Annual Report 2017-2018

Looking ahead, getting ready

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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

Table 6
Prevalence of cognitive disorders among Francophones aged 65 years and over 70
Region 2016 2028
Ontario 10,718 14,648
Central 2,916 3,986
Eastern 4,016 5,489
Northeast 2,651 3,623
Northwest 182 249
Southwest 952 1,301

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.

  1. Alzheimer Society of Canada, Prevalence and Monetary Costs of Dementia in Canada. Toronto, 2016, p. 70.
  2. Feldman, H. and Carole A., Estabrooks, The Canadian dementia challenge: ensuring optimal care and services for those at risk or with dementia throughout the country. Canadian Journal of Public Health. 108 (1), 2017, p.95-97.
  3. Canadian Institute for Health Information (CIHI), Canadian Care Reporting System: Profile of Residents in Continuing Care Facilities 2015-2016.
  4. Tranmer J. E., Croxford R., Coyte P.C, “Dementia in Ontario: Prevalence and Health Services Utilization”, Canadian Journal on Aging, 22 (4), 2003, p. 369-379.
  5. Regional Geriatric Program of Toronto (2012). Frequently Asked Questions about the Regional Geriatric Program of Toronto.
  6. Ministry of Health and Long-Term Care, Developing Ontario’s Dementia Strategy: Discussion Paper, Toronto, 2016, p. 60.
  7. Prevalence is calculated on the basis of 2016 Census data and projections developed for this annual report. Cognitive disorder rates were provided by the Alzheimer Society of Canada (2016).
  8. Alzheimer Society of Ontario (August 2012). Dementia Evidence Brief: Ontario. Toronto.
  9. Bowen, Sarah, Impact des barrières linguistiques sur la sécurité des patients et la qualité des soins, Report prepared for the Société santé en français, August 2015.
  10. Savard, J. et al., “Évaluation métrologique de la mesure de l’offre active de services sociaux et de santé en français en contexte minoritaire”. Reflets : Revue d’intervention sociale et communautaire, 20(2), 2014, p. 83-122.
  11. Bowen, Sarah, Op. cit.

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