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We must confront our dementia challenges now

Every year, thousands of Canadians receive the news that they, or someone they love, have been diagnosed with dementia, the start of personal and challenging journeys in navigating the health system while maintaining their quality of life. For loved ones who become care partners, a diagnosis of dementia can turn their lives upside down as they learn to juggle home, family and caregiving responsibilities that become increasingly demanding as the disease progresses.

According to a new report from the Alzheimer Society of Canada, this will be occurring with greater frequency as our country’s population ages and the last of the “baby boomer” generation reaches the age of 85. The report, Navigating a Path Forward for Dementia in Canada, is the first in the three-volume The Landmark Study and the first significant update of Canada’s dementia forecast since 2010. Using microsimulation modeling from the Canadian Centre for Economic Analysis, the report provides a province-by-province forecast of dementia diagnoses expected over the next three decades. Among the key findings:

  •           More than 1 million Canadians are forecast to be living with dementia by 2030. This figure will climb to 1.7 million by 2050
  •           In 2020, 8.4 per cent of Canadians over 65 had some form of dementia. By 2050, when all the “baby boomer” generation is over the age of 85, the percentage of Canadians over 65 living with dementia is expected to increase to 13.2 per cent.
  •           The number of women experiencing dementia is projected to continue to be significantly greater than the number of men. In 2020, an estimated 61.8 per cent of dementia cases (352,000) in Canada were women. This gap between the sexes is projected to widen to 63.1 per cent in 2050.

The report also highlights the role of care partners, who are often the spouses and/or children of those living with dementia. Their role is likely to get increasingly difficult over the next 30 years. The report notes that: care partners for people with dementia provide an average 26 hours of caregiving per week compared to 17 hours per week for seniors with other health issues, according to information provided by the Canadian Institute for Health Information (CIHI).

Data from the CIHI also has shown that 58 per cent of care partners are the adult children of people living with dementia, 32 per cent are spouses and the remaining 10 per cent are made up of family, friends and community partners. Often known as the “Sandwich Generation,” adult children serving as care partners often face the responsibility of caring for both their own families and parents. This can leave care partners feeling overwhelmed and at a higher risk for burnout.

There are issues we must be prepared to confront. Finding solutions requires the commitments of all levels of government and Canadians themselves on an individual basis to make changes to their day-to-day lives.

At the federal level, the Government of Canada must fully cost and fund the National Dementia Strategy to ensure it meets its three objectives of preventing dementia, advancing treatments to find a cure and improving the quality of life for people living with dementia. This means providing at least $100 million annually to meet the Strategy’s goal of increased funding for dementia research, including work in strengthening health-care systems and health promotions.

The most important action that can be taken comes at the individual level.

Our provincial and territorial governments can support efforts to create new community care and long-term care spaces that are dementia-friendly and provide additional funding for home care and long-term care spaces that will be needed to deal with the expected surge. At a time when our rural and remote areas are facing shortages of health-care services, provinces and territories must offer more help for care partners living in these areas, who often have little or no access to dementia supports and programs.

Even municipal governments have a role to play. Local leaders can play a role in promoting dementia-friendly communities in which social programs and health-care initiatives are available to help reduce the loneliness and isolation that is often part of life for many seniors. Urban planning efforts can include increased accessibility and signage in new buildings or existing spaces to help citizens with a wide range of health issues, including dementia.

But the most important action that can be taken comes at the individual level. While the causes of dementia are still unknown, research has shown that adjusting a person’s modifiable factors can potentially delay the onset of dementia. This means keeping up with regular physical activities and monitoring and treating other health issues like blood pressure and cholesterol levels as needed. More brain-health specific factors include staying social by having regular interactions with family and friends, addressing hearing loss and engaging in activities that stimulate the brain and encourage learning. Others can be found on the Alzheimer Society of Canada website.

The payoff of these risk-reduction efforts at the individual level, along with increased supports from all levels of government, has the potential to be profound. The report points out that delaying the onset of dementia by one, five or 10 years could lead to the following results:

  •           Even a small delay of one year could result in almost 500,000 fewer new dementia cases by 2050 and make a significant difference in national dementia rates across the three decades. If the onset of dementia could be delayed by 10 years, more than 4 million new cases of dementia could be avoided by 2050.
  •           Delaying the onset of dementia could also have an impact on care partners. If the onset of dementia were delayed by 10 years, it could reduce the number of caregiving hours needed by almost 1 billion hours per year.

None of these initiatives will lead to an immediate short-term decrease in the number of people living with dementia. We at the Alzheimer Society know that the only way to reach our objective of creating a world without dementia is through research into the causes of and treatments for dementia in all its forms. However, the steps identified in our first report, along with the subsequent two volumes of The Landmark Study, will help chart a course for treatments and strategies that will allow people living with dementia to enjoy the best possible quality of life.

 

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  • Rob Murray says:

    I agree with the article but wish to point out that medicine has lost its way and there are no researchers or pathologists with advanced microbiological skills looking for the root cause of diseases. In medicine the dead shall speak to the living but autopsies are expensive and no longer done unless violence or very unusual circumstances are involved. Historically inflammation was usually found to be caused by microbes. Medicine is now being driven by shareholder values and shareholders are not interested in cures, new antibiotics or vaccines. The paradigm of modern medicine is to palliate with expensive treatments that provide lifetime annuities to the pharmaceutical industry. No pharmaceutical company would want to invent a cure for autoimmune disease, that simply wouldn’t be profitable. Infectious disease doctors are very unhappy with microbes such as Borrelia bacteria responsible for Lyme can cause demyelinating neurological disease and invade the brain and cause Alzheimer’s. In many cases MS just doesn’t look like Lyme, it is Lyme disease. It just depends on which specialist you see and what lens they are using. Medicine has known about this for over 40 years thanks to the work of pathologist, Dr. Alan B. MacDonald and confirmed by Judith Miklossy in 2011 but chosen to look the other way. -“The greater the ignorance, the greater the dogma.” -Osler

    This amazing article by STAT science writer, Sharon Begley explores a tragic but accidental mistake that was made with Alzheimer’s.
    SPECIAL REPORT The maddening saga of how an Alzheimer’s ‘cabal’ thwarted progress toward a cure for decades, Begley S, Stat 2019-06-29: https://sp-foundation.org/news-resources/news-article-archive.html/article/2019/06/29/special-report-the-maddening-saga-of-how-an-alzheimer-s-cabal-thwarted-progress-toward-a-cure-for-decades

Authors

Joshua Armstrong

Contributor

Dr. Joshua Armstrong is a researcher with the Alzheimer Society of Canada and author of The Landmark Study.

Saskia Sivananthan

Contributor

Dr. Saskia Sivananthan is the Chief Research and Knowledge Transfer and Exchange Officer with the Alzheimer Society of Canada and co-author of The Landmark Study.

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