ARCHIVED - Health Research - Investing in Canada's Future 2003-2004

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Alzheimer’s Disease

The Canadian Institutes of Health Research (CIHR) is the Government of Canada’s premier agency for health research.

Through CIHR, the Government of Canada is investing nearly $30 million in research on Alzheimer’s disease across Canada.

The Facts

• 1 in 20 Canadians over age 65 is affected by Alzheimer’s disease. And 1 in 4 over age 85.
• Familial Autosomal Dominant (FAD) Alzheimer’s disease, which is passed on through families, accounts for about 5-10% of cases; the remainder is sporadic.
• Nearly a quarter of a million Canadians (238,000) suffer from Alzheimer’s disease, and the numbers are expected to more than double by 2030, to nearly 500,000.
• Internationally, 18 million people have dementia, two-thirds of them in developing countries. By 2025, the number of people with dementia is expected to double to 34 million internationally.
• Half of Canadians know someone with Alzheimer’s and one quarter of Canadians have someone in their family with Alzheimer’s.
• Caring for people with Alzheimer's costs about $5.5 billion each year.

Research Strengthening the Health Care System

Planning for the care of increasing num- bers of elderly people with Alzheimer’s disease and other forms of dementia will be a challenge for Canada’s health care system. Health research will help it meet that challenge:

• People with dementia use health services, including hospitals, physician visits, home and long-term care and prescription medication, in patterns similar to those of their age counterparts without dementia, but at a higher level, according to a study by CIHR-funded researcher Joan Tranmer of Kingston General Hospital. For instance, they received a greater number of prescriptions and their drug costs were, on average, 50% greater. Dr. Tranmer’s study provides quantitative evidence of the greater demand that growing numbers of people with dementia will place on health care resources.
• People with Alzheimer’s disease who live in rural or remote areas have limited access to the services they need, and their family caregivers are often reluctant to use the services available to them, such as home care and support groups. Dr. Debra Morgan, a CIHR-funded researcher from the University of Saskatchewan, has worked with communities and care providers to identify eight barriers to the use of formal services, including the stigma of dementia, lack of privacy and anonymity, lack of awareness and lack of access to services because of distance. The study also proposed strategies to overcome the barriers, including making caregivers aware, not only of available services, but of and how they can help in the particular situation, as well as better public education to break down the stigma around dementia.

Research Improving Health

• Thanks to a unique CIHR-funded study, Dr. Cheryl Grady at Baycrest Hospital and a group of Toronto-based researchers have found direct evidence that people who suffer from early-stage Alzheimer’s disease can engage other areas of the brain to perform memory tasks.
• A CIHR-funded study carried out in Ottawa found that a drug called Reminyl helps to stave off deterioration of cognitive abilities in patients with mild and moderate cases of Alzheimer’s and may also improve behavioural problems in people with more severe cases of the disease. Of the patients who participated in the trial, one-quarter responded very well, with 13% showing no deterioration, half responded mildly or moderately, and one-quarter did not respond. Currently only about 20% of Alzeimers’ patients are referred to the drug.
• Toronto researcher and CIHR Distinguished Investigator Dr. Peter St. George-Hyslop has discovered two genes that cause the early onset of Alzheimer’s disease; he has now successfully immunized mice against the disease. The drug he has developed has been found to prevent the onset of the disease and to halt its progress after it strikes and, if successful, could provide a way to immunize humans against the disease. antibiotics
• A combination– doxycyclineof twoandinexpensive rifampin –could slow the process of mental decline experienced by people with Alzheimer’s, according to research by CIHR-funded Dr. Mark Loeb of McMaster University in Hamilton. While the study is preliminary and involved only small numbers, those taking the drugs in combination showed less cognitive decline six months after the start of the trial than those who took a placebo.
• A CIHR-supported researcher from the University of Calgary has found that drugs already being studied as treatments for cancer may be effective in treating dementia, including Alzheimer’s disease. Dr. Christopher Power and his team say the treatment could also be effective for treating AIDS-related dementia.

The Institute

The CIHR Institute of Aging is committed to advancing knowledge in the field of aging to improve the quality of life and the health of older Canadians. Cognitive impairment in aging is one of the Institute’s five priority areas for research. With a growing number of partners, the Institute of Aging led the development of a National Strategy on Cognitive Impairment in Aging.

The Partners

CIHR recognizes the unique role of, and works closely with, all partners in the research process. The Institute of Aging, led by Dr. Anne Martin-Matthews, is working with partners, including the Alzheimer’s Society of Canada, NeuroScience Canada, the Heart and Stroke Foundation, the Canadian Nurses’ Association and the Consortium of Canadian Centres for Clinical Cognitive Research, as well as the federal and provincial governments and private sector partners on the National Strategy on Cognitive Impairment in Aging. As part of the strategy, partners are developing a national research strategy to coordinate research efforts more effectively and create major new funding opportunities for research on cognitive impairment in aging.

The People

He used to know the names of everybody he met – but now the faces aren’t as familiar anymore. About a year ago, Theo Chester Black began to notice that he couldn’t remember things.

“He noticed that he was slowing down and couldn’t retain,” says his wife, Phyllis.

In July 2003, Mr. Black went to see Dr. Serge Gauthier, a CIHR-funded researcher-clinician at the McGill Centre for Studies in Aging at Douglas Hospital, who confirmed Mr. Black’s fear: he had early stage Alzheimer’s disease.

Now Mr. Black, an 80-year-old World War II veteran, is involved in the greatest fight of all: trying to retain the memories of the people and events of his lifetime.

Aricept, a prescription drug, has helped. This commonly-used treatment for Alzheimer’s disease helps patients with their memory, thinking; everyday activities and overall behaviour. So far there have been plenty of benefits for Mr. Black.

“Things don’t bother me as much as they did,” he says. “I’m more alert.”

Now, Mr. Black is a candidate for an international clinical trial of a promising new drug, one that, in combination with Aricept, could slow the progression of the disease even more. The drug, so new that it doesn’t even have a name, just a number – works by stimulating brain repair proteins. By participating in the trial, Mr. Black would help a multidisciplinary team, involving geriatricians, neurologists and psycho-geriatricians from Europe and Canada, including Dr. Gauthier, assess the drug’s effectiveness. If the drug proves effective, it could be added to standard treatments already used to slow down the progression of Alzheimer’s disease.

Mr. Black is ready to participate if he qualifies for the trial, and he is delighted that this kind of research exists for him.

“I don’t know where I would be without it,” he says.

About the Canadian Institutes of Health Research

The Canadian Institutes of Health Research is the Government of Canada’s premier agency for health research. Its objective is to excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system.

For more information, visit: www.cihr-irsc.gc.ca.