By Clare Wilson Alzheimer’s disease causes damaged to the brain (right)JESSICA WILSON/SCIENCE PHOTO LIBRARY Dementia has cemented its position as the leading cause of death in England and Wales, according to the latest figures from the Office for National Statistics. But part of the rise in dementia deaths can be explained by changes in how deaths are recorded. In fact, more people currently die from cancers than they do from dementia. The number of deaths due to Alzheimer’s disease and other forms of dementia have been increasing for several years, accounting for nearly 13 per cent of all deaths registered in 2018. But part of the explanation for this apparent increase is two coding changes by the ONS in 2011 and 2014, to follow guidelines from the World Health Organization (WHO). Read more: Have we found the true cause of diabetes, stroke and Alzheimer’s? Dementia tends to be a contributory factor to deaths, rather than the immediate cause. For instance, those affected may die from falling over and breaking a bone, or they may develop pneumonia because they have a reduced ability to swallow, which lets bacteria enter their lungs. Due to the WHO guidelines, any such cases where dementia is mentioned on the death certificate are now being attributed to dementia. Advertisement Living longer In addition, family doctors have for some years now been encouraged to put a formal diagnosis of dementia in people’s health records at earlier stages. “It’s not so much that more people are getting dementia, we are recognising it more,” says Emma Vardy of the British Geriatrics Society. There are multiple forms of dementia – including Alzheimer’s disease and vascular dementia – but the ONS groups deaths from these conditions together. Cancer, however, is split into different categories. If these had been grouped together, cancer would have topped the list of causes of death – according to Cancer Research UK, 28 per cent of deaths in 2016 were due to cancer. However, aside from how deaths are categorised in the ONS data, we do also know that dementia is rising in incidence. This is because we are, on average, living longer, thanks in part to better medical care. Put crudely, many people who might previously have died from heart attacks in their seventies are now dying from dementia in their eighties. Declining risk Our ageing population often prompts talk of an impending dementia “tsunami”. But recent studies show that a person’s individual risk of developing dementia by a certain age has actually been gradually declining for many decades. Frustratingly, we don’t know why this is happening. Possible explanations include falls in smoking, better nutrition or even the fact we lead more mentally stimulating lives these days. Because of the unknowns, it’s unclear if this trend will continue in future, but it’s worth treating predictions that huge numbers of people will have dementia in the future with some scepticism. What’s not in doubt, though, is that families of people with dementia need more help than they are currently getting – like home care packages. If the renewed attention brought to this condition by the latest figures helps address that problem, then that’s no bad thing. How oral health may prevent Alzheimer’s disease Find out from cell biologist Sim Singhrao at New Scientist Live
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