Wiltshire Dementia Strategy 2023 to 2028
Local and national context
What is dementia
Dementia is an umbrella term to describe a set of symptoms caused by a number of conditions. The most common symptoms are memory loss, confusion (e.g. about time and place), difficulties in planning and organising, problems with language and understanding, and in some cases changes in a person's mood or behaviour.
95% of people with dementia have one or more of four main diseases1:
- the most common cause of dementia is Alzheimer's disease, which accounts for around two thirds of people living with dementia
- up to 20% of people with dementia have vascular dementia
- around 15% have dementia with Lewy Bodies
- fewer than 5% have fronto-temporal dementia
The likelihood of developing dementia doubles every five years after a person's 65th birthday. However, dementia does not only affect older people (research suggests that around 5% of people living dementia are under 65). It is not a natural part of ageing.
Around one third of the risk of developing Alzheimer's disease can be reduced by making changes to one's lifestyle2, and vascular dementia is strongly associated with other vascular risk factors such as smoking, obesity, lack of exercise and high blood pressure. Research shows that changes to the structure of the brain may occur at least 10 years before overt symptoms become manifest. This means that people in their 30s and 40s can proactively address risk.
Recent research by Public Health England found that people with dementia are more likely to live with other health conditions than people who don't have dementia. The study also found people with dementia are more likely to have multiple health conditions. A total of 22% of patients with dementia had three or more comorbidities and 8% of patients with dementia had four or more comorbidities, compared to 11% and 3% respectively in the all-patient group.
Local profile
The 2021 Census showed that Wiltshire's population is ageing. 21.8% of people are aged 65 and over (compared to 18.4% in England), with 3% aged 85 and over. Wiltshire was one of only three local authorities in the South West whose 65+ population grew by more than 30% between 2011 and 2021.
The tables below shows how the age distribution in Wiltshire has changed since the turn of the century. Since 2001, the median age has increased from 39 to 44, and the percentage of the population who are aged 65+ has increased from 16.45% to 21.72%. Over 40,000 more people aged 65+ live in Wiltshire today than did in 2001.
Age range | Number of population | Percentage of population |
---|---|---|
65 to 74 | 37,026 | 8.55 |
75 to 84 | 25,176 | 5.81 |
85 and over | 9,037 | 2.09 |
The total population for the 2001 census was recorded at 432,973. The median age was 39 years old.
Age range | Number of population | Percentage of population |
---|---|---|
65 to 74 years old | 45,070 | 9.57 |
75 to 84 years old | 28,456 | 6.04 |
Over 85 years old | 11,962 | 2.54 |
Total over 65 years old | 85,488 | 18.15 |
The total population for the 2001 census was recorded at 470,981. The median age was 42 years old.
Age range | Number of population | Percentage of population |
---|---|---|
65 to 74 years old | 58,703 | 11.43 |
75 to 84 years old | 37,680 | 7.34 |
Over 85 years old | 15,146 | 2.95 |
Total over 65 years old | 111,529 | 21.72 |
The total population for the 2001 census was recorded at 513,411. The median age was 44 years old.
Wiltshire's Joint Strategic Needs Assessment forecasts that the population of those over 85 years old will almost double between now and 2040.
The Census also showed that there are approximately 44,000 unpaid carers in Wiltshire. The proportion of the total population who provide care has dropped since the last Census3; however, the number of people providing significant levels of care increased.
Estimated dementia prevalence in Wiltshire
There are approximately 8,300 people living with dementia in Wiltshire, although not all these people will have a diagnosis. Based on the prevalence of dementia by age and the recent 2021 Census date, we can accurately predict that around 5,200 women (62.7%) and 3,100 men (37.3%) in Wiltshire have dementia. Approximately 300 people with dementia in Wiltshire are under 65; around 1,900 are aged 90 and over. This reflects the increasing risk of dementia as people get older.
Further information and data about Wiltshire's population can be found in Appendices, under appendix 3.
Links to Business Plans, BSW, other strategies
This strategy aligns with and supports implementation of national and local priorities:
- Equalities Act 2010
- Care Act 2014
- NHS Commitment to Carers 2014
- National Carers Action Plan 2018
- National Institute of Health & Care Excellence (NICE) Dementia: Assessment, Management and Support for People living with dementia and their carers 2018
- NHS Long Term Plan 2019
- People at the Heart of Care: Adult Social Care Reform White Paper 2021
- Health & Social Care Integration White Paper 2022
- DHSC Major Conditions Strategy (expected 20244)
- Wiltshire Council Business Plan 2022-2032
- Wiltshire Joint Health and Wellbeing Strategy
- Wiltshire Independent Living Strategy 2022
- Wiltshire Autism Strategy 2022
- Wiltshire Carers Strategy (to be published in 2023)
- Wiltshire Technology Enabled Care (TEC) Strategy (to be published in 2023)
- Wiltshire Council Prevention Strategy (to be published in 2023)
- Wiltshire Council Climate Strategy5
- BSW Learning Disability Mortality Review (LeDeR) programme
Scope of the strategy
This strategy will support all people with dementia and their carers irrespective of age. The strategy focuses on people who live or are registered with a GP in Wiltshire (excluding Swindon).
It recognises that a minority of people receive a diagnosis of dementia whilst in their 40s and 50s, and that this brings challenges (such as employment, caring/parenting responsibilities, financial questions) which require a distinct and personalised response. The strategy also recognises that carers and/or family members of people with dementia (like other conditions and disabilities) may be children or young people.
Reflecting the Bath & North East Somerset, Swindon and Wiltshire (BSW) Partnership, this is a joint strategy across health, social care and the voluntary and community sector. We recognise the need to work together to develop a seamless response because people with dementia and carers need joined-up support to enable them to live a good quality of life.
1 A description of the most common types of dementia can be found at Types of dementia (dementiauk.org) (opens new window)
2 Brain health and risk reduction (dementiastatistics.org) (opens new window)
3 This may be because the wording of this question in the Census changed between 2011 and 2021
4 Major conditions strategy: case for change and our strategic framework (gov.uk) (opens new window)
5 Research indicates that air pollution has a harmful impact on brain health and can increase the risk of dementia: Air pollution: cognitive decline and dementia (gov.uk) (opens new window)