Dementia care and services in Malta

Abstract

Studies aimed at determining the prevalence rates of dementia in the Maltese islands are lacking even though Malta has an ever-increasing ageing population. In view of the importance of having projected figures on the local number of cases of dementia to guide policy makers undertaking health services planning, a recent study was conducted to estimate the numbers of people with dementia in Malta (Appendix 1). The methodology used was that recommended in the European Community Concerted Action on the Epidemiology and Prevention of Dementia Group (EURODEM) study using demographic data. This study showed that in Malta, there is a clear shift towards a progressively ageing population where the numbers of individuals aged 65 years and over will more than double, reaching 28% by the year 2050. In 2005, for every individual aged 65 years and over, there were 5.2 people in the working-age population bracket. However, by 2050 this ratio is projected to decline to 1 in 2.2. This decrease in the work force will put financial pressures on social and health care services which currently are heavily subsidized by the local government. With respect to the prevalence rates of dementia, the estimated total number of dementia cases in 2005 was 4,072, an increase of almost 14% from the estimated figure for 2001. As expected, the number of dementia cases was higher in females and was considerably evident in 75+ year’s age bracket. The total number of Maltese people aged 65 years and above in 2005 was 51,900. With respect to dementia prevalence projections for the years 2010 to 2050, the number of individuals with dementia in Malta would almost double in the next 20 years to an estimated total number of 6,345 in 2025. This trend is projected to level off with the expected numbers remaining at this same level over the subsequent 25 years. The number of cases in the 75+ age bracket is the highest increase in all age groups. The prevalence estimates for Malta are in line with the trend observed worldwide. Whereas the estimated number of people with dementia in the Maltese islands in 2005 was calculated to be 4,072, this number is expected to rise sharply by the year 2050. Furthermore, projecting as a proportion of the entire population of Malta for that year with the increase in the ageing segment and along with the dwindling number of births, it is estimated that 2% of the total population would have dementia in 2050. There will be fewer individuals in the working-age bracket, as clearly indicated by the progressive decrease in the old-age dependency ratio. Calculations based on EURODEM prevalence rates indicated that the percentage number of people with dementia compared to the total Maltese population in 2005 (as indicated by the latest estimates of the National Statistics Office) was 1.01%. This falls below the EU average of 1.27% and is comparable to countries such as Iceland (0.97%), the Czech Republic (1.03%), Lithuania (1.03%), Luxembourg (1.07%) and Slovenia (1.09%). This is because of the relatively younger age structure of the Maltese Population.