Canada’s national dementia strategy is aimed at advancing dementia prevention, research, and care provided to individuals with dementia and their caregivers. This strategy is guided by 5 principles, which we covered in a previous post in December 2019, as well as 3 national objectives – which are as follows:
“ 1. Prevent dementia
2. Advance therapies and find a cure
3. Improve the quality of life of people living with dementia and caregivers”
Taken from “A Dementia Strategy for Canada: Together We Aspire”: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/dementia-strategy.html
We were fortunate to have the opportunity to ask Professor Nathan Herrmann for his expert opinion and commentary on these 3 national objectives outlined in Canada’s national dementia strategy.
Professor Herrmann is the Richard Lewar Chair in Geriatric Psychiatry at Sunnybrook Health Sciences Centre and the University of Toronto. At Sunnybrook, he is Head of the Division of Geriatric Psychiatry, co-director of the Clinical Neuropharmacology Laboratory, and a scientist in the Hurvitz Brain Sciences Research Program and the Center for Stroke Recovery. With over 530 publications and 130 research grants, Dr. Herrmann is a world leading expert on dementia and Alzheimer’s.
Clinician’s Perspective
The 3 national objectives from Canada’s dementia strategy mentioned above are certainly laudable, though one could be forgiven for being somewhat cynical. After all, the era of Alzheimer’s disease therapeutics is now over 40 years old, and all we have to show for these efforts are 4 drugs (donepezil, galantamine, rivastigmine, memantine) that are modestly effective at best. These drugs do not prevent Alzheimer’s disease, nor do they halt progression of the illness. Unfortunately, there have also been a very large number of drugs and vaccines that have failed in spite of promising preliminary results and sound theoretical basis. We are constantly reminded that what works in rat brains, may not necessarily work in human brains! These failures have had significant consequences, and a number of the large pharmaceutical companies have decided to withdraw from Alzheimer’s disease research believing it is too risky.
And yet, there is reason to remain optimistic. There is good reason to believe that non-drug treatments like exercise, mentally stimulating activities, dietary changes, management of cardiac risk factors including blood pressure, alone and in combination, can improve cognition and perhaps delay onset of dementia. It is estimated that by finding a treatment which delays the onset of Alzheimer’s disease by as little as 5 years, we could cut the prevalence of the illness in half!
Improving the quality of life of for people with dementia and their caregivers is an equally important objective. There will not be a cure found tomorrow, and so we must still deal with the over half a million Canadians that already suffer from the disease. Being a caregiver for people with dementia is a ‘hazardous profession’ as these individuals are at high risk for burn-out, depression and multiple medical illnesses. We must work to discover the best way to provide education and support for patients and their families in order to ease the burden and optimize their quality of life.
Nathan Herrmann MD FRCPC
Professor, Faculty of Medicine, University of Toronto
Lewar Chair, Geriatric Psychiatry
Head, Division of Geriatric Psychiatry
Sunnybrook Health Sciences Centre
