Canadian Health System is Very Strained With the Old-Age Diseases But There are Hopes on New Cures

New Pathway.

An average Canadian is aging. In 1920, life expectancy for Canadians was 59-61 years (males-females), which reached 77-82 years in 2000 and 81-83 years now. Simply because more people are living to the old age, increasingly more people are being exposed to the type of diseases that occur in that age. Doctors say that it is unusual for someone to come into their nursing home on only one medicine – elderly unfortunately often deal with multiplicity of chronic diseases. Dementia is one of the problems. There are estimates that, in the next 25 years, in Canada there will be 1.1 million citizens who will be affected by dementia. At the age of 65, roughly 4% of people have dementia. This number goes up to 15% in the community of 85-year olds and to 30% among those who are 90-year old.

The New Pathway asked Dr Peter Derkach, Medical Director at both the Ukrainian Canadian Care Center and West Park Long Term Care Center, how the Canadian medical system is coping with this growing issue. Dr Derkach is giving a lecture on Alzheimer and other dementias on Sunday, October 30 at the Plast Huculak Centre within the Living with Dignity series of information sessions for Ukrainian Canadian seniors organized by Ukrainian Canadian Social Services Toronto Branch. The Living with Dignity series is offering information about ways to improve well-being of seniors, including medical, psychological, financial and legal advice.

Dr Derkach believes that the system is very strained: “The government began to recognise 20-30 years ago that there will be an explosion of dementia related diseases and a huge increase in demand for nursing and retirement homes, that it will be a financial burden. So they created more social programs and increased the number of beds in long-term care homes. The problem is that those beds fill up very quickly. And every time they add more beds, they fill up and again there is a long waiting list to get into these nursing homes. And there are many patients in the hospitals that are occupying an active bed – they are treated within the first couple of weeks but they could be there for months, waiting for a bed in a nursing home. There is a huge bottleneck and it’s a huge burden on the hospitals, social services and families. These people have to wait but sometimes they can’t wait. Some start to wander around and the police bring them back, they leave the stove on and do very dangerous things. Some develop neuro-psychiatric symptoms. Those people are probably the most difficult to treat – they can’t sleep, they have huge amounts of unexplained anxiety, hallucinations and many physical problems.”

All is not lost for people with dementia, as Dr Derkach says: “There are three specific drugs in one family of medications and there is a fourth one that works by different mechanism. Both of the groups work on the brain, the neurotransmitter called acetylcholine. Those medicines in 25% of the cases can show mild improvement. In 50% of cases there is no improvement, but the patients stay the same longer. It is important because it slows the progression of the disease. And in the last 25% of the cases the medicines don’t do anything. Not all people can tolerate those medicines – there are side effects. So, the combination of using the three medications along with the fourth one can make a difference, one can delay entering a nursing home by several years.”

We asked Dr Derkach if there are any breakthroughs in dementia cure in the pipeline. He said: “There is a lot of research going on, more than ever before. The government recognizes that in the future we will need to make significant breakthroughs in how to control this disease because the financial trajectory (building the nursing homes, providing the support) will be massive. The researchers are gaining a better insight into how dementia develops, they know how different steps occur chemically, and they are trying to tailor certain medicines to interfere at those particular steps. There is a protein called beta-amyloid and the current thinking is that Alzheimer’s disease occurs because of abnormal accumulation of amyloid. A lot of research has been directed towards how you can remove it, break it down and prevent it.”

Are there any lifestyle and dietary choices that can prevent or reduce the risk of dementia? Dr Derkach said that healthy lifestyle can go a long way in preventing this type of disease: “40 minutes of exercises, five days a week starting from your earlier years can reduce your risk of getting a dementia by 50%, which is huge”. We also asked Dr Derkach about a concept, which some people believe in, that aluminium causes Alzheimer’s. Dr Derkach: “A long time ago there was a concept that aluminium, which was leaching from cooking pots and pans, would cause the disease. But these days we know that it is probably not true. Some of the evidence came from aluminium toxicity from companies spilling their heavy metals into rivers and lakes, and then people using that water for drinking. There were well-known cases of aluminium-induced dementia from that pollution, but other type of heavy metals can also cause disease. For instance, too much iron is not good either. In alternative medicine there is a process where they leech the iron and other heavy metals out of one’s blood called chelation therapy. But this process is not proven to be consistent – it helps some people and doesn’t help others.”

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