Dementia
Dementia is an umbrella term for a range of conditions which affect the brain causing a deterioration in memory, thinking, behaviour and the ability to perform everyday activities. Dementia is a long-term, progressive and complex condition. Although dementia mainly affects older people and the risk of developing it increases with age, it is not a normal part of ageing. The most common types of dementia are Alzheimer’s disease, vascular dementia and dementia with Lewy bodies.
Using estimates of the prevalence of dementia in studies published by Alzheimer’s Scotland and the Alzheimer’s Society, along with mid-year population estimates and population projections published by National Records of Scotland (NRS), it is possible to produce estimates for Edinburgh for the number of people who are expected to have dementia.
This topic paper sets out how different data sources have been used to calculate the overall prevalence, how the population data have been used to calculate the estimates and projections of the number of people with dementia, the policy landscape around dementia concluding with a note of the derived prevalence and an analysis of the estimates and projections of the number of people with dementia.
A number of key points to note are:
- In 2019 there were 7,784 people aged 65+ estimated to have dementia; 9.8% of the population.
- For the 85+ population there were estimated to be 3,862 people with dementia; 33.8% of the population.
- 60.4% of older people 65+ living in care homes in Edinburgh are estimated to have dementia.
- Between 2018 and 2030, the number of people estimated to have dementia in Edinburgh is expected to increase by 26.5% from 7,921 to 10,019.
Two sets of prevalence rates have been used in the calculation of estimates for Edinburgh. In line with the prevalence rates adopted by Alzheimer’s Scotland, the EuroCoDe rates are used for people aged 60+[1]. The rates for 90+ have been derived using the NRS Centenarians in Scotland 2009 – 2019 publication[2] as the EuroCoDe prevalence rates have separate rates for 90-94 and 95+ compared with the usual breakdown for population statistics at local authority level where 90+ is the largest category. The rates used for people aged under 60 are those published in the Dementia UK Update from the Alzheimer’s Society[3].
The 2019 estimate of people with dementia in Edinburgh is based on the 2019 mid-year small area population estimates[4]. The datazones have been matched to locality to allow locality estimates to be produced. The 2018-2030 projections of people with dementia in Edinburgh are based on the 2018 based population projections[5]. These are the latest data currently available from NRS.
It is important to note the difference between estimates and projections. The estimate of the number of people with dementia in Edinburgh is based on the latest mid-year population estimate produced by NRS (currently 2019). Applying this population estimate to the prevalence will give the most accurate figure for the estimated number of people with dementia. The projection, which will also give a number for the current year, is based on the latest population projections (currently from 2018). These forward looking projections give the expected number of people with dementia in Edinburgh each year until 2030.
No consideration has been made for the effect of COVID-19 on these estimates and projections, however, this will become apparent in future updates to NRS estimates and projections.
EuroCoDe: Report of WP 7 2006, Prevalence of Dementia in Europe (17 July 2009)
Centenarians in Scotland 2009 to 2019, National Records of Scotland (24 September 2020)
Dementia UK Update, Alzheimer’s Society (November 2014)
Mid-2019 Small Area Population Estimates for 2011 Data Zones, National Records of Scotland (27 August 2020)
Population projections for Scottish Areas (2018 based), National Records of Scotland (24 March 2020)
Because of the impact of Covid, Scotland’s National Dementia Strategy 2017-2020[6] was extended until May 2023 when the fourth strategy was published. Dementia in Scotland: Everyone’s Story[7]was developed in association with the National Dementia Lived Experience panel. It outlines a number of areas which is hoped will improve the lives of people living with dementia, their families and carers, including pre- and post-dementia diagnosis and work to enable more people to live well at home. Tackling the stigma of dementia will be a priority of the plan and it aims to do this by ensuring that two-year delivery plans are agreed, with the first of these expected to be published at the end of 2023.
[6] Scotland’s National Dementia Strategy 2017-2020 , Scottish Government https://www.gov.scot/publications/scotlands-national-dementia-strategy-2017-2020/ (28 June 2017)
[7] Dementia in Scotland: Everyone’s Story https://www.gov.scot/binaries/content/documents/govscot/publications/strategy-plan/2023/05/new-dementia-strategy-scotland-everyones-story/documents/dementia-scotland-everyones-story/dementia-scotland-everyones-story/govscot%3Adocument/dementia-scotland-everyones-story.pdf (31 May 2023)
Table 4.1: Prevalence of dementia by age and sex (percentage)
| Female | Male | |
|---|---|---|
| 30-34 | 0.010 | 0.009 |
| 35-39 | 0.009 | 0.006 |
| 40-44 | 0.020 | 0.008 |
| 45-49 | 0.027 | 0.032 |
| 50-54 | 0.055 | 0.063 |
| 55-59 | 0.097 | 0.180 |
| 60-64 | 0.900 | 0.600 |
| 65-69 | 1.400 | 1.600 |
| 70-74 | 3.800 | 3.500 |
| 75-79 | 7.600 | 7.400 |
| 80-84 | 16.400 | 15.700 |
| 85-89 | 28.500 | 26.200 |
| 90+ | 45.330 | 41.861 |
These rates can be applied to the relevant populations to allow for an estimation of the number of people expected to have dementia in that area.
The tables below give a breakdown of the number of people in 2019 estimated to have dementia split by both age group, gender and locality.
Table 4.2: Estimated number of people with dementia, 2019
| 30-44 | 45-64 | 65-74 | 75-84 | 85+ | Total 30+ | |
|---|---|---|---|---|---|---|
| North East | 3 | 59 | 216 | 563 | 795 | 1,637 |
| North West | 3 | 86 | 348 | 963 | 1,254 | 2,655 |
| South East | 3 | 62 | 258 | 648 | 985 | 1,956 |
| South West | 3 | 61 | 260 | 666 | 828 | 1,818 |
| Total | 13 | 268 | 1,083 | 2,839 | 3,862 | 8,065 |
Graph 4.1: Estimated number of people with dementia, 2019
Table 4.3: Estimated number of females with dementia, 2019
| 30-44 | 45-64 | 65-74 | 75-84 | 85+ | Total 30+ | |
|---|---|---|---|---|---|---|
| North East | 2 | 32 | 114 | 321 | 538 | 1,008 |
| North West | 2 | 48 | 189 | 581 | 840 | 1,660 |
| South East | 2 | 34 | 137 | 385 | 680 | 1,238 |
| South West | 2 | 34 | 137 | 390 | 567 | 1,130 |
| Total | 8 | 149 | 576 | 1,678 | 2,626 | 5,036 |
Table 4.4: Estimated number of males with dementia, 2019
| 30-44 | 45-64 | 65-74 | 75-84 | 85+ | Total 30+ | |
|---|---|---|---|---|---|---|
| North East | 1 | 26 | 102 | 242 | 257 | 629 |
| North West | 1 | 38 | 160 | 382 | 414 | 995 |
| South East | 1 | 28 | 122 | 262 | 305 | 717 |
| South West | 1 | 27 | 123 | 276 | 261 | 687 |
| Total | 5 | 119 | 507 | 1,162 | 1,236 | 3,029 |
In 2019 there were 7,784 people aged 65+ estimated to have dementia, this represents 9.8% of the population. As the prevalence rates above would suggest, as age increases, the percentage of the population with dementia increases steeply. For the 85+ population there were estimated to be 3,862 people with dementia, representing 33.8% of the population.
Using information from the 2019 Care Home census[7] it is possible to identify that in the care home census week in 2019 there were 1,525 older people aged 65+ with dementia living in care homes in Edinburgh. This represents 60.4% of the 2,525 people in cares homes in Edinburgh. Of the 7,784 older people aged 65+ with dementia in Edinburgh 19.6% are living in a care home.
The Care Home census looks at the location of the care home and includes people living in care homes in Edinburgh funded by other Health and Social Care Partnerships.
Care Home Census for Adults in Scotland 2019, Public Health Scotland (27 October 2020)
Between 2018 and 2030, the overall population is expected to increase by 7.7%. This increase is not evenly spread throughout the population, with large increases in the older population anticipated. As such, the number of people estimated to have dementia in Edinburgh over the same period is expected to increase by 26.5% from 7,921 in 2018 to 10,019 in 2030.
The graph below shows the expected increase in the number of people aged 65+ with dementia, by gender and total, indexed to 2018. Overall the expected increase is 27.1%, however, the increase in the number of males aged 65+ with dementia is expected to increase by 37.1%. The rate of increase is expected to accelerate from 2021.
Graph 4.2: Projected number of people with dementia, 2018-2030 by gender
Table 4.5: Projected number of people with dementia, 2018-2030, by gender and age
Total, female and male
| 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | 2026 | 2027 | 2028 | 2029 | 2030 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 30-44 | 12 | 12 | 13 | 13 | 14 | 14 | 14 | 14 | 14 | 14 | 14 | 14 | 15 |
| 45-64 | 263 | 268 | 274 | 280 | 283 | 287 | 290 | 293 | 293 | 295 | 293 | 292 | 289 |
| 65-74 | 1,053 | 1,083 | 1,110 | 1,131 | 1,113 | 1,118 | 1,128 | 1,140 | 1,165 | 1,191 | 1,223 | 1,251 | 1,283 |
| 75-84 | 2,819 | 2,843 | 2,855 | 2,862 | 2,977 | 3,053 | 3,143 | 3,227 | 3,321 | 3,494 | 3,604 | 3,704 | 3,791 |
| 85+ | 3,775 | 3,860 | 3,932 | 4,009 | 4,077 | 4,156 | 4,215 | 4,271 | 4,304 | 4,356 | 4,440 | 4,544 | 4,641 |
| Total 30+ | 7,921 | 8,068 | 8,184 | 8,295 | 8,464 | 8,628 | 8,790 | 8,945 | 9,097 | 9,350 | 9,575 | 9,805 | 10,019 |
Females
| 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | 2026 | 2027 | 2028 | 2029 | 2030 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 30-44 | 7 | 8 | 8 | 8 | 8 | 8 | 9 | 9 | 9 | 9 | 9 | 9 | 9 |
| 45-64 | 145 | 149 | 153 | 156 | 158 | 160 | 161 | 162 | 163 | 163 | 163 | 162 | 160 |
| 65-74 | 562 | 577 | 592 | 601 | 590 | 591 | 596 | 601 | 612 | 626 | 643 | 660 | 677 |
| 75-84 | 1,669 | 1,680 | 1,682 | 1,686 | 1,743 | 1,774 | 1,812 | 1,855 | 1,902 | 1,988 | 2,044 | 2,095 | 2,144 |
| 85+ | 2,603 | 2,643 | 2,667 | 2,703 | 2,738 | 2,789 | 2,823 | 2,850 | 2,869 | 2,901 | 2,942 | 2,990 | 3,038 |
| Total 30+ | 4,986 | 5,057 | 5,101 | 5,153 | 5,236 | 5,322 | 5,401 | 5,477 | 5,554 | 5,687 | 5,801 | 5,916 | 6,029 |
Males
| 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | 2026 | 2027 | 2028 | 2029 | 2030 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 30-44 | 5 | 5 | 5 | 5 | 5 | 5 | 5 | 5 | 6 | 6 | 6 | 6 | 6 |
| 45-64 | 118 | 119 | 122 | 124 | 125 | 128 | 129 | 130 | 131 | 131 | 131 | 131 | 129 |
| 65-74 | 491 | 506 | 517 | 530 | 523 | 527 | 532 | 539 | 553 | 564 | 579 | 591 | 606 |
| 75-84 | 1,150 | 1,164 | 1,173 | 1,177 | 1,234 | 1,279 | 1,330 | 1,372 | 1,419 | 1,506 | 1,560 | 1,609 | 1,647 |
| 85+ | 1,172 | 1,217 | 1,265 | 1,306 | 1,339 | 1,366 | 1,392 | 1,421 | 1,435 | 1,455 | 1,498 | 1,554 | 1,602 |
| Total 30+ | 2,935 | 3,011 | 3083 | 3,142 | 3,227 | 3305 | 3,388 | 3,468 | 3,543 | 3,662 | 3,774 | 3,889 | 3,990 |
Table 4.6: Projected number of people with dementia, 2018-2030 by age and locality
North East
| 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | 2026 | 2027 | 2028 | 2029 | 2030 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 30-44 | 3 | 3 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 |
| 45-64 | 57 | 59 | 61 | 63 | 64 | 65 | 66 | 67 | 68 | 69 | 69 | 69 | 69 |
| 65-74 | 212 | 218 | 225 | 232 | 229 | 234 | 240 | 248 | 255 | 263 | 273 | 283 | 291 |
| 75-84 | 575 | 574 | 577 | 581 | 607 | 619 | 637 | 648 | 665 | 699 | 724 | 746 | 768 |
| 85+ | 774 | 783 | 782 | 784 | 783 | 793 | 794 | 798 | 802 | 808 | 820 | 835 | 848 |
| Total 30+ | 1,621 | 1,638 | 1,648 | 1,664 | 1,687 | 1,715 | 1,741 | 1,765 | 1,794 | 1,843 | 1,891 | 1,937 | 1,980 |
North West
| 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | 2026 | 2027 | 2028 | 2029 | 2030 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 30-44 | 3 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 |
| 45-64 | 85 | 87 | 90 | 92 | 93 | 95 | 96 | 97 | 97 | 97 | 95 | 95 | 93 |
| 65-74 | 341 | 349 | 359 | 366 | 360 | 362 | 368 | 373 | 383 | 393 | 406 | 416 | 429 |
| 75-84 | 967 | 966 | 959 | 947 | 978 | 999 | 1,021 | 1,044 | 1,073 | 1,125 | 1,157 | 1,187 | 1,219 |
| 85+ | 1,239 | 1,277 | 1,303 | 1,336 | 1,359 | 1,379 | 1,396 | 1,408 | 1,410 | 1,421 | 1,442 | 1,471 | 1,488 |
| Total 30+ | 2,636 | 2,683 | 2,714 | 2,745 | 2,794 | 2,840 | 2,886 | 2,926 | 2,967 | 3,041 | 3,105 | 3,172 | 3,234 |
South East
| 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | 2026 | 2027 | 2028 | 2029 | 2030 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 30-44 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 |
| 45-64 | 62 | 63 | 64 | 64 | 65 | 65 | 66 | 66 | 66 | 66 | 66 | 66 | 65 |
| 65-74 | 252 | 264 | 269 | 276 | 272 | 275 | 274 | 273 | 277 | 283 | 286 | 290 | 297 |
| 75-84 | 645 | 658 | 670 | 684 | 714 | 737 | 765 | 797 | 825 | 869 | 896 | 933 | 950 |
| 85+ | 971 | 989 | 1,008 | 1,019 | 1,047 | 1,070 | 1,089 | 1,110 | 1,124 | 1,146 | 1,179 | 1,204 | 1,245 |
| Total 30+ | 1,933 | 1,977 | 2,015 | 2,047 | 2,101 | 2,150 | 2,196 | 2,249 | 2,295 | 2,367 | 2,430 | 2,496 | 2,560 |
South West
| 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | 2026 | 2027 | 2028 | 2029 | 2030 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 30-44 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 |
| 45-64 | 58 | 59 | 60 | 61 | 61 | 61 | 62 | 62 | 62 | 63 | 63 | 62 | 61 |
| 65-74 | 248 | 252 | 256 | 257 | 252 | 247 | 244 | 246 | 249 | 251 | 258 | 263 | 267 |
| 75-84 | 632 | 646 | 649 | 650 | 678 | 698 | 720 | 738 | 758 | 801 | 827 | 838 | 854 |
| 85+ | 790 | 811 | 839 | 869 | 888 | 914 | 937 | 955 | 968 | 980 | 1,000 | 1,035 | 1,060 |
| Total 30+ | 1,731 | 1,770 | 1,806 | 1,840 | 1,882 | 1,923 | 1,966 | 2,004 | 2,041 | 2,098 | 2,149 | 2,201 | 2,245 |