News

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National dementia action plan launched

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The Department of Health and Aged Care has released the National Dementia Action Plan 2024–34, a policy framework to continue improving the lives and care of people living with dementia in Australia over the next 10 years. 
 
The Action Plan sought input from various healthcare stakeholders, with the RACGP highlighting the important role of GPs in recognising, assessing, diagnosing and managing dementia, and mechanisms to better support this care provision.
 
Incorporating multiple focus areas, the new plan consists of eight key actions:

1. Promote equity and human rights
2. Tackle stigma, improve awareness and promote inclusivity
3. Empower individuals and communities to minimise risk where they can, and delay onset and progression
4. Improve dementia diagnosis and post-diagnostic care and support
5. Improve treatment, coordination and support for people living with dementia
6. Support carers of people living with dementia
7. Build capability of the workforce to care for and support people living with dementia
8. Improve dementia data, maximise the impact of dementia research and promote innovation

It is estimated more than 421,000 Australians are currently living with dementia, and without a medical breakthrough, that number is projected to more than double by 2054.
 
According to the plan, GPs are most people’s first point of contact when they ‘identify changes or concerns’, with dementia accounting for approximately 1.6% of general practice encounters.
 
However, it says GPs and primary care teams could benefit from additional training to maintain knowledge and upskill in diagnosis and care.
 
‘As no two people living with dementia present in the same way, GPs may not pick up early signs and symptoms within a short consultation timeframe,’ the plan states. ‘Symptoms can often be mistaken for other conditions.’
 
The Action Plan outlines that while most GPs have a long-standing relationship with patients and their family, they ‘may feel unsupported to have conversations about early signs of dementia’, and there is not always a clear pathway for GPs to screen patients to see the benefits of early intervention activities.
 
Despite GPs being ‘highly trained’ to provide dementia care, the plan also notes there is a current lack of healthcare professionals who receive the support to provide this care.
 
‘GPs … may benefit from additional information and support in recognising dementia symptoms,’ it states.
 
‘This would help to empower them to make a diagnosis of dementia and make appropriate referrals, through readily available information and ongoing professional development.’
 
It also says that medical students often graduate with ‘a poor knowledge and understanding’ of dementia, so training GPs in dementia care ‘needs to start at university’.
 
Dr Marita Long, a GP with a special interest in dementia, knows firsthand GPs’ crucial role in all aspects of the condition – from prevention, diagnosis and post-diagnostic care, to supporting carers.
 
‘Many people living with dementia remain undiagnosed for a range of reasons,’ Dr Long told newsGP.
 
‘The most important role, given there is no curative treatment, is prevention and we do that well in primary care.
 
‘We know we can reduce the risk of developing dementia, or at least delay onset for nearly 50% of cases globally.’
 
While Dr Long says the ‘fantastic’ Action Plan is ‘very welcome’, how it will enhance support for GP remains to be seen. 
 
‘It covers all the key elements that are needed to address what is one of the most significant public health issues,’ she said.
 
‘The dementia clinical practice guidelines are currently being reviewed so it will be very interesting to see how these will marry with the Action Plan – this will inform implementation of the plan so that’s an important part of the puzzle.
 
‘It looks like a chunk of money for training is in the plan, but how that is spent I am not sure – the devil will be in the detail.’
 
She says evidence-based education, and ongoing CPD to support all GPs to access it, is essential, starting with translational research.
 
‘Teaching that dementia is a chronic disease is really important, and that the time to be talking and thinking about this is from early life, all the way through to later life,’ Dr Long said.
 
‘[We also need to] support GPs and other primary care professionals to do clinical research in this space to explore and evaluate interventions for risk reduction.’
 
As well as involvement in research currently recruiting GPs for their input on dementia risk reduction, Dr Long says there are many GPs who are ‘actively engaged with some of the global leaders’ in translating the evidence into practice – a key point in the Action Plan.
 
‘It’s good to know that we are ahead with primary care research and … on track with the plan,’ she said.
 
Aligning with action 8 of the Action Plan, the Australian Institute of Health and Welfare has also released two accompanying documents:

• National Dementia Data Improvement Plan 2023–34 – outlining activities to improve data over the next 10 years to monitor dementia and provide an evidence base for effective policy development, service provision and planning.
• National Dementia Action Plan indicators dashboard – presenting indicators tracked over the 10 years to ensure objectives are being met, with data updated when necessary to assess if indicators are improving over time.

One of the eight actions from the plan is to build capability of the dementia workforce – with the dashboard’s 10-year outlook being that primary care, community, disability and aged care workforces receive necessary training and support to provide ‘high-quality, person-centred’ care to people living with dementia, their families and carers.
 
In its submission last year to inform the Action Plan, the RACGP recommends an integrated health system to support and improve diagnosis and care between dementia services. 
 
However, it also highlights while GP education is detailed as a solution to many of the objectives and a way to measure performance within the Action Plan, the ‘full context of what GPs encounter’ needs to be considered.
 
It said this includes the consultation time needed to complete assessments, patient resistance to undergoing tests or screening processes, long waits for specialist advice, and patient concerns of referral to aged care facilities.
 
But ongoing education and prevention remain Dr Long’s takeaways.
 
‘Prevention is better than cure, but when there is no cure prevention is everything, and it is a whole-of-life approach,’ she said.
 
‘It’s never too early and never too late to be optimising brain health, to build both cognitive reserve that helps resist pathology, and brain reserve that helps prevent pathology.
 
‘Community education is a huge piece of the picture. The recent Alzheimer’s Disease International report showed that the vast majority of the public and healthcare workers believe dementia is part of normal ageing.
 
‘We have a lot of work to do.’
 
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dementia GP education national dementia action plan policy preventive health

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