Greifswald/Germany, September 17th, 2020. People with dementia are by no means evenly distributed across Germany. A study by the German Center for Neurodegenerative Diseases (DZNE) and the University Medical Center Greifswald shows large regional differences: As a result of the age structure, the percentage of people with dementia in the total population is above average in many eastern districts. This also applies to some areas in the north, middle southwest and south of Germany. Care must be optimized in a regionally adapted manner. (With interactive maps, please scroll down)
Dementia is a major challenge for society: According to a representative population survey (Sicherheitsreport 2020), more than 40 percent of Germans are afraid of suffering from dementia and being in need of care in old age. In the next 30 years, the number of people with dementia in Germany could rise from the current 1.6 million to approximately 2.8 million. "In view of rising life expectancy and the shift in the age pyramid in Germany, we are facing a huge task," said Dr. René Thyrian, expert for health care research at the DZNE site in Rostock/Greifswald. "We need adequate care for people with dementia and their families. This also means that services must be tailored to the local situation in districts and municipalities. To do so, one must know the need which we have quantified."
Analysis at district level
Thyrian's research team used public use data to investigate how people with dementia are spread across Germany. For the study, which is published in the journal "Der Nervenarzt", the researchers estimated the number of people affected at district level: districts and independent towns each form a geographical unit. For each of the total of 401 geographical units, the researchers calculated the number of people with dementia aged 65 and older. They also calculated the percentage of the total population and the regional population density of those affected. The researchers used data from the Federal Statistical Office and the "European Collaboration on Dementia" for this purpose. "All this information is publicly available. For our study we have combined them in an appropriate way. Due to the large amount of data, this was an absolutely industrious task," explains Thyrian.
East Germany particularly affected
According to the study, the proportion of people with dementia in the total population - municipal, i.e. at district level - is currently between approximately 1.4 and three percent. "We have found that dementia is very unevenly spread across Germany, so to speak - and that there are areas in which, in percentage terms, twice as many people with dementia are living as in other parts of the country," says Thyrian. The percentage is above average in many regions of eastern German states and in some districts in the north, middle southwest and south of Germany. "While in the district of Freising, for example, the proportion of people with dementia is 1.4 percent of the population, in Görlitz or Dessau-Roßlau, at more than 2.9 percent, this proportion is about twice as high," said Thyrian. The reason for the high proportion of people affected by dementia in some rural districts is to be found in the age structure of the respective region, where an above-average number of older people live. "In conurbations such as the Ruhr area, there is also a high proportion of people with dementia due to the age structure and because these regions are also very densely populated," explained Thyrian.
Long distances to the physician
The researchers also discovered that due to the thinly populated nature of some rural districts, very few people with dementia per square kilometer live there, although their proportion of the total population is actually relatively high. "In sparsely populated areas, the distance to the nearest medical practice or day care center is usually a long way. Therefore, specialized care close to home is difficult. This is because elderly people, and especially people with dementia, usually have limited mobility," said Thyrian. "In districts such as Salzwedel in Saxony-Anhalt and Ostprignitz-Ruppin in Brandenburg, for example, there is a high proportion of people with dementia, but these are spread over a large area. The challenges there are certainly different from those in more densely populated regions.
Tailor-made solutions required
"Our analyses show that a representation at the federal level only incompletely reflects the situation for the individual districts and cities.” Thyrian recommended taking regional conditions into account when caring for dementia patients and their relatives in Germany: "Each district faces an individual challenge. It should be examined to what extent the existing structures in the region are appropriate. If there are more patients with dementia than previously assumed, more care services would be needed. This can also be taken into account in urban planning, for example by providing more barrier-free public places and buildings. Whether the proportion of people with dementia is one percent or three percent of the total population of a district makes a significant difference. So there should be tailored regional solutions, as the districts are affected differently.