Slides form presentation at 2016 Australian Association of Gerontology on modelling dementias at finer geographies and implications for our understanding of demography-epidemiology and service demand aspects of the aged care equation.

1. Microgeographies of Dementia:
An Australian Spatial Dashboard System
Authors
Hamish Robertson
Nick Nicholas
Joanne Travaglia
Andrew Georgiou
Andrew Hayen

2. CONTENTS
•Introduction
•Ageing and the dementias
•Locational variation
•Scale and estimation issues
•Spatial modelling
•Visualisation
•Conclusion

3. Introduction
• Caveat - based on my PhD research
• Proof of concept – no claims to exactitude or total systemic coverage e.g.
limited inclusion of provider types
• Integration of health and medical geography (HMG) concepts and
methods with ageing demography and epidemiology
• Focus on methods for information sharing and spatial/spatially informed
data visualisation
• Aim is an integrated approach to major issues in aged care design and
delivery (e.g. numbers, locations, severity, cost, available resources) – silo-
busting!
• Emphasis on visual data methods including maps but supported by data
throughout the process
• What-ifs and rapid updates based on new data all highly feasible

4. Scenario Builder in Excel
Spatially Referenced to SA2 Geography

5. Four Key Dementia Output Options
Total Dementia, AD, Vascular and Other Dementias
Vascular
Male Female Total Grand Total
Mild Moderate Severe Mild Moderate Severe Male Female
Year no. no. no. no. no. no. no. no.
2012 2573 1404 702 3146 1716 858 4679 5720 10399
2013 2654 1448 724 3221 1757 878 4825 5856 10681
2014 2744 1497 748 3297 1798 899 4989 5995 10984
2015 2835 1547 773 3373 1840 920 5155 6133 11288
2016 2925 1595 798 3448 1881 940 5318 6269 11587
2017 3012 1643 821 3517 1918 959 5476 6395 11871
2018 3099 1690 845 3588 1957 979 5634 6524 12158
2019 3194 1742 871 3665 1999 1000 5806 6664 12470
2020 3292 1796 898 3753 2047 1023 5986 6823 12809
2021 3401 1855 927 3848 2099 1050 6183 6997 13180
2022 3530 1925 963 3960 2160 1080 6418 7200 13618
2023 3653 1992 996 4070 2220 1110 6641 7400 14041
2024 3773 2058 1029 4181 2281 1140 6860 7602 14462
2025 3897 2126 1063 4300 2346 1173 7086 7818 14904
2026 4024 2195 1097 4426 2414 1207 7316 8047 15363
2027 4152 2265 1132 4557 2485 1243 7549 8285 15834

6. Example: Sub-Types and Severity
0
20000
40000
60000
80000
100000
120000
140000
160000
180000
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027
Alzheimer's Disease Sub-Total Vascular Dementia Sub-Total Other Dementias Sub-Total

7. Scale and Estimation Issues

8. Implications for Modelling
The Australian Statistical
Geography Standard (ASGS)

9. Modelling Demography, Epidemiology and
Systemic Infrastructure – Ambulance Stations

10. Spatial Modelling
Projected AD Scenario by SA2 for Sydney Metro in 2027

11. Spatial Accessibility: RACFs and SA2s (5kms)

12. Localisation: 2012 and 2027
0 200 400 600 800 1000
Tweed Heads - South
Port Macquarie - East
Cherrybrook
Umina - Booker Bay - Patonga
Nelson Bay Peninsula
Narrabeen - Collaroy
Berkeley - Warrawong - Windang
Ballina
Tweed Heads
Bateau Bay - Killarney Vale
Mosman
Maroubra
Turramurra
Double Bay - Bellevue Hill
Taree
Top 15 SA2s for AD Prevalence in 2012
0
5
10
15
20
25
30
35
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027
Alzheimer's in the Far West
0
100
200
300
400
500
600
700
800
900
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027
Alzheimer's in Tweed Heads

13. Spatial Dashboard
AD Prevalence Est. Sydney Metro 2027

14. Formal Cost of Care Scenario 1 in 2027

15. Including Aged Care Service Providers
• Only seven service types in this model!
• Hospitals
• Ambulance Stations
• GPs
• Pharmacies
• ACATs
• RACFs
• Meals on Wheels

16. No. of Pharmacies Less than 5kms by SA2

17. Z-Score for all Services – SA2s Spatial Accessibility

18. Next Stage in Development
• SA1 Estimation model for 2012-2027 - done but seriously clunky
in Excel approx. 9650 SA1s for NSW alone
• So far have SA1 AD prevalence estimations and projections –
incidence estimation based on annualised changes
• SA1 Geography in Tableau – also done and still runs fairly slowly
• Need to integrate structural health and aged care data – so far
easier in GIS than Tableau but a developmental learning curve
• Longer term objective is an integrated visual data environment
that incorporates all major components – the spatial dashboard

21. Conclusion
• Population ageing is also a highly geographical (and HMG)
process
• Demographic and epidemiological data can be mapped in an
integrated spatial environment
• Contemporary mapping techniques support complex nature of
ageing and aged care responses
• Policy changes have spatial effects because people and systems
react/respond
• Data visualisation supports engagement with systemic
complexity
• The chance to ask “what?”, “who is affected?” and “where is
affected?” prior to and following implementation