'We are not prepared': New analysis of dementia data points to alarming trends

The last two decades have seen an increase of almost 50% in patients with dementia, according to a new analysis of Ontario health insurance billing data.During a media briefing led by the Ontario Medical Association, which undertook the analysis, OMA president Dr. Andrew Park noted the actual incidence of dementia is likely even higher “as some patients might be treated for other things or have not yet received the diagnosis.”Dr. Park cited a study by the Alzheimer’s Society of Canada, which predicted that by 2050 about 1.7 million Canadians will have dementia—three times today’s estimated total of 600,000. This means that in about 30 years, about 685 Canadians will be diagnosed each day with dementia.“We are not prepared to meet their needs,” he added. “This is an issue that needs urgent attention from all levels of government so people can get the care they deserve and our healthcare system can withstand rising pressures.”The OMA has asked the Ontario government to increase available care in the community for patients with dementia. Dr. Park pointed to Alzheimer Society analysis that found Ontarians with dementia needed 2.5 million home care visits in 2020—but only 82,000 such visits actually took place.Instead, dementia care in Ontario has been taking place primarily in institutional settings such as hospitals and long-term care facilities. This needs to change, said Dr. Park, and expanding care in the community would be a step in the right direction.This will help patients with dementia stay longer in their homes—closer to their families—while freeing up hospital beds for other patients.“One significant cause of hospital crowding is a lack of access to home care, long-term care and palliative care,” said Dr. Park.Read: Lifestyle changes can reduce dementia risk by maintaining brain plasticity—but the time to act is nowDelayed diagnosis is a big contributing factor to the growing problem of dementia. Dr. Alexandrea Peel, a geriatrician in Wingham, Ont.,—about 120 kilometres north of London—said patients referred to geriatricians and other specialists, such as those with expertise in memory assessment, can wait months before they’re seen. This often results in a late diagnosis of dementia.This delay in referrals, and consequently diagnoses, can be blamed on the shortage of specialists in dementia care, said Dr. Peel.“In Canada, the number of children is the same as the number of older adults, but there are 10 times more pediatricians taking care of children than there are geriatricians taking care of older adults,” she said.Family doctors play a critical role in advancing patients towards diagnosis—notwithstanding the long waitlist for referrals—said Dr. Linda Lee, a family physician specializing in care of the elderly.“If people are concerned about their memory (or) if others are concerned, then take that seriously and at least begin some of the investigations,” she said. “There are tests that can be done. There are some locations with memory clinics that would have access to multidisciplinary teams that could take the next step.”Taking action, especially with patients with early memory loss, gives family doctors an opportunity to make a difference.“Those opportunities include interventions,” said Dr. Lee. “We’re recognizing potentially treatable conditions and interventions that might make a difference.”Read: Alzheimer’s drugs might get into the brain faster with new ultrasound tool, study showsA report released in 2022 by the Alzheimer’s Society of Canada highlighted regional differences in dementia rates and forecasts. Ontario, Quebec, British Columbia and Alberta are predicted to have the biggest increases by 2050, due in large part to their younger and faster-growing populations.Ontario, which currently leads the country in dementia rates—Quebec is a close second—is expected to have a 202% surge in dementia rates between 2020 and 2050, according to the society’s report, with 1.5 million new cases of Alzheimer’s dementia, 680,000 of vascular dementia and 780,000 of other types of dementia.This percentage increase puts Ontario above the national predicted increase of 187% between 2020 and 2050.A big challenge in Ontario is the lack of “centralized responsibility” for dementia and frailty care, said Dr. Peel. Instead this care must be coordinated between various ministries and agencies, who don’t always work together effectively. A proposed law—Bill 121, Improving Dementia Care in Ontario Act—currently awaiting second reading in the Legislative Assembly of Ontario, would call for one coordinated body to provide strategic direction for dementia and frailty care in the province, said Dr. Peel.“That coordinated body would need control of funding and deliverables, provide clinical expertise and have participation from all ministries,” she said. “Key components to a dementia strategy would include streamlined and timely access to diagnosis—ideally within three months—timely access to required testing and treatments, specialized interdisciplinary dementia care support and education as well as long-term follow up throughout the dementia journey and access to flexible home and community care support services to meet their care needs at home.”Read: How to help your patients with dementia and their carers

'We are not prepared': New analysis of dementia data points to alarming trends

Register for free access or login.

Related Topics