A Spatial Neuroepidemiology of Australia: Visualising the Current and Future Impact of the Dementias

AuthorsHamish Robertson

Nick NicholasAndrew Georgiou

Andrew HayenJoanne Travaglia

Contents

• Introduction• Population ageing as a global phenomenon• Ageing in Australia• The dementias and neurodegeneration• Spatial patterns of dementia• The value of a geographic perspective• Conclusion

JapanGermany

ItalyGreece

PortugalSweden

Euro area (17 countries)Finland

European Union (27 countries)AustriaEstonia

DenmarkG7

FranceSpain

BelgiumSwitzerland

HungaryUnited Kingdom

SloveniaNetherlands

Czech RepublicNorwayCanada

AustraliaPoland

LuxembourgNew ZealandUnited States

RussiaIcelandIreland

KoreaIsraelChile

BrazilTurkey

ColombiaMexico

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OECD 2012 Populations Aged 65+ (%)

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Ageing Trends 1960-2010 (% 65+)Selected OECD Countries

Australia European Union (27 countries) G7Germany Italy JapanSweden United States

Australia’s Projected Growth in People Aged 65+ Source: ABS, B Series Projection

201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050

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Sum of Total 65+ for each Year Year. Details are shown for Year Year.

Projected Ageing and Compositional Change

Neuroepidemiology• Broadly speaking any disorder of the human nervous system with an

emphasis on brain and CNS disorders as well as conditions affecting the peripheral nervous system;

• Sub-group of these are the hereditary and non-hereditary neurodegenerative diseases such as epilepsy, stroke, Parkinson's Disease, MS, ALS and Huntington's Disease

• In general the prevalence and incidence of the neurodegenerative conditions rise with age and many are highly age-correlated;

• Major neurodegenerative conditions associated with ageing include the dementias; Parkinson’s disease; movement and gait disorders etc

• The dementias include especially Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies and mixed dementias

Name

Warri

ngah (A)

Ku-ring-gai (A

)

Sutherland Shire

(A) -

East

Randwick (C

)

Gosford (C

) - W

est

Canterbury (C)

Rockdale (C

)

Wollo

ngong (C) -

Inner

Ryde (C

)

Gosford (C

) - East

Hornsby (

A) - South

Tweed (A) -

Tweed-Heads

Hurstvil

le (C)

Fairfield (C

) - East

Wyo

ng (A) -

North

-East

Wyo

ng (A) -

South and West

Wollo

ngong (C) B

al

Shoalhaven (C

) - Pt B

Newcastl

e (C) -

Throsby

Sutherland Shire

(A) -

West

Holroyd

(C)

Lake

Macq

uarie (C

) - W

est

Lake

Macq

uarie (C

) - East

Lake

Macq

uarie (C

) - N

orth

Port Macq

uarie-H

astings (

A) - Pt A

Blue Mountains (

C)

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hra (A)

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rley (

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orth

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ughby (C)

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Blacktown (C

) - South-East

Kogarah (A)

Coffs Harbour (

C) - Pt A

Great Lake

s (A)

Bankstown (C

) - South

Greater Taree (C

)

Ballina (A

)

Liverpool (C

) - East

Newcastl

e (C) -

Inner C

ity

North Syd

ney (A)

Eurobodalla (A

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Wingeca

rribee (A

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Ashfield (A

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Marrickv

ille (A

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Maitland (C

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Penrith (C

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est0

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AD in Top 50 NSW SLAs2006 and 2026

Visualisation: Projected AD in Coastal Queensland

Making the Invisible Visible (in Google Earth anyway)

Mapping Health Facility – People Relationships

Accessibility to Services

Some Spatial Dimensions of AgeingSource: After Hugo, 2014

• Older people have lower levels of personal mobility which means they are restricted in their ability to travel long distances to obtain services and interact

• Housing is often the major element in older people’s assets and some don’t own their own home

• The home is usually perceived as a safe place compared to institutional environments

• Their local area is often where their main (remaining) social contacts are located• Their home can hold many important memories crucial to their wellbeing• Many aspects of our health and social care systems fail to acknowledge this• People with dementias are often required to relocate when they are at their

most vulnerable• Spatial relationships between need and resource allocation highly variable

The Value of a Geographic Perspective• Spatial variation in diseases, disability and pre-cursor conditions• But not just Cartesian locational/instrumentalist approaches• Location as deeper and more dynamic – complexity in motion• Space/place theory and practice• Long history of environmental gerontology (waxes and wanes but still

not highly influential)• All social policy changes have geographic effects• Population ageing is therefore a deeply geographic phenomenon• And it is an opportunity for geography/ers

Conclusion• Population ageing is a rising global demographic phenomenon • It adds a new level of complexity to health, illness, social policy and

systemic responses (we have a poor history on ageing, the Workhouse etc)• Collective and individual ageing are deeply geographical -> spatial, place

and relationality of ageing• This can be seen in the clinical domain of age-related neurodegeneration –

variation includes space-place factors • Visualisation methods are growing in sophistication, scope and acceptance• Geography will be central to how we respond to ageing in the 21st century• The potential consequences of failed aged care policies are enormous