The number of dementia medication prescriptions has jumped by almost 50% in Australia in the past decade as more people seek out therapies that may slow the progression of the disease.
The latest report on dementia from the Australian Institute of Health and Welfare, released on Friday, revealed that health services for managing dementia have increased to accommodate 411,100 people.
As dementia rates grow, a neuroscience expert has warned Australia is “unprepared for the full impact” the disease will have on the community, economy and health system. Dementia is the leading cause of premature death in older Australians.
“The western Pacific region, where Australia is situated, has one of the fastest-growing ageing populations in the world, placing us at the forefront of the dementia crisis,” said Prof Matthew Kiernan, the chief executive and director of Neuroscience Research Australia.
Almost 688,000 dementia medication prescriptions were dispensed in 2022-23 to about 72,400 Australians aged 30 and over, the report said. That represented a 46% increase from just over 472,000 scripts for about 50,800 people in 2013-14.
The increase is likely to be due to a combination of factors: a rise in diagnoses, greater awareness among families, carers and healthcare providers about available treatments, and a greater willingness to prescribe, according to Kiernan.
“Previously there may have been a sense of nihilism, but the community is now more informed and proactive,” he said.
Dementia is an umbrella term for several diseases that over time destroy nerve cells and damage the brain, affecting memory, thinking and the ability to perform daily activities. The most common is Alzheimer’s disease but it also common for someone to have multiple types, known as “mixed dementia”.
About one in every 11 deaths in Australia are due to dementia, with 17,800 deaths in 2022 – of whom nearly two-thirds were women (11,300) and one-third men (6,600), the report, titled Dementia in Australia, found.
Melanie Dunford, a spokesperson for AIHW, said dementia was the second leading cause of death in Australia after coronary heart disease, making up 9.3% of all deaths.
“It was the leading cause of death for women and for Australians aged 65 and over in 2022,” she said.
Although there is no cure for dementia, there are four medications – donepezil, galantamine, rivastigmine and memantine – available under the pharmaceutical benefits scheme which may alleviate some of the symptoms and slow the progression of Alzheimer’s disease, the report said.
Three of the medications (donepezil, galantamine and rivastigmine) are acetylcholinesterase inhibitors, which work by blocking the actions of the enzyme acetylcholinesterase, which destroys a major neurotransmitter for memory.
Memantine works by blocking the neurotransmitter glutamate, which causes damage to brain cells and is present in high levels in people with Alzheimer’s disease.
Clinical trials have taken place for two new disease modifying therapies, lecanemab and donanemab, but the benefits of these much-hyped drugs have proved harder to quantify than their potential harms, experts have previously told Guardian Australia.
Donepezil was the most commonly dispensed dementia-specific medication in 2022-23, accounting for 66% of all scripts. It was also the medication most people were likely to be first prescribed, the report found.
In 2022-23, GPs prescribed 50% of initial scripts of dementia medications but can only do so after the patient’s diagnosis of Alzheimer’s disease has been confirmed by a specialist.
There was a 34% increase in the number of people dispensed dementia-specific medications for the first time, mostly due to the ageing population of Australia, the report said.
Kiernan said it was essential that “communities, governments and industries come together to urgently to address this escalating challenge”.
“For every individual with dementia who leaves the workforce, a carer is often forced to leave too, placing significant pressure on our economy.”