“Current dementia care: what are the difficulties and how can we advance care globally?”

Abstract

Background: Dementia is a growing global public health concern, with post-diagnostic care often very limited. Depending on where people live, both within a country and depending on high-, middle-, and low-income countries, they might also face barriers in accessing the right care at the right time. Therefore, it is important to highlight recent evidence on the facilitators and barriers to dementia care, but also evidence on how to move dementia care forward. Main text: Current dementia care is subject to several inequalities, including living in rural regions and being from a minority ethnic background. Evidence in this collection highlights the issues that both people living with dementia and unpaid carers are facing in accessing the right care, with evidence from Australia, Canada, Uganda, to the Netherlands, and further afield. Providing improved dementia-specific training to health care professionals and supporting medication and reablement interventions have been identified as possible ways to improve dementia care for all. Conclusions: This special issue focuses on recent evidence on inequalities in dementia care across the globe and how dementia care can be advanced in various areas.

Do assisted living facilities that offer a dementia care program differ from those that do not? A population-level cross-sectional study in Ontario, Canada

“…More than 90% of assisted living facilities that offered a dementia care program were located in urban communities. Consistent with existing literature, this finding raises important equity considerations for older adults who live with dementia in assisted living facilities located in rural and remote regions [ 29 ]. Rural assisted living facilities house fewer older adults and are more likely to have deficiencies in care provision than urban ones, including challenges with retaining appropriate care staff and resources to meet the needs of residents [ 30 ].…”

Parkinson disease-associated cognitive impairment

“…251 ). However, while care inequalities in demen tia care across the globe 252,253 and research challenges in developing countries are increasingly being recognized for both PD and dementia separately 254,255 , data on the prevalence of PDassociated cognitive impairment, risk prediction, management and societal burden in these regions are lacking. Addressing these disparities with strategies to increase access to health care, research funding and public awareness on the topic is therefore mandatory and represents a global health priority.…”

Social and spatial inequalities in healthcare use among people living with dementia in England (2002–2016)

“…In addition, we found significant differences in experiences between urban and rural areas, suggesting the importance of spatial factors in determining healthcare experiences. In early-onset, people with dementia registered with rural GPs had less contact with their GP, and those with late-onset had greater likelihood of attending A&E. Health and social care services are more sparse in rural areas (Baird and Wright, 2006 ; Bauer et al, 2019 ; Giebel, 2020 ; National Centre for Rural health and Care, 2022) and PLWD from rural areas are more likely to live with relatives than those in urban areas (Rahman et al, 2020 ). Sparsity of local services may also mean PLWD registered with rural GPs have a greater reliance on their GP to act as gatekeeper to diagnosis and treatment (Szymczynska et al, 2011 ).…”