00:00The main one is that we have population ageing, and most people die of dementia when they're
00:07very old, so in their 80s and 90s, but there's a couple of other contributing factors.
00:12One is that we're seeing a reduction in deaths from heart disease, and another one is that
00:17there has been a change in the way deaths are recorded on death certificates.
00:22So we're getting more accurate data now about the actual number of people who are dying
00:25with dementia.
00:26And we're also seeing, with people living longer, that they have more conditions they're
00:32managing, including dementia, it can be a complex number of factors.
00:36Yes, that's right, we're seeing people living longer with chronic diseases because we have
00:42better treatments.
00:43So like I said, we're seeing people living longer with heart disease, people surviving
00:48cancer, so people are surviving into old age, but we're not seeing that compression and morbidity,
00:54we're seeing they're living with a number of chronic conditions.
00:56While we all age, how preventable is dementia?
01:00What can be done to reduce the risks?
01:03Well, there's quite a lot that we can do to reduce the risks.
01:07I mean, there are genetic causes of dementia, but we also know that about 45 to 50% of dementia
01:13cases can be attributed to modifiable risk factors.
01:17And they include things like low education, cardiovascular risk factors, particularly in middle age, like
01:24high cholesterol, high blood pressure, obesity, smoking, depression, very heavy alcohol use.
01:31In later life, we see risk factors like social isolation, air pollution.
01:35So there's quite a lot that can be done to reduce your risk of dementia.
01:40And this can be scaled up to the population level.
01:42So we feel that if there were major prevention programs, we could see a reduction in incident
01:48dementia.
01:49And on that note, what does this data tell us about the priorities in terms of where to
01:54invest the money?
01:55Well, I mean, that's a great question.
01:59There's a number of areas that need urgent investment.
02:02We need investment in dementia care.
02:04We need things like key navigators with the new age care reforms.
02:08We need to see support for people living with dementia.
02:12We need investment in health services, particularly with new drugs coming online.
02:15We need the infrastructure for those.
02:18But we also need to really focus on prevention.
02:21And that needs to be really a whole of government approach, because prevention of dementia needs
02:26to take a life course approach.
02:27We need to build healthy brains in children.
02:30We need to have healthy food, physical activity.
02:32There needs to be more education of health care professionals.
02:36And the risk reduction needs to be much more prominent in our public health sort of thinking.
02:41So we hear about, you know, skin cancer prevention.
02:43We hear about heart disease prevention.
02:45But dementia prevention hasn't really made it into that level of sort of public consciousness
02:50So we really need a big boost in public awareness and investment in prevention of dementia.
02:56And is there still a great lack of awareness around dementia and even a stigma?
03:01And how much does that can contribute to the fact that there isn't this investment that's
03:06needed in dementia prevention?
03:07Yes, there actually is a lack of awareness in the Australian community.
03:12So the Australian Institute of Health and Welfare has conducted a survey to find out how
03:18much the public actually know about dementia and whether they can recognise the main risk factors.
03:23And there's still an alarming number of people who think dementia is a normal part of ageing.
03:28And there's a lot that we need to do to de-stigmatise it.
03:32Just educate people about dementia, that it's a brain disease and what can be done to prevent it.
03:38And then the upcoming treatments as well.
03:41The problem with the stigma is it prevents people from seeking help early and getting the care and
03:47support that they need and the time to make important decisions about their life.
03:52All right, Kyren Ernstie, Director of the UNSW Ageing Futures Institute.
03:56We really appreciate your time and insights this morning.
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