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The Hon. Pana  Merchant, B.A. Appointed to the Senate by the Rt. Honourable Jean Chrétien, Senator Pana Merchant represents the province of Saskatchewan and the Senatorial Division of Saskatchewan. She has served in the Senate of Canada since December 12, 2002.

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Impact of Dementia on Society

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Statement made on 28 June 2010 by Senator Jane Cordy

Hon. Jane Cordy:

Honourable senators, I wish to thank Senator Carstairs for her inquiry calling the attention of the Senate to the impact of dementia on Canadian society.

As Senator Carstairs stated in her speech to this chamber, within a generation the numbers of Canadians suffering from Alzheimer's disease or dementia will increase from 500,000 to 1.1 million people. The costs of care for dementia-related diseases will rise from $15 billion to $150 billion, and the number of hours provided by informal caregivers will increase from 231 million hours a year to more than 756 million hours a year.

Honourable senators, today in Canada someone will develop dementia every five minutes. If things do not change, in 30 years time there will be one new case every two minutes. These are huge numbers and we, as Canadians and as parliamentarians, should be concerned.

Canadians often believe that dementia happens naturally as one ages, but we now know that lifestyle plays an important role in who may get dementia. Indeed, experts are calling for an increased emphasis on health promotion as studies are showing the correlation between lifestyles and dementia.

It has been shown that diet also plays a large role in the prevention of dementia. For example, not smoking, not drinking too much and having proper nutrition are factors that help to prevent this degenerative disease. As well, a healthy diet is seen as a good way to keep the mind healthy and to avoid dementia. We can diminish the risks by eating proper diets, maintaining good health and generally living healthier lifestyles. We must urge Canadians to get their vitamins and minerals from the nutrition in their diets to protect against dementia. Experts recommend eating foods that are high in fibre, omega 3s as well as eating vegetables and fish. Studies show that the same eating patterns that protect the heart also reduce the risk of dementia.

Exercise has been shown to promote brain health and optimal brain performance. We know that physical activity helps to oxygenate the brain and therefore reduces the risk of getting dementia. Dr. Sandra Black from Sunnybrook Health Science Centre's Brain Science Program explains that people are beginning to understand the need to exercise the brain with mental activity and social engagement to guard against the risks of dementia. A variety of exercise several times a week will increase circulation of blood and nutrients to the brain. Simply changing your walking route can help you to exercise not only your body but your brain, which will help prevent dementia.

We also know that challenging your mind with exercise helps strengthen the brain's abilities and prevents symptoms, reduces the risks of dementia and improves the overall quality of life.

Alzheimer's disease is one cause of dementia and the most prevalent, accounting for 64 per cent of all cases of dementia. The other major cause for this degenerative condition is vascular dementia. This is where a person loses brain function due to a series of strokes, often relatively minor. This can cause progressive changes in personality, mood and cognition.

By taking care of yourself early in life, you can reduce the risk of strokes and therefore the risks of dementia. Studies have shown that there should be increased emphasis on health promotion. High blood pressure, high cholesterol and diabetes are risk factors for developing dementia. If hypertension is detected early and controlled, the onset of dementia can be prevented.

According to the annual report of the Heart & Stroke Foundation, rates of high blood pressure among all Canadians rose 77 per cent between 1994 and 2005. By taking steps to reduce hypertension, the risk of developing dementia will be reduced. Simply having a sense of purpose in life can also reduce these risks. A study from Duke University showed that having intellectually stimulating work in adult life can reduce the risk even further than a good education alone can do. A new report in The Journal of the American Medical Association complements these findings. Therefore, knowing that your life means something and that you have a sense of control of it also helps to avoid dementia.

Activities such as face-to-face conversations, socialization and staying socially active help to prevent dementia. There is also some evidence that people with more social connections and who participate more in intellectual activities seem to have reduced risk. We know that staying socially active in mid-life can also help to reduce the risks of getting dementia in later life.

The final report of the Special Senate Committee on Aging from June 2009 states that the federal government must reach seniors in seniors' centres and clubs, but also must reach out to those seniors who may be socially isolated. In fact, the Honolulu-Asia Aging Study stated that maintaining friendships later in life significantly improves the likelihood of avoiding dementia. The authors of the same study show that depression, education and the number of friends one has can also affect one's risk of developing dementia.

Kieran Cooley, Associate Director of Research at the Canadian College of Naturopathic Medicine in Toronto, suggests that being socially active by connecting with family and friends, joining a club or performing activities with other people stimulates the brain and reduces stress.

Other countries have already taken the initiative to reduce the impacts of dementia. In countries such as Britain, France, Norway and the Netherlands there are developed national plans that focus on early diagnosis, specialized home care, research and prevention on the national level.

There are many reasons for the federal government to create a national strategy to combat dementia. There is a definite need to coordinate health care activities in the provinces and to increase the awareness of risk factors among all Canadians. Canada should create a national plan.

The study Rising Tide: the Impact of Dementia on Canadian Society demonstrates this need for all Canadians and the 500,000 of those Canadians now living with dementia. The Rising Tide study recommends a national strategy, including new investment in research, education and support for family caregivers, more focus on prevention, as well as initiatives to increase the number of geriatricians, neurologist, psychiatrists and advanced practice nurses in Canada. The study suggests that assigning case managers to coordinate home-based care of dementia patients would significantly reduce the strain on individual caregivers.

Honourable senators, it is time to return to simple but effective methods to reduce the enormous financial and emotional burdens on Canadian families caring for their loved ones. Families often struggle to find any way of coping that they can. People with dementia need support and so do their caregivers.

Debbie Benczkowski, interim CEO of the Alzheimer Society of Canada, stated that if the increase of dementia cases remains unchecked, dementia will impose enormous burdens on individuals, families, health care infrastructures and the global economy. Furthermore, the information in the 2009 World Alzheimer Report makes it clear that the crisis of dementia cannot be ignored. Unpaid caregivers provide 70 per cent of care and seniors themselves are often caregivers to other family members.

Jack Diamond, Scientific Director of the Alzheimer Society of Canada, says that caregivers often suffer unnecessarily from uncertainty about what is happening. David Harvey, an Alzheimer Society executive, says that caregivers need education and support, including the ability to drop out of the Canada Pension Plan for several years without financial penalty. Further to this, improved services related to care, available treatments and proper coordination of services can help everyone in the treatment of dementia.

There has been some compelling evidence that we can escape or at least postpone or diminish the severity of dementia. The better we understand it, the more equipped we are to delay or prevent it. It has become necessary to provide services and supports that will allow citizens their dignity and well-being.

Honourable senators, many governments have recognized the importance of focusing on the issue of dementia. Australia, Norway, the United Kingdom, France, United States, Scotland and the European Parliament have developed specific plans or frameworks to deal with dementia. Canada should also develop policies to address the looming crisis. We must act now.

We should each take a personal responsibility for our own health to reduce our risk of dementia. These are lifestyle issues and choices we make. Honourable senators, as parliamentarians, we should also take steps to ensure that Canada develops the strategy to deal with the increased levels of dementia in our country.


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