Alzheimer’s and aging: A look at the facts and future

As busy professionals, many of us take on extra roles. For example, we care for our aging parents in addition to juggling careers and young families, a group known collectively as the “sandwich generation.” Over the next couple of decades, the “sandwiches” are going to become increasingly thin.

The proportion of older adults in developed countries is steadily increasing; it is estimated that by the year 2026, approximately 20% of North America’s population will be 65 years of age or older. This figure is especially important given the simultaneous drop in the number of people available to support the aging population. The potential support ratio (the number of persons 15-64 years old per one person aged 65+) will fall from the current 9-12 people to four people by 2050.

In light of Alzheimer Awareness Month, I wanted to take a look at brain health in relation to the aging population.

Brain health is foundational to people’s well-being and their ability to lead independent lives. Brain disorders vary greatly and encompass diseases such as depression, Alzheimer’s or even chronic pain. Most people know someone affected by a condition related to the brain or nervous system, as brain-­related illnesses afflict more than two billion people worldwide (source: The Neurotechnology Industry 2011, NeuroInsights).

While increased age is a disproportionate risk factor for a number of major health disorders, the subjective memory complaints of older people do not necessarily correlate with true current or future cognitive abilities. Instead, many older adults’ subjective memory complaints are thought to reflect disorders that are often treatable, such as depression, as well as an individual’s own anxiety and lack of knowledge about the aging process.

For older adults, the most important factor influencing the ability to cope effectively with both normal and abnormal memory decline is a sense of control, which, in turn, is significantly influenced by anxiety. There is a global fear of deteriorating brain health; Alzheimer Europe’s July 2011 report shows Alzheimer’s disease as the second most feared disease (after cancer) in four of the five nations studied.

Dementia in Canada

The incidence rate for dementia is high (in Canada, it affects one in 11 adults aged 65+), and the suffering is long for both the patient and his/her family: 4–8 years on average for the most common form of dementia, Alzheimer’s, with 40% of those years spent in the most severe stage of the disease.

With the economic burden of dementia in Canada estimated at $15 billion/year currently and forecast to grow to more than $153 billion/year by 2038, there is a powerful economic rationale for seeking a cure.

Early assessment, along with science-based interventions, promise to play a critical role in reducing the impact of all levels of age-related cognitive impairment. For example, helping individuals affected by early-stage cognitive impairment to remain independent could potentially prolong the period before which they are diagnosed with dementia. And the Alzheimer Society of Canada estimates that delaying the onset of diagnosis by two years would result in potential cost savings of $219 billion over 30 years and a 36% reduction in disease prevalence.

Unfortunately, the results of a new survey from the Alzheimer Society show that Canadians are dismissing symptoms of dementia as just “old age,” missing out on valuable early interventions.

The silver lining

But it’s not all doom and gloom. It turns out, there is a silver lining to getting older: despite high levels of stress, people in their 40s, 50s and early 60s generally have a happier outlook than their younger counterparts, which fuels a positive cycle of brain health. Researchers at the University of Toronto have also recently found the first evidence that lifelong naturally occurring experiences such as speaking a second language contribute to the integrity of white matter, which may provide a neural basis for “brain reserve.”

Canadian institutions and aging

It seems, then, that nature has given us a miraculous tool: the brain “software” can change the brain’s “hardware.” I wonder if the “hardware” of our institutions can also change in response to our aging society?

We spend roughly one-third of our lives at work. Chronic diseases cost more than $50 billion in lost productivity in Canada in a given year, a figure that will continue to grow, unless we take proactive steps to keep our aging population healthy.

To highlight the actions being taken to address these issues, the upcoming 2012 Business of Aging Summit will examine them through two lenses:

• Care—Working longer in good health by preventing and addressing chronic illnesses
• Career—Navigating career transitions while balancing personal and family circumstances, such as caring for aging family members