When the Rising Tide Impacts the World: Addressing the Global Challenge of Dementia

Nearly 10 years ago, the Alzheimer Society of Canada brought national attention to the rising challenge of dementia by publishing a landmark analysis entitled "Rising Tide: The Impact of Dementia on Canadian Society" (Alzheimer Society of Canada, 2010). The image was strong, and unfortunately also very accurate. The number of Canadians who will live with dementia will double by 2050. This number will have to be at least doubled, since for every person living with dementia there is at least one caregiver whose health and wellness is also affected by dementia. The magnitude of the challenge requires a major response from the research community in order to understand the causes of dementia, its treatment, and risk reduction strategies, and to ensure the best quality of life for those currently living with dementia. The Canadian Institutes of Health Research's (CIHR's) Dementia Research Strategy was introduced to foster this effort. The Canadian Consortium on Neuro-degeneration in Aging (CCNA), introduced in 2014, has now become the flagship research of this effort. As well, the recently published report by the Standing Senate Committee on Social Affairs, Science and Technology (SOCI), along with Bill C-233 which received royal assent, are encouraging indicators that the effort might be re-energized as we see that the needs are even greater than initially imagined.

But the rising tide is not limited to Canada. The world community also realizes that the rise of the tide is a challenge for each and every country. The aging of the population–and mostly the increase in the proportion of the most aged among elders–is now a reality for all countries. Age is still the main risk factor for the development of dementia. The increase in the number of older individuals, and the relative booming of the oldest among those elders, represent the perfect storm conditions for an explosion of the number of cases of dementia. This trend is not happening only in Canada, but also in all high-income countries. As well, this trend is occurring in low-and middle-income countries, including China, India, and several countries in Africa, in which the overall population is still relatively young. The global recognition of the challenge of dementia is only quite recent. The recognition by the World Health Organization (WHO) of the seriousness of the dementia challenge as a global public health priority was expressed only in 2013 by its director general, Margaret Chan. In the context of a political push for dementia by the G8 countries under the leadership of the United Kingdom's then prime minister, David Cameron, Chan wrote:

"I can think of no other condition that has such a profound effect on loss of function, loss of independence, and the need for care. I can think of no other condition that places such a heavy burden on society, families, communities, and economies. I can think of no other condition where innovation, including breakthrough discoveries, is so badly needed."

(Chan, 2013)

This response from the WHO, although arriving only recently, arrived strongly. Following this fundamental standpoint, a series of actions followed with active participation by Canada.

The first action taken after the G8 Dementia Summit was the First WHO Ministerial Conference in 2015 that allowed for a broad consensus. Three concrete initiatives emerged from this meeting: (1) the creation by the WHO of a Global Dementia Observatory (GDO); (2) the constitution of a WHO-led working group in order to prioritize the required research to face the global challenge of dementia; and (3) the initiation of the work towards the development of a WHO Global Action Plan.

The first WHO area of action is a member state–supported effort at gathering and making available a multitude of data for policy makers, including world data regarding the magnitude of the challenge of dementia in every country; including the resources spent for care, prevention, and research in each country/region; and the nature of the care/prevention policies and their impacts. Canada, through its Public Health Agency, is among the supportive countries of this...