October 4, 2022 October 4, 2022

Alberta neuroscience more aware of dementia or Alzheimer’s disease in rural areas

Posted on 3 March 2022 by Anna Smith

Local Journalism Initiative Reporter

While dementia or Alzheimer’s disease are showing up on more and more death certificates in Southern Alberta, this is indication of an increased awareness in the medical field, not a sign of crisis.

This has been especially noticed among women, particularly those living in remote or rural areas, which Dr. Robert Sutherland, Professor & Chair of the Department of Neuroscience at the University of Lethbridge.

In the last generation, we’ve really come to recognize what Alzheimer’s disease is, what that type of dementia is, and physicians are comfortable now in putting that down on a death certificate as a primary or secondary cause of death, said Sutherland. 

“Technically, the main cause of death is usually pneumonia, from laying in bed and not being able to move around, or sometimes a secondary infection from a bedsore. But the real cause of death is dementia. There’s degeneration of the brain that leaves the person incapable of moving around much or even walking at the end,” said Sutherland. 

“Through most countries in Europe, and in many parts of Canada, it’s now the second cause of death, second leading cause of death,’’ said Sutherland. One of the largest factors causing this increase is far less grim than expected; it’s simply because we’re living longer. With the increase in general health in the population, and progress in the medical field, more people are living long enough to display dementia, especially Alzheimer’s, which is the most common kind of dementia seen in aged people. 

Women are more likely to display Alzheimer’s disease, said Sutherland, though he notes the research is yet to be conducted as to why rural women in particular are more at risk. 

In addition to some observed issues surrounding menopause in all women that are not fully understood, he speculates it may be in part due to the relative isolation of remote and rural areas, and more limited access to resources that help prevent or delay the disease.

“There’s several other things that are related that sort of make the brain less susceptible to Alzheimer’s type dementia,” said Sutherland. “Things like learning a second or third language, staying very cognitively active. So you know, reading newspapers and going into the research literature, or even doing research with Google, these kinds of cognitive activities, socializing with a broad network of friends and acquaintances all make it less likely someone will develop Alzheimer’s disease.”

Sutherland recommends partaking in a variety of hobbies and activities that require planning and use of memory, as this has been shown to make individuals less susceptible to Alzheimer’s disease.

“Maybe forming a club of some sort, participating in it on a regular basis, so many times each week, and varied activities, not just, you know, going curling once a week, but a wide range,” said Sutherland. “A book club, maybe. Travel is immensely stimulating, cognitively. Physical activity, walking, running, lifting bales of hay, I mean, doing anything that involves movement, including strenuous activity, really good riding a bicycle, riding a horse, any kind of physical activity that gets your heart beating.” 

Correcting hearing loss is also noted to be one of the most important things that an individual can do in order to prevent dementia, said Sutherland, though why this has such a strong effect on cognitive health is yet unknown. Level of education is also known to have some effect, as does childhood activity, and the avoidance of concussions.

Long COVID has also been shown to contribute to the abnormal proteins associated with Alzheimer’s disease.

Because of this link between cognitive activity and the prevention of dementia, there is often free access for those over the age of 65 to places such as the University of Lethbridge, said Dr. John Kennedy, neuro-psychiatrist with Brain Health Alberta. However, he notes that this is often not common knowledge in the community.

“After age 65, it’s like come and see us,” said Kennedy. People can learn a second language, they can learn a musical instrument or music theory, art history. They could learn astronomy. And the benefit of education in cognitive stimulation of that type doesn’t end in childhood, by any means. And frankly, universities are fun places to hang around to, there’s a lot going on, added Sutherland. 

While in some cases, such as those disposed to a more tightly genetically controlled form of Alzheimer’s, only delaying the onset is possible, for as many as 30% of cases, these few simple steps can prevent Alzheimer’s, said Sutherland.

“The direction of the arrow in some countries in Europe is that the rate is going down, probably as people become more active, or highly educated, smoke less, probably, we’re looking at a reduction in the rate. So there’s hope there,” said Sutherland. “And the other thing that I mean, I have to mention is that just like type one, diabetes can be cured with proper insulin treatment, I think we’re going to come up with a cure for Alzheimer’s disease. It’s incredibly more complicated than type one diabetes, in terms of its pathology. But I think we’re gonna figure this thing out, and come up with ways of actually curing the disease. I’d like to be here to see it.”

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