Doctor calls for slip, slop, slap-style dementia campaign

With more than 430,000 Australians living with dementia, and that number expected to double by 2050, a leading expert says an overhauled prevention campaign must be rolled out.
 
Dementia is the second leading cause of death in Australia, and while scientists have yet to find a cure, there have been significant advancements in the development of diagnostic blood tests, as well as rehabilitation programs post-diagnosis and medications.
 
Though there is still a way to go, a leading dementia expert is raising awareness about the many steps that can be taken now to delay disease onset until much later in life – and, in some cases, at no added cost.
 
Professor Henry Brodaty, a co-director of the Centre for Healthy Brain Ageing (CHeBA) at the University of New South Wales, presented his insights to the National Press Club this week.
 
In a speech titled ‘Dementia, Hope Beckons’, he called for a dementia awareness campaign akin to the Cancer Council’s ‘slip, slop, slap’ campaign launched in 1981.
 
‘Australia has been a leader in prevention,’ Professor Brodaty said.
 
‘Think about the “slip, slop, slap” for skin health. Think about Australia leading the world in HIV. Think about how we’ve decreased smoking.
 
‘We don’t have an awareness in our community [that] we can do the same thing for dementia.’
 
According to Professor Brodaty, at least 50% of dementia risk can be accounted for by environmentally modifiable factors.
 
‘We all have the power to do more exercise, to keep our brains active [and] keep socially connected,’ he said.
 
‘We can monitor and treat high blood pressure [and] high cholesterol. We can compensate for hearing loss. We can try to avoid obesity. We can reduce the risk of diabetes and head injury. We can live in environments free of air pollution. We can not smoke and avoid excess alcohol.’
 
Dr Marita Long, the first GP appointed as an Honorary Medical Advisor for Dementia Australia and a Clinical Associate Professor for Wicking Dementia Education and Research Centre, agrees there is a need for a public awareness campaign.

She told newsGP there is a persisting misconception that cognitive changes associated with dementia are a normal part of ageing. However, Dr Long is concerned about placing the onus on the shoulders of GPs – or on individuals, without considering the health disparities that influence lifestyle choices.
 
‘We can’t put this onto GPs alone and we certainly can’t put this on to individuals and talk about lifestyle choice,’ she said.
 
‘That can be really demoralising for patients because we know, often, it’s not all about choice; there’s a lot of health disparity that influences lifestyle factors.
 
‘There needs to be a public health commitment to addressing some of those disparities that we see in health and there needs to be better support for primary care as well.’
 
In December, the Department of Health and Aged Care released the National Dementia Action Plan 2024–34, for which the Federal Government allocated $166 million in funding to continue improving the lives and care of people living with dementia over the next 10 years. 
 
However, Professor Brodaty said this is ‘too little for what Australia needs’.
 
With dementia now known to be a chronic disease, where the pathology starts decades before symptoms, Dr Long says any approach needs to take different stages of a person’s lifespan into account.
 
‘If we look at Scotland, they run a lot of public health education starting in primary school that run through to adolescence,’ she said.
 
‘Early adulthood is another time where we could be doing a little bit more because that’s when people are establishing lifestyle habits like smoking, physical activity habits, their drinking practices.
 
‘Then it’s just getting brain health into people’s minds, that dementia is something that we can prevent and looking at some of those risk factors that aren’t ticked off with cardiovascular health.’
 
However, to support people at risk of dementia, Professor Brodaty said more needs to be done to support doctors and ensure they are aware of how much they have in their arsenal.
 
‘We did a survey in 1994 of GPs where we surveyed one in seven GPs … didn’t feel that they could do anything, didn’t have anything to offer and felt that they lacked the skills,’ he said.
 
‘It’s improved a lot since then, and we need to help GPs to know that.’
 
Dr Long agrees. She said there are also validated cognitive risk reduction tools that are available and that it would be beneficial to have embedded into medical software.
 
However, she notes the need for greater funding for longer consults, which are necessary when assessing and educating patients about cognitive health.
 
‘The people we’re thinking about, they’re in midlife, they’re busy, they come to the doctor intermittently and they might come with their list of things. If you want to tack on “while you’re here, you’ve got a few risk factors for dementia” or “have you thought about brain health?” that all takes time and it’s hard when we’re disincentivised to spend time with our patients,’ Dr Long said.  
 
‘I don’t think we need a new Medicare item number; I would hate to see a dementia item number or a brain health check. We need our Medicare rebates to be increased so that we can spend more time with patients.’
 
As part of his speech, Professor Brodaty also touched on his recent research into the CHeBA’s online prevention program ‘Maintain Your Brain’.
 
The study, which followed more than 6000 Australians aged 55–77 with at least two modifiable risk factors over the course of three years, found the online program to be a more cost-effective way of improving cognition and reducing dementia risk than supplying individuals with general health information alone.
 
‘We have a program that can delay the onset of dementia – possibly by a year or more,’ Professor Brodaty said.
 
‘For every year we can delay the onset, [we can] reduce the numbers of people by 10%. [That] reduction is $370 million saved. Imagine what the return on investment would be if Australia did this?’
 
While dementia is one of the most feared conditions, Dr Long says she is hopeful. While she admits to it being rare for patients to bring up cognitive health, she says in her experience, patients are very receptive to risk reduction strategies.
 
‘It’s a growing area of interest [and] the good thing is that many risk factors for heart health are similar for brain health and, in terms of primary care, we do preventative health pretty well,’ she said.
 
‘So, there’s a lot of good news in this; there’s a lot that we can do, there’s a lot we can do in primary care once we’ve got the support to do it, but there has to be that public health messaging.’
 
This is in line with Professor Brodaty’s messaging.
 
‘There is hope; hope beckons,’ he said.
 
‘Hope for earlier diagnosis. Hope to improve the quality of life for people with dementia, and to live positively for many years. Hope that services are improving. And hope for research.
 
‘We need the slip, slop, slap of brain health – now.’
 
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