Statement made on 22 April 2010 by Senator Elizabeth Hubley
Hon. Elizabeth Hubley:
Honourable senators, I should like to express my appreciation to Senator Carstairs for bringing the attention of this chamber to the impact of dementia on Canadian society.
The Alzheimer's Society of Canada has recently released a report entitled Rising Tide: The Impact of Dementia on Canadian Society, which clearly demonstrates how dementia will be an increasing burden on individuals and on society as a whole. Their forecasts predict that, within a generation, the number of cases of Alzheimer's or related dementias will more than double. The hours that Canadians will spend caring for loved ones will increase from 231 million hours per year to 756 million hours per year. The emotional, physical and financial drain on these families is enormous. If nothing is done, it will keep increasing.
Senator Carstairs presented a wonderful summary of the report and recommended actions when she opened this debate a couple of weeks ago. I will not review her points. Instead, today I would like to focus the discussion on an extremely important segment of our society, namely, Aboriginal Canadians.
The first recommendation of the Rising Tide report is an accelerated investment in all areas of dementia research. Nowhere is this more important than in our Aboriginal communities. It seems that, when it comes to dementia, research into Aboriginal groups is lacking. There is a shortage of even basic community-specific statistics on the incidence and impact of dementia. As of now, even the most basic research has not been carried out in these communities.
The Rising Tide report has quantified the potential increasing problem of dementia in the years to come. The number of people living with dementia in Canada is expected to more than double by 2038 to over one million Canadians. Honourable senators, this is the equivalent of the entire population of Saskatchewan suffering from dementia. We cannot be too surprised by this. We know that advancing age is the largest risk factor associated with the onset of dementia and we know the population of Canada is aging. The number of dementia cases can be expected to increase in parallel with this age-bubble making its way through society.
Why, then, have we not heard much about dementia in Aboriginal communities? The sad fact of the matter is that dementia is a condition associated with age and Aboriginal Canadians simply do not live as long as the rest of us. Therefore, they have less opportunity to develop dementia. Does this mean there is less dementia in Aboriginal communities? Can we account for it by this difference in life expectancy? We do not know, because no one has yet done that research.
Another theory that has been forwarded in relation to dementia to our native population concerns the culture itself. In some Aboriginal populations, dementia is considered to be a normal part of aging. Those of us with a western outlook on medicine view dementia as a disease and something to be fought against. In some Aboriginal communities, dementia is simply viewed as one more step in the normal life cycle. This results in the under-reporting of dementia cases in these communities. If it is not viewed as a treatable disease, then why call in a doctor?
Honourable senators, these realities have only masked a problem that will grow in Aboriginal communities. In fact, the Rising Tide report points out that the incidence of dementia cases in the overall population will be growing over the next generation. For Aboriginal communities, this problem will be magnified.
We know that the single largest risk factor for the onset of dementia is age. Aboriginal peoples have been shielded somewhat from this problem because of their lower life expectancy, but that is changing. According to Statistics Canada, in 1975, there was a gap of over 11 years between native and non-native males in this country. By 2000, this gap had closed to 7.4 years. A 2008 study showed it had closed to under five years. For females, it has improved from almost 12 years' difference in 1975 to about six years' difference. The life expectancy gap is improving. Aboriginals are catching up to the rest of the country, but along with this progress comes the increasing problem of dementia. What may have been a rare affliction before — simply because of the life expectancy gap — will become more common.
What else can we surmise from what we know about Aboriginal conditions? Progress is being made on the life expectancy gap, but we know that there are different health profiles between Aboriginals and non-Aboriginals. We know that Aboriginal Canadians suffer from more cardiovascular problems. We know that the incidence of diabetes is higher in the Aboriginal community. Arthritis affects Aboriginal peoples more than the rest of the population, and rates of obesity have been observed to be higher in Aboriginal communities. Cardiovascular disease, diabetes, arthritis and obesity, then, are four problems that affect Aboriginal communities more than the general population of Canada. These same four conditions are identified risk factors for Alzheimer's disease.
Honourable senators, you can understand why, as Aboriginal life expectancy creeps up to the national level, there is concern that dementia will grow to be an even larger problem within Aboriginal communities than in the rest of Canada. Many of the significant risk indicators of dementia are more prevalent among the Aboriginal community than the rest of Canada. However, because of a lack of research into the prevalence of dementia and Alzheimer's disease within our Aboriginal communities, we do not know the current extent of the problem.
However, the Alzheimer's Society of Canada has recognized this knowledge gap and has created the Aboriginal Access Advisory Group. Their aim is to advance the knowledge of the impact of dementia among Aboriginal peoples by trying to bring together the pieces of research and work currently being conducted and to give some direction to future research in this area. I look forward to seeing the results of their work.
In closing, I would like to again thank Senator Carstairs for bringing this important issue to the floor of this chamber.