Number of dementia patients to rise in Canada: study

A new study finds that more services and supports should be tailored to the unique needs of diverse communities, predicting that the number of people living with dementia in Canada will rise 187 per cent by 2050.

With a growing senior population in Canada, the study projects that in 26 years, more than 1.7 million people in the country will likely have the brain disorder, up from an estimated 597,300 people in 2020.

The Alzheimer Society of Canada, a national charity for people living with dementias such as Alzheimer’s disease, released the report on Monday. The organization said it’s one of the first studies focused on gaining better understanding of the many faces of dementia, which is considered a major public health problem in Canada and around the world.

“Understanding the unique needs and experiences of diverse communities is a key step in improving the quality of life for people with dementia and their caregivers,” reads the study, which is the second of three volumes exploring the demographic, social and economic impacts of dementia in Canada.

“Structural barriers and social determinants of health have had an impact on the brain health of a large segment of the population,” said Dr. Joshua Armstrong, Alzheimer Society of Canada research scientist and lead author of the study, in a press release. “Our findings highlight that we need to adapt how we help everyone – including Indigenous, racialized and younger adults – live with dementia, while supporting access to care, diagnosis and prevention tools for all.”

Armstrong wrote in an email to CTVNews.ca that “poverty has been associated with an increased risk for neurological conditions, while those who are wealthy or live in a well-off region tend to have better health outcomes.” 

He said the aging population is mainly driving the increased number of people living with dementia.

“Furthermore, many communities and populations can experience a higher risk of dementia, higher rates of certain dementia risk factors, or greater barriers to dementia care and diagnosis,” Armstrong added.

“However, more research is needed to fully understand the trends and care needs of these populations in Canada. These communities include various ethnic and racialized groups; 2SLGBTQI+ individuals; people living with intellectual and developmental disabilities, including Down syndrome; people who are incarcerated; people who are under-housed; and people living with substance use disorders.”

Stigma, discrimination seen as barriers

The Alzheimer Society of Canada said the impact of dementia “will be felt across borders, sectors and cultures.” It called for more work to fight stigma, discrimination and stereotypes.

“We have to work together to make diversity and inclusion part of a more holistic approach to dementia prevention and management,” said Natasha Jacobs, advisory group lead for Alzheimer Society of Canada who helped take care of her grandfather, originally from Guyana, after he developed young onset dementia. “We have often isolated racialized families, or those who have immigrated here. Fear plays a large role in why folks do not reach out for assistance in a timely manner. Support that recognized my family’s needs would have made all the difference for us.”

The report highlighted that young onset dementia, which affects people under age 65, also poses challenges. Consequently, diagnoses are often delayed and it’s tough to get workplace accommodations.

The number of people under the age of 65 with dementia in Canada could rise to more than 40,000 people by 2050 from an estimated 28,000 in 2020, the study suggests.

The study uses self-reported data from the 2016 Statistics Canada census and other research to estimate the impact of dementia in Canada over the next 30 years. It uses a simplified model by assuming only one ethnic origin of individuals, though many Canadians often report more than one ancestry.

Patient demographics expected to change drastically

The population profile of dementia patients in Canada is projected to significantly change by 2050.

In 2020, nearly two-thirds of people with dementia were of European ancestry. The remaining third were people with other ethnic origins such as Canadian, American, Asian, Indigenous, African, Caribbean, as well as Latin, Central and South American.

The study projects that in 26 years, the fastest growth in dementia patients among ethnic groups will occur for individuals of Asian origin. One out of every four individuals with dementia will be of Asian origin, increasing from eight per cent in 2020 to 24 per cent in 2050, the study noted.

The proportion of dementia patients with European and Canadian origins is projected to decrease by 2050, while more people with Indigenous, Caribbean and African ethnic origins are expected to develop dementia.

“These shifts reflect the diversity of older adults in Canada. With changing immigration patterns over the past number of decades, we are seeing a shift in the landscape of who develops dementia in Canada in terms of ethnicity and race,” the study explained.

Recommendations to improve care

The study recommends health systems and professionals “develop resources to better match the diversity of the population.”

For example, it suggests undertaking more research on racialized groups with dementia to improve how to meet both the care needs of patients and the needs of those who care for and support them.

As well, “culturally safe, accessible, and relevant resources and training” for health-care professionals would be important.

Racism in health care and social support systems should be addressed along with improving the collection of reliable, national race-based data on brain health and dementia, Armstrong added.

“Overall, these findings highlight the need to address, capture, and study diversity in all domains of dementia,” the study noted. “From research studies to care systems, we need to work toward more inclusivity to optimize health and health care for all.”

The researchers acknowledged that these findings are only starting to “scratch the surface” about how dementia affects ethnic and racial groups in Canada.

“Through intentional design, Canadian policies, programs, services and supports need to be tailored to meet the different needs across groups,” they concluded.