GPs to bear the brunt of dementia ‘tsunami’

4 minute read

But general practice is still where people living with dementia are best managed.

Australian GPs can expect to see at least double the number of dementia cases in their practices by 2054, new modelling suggests.

And while Dementia Australia’s Honorary Medical Advisor Associate Professor Michael Woodward said GPs would need more training and support to cope with the impending “tsunami” of cases, he asserted this was the best place for their regular care.

New modelling by the National Centre for Monitoring Dementia (NCMD) at the Australian Institute of Health and Welfare predicts the number of Australians living with dementia will increase from 421,000 in 2024 to 812,500 by 2054 – a rise of 93%.

“What it basically means is that every GP is going to be having twice as many cases with dementia and Alzheimer’s. That’s assuming the number of GPs remains constant at the moment,” said Professor Woodward.

“If the number of GPs falls, many GPs are going to have up to three or four times as many patients on average with significant cognitive disorders.

“And what we have to do about that is basically to better skill GPs in the detection, the diagnosis and the management of disorders.”

He also advocated for more specialised allied health services like dementia care nurses.

The report was deeply concerning in relation to cases of younger onset dementia (diagnosed before age 65). This number – estimated at 29,000 in 2024 – is tipped to rise by 41% to almost 41,000 by 2054.

While worrying, Professor Woodward suggested the increase in rates of younger onset dementia was, in part, due to better diagnosis.

“In the past, people in their 40s, 50s and even early 60s who had Alzheimer’s were initially thought to be depressed or to have a spectrum disorder or ADHD, or maybe substance abuse, and it wasn’t considered that they could have Alzheimer’s, so we’re better at picking it up,” he said.

“We’ve got better. We’ve got better diagnostic tests, like PET scans and CSF and soon blood tests, so we’re much more confident in making the diagnosis.”

Professor Woodward also said that while the modelling was not good news, it was not new.

“The numbers may look alarming, but we’ve known this for at least a quarter of a century,” he said.

“There is still a need to be prepared for the tsunami of people with Alzheimer’s and other dementias.

“And it’s more than just getting GPs prepared. We need our society to be prepared, we need our aged care services to be prepared. We need to train more carers, more workers. We need to train the whole of society to destigmatise dementia.”

The sustained rise in dementia rates will put a growing burden on support services, not only for those living with dementia, but also for the more than 1.6 million people estimated to be involved in caring for them, said Dementia Australia CEO Maree McCabe.

“Dementia is the second leading cause of death of all Australians and the leading cause of death for women.

“Provisional data is showing that dementia will likely soon be the leading cause of death of all Australians,” she said.

“It is one of the most significant health and social challenges facing Australia and the world.”

While all states and territories are expected to see an increase in dementia diagnoses in the next 30 years, Western Australia will see the highest growth at 109%, according to the data. This will be followed by the Northern Territory at 106%, the Australia Capital Territory at 104%, Queensland at 100% and Victoria at 96%.

Only three jurisdictions are forecast not to double, but the numbers are still not positive: NSW is set to see a 79% increase in diagnoses, South Australia a 59% increase and Tasmania 52%.

The modelling drills deeply down into Australian local government areas, providing estimates on the change in dementia prevalence between 2024 and 2054.

The research team has used a standard demographic modelling approach, in which age-sex dementia prevalence rates calculated by the AIHW were applied to age-sex population estimates and projected population estimates.

Although the growth of dementia poses a challenge, “this data will help to inform planning and funding of services and programs around Australia to meet current and future needs”, said Ms McCabe.

Ms McCabe told The Medical Republic that researchers were continuing to work towards effective treatments and eventually a cure.

“Last year, the results of a trial showed that a new drug, donanemab, has been able to slow the progression of symptoms of early Alzheimer’s disease,” she said.

“This research highlights the importance of early diagnosis so people can access treatment and support as soon as possible.

“We know the earlier people access support and services, the better their healthcare and lifestyle outcomes.”

Ms McCabe reminded those concerned about dementia to call the 24/7 National Dementia Helpline on 1800 100 500.

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