Cases of dementia are rising at an alarming rate, creating a public health crisis. At some point, most of us will either know someone living with dementia or someone who is caring for a person with the disease. As advisors, we must become proactive and purposeful by learning about dementia and its impact on clients. So, here are the latest research updates on the incidence, prevention, and care of dementia.

Dementia Incidence in Canada

More than 700,000 Canadians are currently living with dementia. Every day, at least 350 Canadians are diagnosed with the disease. So, by 2030, one million Canadians will be living with dementia. By 2050, an 187% increase is predicted. In about 25 years, 1.7 million Canadians could be living with dementia. [1]

Dementia is an umbrella term describing over two hundred subtypes of this progressive neurodegenerative disease. While the hallmark of dementia is progressive memory loss, there are also life-altering and ongoing cognitive, functional, and behavioural changes. One of the more challenging aspects of dealing with dementia is that by the time there are enough demonstrable symptoms to confirm a diagnosis, brain damage and changes in brain function have already occurred.

Alzheimer’s is the most common subtype of dementia.[2] Other common subtypes are vascular dementia, frontotemporal lobe, Lewy Body dementia and those associated with Parkinson’s disease and traumatic brain injury. More than 50% of people diagnosed with Alzheimer’s will have mixed dementia, which means in combination with at least one additional subtype.

The Ontario Medical Association recently estimated that 50% of dementias go undiagnosed. Combined with the health human resources issues we are currently facing, patients and their families are not accessing drug therapies to delay the disease or adequately planning for the integrated supportive care that will be required.

Updates on Dementia Prevention

While there is no known cure for dementia, there is growing evidence that addressing certain risk factors can help delay or prevent the disease. The Lancet Commission is a global group of researchers focused on reviewing evidence about the prevention, intervention and care of dementia. Led by researchers at the University College London in the UK, risk factors were first modelled in 2017 and updated in 2020 and 2024.

The researchers concluded that reducing the risk factors for dementia across a person’s lifetime can increase the number of years of healthy life; the earlier and longer, the better. Reducing the risk factors could also delay the onset for those people who go on to contract dementia. [3]

Modifiable Risk Factors for Dementia

The 2017 modifiable risk factors for dementia included the following:

• Education in childhood and later adolescence. Better education is linked to better late-life cognition.
• Head injury
• Physical inactivity
• Smoking
• Excessive alcohol consumption
• Hypertension
• Obesity
• Diabetes
• Hearing loss
• Depression
• Infrequent social contact
• Air pollution

Two additional risk factors were added in 2024:

• Vision loss
• High cholesterol

Care Treatments and Management Updates

Drug treatments have not been very successful; however, significant investments continue to be made in this area. Researchers indicate there is some progress with drug treatment to slow cognitive deterioration, especially in the early stages of Alzheimer’s and Lewy Body dementia. The Lancet Commission notes early progress in amyloid immunomodulator trials to modify the progress of Alzheimer’s disease. [4]

Alzheimer’s and dementia are complex conditions where clear clinical pathways are not well defined. Care partners struggle to deal with an array of circumstances, including diminished capacity. It is also estimated that 97% of patients will develop one or more behavioral disturbances over the course of their disease. Neuropsychiatric symptoms can include a variety of behaviors including depression, psychosis (delusions and hallucinations), agitation, aggression, apathy, sleep disturbances, and socially inappropriate behaviors. These distressing symptoms can often create the most challenges for patients, their caregivers, and providers.[5]

Managing care very much depends on the individual, their environment, and the type of expert support and resources they can obtain. Caring for a person with dementia is more stressful, and frequently, care partners themselves become secondary patients due to the physical and emotional toll.

A 2024 review of dementia prevention and treatment in the Journal of the American Medical Association (JAMA) reports on research indicating that the best care management options continue to be personalized holistic care focused on maintaining physical and mental health and improving the overall quality of life. There is also emphasis on the importance of reducing hospitalizations and planning for the future. In addition, more evidence is noted about the increasing effectiveness of psychosocial interventions for family carers and managing neuropsychiatric symptoms. [6]

In summary, we are facing a public health epidemic with dementia. Health human resources across the healthcare system cannot keep up with the ever-increasing demand for dementia diagnosis and care, and Canadians are only beginning to realize the extent of the crisis. As family members and planning advisors, one of the first steps we can take is to be proactive in educating ourselves and our clients on the extent of the crisis, strategies for prevention, and the realities of care management. Only then can we focus effectively on personalized care planning and the human and financial costs.

[1] https://alzheimer.ca/en/about-dementia/what-dementia/dementia-numbers-canada

[2] Alzheimer’s affects more women than men. Women are also living longer than men.

[3] https://www.thelancet.com/commissions/dementia-prevention-intervention-care?dgcid=tlcom_infographic_demetia-risks-24_lancet

[4] Ibid. Page 2.

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7742723/

[6] https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2815813