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April 17, 2018

Tackling Dementia

Reuel S. Amdur

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Eight per cent of the population age 65 and older is afflicted with Alzheimer's or some other dementia. However, the rate rises dramatically as people get older. Over 400,000 Canadians are currently demented.

These things were laid out recently at Ottawa’s Good Companions Centre at a presentation by a panel of speakers arranged by the Canadian Institutes of Health Research.

There were four speakers at the session, in addition to Dr. Yves Joanette, who moderated.  Phyllis Fehr, the first speaker, has Alzheimer’s.  She still functions well in spite of her illness which is still in an early phase.  It was she who first noticed the problem, particularly around memory.  Even her husband had no idea of it. 

Fehr tries to slow the progress of the condition down by exercise—in her case, archery—and by taking medication.  She emphasized the importance of early treatment, adding that in spite of the diagnosis, “Life is not over.”  However, there is a social stigma which needs to be addressed.

She was followed by Dr. Howard Chertkow, Scientific Director, Canadian Consortium on Neurodegeneration in Aging.  The good news, he said, is that we are living longer.  Then came the bad.  The 8% figure “doubles if there is a history of dementia in the family.” 

Diagnosis is difficult.  One technique is to use mental tests, such as the Montreal Cognitive Assessment, which Donald Trump is reported to have aced.  Other diagnostic tools are extremely expensive, such as the PET (positron emission tomography) and testing of spinal fluid.

The consortium is seeking new treatments, but more fundamentally it is still searching for causes and measures for prevention.  In the here-and-now, he noted, “There are not optimal supports for home care and long-term care for people with dementia.” 

CEO Pauline Tardif of the Alzheimer Society addressed social factors.  “Before there is a cure, there is a need for care.”  She noted that dementia affects people in different ways.  Not everyone is the same.  Yet they all require help.  It takes two or three people to support each person afflicted.  As a result, people, predominantly women, drop out of the workforce to provide care.  This fact has significant social and economic implications.  As for the caregivers, they need better support.

Tardif echoed Fehr’s concern about stigma.  She reported on a survey in which people were asked how they would feel about having dementia.  46% would feel ashamed.  How would they feel, she asked, about having cancer?

Dr. Theresa Tam, Chief Public Health Officer, Public Health Agency of Canada, spoke of our growing longevity.  The challenge is in making these extra years good years.  Numbers having dementia will double every 20 years, two-thirds being women.

She stressed the importance of prevention, for things that may be useful: physical activity, nutrition, and mental health.  And physical activity includes brain activity.  Dr. Chertkow had mentioned knowledge of languages as exercising the brain. 

While attention is now being paid to making communities age-friendly, they should also be dementia-friendly. 

And finally, she remarked that dementia is not a normal part of aging.

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