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Guest Viewpoint: The Dementia Puzzle

Reaching for a dignified old age for all

Dementia is not an inevitable factor in ageing. A welcome announcement last week from the World Health Organisation (WHO) and a conclusion arrived at after a comprehensive review of existing evidence. Instead, said the WHO, lifestyle factors, such as inactivity, smoking, poor diet and alcohol consumption are significantly increasing the chances of people getting dementia.

With the announcement coming just a week before Dementia Action Week (May 20 to 26), it represents a timely reminder of what we can all do as individuals to reduce the risk of getting this life changing condition. 

With 850,000 people now living with dementia in the UK*, and this is set to rise further, prevention has got to be something we all take seriously. We can’t just give in to this disease. Yet, we’re also faced with the fact that as a nation we are more inactive than ever before.

Last year Vitality published a study that sought to understand how we could incentivise people to live fitter and healthier lives. Performed in association with Apple and RAND, it found that people who engage with Vitality’s Apple Watch benefit saw an average 34% sustained increase in activity: 4.8 extra days of activity per month. This activity increased across the full spectrum of Vitality participants, regardless of health status, age or gender. In short, effective use of wearables to incentivise behaviour change can lead to greater control of health and wellbeing, encouraging people to become more active, and effectively shifting the focus on to preventative care. The significance for individuals, the insurance industry and wider society with regards to prevention against many conditions – including dementia – is profound.

But, prevention is just part of this dementia puzzle. One of the worst aspects of the condition is the ripple effect it has. It’s not only the person diagnosed that’s affected, but their families too. It’s often the family, certainly to start with, that picks up care for their loved one.

What happens when that person has no family who can take on this task, or they go on to need more extensive care – either at home or in some form of residential care – continues to be a well fought out argument in political circles. Given the pressure on both the NHS and social care, we have arguably long since reached the point where we can simply hope that the state will pick up this bill.

In advance of the social care green paper, expected any time from the government, the Rt Hon Damian Green MP published a paper (Centre for Policy Studies, 2019) earlier this month looking at funding models in more detail and asking what solutions could secure the future of care for someone with dementia. The ultimate goal? To give everyone a dignified old age no matter their economic circumstance or health condition. 

A worthy aspiration. Green puts forward a number of suggestions for funding this care, including a taxation model, equity release, saving for the possibility that you may get the condition. And he also looks to insurance to provide other solutions.

The difficulty with most of these solutions is that they involve asking people to contribute to something they may never get. Whilst we may be able to – and should – use activity and other preventative measures to lower our risk, other factors inevitably play a part. There is no certainty of who will – and will not – go on to get the disease. So, prevention has to be balanced with protection.

In line with this, any solution – from government or insurers – must consider the realities of life. We’re all guilty of looking to the short term and who can blame us – certain life stage priorities, such as buying a house or raising a family, are all consuming. There’s no time, space or inclination to consider the prospect of a potential future dementia diagnosis. Whilst most people realise that early onset, or working age dementia does happen, dementia itself is mostly associated as an older person’s disease. It’s back of mind, if there at all.

Last year, in a world first, Vitality took one step forward in this area, updating its serious illness cover to reflect this growing need in society, providing people with the cover they need in line with life stage priorities, plus an instant pay-out for a number of conditions often associated with old age, including dementia. This has the potential to make the world of difference to a family that has someone diagnosed with the condition. And it’s been hugely popular, with about two thirds of people opting to include it within their insurance. Where insurance as a whole goes next will largely depend on what the forthcoming Green Paper includes and how long it takes whatever it includes to implement.

What is certain is that the need is here now. And we need to all work together to find a solution. Around a million people in the UK will have dementia by 2025, rising to two million by 2050[1]. As a result, it is predicted to cost the UK a staggering £66bn by the same date[2] – over half the entire current NHS budget, meaning the country will also need about 1.7 million informal carers by that time, more than twice the estimated amount of people currently providing care[3]. These are numbers which should have us all looking for solutions, and quickly.

Deepak Jobanputra is Deputy CEO of VitalityLife

[1] Alzheimer’s Research UK, Prevalence by age in the UK, 2018