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Nearly one million Canadians projected to have dementia by 2030, new report

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Nearly one million people in Canada are expected to have dementia by 2030, an increase of more than 65 per cent from 2020, according to the projections of a new report from the Alzheimer Society of Canada.

And unless measures are taken to reduce the risks and delay the onset of the condition, close to 1.4 billion caregiving hours – the equivalent of more than 690,000 full-time jobs – will be required annually to support the 1.7 million Canadians who will have dementia by 2050, the report, published Tuesday, said.


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Number of people living with dementia and the number of new cases of dementia per year in Canada, 2020 to 2050

In thousands

New dementia cases

All dementia cases

THE GLOBE AND MAIL, SOURCE: ALZHEIMER

SOCIETY OF CANADA

Number of people living with dementia and the number of new cases of dementia per year in Canada, 2020 to 2050

In thousands

New dementia cases

All dementia cases

THE GLOBE AND MAIL, SOURCE: ALZHEIMER

SOCIETY OF CANADA

Number of people living with dementia and the number of new cases of dementia per year in Canada, 2020 to 2050

In thousands

New dementia cases

All dementia cases

THE GLOBE AND MAIL, SOURCE: ALZHEIMER SOCIETY OF CANADA

If not much changes to the current trends, the number of people with dementia and the number of people caring for them “is going to be enormous,” said Saskia Sivananthan, chief research officer at the Alzheimer Society of Canada. But this amount of growth is not inevitable, she said. By investing in addressing modifiable risk factors that improve brain health, “as a government and as a country, we can start changing and shifting some of those numbers down.”

The report, titled Navigating the Path Forward for Dementia in Canada, is the first of a series from the organization’s Landmark Study, which uses computer modelling and demographic data from Statistics Canada to forecast the impact of dementia on the country over the next 30 years. Two additional reports, examining the social and economic effects of dementia, will be published in the coming months, the Alzheimer Society of Canada said.

In 2020, an estimated 597,300 people had some form of dementia in Canada, with an incidence rate of 348 new cases diagnosed a day, the report released on Tuesday showed. Common forms of dementia include Alzheimer’s dementia, a later stage of Alzheimer’s disease, and vascular dementia, which occurs from a lack of blood flow to the brain.

There were 350,000 unpaid caregivers for people with dementia, which includes family members, friends and neighbours, in 2020. They provided an average of 26 hours of care each week, totalling 470 million hours of care a year.

Based on current trends, the report said by 2050 both the number of people with dementia and the number of caregivers will nearly triple.

The projections did not account for any potential impact of COVID-19, said Joshua Armstrong, a scientist with the Alzheimer Society of Canada who authored the report. He explained there is a lack of data about how the stresses associated with the pandemic or the virus itself may affect these estimates.

The report, however, showed that improving efforts to reduce the risks and delay the onset of dementia could result in up to millions of fewer cases. If everyone delayed getting dementia by one year, there would be nearly 500,000 fewer new cases by 2050, the projections showed. If everyone delayed getting dementia by 10 years, there would be more than four million fewer new cases by 2050.

Certain risk factors, such as age and genetics, are not modifiable, but the report pointed to various risk factors that are, including lack of education, hearing loss, social isolation, physical inactivity and air pollution. It provided a list of measures people can take, such as being physically and socially active, getting six to eight hours of quality sleep a night, avoiding excessive alcohol use, seeking treatment for depression, avoiding head injuries and using hearing aids, if needed.

Dr. Armstrong emphasized the need for communities, public-health agencies and other governmental organizations to help individuals.

“They’re only modifiable if people have the support and resources to modify them,” he said.

Dr. Sivananthan added it’s important to try to reduce multiple risk factors, since a range of small changes can have a cumulative effect.

The report offered recommendations aimed at organizations, health systems and various levels of government. One is for the federal government to cost out and fully fund the national dementia strategy, a road map that Ottawa released in 2019. Its recommendations for provincial and territorial governments include improving education for all ages and helping workplaces provide flexible support to caregivers.

Roger Wong, a clinical professor in geriatric medicine at the University of British Columbia, said he hopes the report would spur more support for the care of individuals with dementia.

Dr. Wong, who was not involved in the study but chairs the Alzheimer Society of Canada’s research and knowledge committee, also expressed a desire for policy makers to promote research and public education about the issue.

“Now that we know, we have to do something about it,” he said.

Our Morning Update and Evening Update newsletters are written by Globe editors, giving you a concise summary of the day’s most important headlines. Sign up today.

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Toronto reports 2 more measles cases. Use our tool to check the spread in Canada – Toronto Star

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Canada has seen a concerning rise in measles cases in the first months of 2024.

By the third week of March, the country had already recorded more than three times the number of cases as all of last year. Canada had just 12 cases of measles in 2023, up from three in 2022.

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Cancer Awareness Month – Métis Nation of Alberta

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Cancer Awareness Month

Posted on: Apr 18, 2024

April is Cancer Awareness Month

As we recognize Cancer Awareness Month, we stand together to raise awareness, support those affected, advocate for prevention, early detection, and continued research towards a cure. Cancer is the leading cause of death for Métis women and the second leading cause of death for Métis men. The Otipemisiwak Métis Government of the Métis Nation Within Alberta is working hard to ensure that available supports for Métis Citizens battling cancer are culturally appropriate, comprehensive, and accessible by Métis Albertans at all stages of their cancer journey.

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Receiving a cancer diagnosis, whether for yourself or a loved one, can feel overwhelming, leaving you unsure of where to turn for support. In June, our government will be launching the Cancer Supports and Navigation Program which will further support Métis Albertans and their families experiencing cancer by connecting them to OMG-specific cancer resources, external resources, and providing navigation support through the health care system. This program will also include Métis-specific peer support groups for those affected by cancer.

With funding from the Canadian Partnership Against Cancer (CPAC) we have also developed the Métis Cancer Care Course to ensure that Métis Albertans have access to culturally safe and appropriate cancer services. This course is available to cancer care professionals across the country and provides an overview of who Métis people are, our culture, our approaches to health and wellbeing, our experiences with cancer care, and our cancer journey.

Together, we can make a difference in the fight against cancer and ensure equitable access to culturally safe and appropriate care for all Métis Albertans. Please click on the links below to learn more about the supports available for Métis Albertans, including our Compassionate Care: Cancer Transportation program.

I wish you all good health and happiness!

Bobbi Paul-Alook
Secretary of Health & Seniors

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Type 2 diabetes is not one-size-fits-all: Subtypes affect complications and treatment options – The Conversation

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You may have heard of Ozempic, the “miracle drug” for weight loss, but did you know that it was actually designed as a new treatment to manage diabetes? In Canada, diabetes affects approximately 10 per cent of the general population. Of those cases, 90 per cent have Type 2 diabetes.

This metabolic disorder is characterized by persistent high blood sugar levels, which can be accompanied by secondary health challenges, including a higher risk of stroke and kidney disease.

Locks and keys

In Type 2 diabetes, the body struggles to maintain blood sugar levels in an acceptable range. Every cell in the body needs sugar as an energy source, but too much sugar can be toxic to cells. This equilibrium needs to be tightly controlled and is regulated by a lock and key system.

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In the body’s attempt to manage blood sugar levels and ensure that cells receive the right amount of energy, the pancreatic hormone, insulin, functions like a key. Cells cover themselves with locks that respond perfectly to insulin keys to facilitate the entry of sugar into cells.

Unfortunately, this lock and key system doesn’t always perform as expected. The body can encounter difficulties producing an adequate number of insulin keys, and/or the locks can become stubborn and unresponsive to insulin.

All forms of diabetes share the challenge of high blood sugar levels; however, diabetes is not a singular condition; it exists as a spectrum. Although diabetes is broadly categorized into two main types, Type 1 and Type 2, each presents a diversity of subtypes, especially Type 2 diabetes.

These subtypes carry their own characteristics and risks, and do not respond uniformly to the same treatments.

To better serve people living with Type 2 diabetes, and to move away from a “one size fits all” approach, it is beneficial to understand which subtype of Type 2 diabetes a person lives with. When someone needs a blood transfusion, the medical team needs to know the patient’s blood type. It should be the same for diabetes so a tailored and effective game plan can be implemented.

This article explores four unique subtypes of Type 2 diabetes, shedding light on their causes, complications and some of their specific treatment avenues.

Severe insulin-deficient diabetes: We’re missing keys!

In severe insulin-deficient diabetes, beta cells limit production of the keys that unlock cells to allow entry of sugar from the blood.
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)

Insulin is produced by beta cells, which are found in the pancreas. In the severe insulin-deficient diabetes (SIDD) subtype, the key factories — the beta cells — are on strike. Ultimately, there are fewer keys in the body to unlock the cells and allow entry of sugar from the blood.

SIDD primarily affects younger, leaner individuals, and unfortunately, increases the risk of eye disease and blindness, among other complications. Why the beta cells go on strike remains largely unknown, but since there is an insulin deficiency, treatment often involves insulin injections.

Severe insulin-resistant diabetes: But it’s always locked!

A diagram of three closed locks and lots of keys

In severe insulin-resistant diabetes, the locks start ignoring the keys, triggering the beta cells to produce even more keys to compensate.
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)

In the severe insulin-resistant diabetes (SIRD) subtype, the locks are overstimulated and start ignoring the keys. As a result, the beta cells produce even more keys to compensate. This can be measured as high levels of insulin in the blood, also known as hyperinsulinemia.

This resistance to insulin is particularly prominent in individuals with higher body weight. Patients with SIRD have an increased risk of complications such as fatty liver disease. There are many treatment avenues for these patients but no consensus about the optimal approach; patients often require high doses of insulin.

Mild obesity-related diabetes: The locks are sticky!

Illustration of a lock and key

In mild obesity-related diabetes, the locks are ‘sticky,’ making it difficult for the keys to open the locks.
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)

Mild obesity-related (MOD) diabetes represents a nuanced aspect of Type 2 diabetes, often observed in individuals with higher body weight. Unlike more severe subtypes, MOD is characterized by a more measured response to insulin. The locks are “sticky,” so it is challenging for the key to click in place and open the lock. While MOD is connected to body weight, the comparatively less severe nature of MOD distinguishes it from other diabetes subtypes.

To minimize complications, treatment should include maintaining a healthy diet, managing body weight, and incorporating as much aerobic exercise as possible. This is where drugs like Ozempic can be prescribed to control the evolution of the disease, in part by managing body weight.

Mild age-related diabetes: I’m tired of controlling blood sugar!

Illustration of a lock and a beta cell

In people with mild age-related diabetes, both the locks and the beta cells that produce keys are tired, resulting in fewer keys and stubborn locks.
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)

Mild age-related diabetes (MARD) happens more often in older people and typically starts later in life. With time, the key factory is not as productive, and the locks become stubborn. People with MARD find it tricky to manage their blood sugar, but it usually doesn’t lead to severe complications.

Among the different subtypes of diabetes, MARD is the most common.

Unique locks, varied keys

While efforts have been made to classify diabetes subtypes, new subtypes are still being identified, making proper clinical assessment and treatment plans challenging.

In Canada, unique cases of Type 2 diabetes were identified in Indigenous children from Northern Manitoba and Northwestern Ontario by Dr. Heather Dean and colleagues in the 1980s and 90s. Despite initial skepticism from the scientific community, which typically associated Type 2 diabetes with adults rather than children, clinical teams persisted in identifying this as a distinct subtype of Type 2 diabetes, called childhood-onset Type 2 diabetes.




Read more:
Indigenous community research partnerships can help address health inequities


Childhood-onset Type 2 diabetes is on the rise across Canada, but disproportionately affects Indigenous youth. It is undoubtedly linked to the intergenerational trauma associated with colonization in these communities. While many factors are likely involved, recent studies have discovered that exposure of a fetus to Type 2 diabetes during pregnancy increases the risk that the baby will develop diabetes later in life.

Acknowledging this distinct subtype of Type 2 diabetes in First Nations communities has led to the implementation of a community-based health action plan aimed at addressing the unique challenges faced by Indigenous Peoples. It is hoped that partnered research between communities and researchers will continue to help us understand childhood-onset Type 2 diabetes and how to effectively prevent and treat it.

A mosaic of conditions

Illustration of different subtypes of Type 2 diabetes

Type 2 diabetes is a mosaic of conditions, each with its own characteristics.
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)

Type 2 diabetes is not uniform; it’s a mosaic of conditions, each with its own characteristics. Since diabetes presents so uniquely in every patient, even categorizing into subtypes does not guarantee how the disease will evolve. However, understanding these subtypes is a good starting point to help doctors create personalized plans for people living with the condition.

While Indigenous communities, lower-income households and individuals living with obesity already face a higher risk of developing Type 2 diabetes than the general population, tailored solutions may offer hope for better management. This emphasizes the urgent need for more precise assessments of diabetes subtypes to help customize therapeutic strategies and management strategies. This will improve care for all patients, including those from vulnerable and understudied populations.

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