Canada is not prepared to handle rising rates of dementia as its population ages, according to a new study by the national seniors’ advocacy organization CanAge.
In its Dementia in Canada report, released on Oct. 18, CanAge warns Canada will face an influx of dementia patients large enough to overwhelm its healthcare system between now and 2050.
Meanwhile, it finds Canada is falling behind in the global race to deal with the complex needs of a rapidly aging population. According to 2021 census data, people 85 and older are now one of the fastest growing demographics in the country.
More than seven million Canadians are currently over 65. In most provinces, that works out to one in six people. So while one sixth of the global population is expected to be over the age of 65 by 2050, Canada has already reached that milestone. In some provinces, the number is closer to one in four.
“Given that the risk of dementia doubles at age 85 to 25 per cent, the window of opportunity to get ahead of an inevitable health care crisis is growing alarmingly slim,” the report reads.
The report follows the release of the World Health Organization’s Global Action Plan on dementia in 2017, which was intended to spur a co-ordinated worldwide approach to addressing the projected growth in people living with cognitive decline.
Part of Canada’s problem, explains CanAge CEO Laura Tamblyn Watts, is that it lacks health-care providers trained in geriatrics who can diagnose dementia early. In 2016, only two out of five Canadian doctors felt well-prepared to manage community dementia care. And while there was one pediatrician for every 2,822 children in 2020, that same year there was one geriatrician for every 20,905 seniors, or 327 geriatricians total.
“We know that, to the degree treatments are available, they must be given early on, and that (is because) the few medications we have only work at the beginning part of the diagnosis,” Tamblyn Watts told CTV’s News Channel on Wednesday.
She said other interventions, including social supports, also work best when applied during the early stages of dementia. However, because there are so few health-care providers specialized in geriatrics and cognitive decline in Canada, relative to the number of seniors, getting diagnosed with dementia early is a challenge.
“In cases where we can’t even get a diagnosis, the challenges are even bigger,” Tamblyn Watts said.
The CanAge report finds dementia specialists tend to be focused in key urban centres, placing aging populations in remote and rural communities, as well as those in other marginalized communities, at greater risk.
“Many people are concerned about getting a formal diagnosis because many people…feel they’re being actively discriminated against. Those feelings are real and based in evidence,” Tamblyn Watts said.
A WAY FORWARD
In order for Canada’s health-care system to manage the inevitable rise in dementia rates, the report calls for timely access to a diagnosis, physicians with dementia training and innovative treatments and technologies for patients; better support for caregivers; and better support, training and access to guidance for health-care workers.
Canada released a national dementia strategy in 2019, making it one of only 39 United Nations member states to do so. However, the CanAge report states there aren’t clear guidelines for how provinces and territories can implement the strategy and measure its success, and that many provinces and territories lack their own clear dementia strategies.
CanAge recommends the federal government collect better data on the prevalence, risk factors and effects of dementia in Canada to better support its strategy. It also suggests the strategy should be updated to include an implementation plan with clear success criteria, and a clear plan for working with the provinces and territories to carry out the strategy locally. It also states the federal government should work to more efficiently transfer funding to the provinces to manage health-care system capacity, labor shortages and dementia support.
“We need to make sure we’re putting dedicated supports aside for health-care providers so they can get the continuing training they need to support their client base that is aging,” Tamblyn Watts said.