E nga mana
E nga reo
E nga iwi
Tēna kotou katoa
Ka huri ki nga mana whenua o te rohe nei. Tēna koutou.
He mihi hoki ki a tatou kua tau mai nei I raro I te kaupapa o te rā.
No reira tēna koutou katoa
Thank you Catherine for that welcome.
I’m very glad to be here to launch the Dementia Economic Impact Report 2021 in what is World Alzheimer’s Month.
I would like to acknowledge the team at Alzheimers New Zealand, particularly Clare Hynd and Catherine Hall, for the mahi that’s gone into organising this launch during a particularly uncertain time. I’d also like to acknowledge the research team from the University of Auckland, who produced the Dementia Economic Impact Report 2021. And my Parliamentary colleagues who are here today.
As Associate Minister of Health, dementia is one of my priorities in my work around health of older people. It’s in this role that I’ve had the chance to meet with Catherine and her colleagues from other national dementia NGOs.
It’s great to have this opportunity to support the work Alzheimers New Zealand is doing to improve our understanding and management of dementia through improved data.
I want to talk about the important role of that data, for a country with a growing and ageing population.
New Zealand’s ageing, growing and changing population
But first, I want to make it clear that the lives of people living with dementia do matter – immensely.
We must treasure our kaumātua, they are a taonga, and enrich and contribute so much to our society.
I know many of you are here today because of people you love and care for who are impacted by dementia. Similarly I am motivated in my work by knowing the care my grandfather needed when he had dementia.
This Government took action to protect people living with dementia during the Covid-19 pandemic, in a way in which other countries failed to do. They are amongst the New Zealanders who we prioritised for vaccinations early in our vaccine roll out, when we had limited supply. And we have been focused on ensuring their safety, as people who are among those most at risk if they catch the virus.
It is a Labour Party manifesto commitment to support the implementation of the Improving Dementia/Mate Wareware Services in New Zealand – Action Plan.
Because we recognise the significance of this health issue, and the need to act.
New Zealand’s population is ageing, growing and changing – and along with the many opportunities it brings, this also poses significant social and economic challenges for the health, disability and social systems.
Over the next decade the size and diversity of our older population will increase significantly. In fact, older New Zealanders are the fastest growing age group in the country.
The number of New Zealanders aged 65 and over, as at the end of June, was just over 819,000. This number is projected to increase to 1.26 million by the year 2036. And it’s anticipated that by then, there will be almost 393,000 people aged 80 and over, more double the number in that age group now.
The growth amongst older Māori, Pacific and Asian communities will be significant. Between 2013 and 2036 the Māori population is expected to have increased by 115 percent, Pacific by 160 percent, and Asian peoples by 260 percent.
People living longer are often faced with co-morbidities and complex health needs. Our systems and workforce need to be prepared, so they can keep up with the changing needs and expectation of our ageing population. And the coming health and disability system reforms provide a significant opportunity to do that.
Through these reforms we aim to create a strong and equitable health and disability system, which focuses on improving outcomes for people who are currently most disadvantaged – particularly Māori and Pacific peoples. We also know there are condition-specific groups, such as people with dementia … who face clear inequities depending on where they live in New Zealand, the age at which they’re diagnosed, and the presence of other conditions, such as intellectual disability.
Dementia data in New Zealand
I want to talk now about data – as data helps us to understand, prepare and ideally improve outcomes. It might be dry, but it remembering the important lesson I was taught at medical school – that health statistics are human lives with the tears wiped off. By understanding data we aim to improve real people’s lives.
Improving national data collection and information systems for dementia is an action area in the World Health Organization’s Global Plan on Dementia, to which New Zealand is a signatory.
The Global Plan acknowledges the significant challenges in achieving accurate data collection – from the ability to routinely gather information, to accurately recording data, and ensuring inter-operability across information systems.
We know these issues also exist in New Zealand. We see it when dementia goes undiagnosed, when there’s an inaccurate recording of what type of dementia someone is living with, and when dementia is overlooked as someone’s primary cause of death.
District health boards and their community partners have put a significant amount of work into driving improvements in areas such as early diagnosis within primary care. But there is more to do.
The interRAI needs assessments are an area in which key data is collected on dementia, and this data has been used to inform some of the analysis within the report being launched today. This data provides comprehensive and standardised information on cognition for people living in the community and in aged residential care. It paints a picture around things such as decision making abilities, memory and behaviour.
interRAI data supports care planning, the ability to allocate resources to people who need it, and potentially helps identify undetected dementia. However, it has limitations.
Because this data is only captured when people have interRAI assessments, it doesn’t tell us about everyone with dementia and their carers – particularly those in the mild-to-moderate stages, who are not receiving formal supports. In short, there are people out there with dementia who the health system knows nothing about.
While it cannot provide a full picture of the prevalence of dementia in New Zealand, research is underway to look at how InterRAI data can be used in conjunction with routinely collected needs assessment data. Using different sources of data to develop a national prevalence rate is an approach used in Australia, in the absence of a national dataset.
This of course brings me to the significant work that’s gone into producing the Dementia Economic Impact Report. The authors have had to take an innovative approach to determining how prevalent dementia is in New Zealand, in order to estimate its future costs.
The findings in the 2021 report speak for themselves. They confirm projections in the 2016 Dementia Economic Impact Report that by 2050 almost 170,000 people will be living with dementia. And of course, we cannot forget that the impact is so much wider – 170,000 people with dementia means tens of thousands more care partners, whānau and friends who are also impacted.
One of the things I was pleased to see included in this updated report, is the greater focus on data that has implications for how we understand equity in relation to dementia.
As I mentioned before, we know Māori, Pacific and Asian populations are expected to significantly increase over the next few years. So it’s not surprising to see a corresponding projected increase in dementia amongst these populations. This includes a higher prevalence of younger-onset dementia for these populations, than for Europeans.
This means the range and type of supports we should be providing in the future, to what will have to be responsive to an increasingly diverse group of people with dementia, their carers and whānau.
I’m pleased to see the report also addresses prevention, as I like to bring this focus to all my work. The findings in this report also suggest the importance of reaching middle-aged New Zealanders, to try and modify risk factors they face – and reduce the projected numbers of Kiwis who will suffer from dementia.
My hope is that through the health and disability system reforms, we will see a more joined-up approach to how we focus on modifiable risk factors common to most long-term conditions, such as heart disease, diabetes and also dementia. The information outlined in the Dementia Economic Impact Report provides us with a strong evidence base and impetus to make a difference.
This Government is not ignoring the data. We are committed to supporting the implementation of the Dementia Action Plan, and policy work has been underway on this. The sector has been revising the Action Plan, and I received the updated version last week. I’m looking forward to discussing with my colleagues how best to implement it, and working together with the sector to do so.
There is no doubt dementia is a significant health challenge here, and worldwide. Alzheimers NZ has persevered in publishing a report that helps to grow our knowledge and understanding, and to stimulate and encourage the korero about the social and economic impact of dementia into the future.
The challenge is to take these learnings, and use them for developing policy, and improving support for all those impacted by dementia.