Mediaplanet: How much of a public health challenge is dementia for Canada? Is the challenge the same for all countries, even developing ones?

Dr. Yves Joanette: Dementia is a devastating health condition that is caused by various neurodegenerative diseases, of which Alzheimer’s is the most common. It is characterized by a progressive loss of autonomy due to the impairment of memory and other brain functions. Every time that one Canadian develops dementia, at least one other Canadian is also affected since the loss of autonomy means that another person -- 80% of them being women -- will play the role of caregiver. Nearly 600,000 Canadians are currently living with dementia and this number will double over the next 20 years due to the fact that age is the main risk factor and that the Canadian population is aging. In 2016, the total of the costs related to the care of people with dementia was $10.4 billion, including that of both the Canadian health care system and additional out of pocket expenses. In the rest of the world, the situation is also dramatic, particularly in developing countries where the number of people living with dementia will more than triple by 2050. The global economic impact of dementia will reach 1 trillion dollars by next year, and 2 trillion dollars by 2030.

MP: What kind of research is needed to face the challenge of dementia?

YJ: There is currently no cure for the different diseases causing dementia. Brain diseases that cause dementia are very complex and they typically start more than two decades before the first appearance of clinical signs. Once the clinical signs of dementia appear, there is still no way to stop or reverse the progression; therefore, extensive research is needed. The research efforts need to be balanced between three main questions: (a) how to identify the initial factors that will ignite a brain disease that will cause dementia, (b) how to slow down or stop the process once it has started, and (c) how to help those living with dementia, and their caregivers, to have the best possible quality of life. Since the magnitude of the challenge is so immense, such that no single researcher, university or country can alone crack the code and come up with the answers and solutions, the research also needs to be collaborative and inclusive of all disciplines and sectors.

MP: How can we help people living with dementia?

YJ: People living with dementia can be helped by a number of strategies that are now known to be effective. First of all, overall good health can help to slow down the brain diseases that cause dementia. A healthy diet and physical exercise are good for both the heart and the brain. Second, maintaining and enhancing cognitive activities (i.e. playing games that challenge the brain, or learning a new language or musical instrument) are known to delay or slow down the progression of the disease. Third, maintaining a rich social network of friends, family and neighbors, as well as living with an optimistic attitude can also have positive effects. Fourth, providing support to the caregivers is important, as their role is critical to the health and well being of the person living with dementia. Finally, enhancing the awareness of dementia in society, and understanding the needs of those living with dementia, will help them to enjoy an active presence in society as long as possible (i.e. working, shopping, etc.).

MP: Can you tell us about the most promising research occurring in Canada?

YJ: Research on dementia in Canada is supported by provincial and federal funding agencies, as well as charitable organizations. At the federal level, the Canadian Institutes of Health Research (CIHR) leads the national Dementia Research Strategy. The Strategy brings together the best of Canadian researchers from universities and research centers in all provinces in order to work together on: (a) preventing the diseases that cause dementia, (b) stopping or reversing the diseases that cause dementia, and (c) identifying the best solutions to support the health and wellness of those living with dementia. The flagship initiative of the Strategy is the Canadian Consortium on Neurodegeneration in Aging (CCNA), which brings together 350 of Canada’s best researchers to work on these objectives. The Strategy also supports research collaboration with other countries, including the USA (Alzheimer's Disease Neuroimaging Initiative – ADNI) and European countries. In 2012, Canada was the first non-European country to establish a collaborative research effort with European countries through membership in the EU Joint Programme – Neurodegenerative Disease Research (JPND).

MP: How does research in Canada compare with the rest of the world?

YJ: The efforts of Canada in dementia research are well recognized and valued, and Canada is considered amongst the top countries in the world in this regard. The collaborative approach supported by the national Dementia Research Strategy is quite unique and is starting to be copied by other countries, including the United Kingdom and Australia. The key characteristics of Canada’s research efforts are its integrated and collaborative nature, as well as the inclusion of the gender-based dimension that will help to understand the reasons why women tend to develop dementia more often than men.

MP: Is there a global response to the challenges of dementia? Where does Canada fit in?

YJ: The World Health Organization considers dementia to be one of the most important public health challenges. In May of this year, all member countries of the WHO will be invited to adopt a Global Action Plan for dementia. Another prominent global organization is the World Dementia Council, which was created in 2013 by the former Prime Minister of the United Kingdom, David Cameron, as an investment in the cause for dementia. A Canadian (YJ) currently chairs the Council, so Canada is truly at the forefront of the global response to the challenge of dementia.