Does Ontario Recognize Alzheimer’s Disease as a Chronic Disease?
The World Health Organization (WHO), considers dementia as a chronic disease and emphasizes the importance of early diagnosis, home-based support/care, individual, family and caregiver involvement in self-management such as; learning about the disease and how to cope, risk management, and utilization of available resources(2019). However, it has been argued whether dementia is considered a chronic disease and it is recognized differently among provinces in Canada. Chronic disease is defined by the Public Health Agency of Canada as “ chronic diseases, also known as noncommunicable diseases or NCDs, are diseases that are persistent and generally slow in progression which can be treated but not cured.” When we accept this definition we would agree that dementia (a treatable but non curable disease) can be considered a chronic disease.
I will continue on to review how Ontario recognizes dementia, specifically Alzheimer’s Disease (AD)—the most common from of dementia, and whether or not the province identifies it as a chronic condition. I will be using this blog post to contrast with my classmate Carolyn's post reviewing AD and chronic disease in British Columbia posted below.
In Ontario approximately 80% of individuals 45+ have on or more chronic disease(s) leading cause of death and disability (MOHLTC,2007). The figure to the right shows individuals diagnosed with dementia in Ontario by age group. As individual's age they become more susceptible to having AD and other dementia's. Disease prevention and management has become integral in improving health outcomes at the individual, community and global level. According to the MOHLTC Ontario is lacking policy framework and strategies on chronic disease to guide overall program planning. The Canadian Mental Health Association (2018) has urged the need for a focus on health promotion and disease prevention to reduce health care costs and reduce economic burden of chronic disease. The Alzheimer’s Society Ontario (ASO) is the primary foundation that promotes disease prevention strategies specific to AD. However, Public Health Ontario does not directly recognize any form of dementia as chronic disease. On June 22nd, 2017 a Bill was passed that will respect a national strategy for Alzheimer's Disease and other dementia's (Alzheimer's Society Canada, 2019). The Dementia Strategy has been recently implemented and can be found here. The image below outlines the strategies primary focus and goal to prevent dementia, advance therapies and find a cure, improve quality of live of people living with and touched by the disease.
At a provincial level Ontario has aligned with the Dementia Strategy by implementing the Patients First: Action Plan for Health Care to work toward improving access to dementia support in the province. Although Ontario does not directly refer to AD as a chronic disease the risk factors associated with most chronic diseases are the same for AD. Early diagnosis of AD and other dementias is a crucial factor in helping an individual cope and manage their own health (Ibrahim et al., 2017). The Government of Ontario has also developed the Dementia Strategy Discussion Paper that further explored the following:
Supports for people living with dementia
Accessing dementia services
Coordinated care
Supports for care partners
Well-trained dementia workforce
Awareness, stigma, and brain health
Though AD may not be categorized as a chronic disease in Ontario having chronic diseases such as cancer, stroke, and/ or obesity can contribute to one’s susceptibility of having AD. It is evident that AD and other dementias impact a sizable portion of Ontario’s population and will continue to grow. That being said, provincial strategies must come into play to support national strategies, such as the Dementia Strategy, in order to address the impact of AD in specific regions. Recognizing AD as a chronic disease in Ontario may help bridge the gap between existing barriers in the health care system such as stigma, ageism, and isolation and may help promote preventing the onset of AD.
The Alzheimer's Society First Link program supports this by providing those impacted by dementia with a variety of resources to aide them in living in the community longer and navigate through the health care system. The following video further explains this program.
In Ontario there is only one primary foundation that promotes the public health aspect of Alzheimer’s Disease which is Alzheimer's Society Ontario. AD impacts everyone—the individual, family, community and globally yet the province has minimal health promotion strategies in place that target different levels of the population. Early diagnosis is a major key in being able to delay, self-manage and cope with AD. Therefore, Ontario needs to put emphasize on the health of AD and provide resources for Ontario’s approach to fighting the prevalence of chronic disease is to empower individuals to be a part of their own care by teaching them self-management skills, coping methods and aligning them with appropriate resources.
References
Alzheimer's Society Canada. (2019, January 14). Your guide to Canada's national dementia strategy. Retrieved July 1, 2019, from https://alzheimer.ca/en/Home/Get-involved/Advocacy/National-dementia-strategy-guide#whats-happening-on-the-provincial-level
Canadian Mental Health Association. (2018, May 22). New OCDPA report: Why Ontario needs a chronic disease prevention strategy now more than ever. Retrieved from https://ontario.cmha.ca/news/new-ocdpa-report-why-ontario-needs-a-chronic-disease-prevention-strategy-now-more-than-ever/
Ministry of Health and Long-Term Care. (2007). Preventing and Managing Chronic Disease. Retrieved June 27, 2019, from http://www.health.gov.on.ca/en/pro/programs/cdpm/
Public Health Agency of Canada: Canadian Best Practises Portal. (2013). Chronic Diseases. Retrieved June 28, 2019, from https://cbpp-pcpe.phac-aspc.gc.ca/chronic-diseases/
British Columbia
In British Columbia there are approximately 70,000 people affected by Alzheimer’s Disease. As the population ages, this number is expected to increase.
The province of British Columbia recognizes the significance of Alzheimer’s disease and other dementia’s as a contributing factor to the loss of independence and frailty of seniors and has implemented the Provincial Dementia Action Plan. This plan was developed through a variety of clinical, research and policy experts. The plan is to demonstrate the BC Government’s commitment to those living with dementia and their families and is designed to improve the care through the BC health systems and services for those suffering with AD and other dementia diseases. The Ministry of Health has a goal to increase the health care capacity through the individual and community to provide early and effective care as well as support the caregivers while assisting the people afflicted to remain in their homes and communities as long as possible.
Like Ontario, BC families and individuals diagnosed with dementia have access and support through First Link. This is a service through the Alzheimer’s Society that is designed to connect those affected by AD and other dementia with the service and support they need as early as possible after diagnosis.
Another excellent program offered through the Alzheimer’s Society of BC is the Minds in Motion. Many of our clients and their partners have participated in this fitness and social program that is designed for those displaying early signs of a dementia illness and a family member or friend. This program is led by a certified fitness instructor and includes physical activity, socialization, and provide information regarding dementia and the services provided (Alzheimer’s Society of BC 2019).
Both Ontario and British Columbia have made strides to increase support for the individual and caregivers afflicted with AD and other dementias. Both of these provinces are committing to support healthier aging and a patient centred approach to caring for the individuals and their families and caregivers despite the lack of knowledge surrounding chronic disease prevention strategies overall.
References
Dementia | HealthLink BC. (n.d.). Retrieved from https://www.healthlinkbc.ca/health-topics/uf4984
First Link® dementia helpline | Alzheimer Society of B.C. (n.d.). Retrieved from https://alzheimer.ca/en/bc/We-can-help/Resources/First-Link-dementia-helpline
Minds in Motion® | Alzheimer Society of B.C. (n.d.). Retrieved from https://alzheimer.ca/en/bc/We-can-help/Minds-in-Motion
of British Columbia, G. (2012). Dementia Action Plan FOR BRITISH COLUMBIA Priorities and Actions for Health System and Service Redesign.
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