Comprehensive Briefing: Dementia Prevention, Prevalence, and Economic Impact

Executive Summary

Dementia represents a significant and growing challenge to both public health and global economies. As life expectancy increases, the number of individuals living with dementia continues to rise, despite a decrease in age-specific incidence in high-income countries. This briefing synthesizes the latest clinical findings from the 2024 Lancet Commission and the economic analysis provided by the Centre for Economics and Business Research (Cebr) on the burden to English businesses.

Critical Takeaways:

• Preventable Risk Factors: New evidence identifies untreated vision loss and high LDL cholesterol as modifiable risk factors, joining 12 previously identified factors such as hearing loss, hypertension, and air pollution.
• Economic Burden on Businesses: As of 2019, dementia costs English businesses approximately £3.2 billionannually in lost working time from carers. This figure is projected to nearly double to £6.3 billion by 2040.
• Workforce Loss: Approximately 47,000 people are currently working with dementia in England. The loss of their skills through early retirement costs businesses over £1 billion annually.
• Productivity Impacts: "Presenteeism"—reduced productivity due to the stress and exhaustion of caring for relatives with dementia—costs businesses an estimated £64.4 million per year.
• Consumer Power: Households affected by dementia spend £16.7 billion annually, a figure expected to rise to £33.9 billion by 2040, highlighting a massive market risk if businesses fail to become "dementia-friendly."

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1. Clinical Developments and Risk Factor Management

The 2024 Lancet Commission report emphasizes that dementia is not an inevitable part of aging but a condition influenced by modifiable factors across the life course.

Newly Identified Risk Factors

The 2024 update adds two compelling new risk factors to the existing model:

1. Untreated Vision Loss: Identified as a significant contributor to dementia risk.
2. High LDL Cholesterol: Elevated "bad" cholesterol is now linked to increased dementia incidence.

Life-Course Risk Factors

Tackling known risk factors is estimated to reduce the overall risk of developing dementia. These include:

• Early Life: Lower levels of education.
• Midlife: Hearing loss, hypertension, obesity, smoking, and traumatic brain injury (TBI).
• Later Life: Depression, physical inactivity, diabetes, excessive alcohol consumption (>12 US units/week), air pollution, and social isolation.

Environmental and Physical Trauma

• Air Pollution: Reducing exposure to air pollution is directly linked to improved cognition and reduced dementia risk.
• Traumatic Brain Injury (TBI): TBI at any age is a risk. New evidence suggests contact sports pose a specific risk; public health priorities should include head protection and reducing high-impact collisions in sports training.

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2. Economic Impact on English Businesses

Dementia impacts the private sector through three primary channels: the withdrawal of carers from the workforce, the early retirement of employees with dementia, and the potential loss of consumer spending.

Impact on the Workforce Carer Pool

In 2019, there were over 1.8 million people in England caring for someone with dementia. Approximately 20% of these carers (355,000) remain in the paid workforce.

Impact Category

Number of Workers (2019)

Annual Cost to Businesses

Reduced Hours/Commitments

147,000

£654.9 Million

Complete Withdrawal from Work

112,540

£2.6 Billion

Total Cost of Lost Work Time

N/A

£3.2 Billion

Loss of Skills from Employees with Dementia

Dementia is a progressive condition. While many individuals can continue working with "reasonable adjustments" under the Equality Act (2010), the eventual loss of their accumulated on-the-job knowledge is costly.

• Current Impact: 47,000 workers currently live with dementia.
• Financial Loss: The retirement of these individuals costs businesses over £1 billion annually in lost skills and experience.

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3. The Phenomenon of Presenteeism

Beyond physical absence, businesses face "presenteeism," where employees are at work but experience a fall in productivity due to the mental and physical strain of caring for a relative with dementia.

• Primary Triggers: Exhaustion (81% of carers), disturbed sleep (72%), general stress (66%), and depression (49%).
• Productivity Loss: Research suggests a 1.9% reduction in output occurs due to factors like sleep deprivation.
• Cost Calculation: This loss in productivity among carers who feel tired or stressed cost English businesses £64.4 million in 2019.

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4. Market Risk and Consumer Spending

Households with a member living with dementia represent a significant economic segment. If businesses are not welcoming or accessible, they risk losing this substantial spending power.

Household Expenditure (2019)

Total spending by these households reached £16.7 billion in 2019. The distribution of spending includes:

• Recreation & Culture: £2.4 billion (14%)
• Housing, Fuel & Power: £2.2 billion (13%)
• Food & Non-Alcoholic Drink: £2.2 billion (13%)
• Transport: £1.7 billion

Retail Insight: An Alzheimer’s Society survey found that 80% of people with dementia list shopping as their favorite activity, yet they often face barriers in retail environments as their condition progresses.

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5. Future Projections (2019–2040)

As the population ages, the prevalence of dementia is expected to rise, leading to a significant escalation in costs if current trends continue.

Metric

2019 Actual

2040 Projection

Change

Total Carers (England)

1.8 Million

2.2 Million

+22%

Value of Foregone Carer Labour

£3.2 Billion

£6.3 Billion

+97%

Cost of Retiring Workers with Dementia

£1.0 Billion

£2.0 Billion

+100%

Household Consumer Spending

£16.7 Billion

£33.9 Billion

+103%

Presenteeism Costs

£64.4 Million

£125.0 Million

+94%

Prevalence by Age Group (2019)

The risk of dementia increases dramatically with age, which will drive the future economic burden as the "80+" demographic expands.

• Ages 16-64: 0.03%
• Ages 65-69: 1.7%
• Ages 70-79: 4.5%
• Ages 80+: 21.6%

Gender Disparity

Dementia disproportionately affects women. In 2019, 63% of all people living with dementia were women, a trend expected to remain stable, with a projected 62% in 2040.

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6. Conclusion

The evidence indicates that dementia is both a health crisis and a structural economic risk. While clinical findings suggest that nearly half of dementia cases could potentially be delayed or prevented by addressing 14 modifiable risk factors, the current trajectory points toward a doubling of the economic burden on businesses over the next two decades. For businesses, the challenge lies in providing flexibility for carers and creating accessible environments to retain the spending power of an aging consumer base.