1. Dementia

It is impossible to deal with aging without addressing dementia because rising life expectancy means an increase in the sorts of cognitive disorders that generally appear around 80 years of age.

Dementia is among the cognitive disorders whose diagnosis is based on signs and symptoms such as memory loss, trouble in performing everyday tasks or problems with language.⁶⁴

Alzheimer‘s disease affects between 60% and 80% of people with dementia.⁶⁵ It is therefore by far the most widespread of these disorders. Moreover, over half of people in long-term care have a form of dementia.⁶⁶ Focusing on this type of disease will therefore shine a light on public health, and the social and economic realities that will affect most Ontarians directly or indirectly.

The care and services provided to those with dementia vary widely, but are increasingly necessary. For example, doctors are consulted more frequently, more prescriptions are issued and there are twice as many visits to emergency or hospitalization. Likewise, over 90% of those diagnosed with dementia have at least two other chronic illnesses. As a result, one often hears people refer to “the domino effect of dementia”.^{67, 68, 69}

65% of people diagnosed with dementia are women. This percentage is expected to decrease.

42% of people diagnosed with dementia are 85 years of age and older. This percentage is expected to increase.

Alzheimer Society of Ontario, 2012

This domino effect will also have an impact on the caregivers of people with dementia, who are five times more likely than other kinds of caregivers to develop psychological distress.⁷¹

For Francophones, specific realities further complicate the situation because, generally speaking, access to health care, patient satisfaction and experience are negatively affected when there are language barriers.⁷²

Patients who encounter language barriers also tend to abandon treatment, and there is also a greater risk of adverse events.⁷³ Health risks increase when language is required to proceed with the patient’s care, such as when the time comes to diagnose dementia, evaluate progress or specify related mental health disorders.

For many seniors, second language proficiency decreases with age.⁷⁴ Stressful conditions may be aggravating factors. Nevertheless, the decline in second language proficiency is worse for patients with dementia.