Data Journalism piece
Alzheimer's and dementia disease now the main cause of women dying in England and Wales.
Dementia and Alzheimer’s are now the leading causes of death in England, affecting more women than men, according to the latest figures from the Office for National Statistics.
The difference between Alzheimer’s and dementia
The Alzheimer’s society state that “The main difference between Alzheimer’s and dementia is that Alzheimer’s is a disease in the brain, whereas dementia is a collection of symptoms…”
The UK’s population is estimated to be around 68 million and in 2022 it was reported that dementia and Alzheimer’s was the leading cause of 20.7% of all deaths – a total of 13 million people.
Dementia deaths increasing
According to the ONS (Office of national statistics), the number of deaths due to dementia and Alzheimer’s shows a relatively large increase of 13.4% between the years of 2015-2020.
There are a lot of factors affecting this, some include: reporting by physicians at the source, the growing population and a significant demise in the general health and wellbeing of individuals.
It is also worth noting the recent changes in ONS reporting of dementia and Alzheimer’s allowing it to be recorded as the direct cause of death, instead of it being a factor. Up until 2011, vascular dementia was recorded as cerebrovascular disease. ONS also state in the death registration and summary statistics report, “Additionally, deaths that were previously coded to aspiration pneumonia (I69) where dementia was mentioned on the death certificate would now be coded to dementia (F01 or F03).” This will have undoubtedly influenced the current cases being reported and therefore the mortality rates.
It is not only ONS reporting / recording factors that appear to be at play here but also some of this may lie with the hospitals themselves. It has long been known the challenges doctors face when it comes to recording the cause of death on the certificate of someone recently departed. In May 2023 Dr Alan Fletcher the national medical examiner wrote, “It is important to distinguish on the MCCD between dementia that has a direct causal relationship to terminal events and dementia that has a contributory effect. In general, dementia should only appear in 1(a) in the absence of more specific pathology or causality.” https://www.rcpath.org/static/89d3402a-1e54-4bff-80967d5add743004/Good-Practice-Series-MEs-and-dementia.pdf
These changes in recording and difficulties faced by clinicians reporting deaths must be considered when looking at the wider numbers associated with dementia.
Taking these changes of reporting into account, one can’t deny the possibility of such changes skewing results. This is one of many possibilities as to why these numbers certainly appear to be on the rise.
Top five leading causes of death in England and Whales, 2022, by sex.
Dementia doesn’t equal equality.
According to data from ONS, while the leading cause of death for males was ischaemic heart disease – accounting for 13.3% of all male deaths, the leading cause of death for women was dementia and Alzheimer’s – accounting for 15% of all female deaths in 2022.https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregistrationsummarytables/2022
This isn’t a new thing. In 2018 males made up 34.1% of all dementia deaths, in the same timeframe, females made up 65.9% of all dementia deaths – which is a stark difference.
Dementia has been the leading cause of death for women since 2011, but why?
Research carried out by Alzheimer’s Research UK shows that the gender data gap in medical research plays a big part in the lack of knowledge of how women are affected so differently to men. Women are less likely to be included in clinical trials, despite experiencing drug reactions more often than men, further contributing to the void of understanding in this area.
It’s also known that the hormonal differences between the two sexes vary substantially, as well as the effects of high blood pressure and levels of physical activity.
Paramedic Rachel Holden, Director of NR Group East Anglia, who has worked in healthcare for 22 years, started her career in a care home setting. She says that” thinking back to the years I spent working in residential care homes and hospital wards, there has always been an overwhelming number of women in comparison to men. It was just always the norm that the care homes and elderly wards were overwhelmingly female”
The difference remains unclear
Despite continued research, it remains unclear as to why dementia and Alzheimer’s affects far more women than it does men. It’s clear that there is much to be done in the way of these gender-based differences in these diseases.
When considering the care and support for those affected by the disease, NICE guidelines state that best practise interventions should include activities that promote cognitive stimulation, allow people to continue to make their own decisions where this is appropriate, and reminiscence sessions whereby they are given time and space to remember things about their past. https://www.nice.org.uk/guidance/ng97/chapter/Recommendations#interventions-to-promote-cognition-independence-and-wellbeing
Dementia is a progressive disease and the management needs of those affected will change and develop over time. It is important that those caring for someone have upon to date and best practice training, to enable them to look after them to the best of their ability.
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