In both its impact on lives and its economic consequences, dementia already takes a tremendous toll in Canada – and that cost will only skyrocket.

Research commissioned by the Alzheimer Society (Rising Tide: The Impact of Dementia on Canadian Society – see www.alzheimer.ca) paints an alarming picture. Over the next 30 years in Canada, the number of people living with Alzheimer’s disease and related dementias is expected to grow from just over 480,000 to over 1.1 million. And the number of new annual cases will go from about 104,000 to 258,000.

What will fuel such an increase?

Number one, the Canadian population is aging, and age is the biggest risk factor in developing dementia. As we make progress in preventing and treating conditions like cancer and cardiovascular disease, Canadians are also living longer – but again, that means a rise in dementia. Improved awareness of the disease is also contributing to the increase in people identified as living with dementia.

With the growing numbers will come a rapidly mounting economic burden. Today, that stands at $15 billion – direct costs like providing care, long-term care/nursing homes, medication, etc.; indirect costs like the reduction in labour productivity due to dementia; and opportunity costs like the wages unearned by caregivers.

The cost is already staggering, and the economic burden is forecast to double every decade, so in 30 years it could reach $153 billion.

That’s the future we face – if we take no action. So how can we improve the management of Alzheimer’s disease and other dementia, and possibly ease the pressure on the health care system?

The first thing we need is a comprehensive plan – a pan-Canadian strategy for addressing dementia at the national, provincial and territorial levels.

The most crucial aspect is to accelerate investment in all areas of dementia research – treatments and (ideally) a cure, to be sure, but also research into effective ways of developing health promotion, and delaying the symptoms of the disease.

Health promotion is critical. We know that physical activity and healthy eating have a positive effect on your brain, and that keeping socially connected is one antidote to the progress of dementia. Clearly, preventing or delaying onset of dementia would have an enormous impact on stemming direct costs.

Beyond prevention, early intervention and education is vital. The earlier the diagnosis, the better equipped people with dementia (as well as their family or other caregivers) will be to cope. That alone can reduce the burden on society, by lowering, for instance, the need for long-term care.

Unfortunately today, most people with dementia aren’t diagnosed until the disease is well along and symptoms are severe.

One reason is that people suffering from signs of dementia (and their families) can become afraid or embarrassed, and fail to seek attention from the health care system. Just as problematic, frontline health professionals are often reluctant to name the disease and communicate a diagnosis to the patient. Why? Because they themselves aren’t sufficiently informed of the symptoms, or they feel that little can be done.

Bottom line – we need to strengthen the abilities and sensitivity of Canada’s dementia workforce. That could have a huge impact on early intervention, on valuing the autonomy of patients, and on empowering them to take control of their health.

We must also clearly recognize the importance of informal caregivers. A sobering statistic – in Canada, the informal care provided annually for people with dementia is now 231 million hours. In 30 years, that will rise to 756 million hours. It’s essential that caregivers receive skill building to understand the role they can play and how to play it.

Besides becoming educated on the support they need to offer, caregivers must be supported in turn. I would love to see economic support for caregivers in the form of tax credits, an allowance (for lower income caregivers), and labour market protection (i.e. an assurance of return to work should they have to leave temporarily to provide care, similar to maternity leave). Respite services are another key element of support for caregivers.

Many other factors come into play when we talk about an aging population and ensuring a sustainable health care system. Do social values need to change, so people save more for their future care as opposed to relying heavily on government? Do we need to alter the design of housing and communities to support independent living for seniors?

The challenges are complex – but the opportunities are clear.

The Rising Tide report ran through scenarios, and based on independent research found, for instance, that delaying the onset of dementia by just two years would yield a 30-year reduction in the total economic burden of $219 billion.

Increasing by 50 per cent the activity level of already active Canadians, age 65-plus, would reduce direct health costs by $31 billion over 30 years.

And helping people to develop coping skills and build competencies in their caregiving roles would yield a 30-year value of $63 billion.

Only by acting purposefully today will we be able to effectively respond to the rising number of people and families affected by Alzheimer’s disease and dementia – and reduce the toll on us all.

David Harvey is the Chief Member Services Officer, Alzheimer Society of Ontario, and the national spokesperson for an Alzheimer Society’s report called “Rising Tide: The Impact of Dementia on Canadian Society”.