Statistics report dementia the biggest killer in the UK, moving dementia to second for the first time since 2015. But deaths from dementia remain high compared with other major diseases. We explore why.
This article was first published on 6 September 2019 and most recently updated on 12 September 2023.
Annual death statistics for England and Wales, released by the Office for National Statistics (ONS) in 2020, showed the number of people whose deaths were due to dementia is steadily increasing year on year.
Due to the pandemic, COVID-19 was the leading cause of death in England and Wales in 2020 and 2021, however, in the last year dementia is once again listed as the leading cause of death.
At a glance: the top 5 leading causes of death in England and Wales in 2022
In 2022, the top five causes of death were:
- Dementia and Alzheimer’s (20.7% of all deaths)
- Ischaemic heart disease (18.7% of all deaths)
- Chronic lower respiratory diseases (9.4% of all deaths)
- Cerebrovascular disease (9.3% of all deaths)
- Lung-based cancers (9.2% of all deaths).
These records only include England and Wales and treat all the diseases that cause dementia in one group – whereas cancer is separated. Alzheimer’s disease alone would make up an estimated 13% of deaths.
Why are the diseases which cause dementia still a leading cause of death in the UK?
There are a few reasons why dementia remains a leading cause of death in England and Wales.
1. Overall, more people are getting a dementia diagnosis
Greater awareness and understanding of dementia mean more people are now receiving a diagnosis. Before the pandemic, it was estimated that two-thirds of people with dementia in the UK have been diagnosed which is up from only 40% of people in 2012. Alzheimer's Society has long campaigned to increase the number of people with dementia receiving a diagnosis so they can gain access to vital treatments and support services.
Especially after seeing diagnosis rates decline during the pandemic, we have been campaigning for funding to ensure diagnosis levels get back up to where they were before.
However we expect there are still many people living with dementia who do not have a diagnosis.
2. More people are living longer in the UK
Due to medical advances, more people than ever are surviving heart disease, strokes and many cancers.
Age is the biggest risk factor for dementia, so as more people live longer, the number of people developing dementia is increasing.
Dementia is a terminal condition and more research is needed to find treatments that can slow or stop the diseases that cause dementia.
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3. Changes in the way UK deaths are recorded
Reliable death records are important to follow changes in the impact of diseases and to decide priorities for medical research. In 2011, the ONS made changes to the way deaths due to dementia are recorded to better reflect guidance from the World Health Organisation (WHO).
Now if a person dies with dementia, doctors can report it as the main cause of death on their death certificate. Previously, the immediate cause of death would be listed, such as a fall or an infection like pneumonia.
But in many cases, these illnesses are a result of underlying dementia causing increased frailty, a weakened immune system, or problems with swallowing.
The ONS also updated their coding system so that vascular dementia would be reflected in the dementia category instead of the stroke (cerebrovascular disease) category.
Additionally, if people with dementia die from other causes – such as COVID-19 – they may not be counted as dying from dementia. This reduces the numbers recorded for people with dementia who have passed away.
This is important to consider if rates of deaths caused by dementia appear to fluctuate because it might not necessarily be an indicator of a change in the number of deaths.
How does the number of deaths from dementia compare to other diseases in the UK?
Under the revised methods, the ONS groups all of the diseases causing dementia – like Alzheimer’s disease and vascular dementia – together into one category.
This contrasts with conditions like cancer, which is separated by disease type. Deaths from diseases such as lung cancer, breast cancer, and pancreatic cancer are all analysed separately. Lung cancer caused the most deaths of all cancers in 2022, recorded on 9.2% of death certificates.
However, if all the different types of cancer were grouped, the picture would look different. For example, cancer would have been responsible for 1 in 4 UK deaths in 2017 if this was the case.
The grouping of diseases, therefore, influences how these conditions rank in the causes of death in the nations of the UK.
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