Universities lead attack on dementia
Three East of England universities are conducting vital research in the field of dementia – one of the UK government’s priority target areas for healthcare improvements.
The Universities of Hertfordshire, Cambridge and East Anglia are contributing positively to the debate for more targeted research.
Every year disorders of the brain, including dementia, stroke, and mental health, cost the UK around £112 billion, according to a new report by leading neuroscientists.
Professor Naomi Fineberg, one of the lead authors of the report from the University of Hertfordshire and Hertfordshire Partnership University NHS Foundation Trust (HPFT), said: “The findings emphasise the extremely high burden and cost that brain disorders present to the UK economy. This is largely a result of their impact on lost productivity, rather than the direct cost of medical or social care.
“These costs are only likely to increase further, as the population ages, unless better treatments become available.”
The cost of dementia on the social care system was found to be much higher than that for cancer, coronary heart disease (CHD) and stroke. The annual cost for health and social care for dementia is £10.5 billion, compared to £4.5 billion for cancer, £2.7 billion for stroke and £2.3 billion for CHD. The added cost of informal care and productivity losses brings the total to £23 billion.
The researchers argue that investing in research into brain disorders, which will allow us to better understand, prevent and treat brain diseases, has the potential to considerably reduce the overall economic burden to society and improve patient quality of life.
The report, The Size, Burden and Cost of Disorders of the Brain in the UK, published in the Journal of Psychopharmacology, is a collaboration between the University of Hertfordshire, University of Cambridge and Imperial College London.
In a separate initiative, researchers at the University of East Anglia have been awarded a £2 million programme grant from the National Institute of Health Research (NIHR) to examine ways to improve hospital care for people with dementia. The grant is one of the largest awarded in the NIHR’S recent dementia-themed call.
At present, one quarter of acute NHS hospital beds are occupied by people with dementia. But rehabilitation is difficult due to acute confusion “delirium” and other complications. Many return home in worse health than when they were admitted.
The five-year programme will investigate how better standards of care can be implemented across the NHS to improve the outcomes of hospital admission for people with dementia.
Programme leader Dr Chris Fox, from UEA’s Norwich Medical School, said: “People with dementia are admitted to hospital for a range of reasons. Fractures and other injuries from falls are common, along with reasons such as heart attacks, strokes, or diabetes.
“It is particularly difficult to care for people with dementia because they can’t remember what has happened to them. They don’t know why they’re in hospital. And many will end up worse off than before they came in.
“An injury such as a fractured hip often leads to acute confusion known as delirium and other complications. These are linked to a very negative outcome on people’s lives with impairment of function, independence and quality of life. This in turn causes distress for individuals and their families and is also associated with significant care costs.
“On average, people with a hip fracture in addition to dementia stay in hospital three times longer than those with a hip fracture who do not have dementia. They also have a much lower survival rate (up to 40 per cent mortality).
“There is good quality evidence which shows that preventing acute confusion, and other dementia-specific care challenges, is possible. But this standard of care is not being routinely implemented.”
Inconsistent standards of care for people with dementia, poor physical and mental health management and overuse of sedatives have been highlighted in national reports. Dr Fox said: “Our research will look at people admitted with hip fractures, but it will have impact across the board. We will create a set of guidelines for care and rehabilitation of individuals with training materials for staff.
“These may have massive benefits to people with dementia, their families and healthcare professionals – not only in the UK but around the world. We are creating a better system of care that can feature in any hospital in any country with our international collaborators.”
The programme will involve a UK and international team of researchers with the Alzheimer’s society and Dementia UK as partners.
A key international collaborator is Dr Malaz Boustani – a US expert in implementation science and aging brain care at Indiana University’s School of Medicine and the Regenstrief Institute, who is also president of the American Delirium Society.
• PHOTOGRAPH SHOWS: Professor Naomi Fineberg. Image courtesy: British Association for Psychopharmacology