Madam Chair, members of the committee, I would like to thank you for inviting me to speak on the issue of chronic diseases related to aging. As a researcher, I feel it is important that I tell you how my work and the work of my colleagues could be useful to your study of this issue. As you probably know, the first baby boomers were born in 1946 and they turned 65 in 2011. This year therefore marks some major demographic changes that will shape the social, economic, and medical landscape in Canada.
In Canada, one person out of five will be over 65 years old by 2026. The number of people over the age of 65 will be higher than the number of those under 15 in 2015. This is already the case in Quebec, New Brunswick, Nova Scotia, Newfoundland and Labrador, and British Columbia. Those are the kinds of changes Canadian society will be facing based on these demographic changes. Canada will have to work particularly hard in order to meet the needs and expectations of those seniors who built today's society so that they can continue to play a key role in the world of tomorrow. I think it is urgent that we put aging at the top of our priorities, and I thank you for undertaking this study.
I am going to make three points in my remarks. First, the importance of training, second, chronic cognitive issues associated with aging, in particular those caused by Alzheimer's and similar illnesses, and finally, the importance of prevention for healthy aging.
I would like to begin by underscoring how important it is to provide our future health professionals with better training. Individuals who care for the aged often have insufficient tools to do so. One could think that that is no longer the case and that our university and college institutions are now training our students to meet the challenge of aging, but it is most likely not the case in many areas in Canada. In 2011, the geriatrics committee of the Réseau universitaire intégré de santé de l’Université de Montréal undertook a survey that showed that aging is not sufficiently covered in most of the training programs of future physicians and health professionals.
Therefore there hasn't been a true change within our educational institutions. That has to be changed through a two-tiered strategy. Professionals already working have to be trained—that's professional development—but aging must also be included in the university curricula. This change has to be multidisciplinary because aging implies changes from a health point of view but also from a psychological, social, economic and sociological point of view. This will obviously inform how we are going to prevent and treat chronic illnesses. In order to deal with this complexity and diversity related to aging, we have to take a pluri-professional approach to health and include physicians as well as professionals and practitioners working in the areas of social and economic sciences and the humanities.
I would now like to speak about the prevalence of cognitive issues that accompany chronic diseases related to aging. A very broad study on the health priorities of Canadian seniors was undertaken by a researcher from the Institut universitaire de gériatrie de Montréal, Cara Tannenbaum, and it covered 1,500 women. The study showed that the priorities of female seniors dealt more with conditions that can prejudice their quality of life rather than diseases that can be life-threatening to them. For example, these women stated that memory issues were at the top of their health priorities. They also identified factors that limit their mobility, such as falls or osteoporosis, and vision problems. What was quite troubling was that these women also stated that health professionals do not pay enough attention to those factors, and in particular, to their concerns about memory and Alzheimer's.
This study demonstrates that we have to pay particular attention to both care and research and the policies on those diseases that can cause memory or cognitive problems for seniors.
The decline in cognitive function is one of the most worrying consequences of aging, and its repercussions are manifold. You probably know that if we reach age 65, 2 out of 10 people—about 5 people here—will have Alzheimer's disease or a related disorder.
Today, half a million Canadians have Alzheimer's disease, and every five minutes a person develops the disease. Just during our meeting, nearly 25 new people will be diagnosed with it in Canada. Clearly, Alzheimer's disease causes significant, long-term disorders, which greatly affect quality of life and for which we have no cure. The disease also affects caregivers, who are often elderly themselves and who go through a lot of distress and exhaustion.
Currently, Canadian researchers, including me, are investing their time and their passion in trying to better understand this disease, but there remain many questions without answers. We do not know what the causes are yet, which makes it difficult to find medication to treat or eliminate it; we do not diagnose it well yet. Currently, there's no sure marker of the disease while the patient is alive, and studies that have looked at the brains of people diagnosed with Alzheimer's disease indicate that many of them had in fact another disease. This is a significant problem when we try to find effective medication, because when we assess the effectiveness of medication, we do it in people who have very different diseases and who do not necessarily have Alzheimer's disease. It is therefore absolutely crucial to be able to find ways to better diagnose the disease.
Another significant problem has to do with the fact that this disease develops silently during many years and that we currently diagnose it much too late, when the disease has already devastated patients' brains. For this reason, many researchers believe that we must try to establish a "pre-clinical" diagnosis, that is before the person has significant memory problems. This is very crucial because we will have to be able to identify patients rapidly and early when we have found the medication.
The pitfall for early diagnosis is that our current techniques are imperfect. Some are not sensitive enough, while others identify people as being at risk for Alzheimer's disease, when in fact they will live a very long time and die without developing the disease. Ethically, it will be important to ensure that we do not stigmatize people by diagnosing them early and inappropriately.
For these two diagnostic problems, my team's work indicates that combining memory tests, simple neuropsychological tests and neurological brain exams will be the most promising way of contributing to a correct diagnosis, but only research will help us identify these tests.
There is also hope in the methods of intervention. One of the very great advances in recent years has been to show the extraordinary plasticity and reorganization abilities of the human brain, even when it is aging. Researchers already knew that children had this plasticity, but studies have recently shown that brain plasticity also exists in older people. With aging comes the loss of cells, the brain loses cells, but the brain compensates by recruiting other areas to perform the cognitive tasks requested of it. My team has shown that this brain plasticity, this compensatory plasticity, is present even during the first stages of Alzheimer's disease, and that it can be amplified by relatively simple stimulation programs.
This data obviously leads to significant opportunities regarding research and the care of patients likely to develop the disease. It proves the potential role of brain plasticity in Alzheimer's disease and indicates that, perhaps, lifestyle factors could contribute to delaying the onset of chronic cognitive disorders, such as those caused by Alzheimer's disease.