‘It’s Never Too Late’ to Fight off Risk of Dementia as You Age

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07/16/2021

Photo: DARRYL DYCK/The Globe And Mail

theglobeandmail.com

Every day, Christine Elsey takes vitamins, maintains a healthy diet, practices yoga, and walks up to five kilometers. The 68-year-old swims in the ocean near her home in Deep Cove, B.C., year-round and, even though she retired from teaching at the University of the Fraser Valley this year, she will continue in her role as secretary of the New Democratic Party in her riding and has a book in the works.

As she ages, Ms. Elsey is determined not to be among the growing number of Canadians who suffer from dementia.

“I just think getting into the more senior years is a wake-up call,” she says.

For the past several years, she cared for her former partner and father of her children as he has struggled with Parkinson’s-related dementia.

Two years ago, he moved into long-term care.

“I know what he’s gone through,” she says. “And I’m in that care home quite a lot, so I see what’s around me and what people are going through. It’s really troubling.”

There are 564,000 people in Canada with dementia, the broader category of cognitive impairment that includes Alzheimer’s disease, according to the Alzheimer Society of Canada. Every year, 78,600 new cases are diagnosed, according to a national dementia strategy released by Health Canada in 2019.

There are many different risk factors, including lifestyle, environment, and genetic background, says Josée Guimond, the society’s director of research, knowledge translation, and exchange.

“Risk factors, on their own, don’t cause disease. Rather, they represent an increased chance of getting a disease, but it’s not a certainty,” says Dr. Guimond. “And some of the risk factors are modifiable, meaning they can be changed.”

It’s estimated that around 40 percent of dementia cases may result from modifiable risk factors including physical activity, avoiding smoking and excessive alcohol consumption, and keeping blood pressure, cholesterol, blood sugar, and weight within recommended ranges.

A healthy diet, maintaining social connections, reduced stress, and challenging the brain with new learning are also key factors, she adds.

“It’s never too late to make these changes,” Dr. Guimond says. “Recent research shows that rates of dementia are actually going down, so we may be doing a better job at managing some of these risk factors than we have previously.”

Prevention is the number one national objective of Health Canada’s dementia strategy.

At the Institute on Aging and Lifelong Health’s Cortex Lab at the University of Victoria, neuropsychologist Mauricio Garcia-Barrera and his colleagues are recruiting adults aged 65-plus to study the relationship between physical and mental exercise, memory, and cognitive acuity.

Participants in the executive function improvement training (eFIT) study take part in 10-minute video exercise classes with an added element of cognitive stimulation in the form of a card game. They will use an app to self-assess daily their mood, sleep, health, and well-being.

“We are very interested in how plastic the brain is as we age,” Dr. Garcia-Barrera says.

While dementia can’t be stopped entirely, several preventive measures have proven to delay the onset and severity of symptoms, he says.

Physical activity is one of those measures, but research shows that the most important is to engage the brain in new learning, he says.

“When you are taking courses and all this novel learning, you have a little bit stronger wiring in the brain. It creates a little more resistance in the brain system,” Dr. Garcia-Barrera says.

“As we age, that’s exactly what the brain needs – to be engaged, to keep a little bit of the reserve and the resiliency that is very preventative and protective of dementia.”

As the baby boom generation ages, Canada is heading toward a dementia crisis, he says.

“The number of people who are going to be 65 and up is incrementally increasing by the year. In a few years, we are going to have a lot of people who are living healthier lives longer, so we also have a number of them developing signs of dementia,” he says. “There is a big concern.”

By 2031, total health care costs and out-of-pocket caregiver costs of dementia in Canada are projected to reach $16.6-billion annually, according to Health Canada.

While prevention is possible and there is the possibility a treatment will emerge, Canadians need to plan financially for health concerns such as dementia as they age, says Cathy Fletcher, a certified financial planner at Caring for Clients in Toronto.

Ms. Fletcher went through the progression of Alzheimer’s disease with her mother and knows first-hand the challenges, including financial.

“As part of overall retirement planning, plan for and anticipate the possible expenses that you might incur in the later years of your retirement,” she says.

Those savings could make the difference in being able to live independently longer, she says.

“Ignoring the impact of possible future health care expenses can be a really tough place to be in your later years if you lose some of the choices around staying at home and just hiring some extra help and that type of stuff,” she says.

However, don’t avoid spending money on activities that maintain healthy aging, such as a university course, gym membership, or classes, she advises.

“That’s part of what keeps you healthy longer – staying fit, staying active and keeping your brain active and engaged and keeping social, not isolating yourself,” she says.

Ms. Fletcher also advises older adults to make sure they have their affairs in order. That includes an updated will and power of attorney for both property and personal care, which grants someone you trust the right to make decisions on health care for you if you can’t speak for yourself.

An advanced care directive may also be beneficial, which details what your wishes are in terms of end-of-life care, she says.

“The most important part is to communicate with your family. Make sure they know where everything is and make sure they know what your wishes are,” she says.

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