This story is part of CBC Health’s Second Opinion, a weekly analysis of health and medical science news emailed to subscribers on Saturday mornings. If you haven’t subscribed yet, you can do that by clicking here.
Parminder Raina stepped up his workouts when he realized just how important the activity could be in preventing or forestalling dementia.
Raina now hits the gym five times a week for aerobic exercise like running and cycling, as well as strength training.
As the scientific director of the McMaster Institute for Research on Aging at McMaster University in Hamilton, Raina works to understand why some people age in a healthy fashion and others don’t.
“I have become much more prudent in my own behaviour,” said Raina, who is in his early 60s.
Researchers believe that better nutrition, physical activity and socialization that can improve heart health also tend to boost brain health and could at least delay dementia. Previous studies suggest that heart conditions may cause brain changes that increase the risk of stroke and dementia.
To understand why heart health could ease the challenges of aging, including boosting brain health, Raina and his colleagues are examining the issue from multiple perspectives.
Parminder Raina says research findings motivate him to strive for a healthier lifestyle, despite the challenges. (Ousama Farag/CBC)
Raina also heads up the Canadian Longitudinal Study on Aging (CLSA), a large, long-term research project on about 50,000 individuals who are between the ages of 45 and 85 when they are recruited.
Teams of researchers follow the subjects for at least 20 years with regular questionnaires on health, finances, social aspects, lifestyle, medications and nutrition.
The researchers will also explore whether providing people with information about better nutrition helps motivate them to improve their diet.
Some participants come in for appointments every few years to measure their blood pressure, lung function, bone density and other metrics.
Dementia not a normal part of aging, doctors say
Dementia is a collection of symptoms affecting brain function such as a decline in memory, planning and language, as well as physical and mood changes. Dementia is not a normal part of aging, doctors say, and Alzheimer’s disease is the most common type.
For dementia, the CLSA studies will help update Canada’s estimates on how common it is. In 2020, almost 477,000 Canadians aged 65 and older were living with dementia, according to the Canadian Chronic Disease Surveillance System.
A recent longitudinal study based on the U.K. Biobank of more than 356,000 participants in England and Scotland aged 40 to 69 looked at a wide range of risk factors for young onset dementia that develops before age 65, as well as other chronic diseases.
Dr. Roger Wong says there’s a relationship between physical mobility impairments such as trouble walking and poorer brain health, including dementia. (UBC)
The Biobank researchers found associations between a variety of conditions, including stroke, diabetes, heart disease and depression, and an increased risk of young onset dementia.
Dr. Roger Wong, a clinical professor in geriatric medicine at the University of British Columbia, works with people with long-standing conditions like dementia.
“What I say to people and their loved ones is that what is good for the body is good for the brain,” Wong said.
“There are things that every one of us can do regardless of age to prevent dementia.”
Take a combined approach
Wong pointed to a recent CLSA study from Raina’s team at McMaster that found a close relationship between physical mobility impairments such as trouble walking and having more difficulty with brain health, including dementia, and vice versa.
The investigators use traditional tests like a timed walk or grip strength to assess how impairments relate to brain health.
Some participants in the CLSA don wearables like accelerometers to measure their steps. Scientists hope the objective measures will help further clarify the associations between walking and dementia risk.
For now, Wong suggests taking a combined approach to preventing or forestalling dementia: Exercise in a group setting so that you can socialize at the same time — think dance, playing pickleball or group walks — because of the strong signals from observational studies like the CLSA and U.K. Biobank.
WATCH | Traumatic brain injury a risk factor for dementia:
One more fight? Boxer lends brain to head trauma research
13 days ago
Duration 10:50
After years of training, sparring and fights, top-ranked boxer Claire Hafner is about to discover the toll the ring has taken on her brain health. She’s part of a groundbreaking study of living athletes that hopes to better understand head trauma risks — and help athletes figure out when it’s time to quit.
Dr. Marie Pigeyre, an endocrinologist at Hamilton Health Sciences, treats adults with diabetes. She agrees with Wong about the importance of long-term, observational research.
Pigeyre, an assistant professor of medicine at McMaster, received a grant recently from the Canadian Institutes of Health Research (CIHR) to study potential markers in the blood. The goal is to better understand the relationship between lifestyle, certain fat deposits and cognition.
Pigeyre and her team use questionnaires that assess participants’ cognition as well as blood tests and advanced MRI scans to look for early changes in small blood vessels to track consequences of blood flow in the heart and brain.
“This little [blood] vessel abnormality can change how your heart is contracting and … so it could affect how as well how the blood flow is going up in your brain.”
Enough oxygen?
Some people may not have any symptoms of dementia, but the tests sometimes show that parts of the heart and brain aren’t getting as much oxygen as they should. Pigeyre’s research has found that these early abnormalities can be traced back to fat deposits surrounding the internal organs, known as visceral fat.
Scientists have found visceral fat to be more active in increasing inflammation that causes diabetes and coronary artery disease than fat in the legs and buttocks. That’s why apple-shaped bodies are thought to be more damaging to health than pear-shaped bodies.
Given that about one-third of the population doesn’t exercise, the lack of physical activity raises concerns for their risk of dementia and other health issues as they age, Raina said.
WATCH| A family adapts to dementia:
Handling dad’s dementia: One family’s journey
6 months ago
Duration 6:14
A study from the Alzheimer Society of Canada predicts that the number of people in Canada living with dementia will triple within three decades. We follow one family who have been on this journey for a few years, as they prepare for the transition from home care to long-term care.
The Canadian Physical Activity Guidelines recommend that adults should get at least 150 minutes of moderate to vigorous-intensity physical activity every week, which can be in 10-minute intervals.
“Walking and doing some level of movement is good for you in many ways and I think we just have to come to terms that it’s not an all-or-none phenomena,” Raina said.
As data from the CLSA starts to come in, Raina said it motivates him to strive for a healthier lifestyle, despite the challenges.
“I eat better,” Raina said. “I try to sleep better because as a researcher, you are prone to not take care of yourself like any health-care professional. I was sleeping four to five hours a night because so much work had to be done.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
