WHEN I worked in a long stay hospital the ward sister pointed out an elderly lady. She did not look any different from the others.

She was sitting, staring into space and not talking. She was occasionally incontinent and did not recognise her family.

"She was the first woman to graduate from one of the Oxford Colleges when they first allowed women in," I was told.

Dementia is a common problem in South Devon.

In the early stages the person may live alone. The family find it hard to offer support, but she refuses to admit there's a problem. The GP visits but she insists: "I'm fine dear."

However caring the family, phone call after phone call asking the same question can be wearing. And things can only get worse.

The confusion will progress. Sometimes worried staff at care homes ring the GP. "She's deteriorating, not eating and losing weight. Surely something can be done?" they ask.

Not all confusion is dementia and someone whose memory is deteriorating will need tests to make sure she is not suffering from another disease such as an underactive thyroid gland.

If it is dementia, treatment may slow the disease down but there is no cure.

This week the Alzheimer's Research Trust published a report on the costs of dementia to the country and compared these costs to other diseases such as cancer, stroke and heart disease.

They also looked at how much money is being spent on research for all the different diseases. And the results explain some of the problems we face here in South Devon.

Dementia is common, affecting 821,884 people in the UK. Torbay has the highest prevalence of dementia in England affecting two per cent of the population.

In a typical Torbay practice of 10,000 patients, there will be about 200 with dementia. The rest of Devon also has a high rate of 1.67 per cent of the population making Devon the fifth highest in England.

On average every patient with dementia costs the country £27,647 per year. This is far higher than the costs of cancer, stroke and heart disease which cost £5,999, £4770 and £3,455 a year.

In Devon, Cornwall, Somerset and Dorset the overall cost of caring for people with dementia comes to more than £1billion a year.

But how did they come to these figures? Surely the Alzheimer's Research Trust is likely to come to the conclusion that more money should be spent on Alzheimer's research?

There are many separate costs. The health costs alone are massive, estimated at £1.2billion.

Half this figure is spent on hospital admissions. More than a third of patients with dementia are in long term care at a cost of another £9billion a year. I was pleased to see they have also included the cost of time spent by the GP team.

But they have also looked at hidden costs. These include the cost of the 1.5billion hours put in by unpaid carers which they value at £12.4billion a year.

There is no simple solution. Dementia is not one disease. There is a tendency to use the word 'dementia' and 'Alzheimer's disease' synonymously.

Dementia is a symptom and can be caused by many different diseases. Alzheimer's disease is only one cause.

The other common cause in the elderly is 'vascular dementia'. Here the blood supply to the brain is affected, often through recurrent strokes. Some other diseases can lead to dementia such as Parkinson's disease and the later stages of Down's syndrome.

Dementia research is not as glamorous as research into heart disease or cancers. Treatment is not yet as successful, although there has been some progress.

A young woman with cancer will, understandably, have more sympathy than an elderly, confused lady, but we need to invest in research into dementia and we need to ensure people dealing with this problem are adequately trained.

The cost of dementia is both human and financial. Further research may bring down both costs.