SADLY, we knew this day was coming. For many years, cancer and heart disease have been the biggest killers in Scotland – and they still have a devastating effect. But in the last few years the national records have been revealing a dramatic and disturbing change. Twenty years ago, dementia and Alzheimer’s did not even feature in the five most common causes of death; today, the records show that, for the first time, they have become the biggest killer among women.

Part of the explanation is that the number of Scots surviving the four most common cancers has soared during the last 20 years due to earlier detection and better treatment. We are also all living longer and women live longer than men – therefore they are more likely to suffer the effects. As for the future, the number of over-85s is expected to increase by 110 per cent by 2034, meaning the challenge of dementia is only heading in one direction, putting more of a strain on services that are already under-funded and under-staffed.

In its reaction to the latest figures, Alzheimer Scotland said the data underlined the importance of co-ordinated action - some of which has already been taken. The Scottish Government has laid out several strategies for improving care and support, one of the most important of which is the aim of developing dementia-specific education and training for health and social care professionals. However, overall, there is still very little evidence of the systemic and sustained approach to dementia that is desperately needed.

One of the priorities should be to improve community health and social care and keep people out of hospital, where they can become frailer and more confused. The Government has already started to tackle this with the establishment of health and social care partnerships but there are serious worries over a lack of proper funding, even though investment in better social care would save money in the long run.

Much more can also be done on prevention. Scientists at Glasgow University have recently discovered how a brain injury sustained in a sporting or car accident can develop years later into dementia – we need more research of this kind. Dementia check-ups should also be routine as we get older so problems can be identified as early as possible. And of course every Scot needs to know what they can do themselves to reduce the risks by eating and drinking well and exercising regularly.

All of this needs to be part of a coordinated strategy so we can better prevent dementia as well as improve the lives of those who are living with it. The latest national records have shown the dementia time bomb is ticking louder than ever in Scotland – we need a coordinated, systemic and above all well-funded strategy to prevent the situation from getting a good deal worse.