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1. Primary care protocols to screen for and treat mental health problems in older people need to be used more widely.

The predicted increase of an additional 673 people with dementia by 2025 includes some 550 aged over 85. This group are likely to have other health and social care needs thus the care burden and service needs associated with dementia will be both high and complex, needing to work with a range of other services aimed at older people.

There are many initiatives in place, but there are a considerable number of areas that still require action. See Draft Strategy for the mental health and wellbeing of older people version 4, 18th July 2007.

• People with dementia receiving sub-standard care
• Under-diagnosis - people with dementia not receiving access to treatment
• Lack of support services available to help maintain the independence of people with dementia.
• Lack of social and community participation for older people, particularly for those most at risk of isolation and exclusion.
• People going into long-term care too early or admitted to hospital when a bit more support in the community could have prevented it

The draft strategy for older people includes a detailed list of gaps to be addressed (included in full in the final 'What next' section).

Broadly these cover:

The key risk factors are:

• Age
• Poverty
• Isolation
• Ill health
• Living alone
• Unfit housing or rundown neighbourhoods

Current services