Capgemini have been working closely with our charity of the year, Alzheimer’s Research UK. The goal is to raise £25,000 for them this year to support them in their incredible work. Alzheimer’s is the most common form of dementia, which is the loss of brain function that progressively gets worse over time. Alzheimer’s Research UK have shown from their research that 820,000 people in the UK suffer from dementia and it costs the UK economy 23 billion pounds a year.
It is important that health policy planners in the UK thoroughly understand the future implications of dementia, especially in light of an ageing population. It is known that the prevalence of dementia increases with age. The Alzheimer’s Society have shown that 1 in 1,400 people aged 40-64 suffer from dementia; however it is much prevalent for those aged sixty-five and over. The dementia prevalence rates for those aged 65-69 is 1 in 100, those aged 70-79 is 1 in 25, and for those aged 80 and over, 1 in 6 people suffer from dementia. Analysis of population projection data from the Office for National Statistics shows that there are estimated to be nearly 10.5 million people aged over 65 in the United Kingdom and this is predicted to increase by 21% by 2020.
Operational Research (OR) techniques can play an important role in preparing for an uncertain future and one way OR can help is through the use of system thinking. There are many stakeholders and influences involved in the system for dementia and they all have an impact upon each other. Systems thinking allows for these relationships to be described graphically and then turned into a mathematical model (system dynamics). For the purpose of this article we will concentrate on the first part. The graphical representation is called a causal loop diagram.
So how does systems thinking work? Each component in the system is connected by an arrow. A positive arrow means what happens in the first component will happen in the next (as one goes up, so does the other). A negative arrow means the opposite will be happen.
One of the key reasons for doing this is to see if any feedback exists in the system. Feedback is essentially where information flows through a system and returns to its point of origin. The example below will provide you with a better understanding of the concept. The result of feedback existing in complex systems could result in actions having unexpected consequences. Some of the feedback loops have been identified in the diagram with a red sign.
After some initial research we have come up with an initial causal loop diagram. It has been kept relatively simple for the purposes of Figure it Out.
The number of people with dementia (Population with Dementia) is dependent on a number of factors. For example Physical Exercise Uptake has the potential to reduce the chance of somebody suffering from dementia. More research is needed in this area but the potential impact can be explored. The effect is shown as a negative arrow in the diagram. This is because as more people take care of themselves, the number of people suffering from dementia can be potentially reduced. There are other effects which have been captured in the causal loop diagram which you can explore for yourselves.
An example of a feedback loop is in relation to Raising Awareness of Dementia. This could be done by national public health campaigns, for example. This will potentially lead to an increase in the number of Diagnosed Cases of Dementia. This increase is likely because as more people become aware of the issue, more people will get themselves examined by their doctors resulting in more diagnosed cases. This will in turn lead to more people being taken care of by the voluntary sector (Care Provided by the Voluntary Sector). As the number of people receiving care from the voluntary sector increases, the importance of this area is likely to continue to grow through voluntary organisations’ publicity campaigns to raise additional funds, and word of mouth. The awareness of dementia is likely to continue to grow, leading to more diagnosed cases. That is an example of a positive loop. So over time, the number of diagnosed cases should increase which will be good for the welfare of these people as they can receive care and support to help them in their lives.
There are more feedback loops in the diagram; we have only presented one of them in this article. As it is a first pass this diagram will continue to evolve as we explore further the influences with Alzheimer’s Research UK. If you have any ideas on how to further develop the diagram, please leave a comment on this blog.
Once the causal loop diagram has been refined it can be potentially converted into a system dynamics model. It is evident that further research is required to provide data for some of the influences, but the modelling allows for various inputs to be tested. Systems thinking alone is a powerful tool to better understand systems and decisions but if the model can be converted into a system dynamics model, we will publish the results in a future edition of Figure it Out.