Recorded Dementia Diagnoses England, 2019-20

Figure 1: National estimated dementia diagnosis rate 65+, including upper and lower confidence limits, April 2019 - March 2020

The national estimated dementia diagnosis rate for those aged 65 and over has remained stable over the last 12 months, as it has since data collection began. Figure 1 shows this national rate from April 2019 to March 2020, with 95% confidence limits; it shows that there have been no statistically significant changes in rate throughout the year.

The aim set out in 2015 in the 2015 Prime Minister’s Challenge on Dementia 2020 is for at least two thirds (66.7%) of people with dementia to have received a formal diagnosis. In the past year, the national estimated dementia diagnosis rate for those aged 65 and over has consistently exceeded this ambition, however at no point has it become statistically significantly greater.

Figure 2: Regional estimated dementia diagnosis rate 65+, April 2019 - March 2020

The regional estimated dementia diagnosis rates for those aged 65 and over have remained stable over the last 12 months. There are no regions with a rate that is statistically significantly different to the national ambition of 66.7% at any point. The diagnosis rates of the London, Midlands, North West and North East and Yorkshire regions all remained above the ambition throughout the year.

The tables below display information about CCGs which are significantly above or below the national ambition for diagnosis rate, and how the statistical significance of these differences has changed throughout the year. Since April 2019, no CCGs have moved to become statistically significantly higher than the national ambition, while 5 are no longer significantly higher. Meanwhile, 3 CCGs have moved to become statistically significantly lower than the national ambition, and 2 CCGs are no longer significantly lower. These changes have resulted in 37 CCGs now being significantly above the national ambition and 23 CCGs now being significantly lower than the ambition. The data for all CCGs can be found in the supporting excel file for this publication.

Table 1: CCGs that have continued to be statistically significantly above the national ambition in diagnosis rate between April 2019 and March 2020, including upper and lower confidence limits.

Table 2: CCGs that are no longer statistically significantly above the national ambition in diagnosis rate between April 2019 and March 2020, including upper and lower confidence limits.

Table 3: CCGs that have moved to become statistically significantly below the national ambition in diagnosis rate between April 2019 and March 2020, including upper and lower confidence limits.

Table 4: CCGs that are no longer statistically significantly below the national ambition in diagnosis rate between April 2019 and March 2020, including upper and lower confidence limits.

Figure 3: Actual and forecasted national estimated dementia diagnosis rate for patients aged 65+, including upper and lower confidence limits, December 2019 - March 2020, forecast from April 2020 – November 2021

In Figure 3, an Autoregressive Integrated Moving Average Model (ARIMA model) has been used to investigate and forecast any trend in the national diagnosis rate, using the most recent 40 months of data (December 2016-March 2020). This has been done with a view of determining the likelihood that the national diagnosis rate will remain above the national ambition of 66.7% over the next year.

As can be seen in Figure 3, the national estimated diagnosis rate forecast remains stable and above the national ambition for the foreseeable future. The lower limits forecast by the model predict that the national rate dropping below the national ambition is a possibility in 2021, however as the lower limit it is unlikely to happen. This graph does not give any indication of whether the national diagnosis rate is likely to become statistically significantly different to the set ambition.

The ARIMA model used data to 31^st March 2020; since the forecast was calculated, using data to 31^st March 2020, data for the 30^th April 2020 was collected and released with a national diagnosis rate for patients aged 65+ of 65.4%. When the diagnosis rate recorded in April 2020 is plotted against the ARIMA forecast for April 2020, the model shows the published diagnosis rate to be an outlier, falling far outside the prediction confidence intervals. This suggests the decrease observed was not due to chance, and was not a likely outcome given the trends seen in the previous 40 months of data and therefore a result of the coronavirus (COVID-19) pandemic. As the forecast of national diagnosis rate was not trained using COVID-19 affected data, the rates forecast by this ARIMA model could be compared to the actual national diagnosis rate from April onwards in order to estimate the impact of COVID-19.

Figure 4: Number of people with a coded diagnosis of dementia under the age of 65, April 2018 – March 2020

Although the methodology for national estimated dementia diagnosis rate for those aged 65 and over does not allow for estimating diagnosis rate in populations below the age of 65, NHS Digital continues to collect and publish the number of people diagnosed with dementia aged 0-64 (known as ‘young-onset dementia’). Figure 4 displays how the total number of dementia patients aged 0-64 has changed over the last 24 months; Following a large increase in September 2018, the number has shown a gradual decrease month by month.

It is important to note, however, that despite the trend over time in the total number of patients diagnosed with dementia aged 0-64, the proportion of patients aged 0-64 who were diagnosed with dementia shows little fluctuation. The proportion of patients diagnosed with dementia has ranged from 0.03% to 0.035% of the total number of patients aged 0-64 in the 2 years of data examined; In March 2020 the proportion is 0.032%. The denominator used was the number of patients registered at a general practice, aged 0-64 years old.