Sube Banerjee MBE, Professor of Dementia at Brighton and Sussex Medical School (BSMS), a partnership between the universities of Brighton and Sussex, said there has been significant progress in recent years: "It has been a real achievement to drive dementia from being one of the least thought about conditions in health and social care to being the very top priority."
Professor Banerjee explains why there is a better future for those with dementia in his inaugural lecture Dementia: Reasons to be cheerful.
He said dementia is one of the biggest challenges to global healthcare systems: "Currently 35 million people have dementia around the world and this will double in a generation. This disease has a real impact not just on those who have it and those who care for them, but also on healthcare costs and provision. It has been estimated that $600 billion is spent in response to the condition: If dementia was a country it would be the eighteenth largest economy in the world."
Diagnosis rates are still too low, he said, with only 44 per cent of people with dementia in the UK ever knowing they have it, and even when the diagnosis is made it tends to be too late: “It is usually at a time of crisis, when it is too late to prevent harm, and too late to allow people to make their own choices. And then there are things that go wrong in terms of service provision for both those who have dementia and their families."
But, he said, there are reasons to be positive. At the Centre for Dementia Studies, run in collaboration with the Sussex Partnership NHS Foundation Trust, where Professor Banerjee is a consultant psychiatrist, his team looks at all aspects of quality of life and quality of care for dementia to define and test better models of provision. He said: "The brilliant news is that there are answers to each set of problems. We have done work to measure quality of life in dementia; we need to know what helps people and what doesn't."
His team developed the DEMQOL system and used it to evaluate his service model to improve early intervention, defining what good means in terms of quality of service. "We have shown that such services are both clinically-effective and cost-effective. They have been implemented not just in the UK but around the world. In Japan it is a key element in their dementia strategy, with 4,000 new dementia teams based on this model."
Professor Banerjee's team has also identified some harmful outcomes for patients through the use of anti-psychotic drugs for behavioural disturbance in dementia: "Those drugs were associated with 1,800 deaths a year. We demonstrated this and we formulated plans throughout the NHS that led to the use of those drugs being decreased. Use of these drugs has since been halved compared with 2008, meaning 900 lives are saved each year by the changes made."