Why should we care about the effects of dementia on Canadians in the 21st century ?

In a time where the prevalence of dementia is spreading like wild fire, it is a must to be aware that our chances of being cursed with dementia in our mid-sixties are not the same as previous generations. We should care about the effects of dementia because of the gravity of the symptoms, the lack of solutions and the projected burden it will cause to our population. The gravity of dementia’s symptoms on an individual’s quality of life are ultimate. Even with significant research being done on this matter, there is no cure to dementia and no known ways to counter its progression (World Health Organisation 2012). In addition, we all know how important a normal functioning memory is to our Canadian life style. After all, life without memory results by deduction to a life without quality.

Memory is a complex system that is being researched by multiple groups in various disciplines. The assumption that memory is physical is quite misleading; memory is not physical, neither a mere simple neurological connection, the term memory refers by definition to a four step process consisting of collecting, storing, retaining and finally retrieving information (Goldstein, B. 2004). This process is well explained by the modal model of memory: information catches our attention, our attention is our sensory memory, hence step one of all memories is information entering our sensory memory. If the information received is deemed important we will shift it towards the short term memory (STM). Once step two has been completed, we can output the information or if we still need to remember, it goes to the long term memory (LTM). This is accomplished using a rehearsal process and the transfer of information from the STM to the LTM process called information storage operation, this is done to enable us in retrieving the information when needed (Atkinson & Richard, S. 1968)

No one wants to live a life with no identity, no remembrance and no control over what is going on. There is no way of predicting this illness, the diagnostic means that the impact to a person’s functioning is no longer enough to give stability and control of life to this person, in some cases this can be dangerous for this individuals own safety. To elaborate, dementia is a mental health problem that demolishes an individual’s cognition. This causes critical memory disturbances, and its onset is caused by an etiological physiological problem or is linked to ongoing substance abuse effects (American Psychiatry Association, 2000). In addition, contrary to popular beliefs Alzheimer's disease (AD) is a sub category of dementia; knowing this makes the illness more apparent since it is quite common to encounter information or witnesses of AD, this because Alzheimer's disease is the most common form of dementia(American Psychiatry Association, 2000). Someone may be diagnosed with dementia professionally by a psychologist, psychiatrist or a neurologist if the damage to an individual’s memory is severe enough to affect that person in a multitude of aspects (e.g. work, friends, regular tasks like how to use a phone or how to lock a door...). Furthermore, there must be a clear negative correlation between present and previous levels of functioning. One might ask himself, how can you know if someone’s memory is becoming worse? According to the DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, If one does not learn new and/or remember old knowledge (E.g. does not learn his new address, does not recognise his kids, forgets his birthday, forgets his name) there has been an impact on that persons levels of functioning, their quality of life is spiraling out of control.

What is life if one cannot remember his past or learn his future, this rises empathy and is a strong moral compass to push further questioning on this topic. The four main symptoms of dementia are critical, aphasia which can be explained by an alarming language disturbance, apraxia meaning a problem with motor functions, agnosia defined by not being able to recognise objects and disturbance in executive functioning explained by the loss of abilities linked to organization, planning and carrying out a set of assignments in a effective way (APA, 2000). Together these four symptoms are the source of collapse in this person’s life, causing major deterioration to an individual’s social, professional and personal life. If one compares previous levels of functioning to the levels affected by severe dementia, an individual that was previously always on time taking the same bus everyday to work can now not only not recognise the bus, but also not know where the bus stop is, and by miracle if this person got on the bus because a humanitarian helped him, he would not have the motor ability to pay his fair and this if he evens remembers what money is! It is quite obvious that there is a giant problem here, not only does the requirements needed for a diagnostic mean it’s too late to help but also ‘’The disease is gradually progressive, with median survival being 6–11 years after symptom onset and 3–4 after diagnostic’’ (APA 2013).

The equivalent of a dementia diagnostic is a life sentence with no parole; there is no cure, no solutions, no stopping its progression, it is irreversible and will follow an individual till his last breath. This is major and plays the role of a significant motivating force to researchers of this subject. I strongly believe that a effective solution finding plan, would start with the localisation of the environment or stimulus leading to dementia, this will help us know what is the cause and directions we must concentrate on. Once this is done it will facilitate the creation of strong hypothesises to be researched, we also need a massive amount of data on individuals before the onset of dementia progression, this should in principle help us see the areas affected and the interaction in-between dementia and the brain. Finally we must searching for a prevention method, but what is the purpose of all this research if one does not present it to the specialists all over the 9,984,670 km covered by Canada, furthermore it is key to have the research peered reviewed, criticized and challenged by other theories and findings. ‘’An Ounce of Prevention Is Worth a Pound of Cure: Improving Research Quality Before Data Collection’’ should be the main focus of research on dementia (Herman, A. and Robert, J.V., 2013). A defiantly shocking fact is that to this day there is no coordinated plan between provinces on what path our nation will take to help raise the quality of life for patients with dementia (Kenneth, R. 2010), this is shocking especially since the average prognosis on the survival rate after diagnostic is 10 years (APA 2013).Today dementia’s care is mostly taken in charge by psychiatrists, psychologists and neurologists the following assisted by other health care workers. In the present time the province in Canada with the best approach is Ontario, having 36 dementia care societies and a somewhat clear approach to the problem called Alzheimer’s Knowledge Exchange offering multiple programs like their most popular one the PIECES program(Kenneth, R. 2010). These programs also offer education and knowledge to individuals seeking to understand or help people living with dementia (Kenneth, R. 2010). Even if Canada is leading the wolf pack in research and discoveries on this matter we are not very close to finding a cure (Kenneth, R. 2010), in fact many things about memory are still a mystery, this is why we need to change our way of thinking about this problem to find a clear path towards solving this issue. In addition research and care should be coordinated between provinces facilitating the transmission of knowledge and assistance that we can all add as fellow Canadians.

The unknown is a major fear we all share. This is why projections help enlighten us on long term topics like dementia. They help us grasp what is to expect if the situation stays the same. The prognostic of dementia are not favorable, there is an estimated growth in the number of individuals affected and if we do not act on this lead a very big obstacle will await us in the near future. This year there is an estimated 747 000 individuals with cognitive disabilities and it is forecasted that by 2031 there will be a giant increase of almost 200% raising the number of affected people to nearly 1.4 million Canadians (Canadian Institutes of Health Research, 2013). Even a individual that is lacking of empathy or willingness to help the ones in need assistance, pays taxes and would appreciate paying less taxes to have better savings and live a more prosperous live this is after all a major goal of all Canadians. There is a extremely high correlation between time moving forward and heavy tax payer investment, since this is a medical cost covered by Medicare. Like it or not this emphasises the importance of finding a feasible and reliable solution since this implicates all of us, hence we should all care. To elaborate metaphorically, we are all on the same boat in the middle of the ocean, the engine is out and we are all stuck, if we all get involved we can help speed up the process of fixing the problem. The current investment in dementia is 15 billion dollars this year alone, due to the expected inflation of dementia affected people this number is expected to reach 153 billion dollars a year by 2038 (Alzheimer Society of Canada. 2010).

To conclude, the universal emotion of fear is innate and powerful, the unknown is a source of major fear to us humans. Lets avoid facing the unknown by informing our self’s, lets care about this life sentence distributed by nature to innocents. As Canadians we must all apprehend the astonishing effects caused by dementia on our population, we can achieve this by paying attention to the lack of solutions and if one is still not convinced he must foster the knowledge of the raising chances of developing dementia, after all they are raising day by day . The quaternary of symptoms, aphasia, apraxia, agnosia and executive functioning cause critical damage to one’s life, the impact is only worsen since its negativism is transmitted the daughter that is not recognised by her own father or the mother affected by dementia that thinks her grandkids are strangers. It is trough research that we will find the key to unlock the doors of curing and stopping the onset of this mental decay. This research of course needs improvement and organisation it is a process that must be worked on but at least it is present giving us a foundation to work on. With a increase of 200% in cases of cognitive disturbances and the major inflation of all Canadians funding via taxes the future does not looks bright, but together asking the right questions and demanding the right answers we can make change, innovate the future. To conclude you must ask yourself the following question, as a person that is becoming older every day, what will happens when you enter the age of onset and you face higher chances of dementia then our previous Canadian generations, will you think that others should care?

Written by: Tarek Benzouak

Reference

Alzheimer Society of Canada. 2010. Rising Tide: The impact of dementia in Canada. Available: http://www.alzheimer.ca/english/rising_tide/rising_tide.htm

American Psychiatric Association(2000) Delirium, Dementia, and Amnesic and Other Cognitive Disorders IN Michael B.F.(Eds.) Diagnostic and statistical manual of mental disorders : DSM-IV. — 4th ed. (pp. 123-163). Washington, DC: American Psychiatric Association

American Psychiatric Association. (2013).Neurocongitive disorders In Diagnostic and statistical manual of mental disorders (5th ed.). doi: 10.1176/appi.books.9780890425596

Atkinson & Richard Shiffrin 1968 the information available in brief visual presentations psychological monographs74, pp. 1-29

Pam Denicolo (ed.), Achieving impact in research, Sage Publications Ltd: London, 2014; 192 pp. ISBN 978-1446267059,

World Health Organization, Dementia Fact sheet N°362. (2012, April 1). Retrieved November 10, 2014, from www.who.int/mediacentre/factsheets/fs362/en/

Goldstein, B. (2004). Long-Term Memory: Structure In L. Schereiber-Ganster (Eds.), Cognitive Psychology: Connecting Mind, Research And Everyday Experience (pp. 146-169). Belmond, CA: Cengage Learning.

Information about Alzheimer's and related dementias. (2013, December 5). Retrieved November 10, 2014. http://www.cihr-irsc.gc.ca/e/45554.html

Rockwood, K.,(2010). Special Issue: The challenges of dementia: An international perspective, IN International Journal of Geriatric Psychiatry 25(9), pp. 876-880.