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Speech to Dementia Collaborative Research Centre, Canberra.



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THE HON CHRISTOPHER PYNE MP

Minister for Ageing

SPEECH

Parliament House Canberra ACT 2600 • Telephone: (02) 6277 7780 Facsimile: (02) 6277 4138

Dementia Collaborative Research Centre John Curtin School of Medical School Australian National University, Canberra

13 August 2007

Thank you, Ian.

To Professor Ian Chubb, Associate Professor Marc Budge, Professor Colin Masters, whom I know has been at the forefront of dementia research in this country for many years, Professor Henry Brodaty, Professor Jenny Abbey, Professor Ashley Bush and Senator Jan McLucas.

I am pleased and humbled to be surrounded by such distinguished medical scientists, all of you with a great interest in the vexing condition, dementia.

Each of you is playing a role in increasing our understanding of this syndrome - not just the understanding within our country, but the understanding of the whole of humankind.

Your work in this regard will be made easier by the creation of this new research centre into dementia - completing our network of such centres.

The centres form a highly significant part of the Australian Government’s concerted efforts to address dementia on all levels - through research, through medical treatment for sufferers, through education and support for them and their families - and also through care - by providing specialised care in the community, support for informal carers including respite, and through a growing provision of specialized residential aged care for those with advanced dementias.

We all hope that in the not too distant future the research done here and in the other dementia research centres will signal a new era in our approach to dementia.

But we can nonetheless take some joint pride in having reached this stage.

Twenty years ago, scientists of your ilk who were working on dementia issues were in a small minority. Even then, some of the leaders in the field were in this country. An Australian, Professor Colin Masters, and his team were among the first to isolate and characterise amyloid proteins in the brains of people with dementia.

In those days, Alzheimer’s and other forms of dementia were relatively rare because they are much more likely to occur in people of an advanced age.

Between 1970 and 2004, life expectancy for men aged 65 in NSW rose from 76.6 years to 83.3 years, and for women from 80.4 to 86.8.

Of course, living longer is a good thing.

But after the age of 65, the likelihood of a person having dementia doubles every five years.

Twenty-four per cent of people over 85 years have dementia.

Our longer - indeed record - life expectancy coupled with the demographic ageing of the population means that we are now facing a significant increase in the number of people living with dementia.

It is estimated around 200,000 Australians at present have dementia.

By 2031, according to an Institute of Health and Welfare report released early this year, that number will rise to around 465,000 people.

To put those figures into another perspective, the report “The Burden of Disease and Injury in Australian 2003 - released by Australian Institute of Health and Welfare in May this year stated that dementia was the fourth-ranked cause of non-fatal burden of disease for Australians overall, and for those over 75, dementia accounted for 23 per cent or nearly a quarter of the total non-fatal burden of disease.

The AIHW report measured this burden of disease in “disability adjusted life years” lost - that is, both years of life lost due to premature death, and years of “healthy” life lost due to disability.

The report said neurological causes - primarily dementia - accounted for 10 per cent of the total lost years - fatal and non-fatal - in 1993.

By 2003 it had risen to 12, and projections show that by 2013 it will be 14 per cent and by 2023, 18 per cent of the total burden on disease and injury for the entire Australian population.

Translated into real life, that figure represents an enormous amount of human suffering for individuals and families and also an enormous challenge for our health system, our aged care system and carers, friends and familiy.

As their condition progresses, people with dementia require a very high level of care. The rise in dementia will therefore have very major economic consequences in terms of costs in the home and community care sector and the residential aged care sector.

A report commissioned for Alzheimer’s Australia in 2004 estimated that if the onset of Alzheimer’s disease in each person could just be delayed for five years - by the middle of this century there would be 49 per cent less people living with the condition.

Forty-nine per cent - that is almost cutting the number in half - and that was not based on finding a cure, or a foolproof protection against the condition but by delaying it.

As you know this is a particularly promising area of research with recent studies suggesting that lifestyle factors - such as diet, exercise, learning and even socialising - as well as pharmacological drugs can delay the onset of dementia.

For all of these reasons - if you didn’t already know it - your work is of great importance.

Finding ways to prevent or avoid dementia, to reduce and delay its onset, to diagnose it early - or of course to cure it - any of those - would provide a huge benefit to Australians individually, and to the nation as a whole.

I don’t think it is overstating the case to say that the creation of the Dementia Collaborative Research Centres is both a reflection of, and the result of, a new era of focus on dementia - in terms of government, society and the medical profession.

Over the past nine years, the Australian Government has recognised the urgency of coming to grips with dementia among older Australians and has progressively accelerated its response.

While governments are often - always - accused of being obsessed with the short term and, dare I say, the next election, this government has put a whole of government effort into preparing the nation for the demographic changes that will occur over the next 40 years.

A significant part of those preparations has been directed to meeting the challenge of dementia.

We have overhauled the aged care sector - with changes still coming into effect - so that it can provide quality care for larger numbers of people both in their own homes, and in residential facilities.

We have also provided greater incentives for aged care providers to make special provision for the growing number of their clients who will have dementia.

According to the AIHW report on dementia data, about 15 per cent of people with this condition have it in severe form and another 30 per cent have moderate cases.

Those with moderate to severe dementia usually require permanent supervision in cared accommodation such as residential aged care facilities and hospitals.

Around half of the residential aged care population in 2003 comprised people with dementia, of whom 83 per cent were in high care settings.

The government does not operate aged care but steers its directions through policy and financial support.

In 2005 the Government provided $320.6 million over five years for a major package of measures to help people with dementia and their carers - and made dementia one of its national health priorities.

This package included $225.1 million to create 2,000 new Extended Aged Care at Home Dementia packages by providing home-based care for people with dementia, even those with complex high care needs because of psychological and behavioural symptoms, to stay in their own homes.

We built on that in the current 2007-08 Budget with an additional $26.5 million over the next four years for community-based respite care to give carers a break - including those looking after people with dementia.

Another element of the 2005 dementia package was $70.5 million for projects to strengthen the capacity of the health and aged care sector to deal with dementia.

These projects include new research, as well as embedding new research into care and treatment; providing support for improved diagnosis, assessment and behavioural management services; and improving prevention and intervention strategies.

This brings me back to this centre as $7.2 million of this funding was provided for the creation of the three Dementia Collaborative Research Centres (DCRCs) to pull together our national research effort on dementia and make it as effective as possible.

Each of the DCRCs focuses on one area of research with the potential to improve the quality of life of people with dementia and their families and carers.

• the University of NSW Centre focuses on assessment and better care outcomes • the Queensland University of Technology centre focuses on consumers, carers and social research • and this centre at the Australian National University will concentrate on prevention, early

intervention and risk reduction.

The eminent leaders of these centres can explain their work to you much better than I can so I won’t even attempt it.

I can say that each centre has multiple collaborators comprising many of the top researchers in Australia, community groups and aged care service providers.

There is also a very strong focus in the centres on getting practical results from their research in terms of solutions and guidelines for people with dementia and their carers.

I am sure you agree that this collaborative model holds out a lot of promise in terms of facilitating interpretation of research and communication between researchers, speeding up the process of deduction and conclusions and the ultimate aim of better dementia care.

As the Minister for Ageing I have high hopes for your research - and for other dementia or aged care research being conducted in Australia.

The government provides support to all of this research either directly or indirectly.

For example, the researchers from the Howard Florey Institute and St Vincent’s Institute who are analysing the chemistry of memory will be among the first to use the new synchotron funded partly with $50 million from the government from this year’s Budget.

The Howard Florey Institute and the Brain and Mind Institute were also among the recipients of almost $600 million in one off grants for medical research infrastructure in the 2006 and 2007 Federal Budgets.

In addition, $16.4 million has been made available under the Dementia Initiative for the next round of Dementia Research Grants managed by the National Health and Medical Research Council.

I hope to be able to announce the successful applicants at the Australian Association of Gerontology Conference in November. I’m sure my opposite number also hopes she will be able to make that announcement!

The dementia initiative also provides funding for Alzheimer’s Australia to implement the National Dementia Support Program to provide information, support, counselling, training and education to people with dementia, their families and carers as well as to professionals

working in the field.

This includes the Dementia and Memory Community Centres that are doing a great job in all of those areas including relaying to the public the findings that are emerging from researchers such as yourselves.

In addition, $25million has been provided under the dementia initiative to improve the skills of aged care workers by providing dementia education and training for up to 17,000 aged care workers and 7,000 community workers and carers.

I am pleased that the government’s commitment to make dementia a national health priority has come to fruition in programs such as the Dementia Collaborative Research Centres.

The efforts that both the government and the community - with your assistance - are making will help us all to best manage the predicted growth in the number of people with dementia.

Our aim must be that each and every person who is affected receives the care - and respect - that they deserve.

Much has been achieved, but more needs to be done.

The government is committed to supporting researchers of your calibre to make those achievements, to improve the lives of people with dementia - and those of us who may get it in the future.

It is a condition that is likely to affect all of us, one way or another. I sincerely wish you the best with your research.