utilities

Meet Bev: the NHS as a 70-year-old woman

Kirsty MaraisClare van LyndenSusan MitchellEmily CookEmma HardwickHelen DaviesMelody Paton Borchardt

As the NHS celebrates its 70th birthday today, we’re reflecting on how the National Health Service has shaped and delivered medical advances and how it needs to adapt to the changing face of health today.

With 850,000 people in the UK living with dementia today, a number expected to grow to 1 million by 2025 at a cost of £30bn annually, it’s no stretch of the imagination to say that dementia will be a leading health issue facing the NHS in the future.

In fact, a recent YouGov survey has shown UK adults believe dementia to be the biggest challenge facing the NHS in the coming 70 years.

But let’s imagine for a minute that the NHS was a 70-year-old woman named Bev. What advances would she have seen in dementia care, diagnosis and treatment during her lifetime, and what progress could she hope to see in the future?

70 years of progress for dementia

In her lifetime, Bev would have seen society’s view of dementia change. Once assumed to be a fact of old age, there is now a growing understanding that dementia is caused by diseases, which can be tackled through advances in research.

1948: Bev is born. It’s almost a half century after the first documented case of Alzheimer’s disease, but it will be several more decades before dementia becomes a widely recognised health condition.
1976: When Bev is 28, Alzheimer’s disease is recognised as the most common form of dementia and organisations dedicated to tackling dementia begin to appear around the world.
1980s: The two hallmark proteins involved in Alzheimer’s, amyloid and tau, are identified. From then on, advances in our understanding of the disease and ability to treat it begin to develop more quickly.
1993: Bev turns 45 as researchers celebrate two major milestones. Research that began a decade before leads to the discovery of the first risk gene associated with Alzheimer’s disease and the first drug to help treat symptoms of dementia, which is initially licensed in the US.
1996: Alzheimer’s Research UK, then a relatively new charity called the Alzheimer’s Research Trust, publishes its ‘Alzheimer’s Facts’ booklet to empower GPs to advise patients on treatments and support. There are an estimated 500,000 people living with dementia in the UK.
2004: Bev celebrates her 56th birthday. At the same time, a major breakthrough is made in our ability to monitor the progression of Alzheimer’s disease, opening new avenues for research. It’s a procedure that uses a special type of scan to show the presence of amyloid in the brain. In time, studies using this technique will show that Alzheimer’s begins to take hold in the brain years before symptoms like memory loss begin.
2009: Alzheimer’s Research UK Patron Sir Terry Pratchett presents a petition to Prime Minister Gordon Brown calling for an end to government underfunding of dementia research. His action is the first in a series of developments that catalyse government support for dementia research in the UK and around the world.
2012: The Prime Minister’s Challenge on Dementia is launched and includes research as a core goal. The NHS is a vital route for these goals to be achieved. This same year, the World Health Organisation calls for dementia to be a global health priority.
2015: Bev turns 67 as the number of people in the UK with dementia rises to 850,000. Doctors are now using several memory tests as well as brain scans and sometimes lumbar punctures to diagnose dementia. Diagnosis rates are improving – the UK has seen an increase of 56% in diagnoses compared to 2010 – but more work is needed to ensure people across the UK receive accurate and timely diagnoses.

The £250m UK Dementia Research Institute, a pioneering initiative in dementia research, is launched through funding from the Medical Research Council, Alzheimer’s Research UK and Alzheimer’s Society.

2017: The number of people with dementia around the world is estimated to be 50m. Projections say this number will double by 2050.

By this time, nine potential risk factors for dementia have been identified. We know now that what’s good for your heart is good for your brain and can use this knowledge to focus more effort on reducing dementia risk.

2018: New dementia risk reduction messaging is included in the NHS Health Check for people in mid-life just a few months before Bev celebrates her 70th birthday.

We’ve made great strides for dementia in Bev’s lifetime, but we have more work to do to deliver earlier and more accurate diagnosis and deliver life-changing dementia treatments and preventions in the NHS.

As someone over 65, Bev’s risk of dementia doubles every five years. As a woman, Bev has a higher risk of dementia and is also more likely to care for someone with the condition. Since over 80% of the cost of dementia is carried by social and informal care, it’s likely that Bev’s family has shouldered the burden of the financial cost of the condition, as well as the emotional cost.

These issues are part of Bev’s life today, but with more progress, they don’t have to define her future.

Pushing for future progress

In years to come, Alzheimer’s Research UK wants to see a revolution in the way dementia is diagnosed, as well as ensuring people get a timely diagnosis today.

If we are to stop this condition, we must begin to identify the diseases that cause dementia 15 to 20 years earlier than we do today, before they have been able to cause significant damage to the brain. We must pioneer new ways of diagnosing these diseases and build resources within the NHS to use them. We must also ensure that medical professionals have crucial training to identify the early signs of dementia today and support in using new diagnostic tools as they become available.

We must begin thinking of brain health the same way we think of wellbeing for other disease areas.

If we thought of brain health like we think of heart health, we could promote the importance of protecting our brains and better understand how this vital organ contributes to overall health. This includes working to reduce people’s risk of dementia from midlife, when we know we are likely to have the greatest impact.

We must also continue to foster research and innovation.

We can do this in part by encouraging people to take part in dementia research. We’ve seen good progress in this area: new NICE guidance that promotes participation in research, new provisions made for the safe and transparent use of anonymised patient data, and ambitious goals laid out in the Challenge on Dementia 2020. These efforts must continue to grow for research to continue making progress.

We know that if we are to prepare for future dementia treatments, we must begin working today.

Through efforts like Alzheimer’s Research UK’s Dementia Access Taskforce, we can start to lay the path to ensure future treatments for dementia reach people within the NHS without unnecessary delay.

With these efforts, one of Bev’s future birthdays could mark the end of dementia as we know it today.

A very happy birthday to Bev and the NHS!

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