Dementia Profile

August 2020

Indicator Update:

The following indicator has been updated with March 2020 data in line with the planned update schedule. The data is now available at local authority, CCG and STP for the 2020 period. The data used for this indicator has been impacted by COVID19. It is not possible to quantify the impact at this time. The latest data is available from NHS Digital at https://digital.nhs.uk/data-and-information/publications/statistical/recorded-dementia-diagnoses :

Diagnosing well

• Estimated Dementia Diagnosis Rate (EDDR)

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The following indicator has been updated so that the 2017 data now represents December this is consistent with 2018 and 2019:

Prevalence

• Dementia: Recorded prevalence (aged 65 years and over)

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The definition of the numerator for the following indicator has changed and now also includes people with a recorded diagnosis of psychosis who are receiving a prescription for anti-psychotic medication. The name has also been ammended to reflect the change. The indicator is available at CCG and STP for 2018 and 2019:

Living well

Old name

• Dementia: Proportion of people with dementia (with no formal diagnosis of psychosis) prescribed anti-psychotic medication in the last six weeks (All ages)

New name

• Dementia: Proportion of people with dementia prescribed anti-psychotic medication in the last six weeks (All ages)

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April 2020

New Indicator

The following indicator has been added to the Living well domain and has been produced at CCG level for the years 2018 and 2019

• Dementia: Proportion of people with dementia (with no formal diagnosis of psychosis) prescribed anti-psychotic medication in the last six weeks – as at 31st October

Indicator Update:

Revisions have been made to the International Classification of Diseases 10 (ICD) codes used to define the dementia cohort and now includes dementias and Alzheimer’s Disease. The changes affect 17 indicators based on the Hospital Episodes Statistics database (HES) and the Office for National Statistics (ONS): Public Health England Annual Mortality Extract datasets. The indicators have been backdated three years and use the latest geographical boundaries.

The following indicators have been updated for every CCG, STP and local authority in England.

Prevalence:

• Dementia: Recorded prevalence (all ages) - as at 31st March 2019
• Dementia: Recorded prevalence (aged 65 years and over) - as at 31st December 2019
• Rate of newly diagnosed dementia registrations (Experimental) - accumulative for financial year to the 31st March 2019
• Dementia: Crude Recorded Prevalence (aged under 65 years) per 10,000 - as at 31st December 2019
• Dementia (aged under 65 years) as a Proportion of Total Dementia (all ages) per 100 - as at 31st December 2019

Preventing Well:

• Stroke: Recorded prevalence (all ages) - as at 31st March 2019
• Hypertension: Recorded prevalence (all ages) - as at 31st March 2019
• Diabetes: QOF prevalence (aged 17+) - as at 31st March 2019
• CHD: Recorded prevalence (all ages) - as at 31st March 2019
• Depression: Recorded prevalence (aged 18+) - as at 31st March 2019
• Estimated smoking prevalence (aged 15+) (QOF) - as at 31st March 2019
• People receiving an NHS Health Check per year - Local Authority only - as at 31st March 2019
• Admission episodes for alcohol-related conditions (Narrow) 40 - 64 years - Local Authority only - as at 31st March 2019
• Smoking Prevalence in adults (18+) - current smokers - Local authority and CCG only – for calendar year 2018
• Obesity: Recorded prevalence (aged 18+) - CCG and STP only - as at 31st March 2019

Diagnosing Well:

• Dementia: Blood tests recorded at diagnosis - as at 31st March 2019

Living Well:

• Dementia care review documented in last 12 months - as at 31st March 2019

Supporting Well:

• Dementia: Direct standardised rate of emergency admissions (aged 65 years and over) - Local Authority - accumulative for financial year ending 31st March 2019
• Dementia: Direct standardised rate of emergency admissions (aged 65 years and over) - CCG of Responsibility - accumulative for financial year ending 31st March 2019
• Dementia: Short stay emergency admissions (aged 65 years and over) - Local Authority - accumulative for financial year ending 31st March 2019
• Dementia: Short stay emergency admissions (aged 65 years and over) - CCG of Responsibility - accumulative for financial year ending 31st March 2019
• Dementia: Ratio of inpatient service use to recorded diagnoses - Local Authority - accumulative for financial year ending 31st March 2019
• Dementia: Ratio of inpatient service use to recorded diagnoses - CCG of Responsibility - accumulative for financial year ending 31st March 2019
• Alzheimer's disease: Direct standardised rate of inpatient admissions (aged 65 years and over) Local Authority - accumulative for financial year ending 31st March 2019
• Alzheimer's disease: Direct standardised rate of inpatient admissions (aged 65 years and over) - CCG of Responsibility - accumulative for financial year ending 31st March 2019
• Vascular dementia: Direct standardised rate of inpatient admissions (aged 65 years and over) Local Authority - accumulative for financial year ending 31st March 2019
• Vascular dementia: Direct standardised rate of inpatient admissions (aged 65 years and over) - CCG of Responsibility - accumulative for financial year ending 31st March 2019
• Unspecified dementia: Direct standardised rate of inpatient admissions (aged 65 years and over) - Local Authority - accumulative for financial year ending 31st March 2019
• Unspecified dementia: Direct standardised rate of inpatient admissions (aged 65 years and over) - CCG of Responsibility - accumulative for financial year ending 31st March 2019
• Dementia: Quality rating of residential care and nursing home beds (aged 65 years and over) - as at 31st December 2019
• Dementia: Residential care and nursing home bed capacity (aged 65 years and over) - as at 31st December 2019
• Dementia: Percentage of assessed residential care and nursing home beds (aged 65 years and over) - as at 31st December 2019

Dying Well:

• Directly Age Standardised Rate of Mortality: People with dementia (aged 65 years and over) - accumulative for calendar year ending 31st December 2018
• Deaths in Usual Place of Residence: People with dementia (aged 65 years and over) - accumulative for calendar year ending 31st December 2018
• Place of death - care home: People with dementia (aged 65 years and over) - accumulative for calendar year ending 31st December 2018
• Place of death - hospital: People with dementia (aged 65 years and over) - accumulative for calendar year ending 31st December 2018
• Place of death - home: People with dementia (aged 65 years and over) - accumulative for calendar year ending 31st December 2018

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August 2019

The following indicator has been updated and is now available at local authority, CCG and STP for the 2019 period:

Diagnosing well

• Estimated Dementia Diagnosis Rate (EDDR)

The profile homepage has been adapted to include an interactive further resources section. The dementia data catalogue has also been updated and an excel version is now available for download. These changes have been made to improve signposting to other sources of dementia intelligence. 

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April 2019

Changes to the presentation of the Fingertips profile:

We have made changes to the benchmarking and presentation of some indicators in the dementia profile. These changes are being made to ensure consistency in how Fingertips profiles are displayed across PHE. Key changes are:

• RAG (Red Amber Green) replacing BOB (Blue Orange Blue) as the standard benchmarking format where this is appropriate.
• Changes to indicator names. 
• Over the coming months, streamlining of the ‘Definitions’ page, ensuring consistency of display across multiple profiles.

Indicator Update:

The following indicators have been updated for every CCG, STP and local authority. In addition, the data period is April 1st 2017 to March 31st 2018, unless stated otherwise.

Prevalence:

• Dementia: Recorded prevalence (all ages)  - as at March 31st 2018
• Dementia: Recorded prevalence (aged 65 years and over)  - as at December 31st 2018
• Rate of newly diagnosed dementia registrations (Experimental)  - as at March 31st 2018
• Dementia: Indirect Age-Standardised Recorded Prevalence (aged under 65 years) per 10,000 - this indicator has been withdrawn
• Dementia: Crude Recorded Prevalence (aged under 65 years) per 10,000 - as at December 31st 2018
• Dementia (aged under 65 years) as a Proportion of Total Dementia (all ages) per 100 - as at December 31st 2018

Preventing Well:

• Stroke: Recorded prevalence (all ages) - as at March 31st 2018
• Hypertension: Recorded prevalence (all ages) - as at March 31st 2018
• Diabetes: QOF prevalence (aged 17+) - as at March 31st 2018
• CHD: Recorded prevalence (all ages) - as at March 31st 2018
• Depression: Recorded prevalence (aged 18+) - as at March 31st 2018
• Smoking: Recorded prevalence (aged 15+) - CCG and STP only - as at March 31st 2018
  
• People receiving an NHS Health Check per year - Local Authority only - as at March 31st 2018
• Admission episodes for alcohol-related conditions (Narrow) 40 - 64 yrs - Local Authority only - as at March 31st 2018
• Smoking Prevalence in adults (18+) - current smokers - Local authority and CCG only - as at March 31st 2018
• Obesity: Recorded prevalence (aged 18+) - CCG and STP only - as at March 31st 2018

Diagnosing Well:

• Dementia: Blood tests recorded at diagnosis - as at March 31st 2018
• Estimated dementia diagnosis rate (aged 65 and over) - as at March 31st 2018

Living Well:

• Dementia care review documented in last 12 months - as at March 31st 2018

Supporting Well:

• Dementia: Direct standardised rate of emergency admissions (aged 65 years and over) - Local Authority - as at March 31st 2018
• Alzheimer's disease: Direct standardised rate of inpatient admissions (aged 65 years and over) Local Authority - as at March 31st 2018
• Vascular dementia: Direct standardised rate of inpatient admissions (aged 65 years and over) Local Authority - as at March 31st 2018
• Dementia: Ratio of inpatient service use to recorded diagnoses - Local Authority - as at March 31st 2018
• Dementia: Short stay emergency admissions (aged 65 years and over) - Local Authority - as at March 31st 2018
• Unspecified dementia: Direct standardised rate of inpatient admissions (aged 65 years and over) - Local Authority - as at March 31st 2018
• Dementia: Quality rating of residential care and nursing home beds (aged 65 years and over) - as at December 31st 2018
• Dementia: Residential care and nursing home bed capacity (aged 65 years and over) - as at December 31st 2018
• Dementia: Percentage of assessed residential care and nursing home beds (aged 65 years and over) - as at December 31st 2018
• Dementia: Ratio of inpatient service use to recorded diagnoses - CCG of Responsibility - as at March 31st 2018
• Dementia: Direct standardised rate of emergency admissions (aged 65 years and over) - CCG of Responsibility - as at March 31st 2018
• Dementia: Short stay emergency admissions (aged 65 years and over) - CCG of Responsibility - as at March 31st 2018
• Alzheimer's disease: Direct standardised rate of inpatient admissions (aged 65 years and over) - CCG of Responsibility - as at March 31st 2018
• Vascular dementia: Direct standardised rate of inpatient admissions (aged 65 years and over) - CCG of Responsibility - as at March 31st 2018
• Unspecified dementia: Direct standardised rate of inpatient admissions (aged 65 years and over) - CCG of Responsibility - as at March 31st 2018

Dying Well:

• Directly Age Standardised Rate of Mortality: People with dementia (aged 65 years and over) - as at March 31st 2018
• Deaths in Usual Place of Residence: People with dementia (aged 65 years and over) - as at March 31st 2018
• Place of death - care home: People with dementia (aged 65 years and over) - as at March 31st 2018
• Place of death - hospital: People with dementia (aged 65 years and over) - as at March 31st 2018
• Place of death - home: People with dementia (aged 65 years and over) - as at March 31st 2018

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August 2018 

The following indicator has been updated and is now available at local authority, CCG and STP for the 2018 period. In addition to this the England value for 2017 has been updated to reflect the NHS health boundaries to be consistent with the 2018 data:

Diagnosing well

• Estimated Dementia Diagnosis Rate (EDDR)

March 2018

The following indicators have been updated for every CCG, STP and local authority for the 2016/17 period, unless stated otherwise.

Prevalence

• Dementia: Recorded prevalence (all ages)  
• Dementia: Recorded prevalence (aged 65+)  - as at September 17
• Rate of newly diagnosed dementia registrations (Experimental)  

Preventing Well  

• CHD: Recorded prevalence (all ages)
• Depression: Recorded prevalence (aged 18+)
• Diabetes: Recorded prevalence (aged 17+)
• Hypertension: Recorded prevalence (all ages)
• Obesity: Recorded prevalence (aged 18+)   - CCG only
• Smoking: Recorded prevalence (aged 15+)  - CCG only
• Stroke: Recorded prevalence (all ages)

Diagnosing Well 

• DEM005: Blood tests recorded (den.incl.exc.)  - CCG only  

Living Well

• Carer-reported quality of life score for people caring for someone with dementia - local authority only
• DEM002: Dementia care has been reviewed last 12 months (den.incl.exc.)  - CCG only 

Supporting Well

CCG values for the period 2014/15 to 2015/16 have been calculated due to a change to methodology and boundaries.  

• Alzheimer's disease: DSR of inpatient admissions (aged 65+)
• Dementia: DSR of emergency admissions (aged 65+)
• Dementia: Ratio of inpatient service use to recorded diagnoses
• Dementia: Short stay emergency admissions (aged 65+)
• Unspecified dementia: DSR of inpatient admissions (aged 65+)
• Vascular dementia:  DSR of inpatient admissions (aged 65+)

Dying Well  (all as at 2016)

• Deaths in Usual Place of Residence: People with dementia (aged 65+)
• Directly Age Standardised Rate of Mortality: People with dementia (aged 65+)
• Place of death - home: People with dementia (aged 65+)
• Place of death - hospital: People with dementia (aged 65+)
• Place of death - care home: People with dementia (aged 65+)

November 2017

Preventing Well

The new PHOF excess weight indicator 'Percentage of adults (aged 18+) classified as overweight or obese' supersedes 'Excess weight in Adults'. The new indicator is not comparable to the historic one, as the source data has changed and the age classification has changed from 16+ to 18+. The indicator has also changed from a three year average to a one year estimate. 

Living Well

'Social Isolation: % of adult carers who have as much social contact as they would like' has been updated. This indicator is presented for local authorities.

October 2017  

Opportunity for feedback: We are very interested in any feedback on the downloadable outputs which are available from the download section of the tool. The survey has now closed.

Supporting Well:

The following three new indicators are available at local authority, CCG and STP:

• Dementia: Residential care + nursing home bed capacity per 100 persons registered with dementia (aged 65+)
• Dementia: Percentage of residential care and nursing home beds (suitable for a person with dementia, aged 65+), which received an overall rating of ‘good’ or ‘outstanding’ from the Care Quality Commission (1st April 2017)
• Dementia: Proportion of residential care + nursing home beds (suitable for a person with dementia, aged 65+), which have received a rating from the Care Quality Commission (1st April 2017)

September 2017 

Preventing Well

The following new indicator is available for each local authority:

• Percentage of physically inactive adults - current method

This indicator replaces 'Percentage of physically active and inactive adults - inactive adults'.

Diagnosing Well

Estimated dementia diagnosis rate (aged 65+) has been moved from Prevalence to this domain.

Prevalence

The following three new indicators are available at local authority, CCG and STP:

• Dementia: Crude Recorded Prevalence (aged under 65 years) per 10,000
• Dementia: Indirect Age-Standardised Recorded Prevalence (aged under 65 years) per 10,000
• Dementia (aged under 65 years) as a Proportion of Total Dementia (all ages) per 100

The following indicator has been updated for local authorities, CCGs and STPs:

• Dementia: Recorded Prevalence (aged 65+) (April 2017)

July 2017

A PDF download displaying a range of charts is now available for each local authority and CCG  from the 'Download' section of the profile.

The downloadable PDFs have been developed as the first part of a programme of work, which seeks to meet a user need for a non-web based version of the profile. An evaluation of this development will soon begin in order to inform future work.  If you have any comments, or wish to be notified when the user survey is available, please contact mhdnin@phe.gov.uk. 

Prevalence

The following two new indicators are available at local authority, CCG and STP:

• Rate of Newly Diagnosed Dementia Registrations (Experimental)
• Estimated Dementia Diagnosis Rate (aged 65+)

The following indicators have been updated for local authorities:

People receiving an NHS Health Check per year

Smoking Prevalence in adults - current smokers (APS)

May 2017

Preventing Well

The following indicator has been updated for local authorities.

Admission episodes for alcohol-related conditions (Narrow) - 40-64 yrs

March 2017

Dying Well

The following indicators have been updated for both CCG and local authorities.

Deaths in Usual Place of Residence: People with dementia aged 65+

Directly Age Standardised Rate of Mortality: People with dementia aged 65+

Place of death - care home: People with dementia aged 65+

Place of death - hospital: People with dementia aged 65+

Place of death - home: People with dementia aged 65+

February 2017

Supporting Well

The following indicators have been updated for both CCG and local authorities. Values for the period 2012/13 to 2015/16 have been calculated due to a change to methodology. The main change is data are presented at CCG of responsibility. For further information refer to the indicator's metadata.

Dementia: Ratio of inpatient service use to recorded diagnoses

Dementia: DSR of emergency admissions (65+)

Dementia: Short stay emergency admissions (65+)

Alzheimer's disease: DSR of inpatient admissions (65+)

Vascular dementia: DSR of inpatient admissions (65+)

Unspecified dementia: DSR of inpatient admissions (65+)

Please note the following indicators have been removed from the profile and will be reviewed. 

Supporting Well

Dementia: DSR of emergency admissions (20+)

Dementia: Short stay emergency admissions (20+)

Alzheimer's disease: DSR of inpatient admissions (20+)

Vascular dementia: DSR of inpatient admissions (20+)

Unspecified dementia: DSR of inpatient admissions (20+)

Dying Well

Directly Age-Standardised Rate of Mortality: People with Dementia (20+)

January 2017

Prevalence

The following indicators have been updated for both CCG and local authorities:

Dementia: Recorded Prevalence (all ages) (2015/16)

Dementia: Recorded Prevalence (aged 65+) (March 2016 and Sept 2016)

Diagnosing Well

The following indicators have been updated for both CCG and local authorities:

Hypertension: Recorded Prevalence (all ages) (2015/16)

Stroke: Recorded Prevalence (all ages) (2015/16)

Diabetes: Recorded Prevalence (aged 17+) (2015/16)

CHD: Recorded Prevalence (all ages) (2015/16)

Obesity: Recorded Prevalence (aged 18+) (2015/16) CCG only

(replaces Obesity: Recorded Prevalence (aged 16+) (2015/16)

Smoking: Recorded Prevalence (aged 15+) (2015/16) CCG only

December 2016

Preventing Well

The following indicators have been updated:

Depression: Recorded prevalence (aged 18+) (2015/16)

Smoking Prevalence in adults - current smokers (APS) (2015)

(Please note this replaces Smoking Prevalence in adults - current smokers (IHS))

Diagnosing Well

The following indicator is new:

DEM005: Blood tests recorded (den.incl.exc.)  (2015/16)

(Please note this replaces indicator DEM003 Blood tests recorded (den.incl.exc.))

Living Well

The following indicator has been updated:

DEM002: Dementia care has been reviewed last 12 months (den.incl.exc) (2015/16)

October 2016

Preventing Well

Four indicators have been updated:

Hypertension: Recorded prevalence (all ages) (2014/15)

Stroke: Recorded prevalence (aged 17+) (2014/15)

Diabetes: Recorded prevalence (aged 17+) (2014/15)

CHD: Recorded prevalence (all ages) (2014/15)

A new indicator: People receiving an NHS Health Check per year, has replaced the old indicator: People receiving an NHS Health Check (cumulative).

August 2016

Pathway on a Page

A ‘Pathway on a Page’ domain has been created; this includes a number of key summary indicators from other dementia domains.

Living well

One new indicator:

Carer-reported quality of life score for those reported to be caring for someone with dementia (2014/15)

Preventing well

Two indicators have been updated:

Percentage of physically active and inactive adults - inactive adults (2015)

People receiving an NHS Health Check (2013/14 Q1 - 2015/16 Q4)

July 2016

A number of indicators have been updated as shown below.

Preventing well

Admission episodes for alcohol-related conditions (Narrow) (aged 40-64) (2014/15)

Depression: QOF Prevalence (18+) (2014/15)

Supporting well (In addition, the indicators in the supporting well domain have been revised with new methodologies for calculation – please see definitions tab for more detail.)

Dementia: Ratio of inpatient service use to recorded diagnoses (2014/15)

Dementia: DSR of emergency admissions (aged 65+) (2014/15)

Dementia: DSR of emergency admissions (aged 20+) (2014/15)

Dementia: Short stay emergency admissions (aged 65+) (2014/15)

Dementia: Short stay emergency admissions (aged 20+) (2014/15)

Alzheimer's disease: DSR of inpatient admissions (aged 65+) (2014/15)

Alzheimer's disease: DSR of inpatient admissions (aged 20+) (2014/15)

Vascular dementia:  DSR of inpatient admissions (aged 65+) (2014/15)

Vascular dementia: DSR of inpatient admissions (aged 20+) (2014/15)

Unspecified dementia: DSR of inpatient admissions (aged 65+) (2014/15)

Unspecified dementia: DSR of inpatient admissions (aged 20+) (2014/15)

Dying well

Directly Age Standardised Mortality Rate: People with dementia aged 20+ (2014)

Directly Age Standardised Mortality Rate: People with dementia aged 65+ (2014)

Deaths in Usual Place of Residence: People with dementia aged 65+ (2014)

Place of death - care home: People with dementia aged 65+ (2014)

Place of death - hospital: People with dementia aged 65+ (2014)

Place of death - home: People with dementia aged 65+ (2014)

March 2016

The regional values for the indicator 2012/13 - Age standardised rate of people (aged 65+) with a mention of vascular dementia using inpatient hospital services per 100,000 resident population have been revised.

January 2016

First version released