Dementia and Cognitive Frailty

Summary: This chapter explores dementia and cognitive frailty – a syndrome of combined cognitive and physical impairments distinct from dementia – and their relationship to social inequalities in the North compared with the rest of England. • Dementia prevalence in older adults (60+ or 65 and over, depending on data) shows no clear regional differences across England. • For those under 65, regional disparities emerge, with the North experiencing higher rates of early-onset dementia. • We hypothesise that accelerated physiological ageing, linked to shorter healthy life expectancy and higher deprivation, contributes to earlier dementia diagnoses in these areas. • This hypothesis aligns with evidence showing higher rates of cognitive frailty, a precursor to dementia, in the North. • Key risk factors (e.g., low education, pollution) are either more prevalent in the North or interact with poverty in ways that heighten vulnerability to dementia and cognitive frailty. • A case study from Salford illustrates neighbourhood-level dementia support, leading to policy recommendations.