Malta recorded the highest rate of deaths caused by dementia in Europe, according to Eurostat data published on Tuesday, with just over 80 deaths per 100,000 people in 2020.

This is almost double the rate recorded in 2011, when 47.6 deaths per 100,000 people were reported.

However, specialists in the field warn that this data cannot be taken at face value to mean that the incidence of dementia has doubled.

‘Increased awareness’ may lead to higher reporting

Charles Scerri, an associate professor at the University of Malta’s Department of Pathology and co-founder and chair of the Malta Dementia Society, told Times of Malta that the reasons behind this increase are likely to be complex, but may reflect the “dramatic increase in awareness” around the condition over the past decade.

Awareness of dementia has increased among both the public and medical professionals, according to Scerri.

This could lead to more doctors listing dementia as the main cause of death when they would have previously listed other conditions that often develop as a result of dementia, such as pneumonia and septicaemia.

As public debate about dementia became more widespread and the condition became normalised, Scerri says, more people have started to seek professional advice early on, resulting in a higher rate of diagnoses.

Another possible factor, Scerri says, is Malta’s relatively high life expectancy, which may lead to higher rates of dementia than in countries with a lower life expectancy.

Charles Scerri, associate professor at the Department of Pathology and co-founder and chair of the Malta Dementia Society. File photo: Darrin Zammit Lupi

The data appears to back up Scerri’s views.

The countries that recorded the highest rates of death caused by dementia, such as the Netherlands, Sweden and Denmark, are developed countries that have a high degree of awareness around dementia diagnoses.

On the other hand, the lowest rate of deaths was registered by some of the EU’s poorest countries, including Romania, Bulgaria and Poland.

Meanwhile, the data shows a dramatic increase in the rate of dementia-related deaths across most countries, compared to 2011. Some of the highest increases were recorded in Germany, Luxembourg, Lichtenstein and Austria.

Devastating impact of COVID

Scerri also emphasised the devastating impact that the COVID-19 pandemic had on persons living with dementia, with lockdowns and the closure of essential support services casting them into a “constant state of confusion and anxiety”.

These services, Scerri says, were a “lifeline” for persons living with the condition as they provided a welcome routine and link to normality. The closure of day centres and support services exacerbated isolation, with dire consequences to their mental and physical health.

This is not unique to Malta.

Dementia and Alzheimer's were found to be the most common pre-existing condition linked to COVID-19 deaths in Northern Ireland, with other studies finding that dementia accounted for as many as a quarter of all pandemic-related deaths in England and Wales.