Introduction

Dementia is a syndrome (a group of related symptoms) associated with an ongoing decline of brain functioning. There are many different causes of dementia, and many different types. Alzheimer's disease is a type of dementia and, together with vascular dementia, makes up the majority of cases [1].

Dementia is not a single disease. It's an overall term to describe a collection of symptoms that one may experience if they are living with a variety of diseases, including Alzheimer's disease. Diseases grouped under the general term "dementia" are caused by abnormal brain changes. Dementia symptoms trigger a decline in thinking skills, also known as cognitive abilities, severe enough to impair daily life and independent function. They also affect behavior, feelings and relationships. Alzheimer's disease accounts for 60-80% of cases. Vascular dementia, which occurs because of microscopic bleeding and blood vessel blockage in the brain, is the second most common cause of dementia. Those who experience the brain changes of multiple types of dementia simultaneously have mixed dementia. [2].



Dementia symptoms may include problems with:

• memory loss
• thinking speed
• mental sharpness and quickness
• language, such as using words incorrectly, or trouble speaking
• understanding
• judgement
• mood
• movement
• difficulties doing daily activities [1]

Although there is no cure for dementia at the moment, an early diagnosis means its progress can be slowed down in some cases, so the person may be able to maintain their mental function for longer. A diagnosis helps people with dementia get the right treatment and support. It can also help them, and the people close to them, to prepare for the future. With treatment and support, many people are able to lead active, fulfilled lives with dementia[1].

Research shows there are more than 944,000 people in the UK who have dementia. 1 in 11 people over the age of 65 have dementia in the UK. The number of people with dementia is increasing because people are living longer. It is estimated that by 2030, the number of people with dementia in the UK will be more than 1 million [1].

Data

Dementia Prevalence

The recorded dementia prevalence provides an indication of the concentration, within a population, of the number of people aged 65 or older who have been diagnosed and who are now living with the condition. This indicator can be used to inform local service planning as to the scale of services required to provide treatment, care and support as needed, so those with dementia can live well with the condition. The measure represents the percentage of patients (aged 65+) with dementia as recorded on all open and active GP practice disease registers.

There is a declining trend across oldham, North West and England in the recorded dementia prevalence of those aged 65 years and above. Oldham's rate is consistently above that of regional and national averages. The percentages for all regions remained relatively stable from 2017 to 2019, with only slight fluctuations. The most significant decreases appear between 2019 and 2020, indicating a sharper drop during that year. Oldham sees the most significant percentage drop between 2019 and 2020, where it decreases by 0.52 percentage points. The North West saw a drop of 0.42 percentage points between the same years. England's decrease was slightly lower at 0.37 percentage points. The drop in the latest year of data available (2020) is likely due to the effects of the Covid-19 pandemic on health services and rates are likely to return to pre-pandemic levels with the next data release. Oldham's rate is 4th highest across Greater Manchester and ranks centrally amongst CIPFA nearest neighbours.

Figure 1: Recorded dementia prevalence (aged 65 years and over) trend
Source: OHID, based on NHS England data

Figure 2: Recorded dementia prevalence (aged 65 years and over) across Greater Manchester
Source: OHID, based on NHS England data

Figure 3: Recorded dementia prevalence (aged 65 years and over) across CIPFA neighbours
Source: OHID, based on NHS England data 

Estimated dementia diagnosis rate

A timely diagnosis enables people living with dementia, their carers and healthcare staff to plan accordingly and work together to improve health and care outcomes. This indicator allows us to estimate the number of people living in Oldham with dementia both with and without a diagnosis and helps to identify the potential gap. Oldham's rate is consistently above the North West and England and follows a similar trend. We can see a period of decline between 2017 and 2022, but the trend reversed in 2023, and the recovery continued in 2024. Overall, rates have decreased more in Oldham (-9.7%) compared to regional (-5.9%) and national (-4.6%) averages. Oldham ranks 3rd highest in Greater Manchester and 4th highest amongst CIPFA neighbours.

Figure 4: Estimated dementia diagnosis rate (aged 65 years and over) trend
Source: OHID, based on NHS England data

Figure 5: Estimated dementia diagnosis rate (aged 65 years and over) across Greater Manchester
Source: OHID, based on NHS England data

Figure 6: Estimated dementia diagnosis rate (aged 65 years and over) amongst CIPFA neighbours
Source: OHID, based on NHS England data

Emergency Hospital Admissions

The below charts represent the directly standardised rate (per 100,000) of emergency hospital admissions with any mention of dementia or alzheimer's. This indicator is part of the developmental approach to understanding the variation in the provision of care of people with dementia in England. This indicator illustrates the variation across England in the rate of emergency admissions for people aged 65+ with dementia or alzheimer's and will identify areas where the rates are both higher and lower than the national average. Areas identified of both types might warrant further investigation to establish either the underlying causes for higher rates and thus gain an understanding of where improvements might be required, or for lower rates what good practice might look like.

Oldham's rate is consistently higher than North West and England averages and was particularly high in 2017/18, rising to the highest rate shown below of 4,981 per 100,000. Overall, Oldham's rate has increased by 9.7%. This is higher than regional and national changes, whereby the North West saw a decrease of 1.4% and England an increase of 4.5%. Despite Oldham having a rate well above regional and national averages, it ranks only 4th highest across Greater Manchester and 5th highest amongst CIPFA nearest neighbours.

Figure 7: Dementia related emergency admissions (aged 65 years and over) trend
Source: OHID, based on NHS England and Office for National Statistics data

Figure 8: Dementia related emergency admissions (aged 65 years and over) across Greater Manchester
Source: OHID, based on NHS England and Office for National Statistics data

Figure 9: Dementia related emergency admissions (aged 65 years and over) amongst CIPFA neighbours
Source: OHID, based on NHS England and Office for National Statistics data 

Mortality

The below indicator represents the directly age standardised rate of mortality in persons (aged 65+) with a recorded mention of dementia or alzheimer's per 100,000 population and exists in order to understand the geographical variation in the deaths of people with dementia or alzheimer's.

Despite some fluctuations, Oldham consistently experienced higher death rates in people with dementia compared to both the North West region and England as a whole. For 2019 (the latest year of data), Oldham's rate was 1,045 per 100,000, higher than regional (914 per 100,000) and national (849 per 100,000) averages. While there was some decrease in 2017, this improvement was not sustained in 2018. Although the North West and England experienced fluctuations, they showed a more consistent downward trend by 2019. Oldham ranks 4th highest across Greater Manchester and performs averagely when assessed against CIPFA neighbours.

Figure 10: Mortality in people with dementia (aged 65 years and over) trend
Source: OHID, based on Office for National Statistics data

Figure 11: Mortality in people with dementia (aged 65 years and over) across Greater Manchester
Source: OHID, based on Office for National Statistics data

Figure 12: Mortality in people with dementia (aged 65 years and over) amongst CIPFA neighbours
Source: OHID, based on Office for National Statistics data

Further Information & Resources

NHS Dementia Page
Information and advice from the NHS on living with dementia and Alzheimer's.

Dementia UK
Dementia UK are a specialist dementia nursing charity that is there for the whole family. Their nurses, known as Admiral Nurses, provide free, life-changing support and advice to anyone affected by dementia. The website has information and advice relating to dementia and Alzheimer's.

OHID Dementia Data Profiles
This profile was developed originally to support the work of the Dementia Intelligence Network (DIN) in providing health intelligence with which to inform the provision of care of people in England who have dementia. 
This dementia profile shows indicators arranged into 5 data domains:

• pathway on a page
• preventing well
• diagnosing well and prevalence
• living well and supporting well
• dying well

Alzheimer's Research UK Statistics Hub
A range of resources and data relating to dementia and Alzheimer's, provided by Alzheimer's Research UK.

References

[1] Alzheimer's Association https://www.alz.org/alzheimers-dementia/what-is-dementia accessed September 2024
[2] Dementia UK https://www.dementiauk.org/ accessed September 2024

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