Deaths related to dementia and Alzheimer’s disease has more than doubled over the past ten years, according to new figures released by the Australian Bureau of Statistics (ABS). Shiney Mehrotra reports.

Dementia and Alzheimer’s disease are now the third highest killers in Australia. Image: Dr Laughlin Dawes

The causes of death statistics, which were released on March 31, indicates that Dementia and Alzheimer’s disease has overtaken Trachea and lung cancers has the third highest killer in Australia.

While heart disease remains the number one killer in Australia, there are fewer deaths associated with the disease, according to the ABS report.

Professor Robert Cumming, from the Faculty of Epidemiology and Geriatric Medicine at the University of Sydney, believes there is no doubt that the cases of Alzeimer’s disease and dementia will continue to grow as the number of older people increases.

However, there is still some uncertainty with regards to the explanation of the resulting deaths.

“The question has to be asked whether the number of deaths due to dementia has increased or whether older people are just more likely to die of other things such as stroke or heart attacks.”

Professor Cumming believes that the likelihood that dementia is now being recorded as the ‘cause of death’ on death certificates could be contributing to the increased numbers.

“Fifty years ago, dementia was called ‘senile dementia’, and doctors were less likely to put this on the death certificate, as it was thought to be embarrassing. More recently, as dementia is something that is well known and discussed, doctors are more likely to put it on the death certificate.”

In the ABS report, figures indicate that while trachea and lung cancers were responsible for most cancer related deaths, the number of deaths had decreased, making lung cancer the fourth leading cause of death overall.

According to the ABS report on Australian Social Trends (Dec 2009), smoking and exposure to tobacco is strongly linked to lung cancer, chronic obstructive pulmonary disease and ischaemic heart disease.

The risks associated with tobacco accounts for nearly 8 per cent of the total burden of disease and injury within Australia.

Kylie Lindorff, Chair of Cancer Council Australia’s Tobacco Control Committee, believes there has been a downward trend in the prevalence of smoking amongst the adult population over the last 30 years.

Lindorff said the time lag between when people started smoking and when they are diagnosed with lung cancer is about 30 years.

However, while there is an expected decrease in deaths from lung cancer in men, there is some uncertainty when it comes to women.

“With women, we are not sure if the lung cancer rates have piqued, plateaued or decreased, as women started smoking later and there is a lag time associated with lung cancer related deaths.”

According to Professor Simon Chapman, a specialist in tobacco control at the University of Sydney, the decline in smoking numbers, can be attributed to the tobacco control measures that are currently in place.

“Tobacco control policies including price, advertisement bans, smoking restrictions, campaigns, pack warnings etc. all work synergistically to reduce smoking.”

Lindorff adds that the declining numbers could also be attributed to the attitudes towards smoking.

“It is becoming socially unacceptable to smoke and more people are quitting,” she said.

The reduction in lung cancer related deaths as reported by ABS, can be attributed to a combination of earlier detection, changes in risk factors and treatment improvement.

Yet, while the tobacco control measures appear to be working, Lindorff believes there is a long way to go.

“If the government is able to implement the plans outlined in their health prevention taskforce set up last year, then we should see a sharp decline in the prevalence of smoking and therefore lung cancer.”

Chapman explains that current trends in smoking will dictate mortality rates in the future.

“People who stop smoking today will influence patterns of lung cancer deaths 30-40 years from now.”

For dementia and Alzheimer’s however, the prognosis is not so good. The dementias are a group of diseases characterised by loss of short-term memory, cognitive abilities and daily functioning.

Alzheimer’s disease and vascular dementia are the most common types of dementia.

With no breakthrough cure or effective treatment in sight, Professor Cumming emphasises the need to reduce the risk factors that cause Alzheimer’s, such as high blood pressure and elevated cholesterol.

He says reducing fat in the diet as well as regular exercise is important for also preventing the disease.

Recent studies published by the Archives of Neurology, indicate that certain food combinations are linked to a reduced risk of suffering Alzheimer’s disease. Increasing the intake of salad dressing, nuts, fish, tomatoes, poultry, fruits, and dark, leafy green vegetables, while reducing high-fat dairy, red meat, organ meat and butter, reduce Alzheimer’s risk.

According to Access Economics’ report, Dementia in the Asia Pacific Region: The Epidemic is here, dementia will overtake depression as the largest source of disability burden in Australia by 2016.

Dementia also has the potential to have a devastating impact on the public health systems as it is among the most disabling of all chronic diseases.

The report indicates that some of the challenges that Australia faces, along with other countries in the Asia-Pacific region, include the inadequate human and financial resources available to meet the care needs, the limited policies on dementia care, and also the inadequate training for professional care givers and a lack of support for family.

Jenny Famer, and her sister, Liz, have experienced the significant burden associated with caring for their eighty-year-old father, who suffers from Alzheimer’s.

As their parents still live in their own home, Jenny’s mother, 79, is the primary carer for him.

“He needs her to help him dress, remind him to go to the bathroom, change him if he forgets to go, get his medicine, feed him.”

While the pension provides some relief and reduced medication prices, additional expenses are paid by their daughters.

Emotionally, the burden is sometimes too much to bear for their mother.

“Some days she feels sorry for him but other days she gets so angry with him. He is not aware of how much he relies on her and she gets so tired of looking after him. Sometimes she just can’t cope and calls us up crying.”

Dementia Care Australia declined to comment.