer’s Australia (Access Economics 2009). In the study dementia prevalence rates were estimated by age and gender using a combination of published international epidemiological studies and meta‐analyses. The studies used for each age bracket are outlined below.