Neurodegenerative Diseases: Coping with Canada’s Aging Population

April 29, 2022 annieparkerfoundation

Brain Health, Environmental Factors, Health & Wellness, Healthy Lifestyles, Immunity/Immune System, Medical Interventions, Microbiome, Neurodegenerative Diseases, Nutrition

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By Patricia Thangaraj

Neurodegenerative Diseases

Neurodegenerative diseases are illnesses that cause certain parts of the brain to disintegrate and eventually die. Parkinson’s Disease and Alzheimer’s Disease are two of the most common Neurodegenerative Diseases.

The brain is made up of billions of cells which help us function on a daily basis. Some of the most important cells in the brain are called neurons. Neurons communicate with each other to help us with mental and physical activities. However, because of the brain’s complexity, brain disorders can arise from minute miscommunications between the cells.

Since the cells in the brain are closely linked, miscommunications in one area can disrupt other brain functions, causing brain disorders that lead to numerous issues.

Neurodegenerative, a.k.a. neuron death can be split into two words for better comprehension. Neuro meaning brain and degenerative, meaning breaking down and/or dying.

Neurodegenerative diseases can negatively impact the miscommunications between brain cells. They affect their movement, speech, memory, intelligence and other things. Due to the complex nature of these diseases, what exactly causes them remains a mystery, and presents a great area for research.

However, what is known is that the likelihood of getting neurodegenerative diseases increases as persons get older.

Parkinson’s Disease

Parkinson’s disease is the second most common disease of the nervous system after Alzheimer’s disease. Parkinson’s disease occurs when there is a degeneration in the part of the brain that helps coordinate movements. General onset is between 50 to 79 years old.

When neurons die in a part of the brain known as the substantia nigra, movement problems become to develop. The substantia nigra, which is Latin for black substance, is a region within the brain that contains a large number of neurons that release a substance called dopamine. By releasing dopamine, the neurons of the substantia nigra, communicate with movement-producing parts of the brain like the frontal lobe and the basal ganglia. These cluster of neurons are located deep in the centre of the brain and comprise of several different groups of neurons.

Neuronal death in the substantia nigra, means that these group of neurons can no longer function effectively, resulting in shaking and stumbling in persons diagnosed with Parkinson’s disease. These persons also experience difficulty starting and maintaining their movements.

The more obvious symptom is a tremor that takes place when muscles are relaxed. Muscles become stiff, movements get slower and uncoordinated and persons loose their balance easier. Physicians base their diagnosis off of these symptoms. While drugs such as levodopa in addition to carbidopa, surgery and simplifying daily tasks can help, the disease is progressive, eventually leading to severe disability and immobility.

Men and Women: What’s the Difference?

Women have a lower risk of getting Parkinson’s Disease than men. This is according to studies conducted across different demographic groups. However, why this is the case is still unknown. Possible speculations circulate around the fact that women are less likely to be exposed to environmental factors that can lead to Parkinson’s Disease such as pesticides and metals. There is also a theory that estrogen plays a vital role in enhancing brain health, which in turn, reduces a woman’s chances of getting Parkinson’s Disease.

Women have different symptoms than men, report side effects more often and tend to have more fluctuations in their symptoms throughout the day as compared to men. Women are also less likely to have symptoms such as dyskinesias, which take place when levodopa levels are at their highest in the blood.

Women are also less likely to receive quality health care when it comes to diagnosing and treating their Parkinson’s Disease. Furthermore, doctors have a harder time prescribing medicines for women than they do for men. This is because women are more likely to experience larger swings in symptoms from even small alterations in medicines and/or schedules.

Deep brain stimulation (DBS) is an accepted surgical therapy for both men and women whose symptom fluctuations are difficult to control. However, while it has been noted that women are more likely to experience more improvements in quality of life after DBS than men, they are less likely to receive this treatment.

Women are also less likely to be properly cared for by a disease specialist, neurologist or movement disorder specialist, which explains why they are less likely to access medical care for their disease as compared to men.

Statistics

More than 25 people are diagnosed with Parkinson’s every day. Between 2011-2031, the number of Canadians diagnosed with Parkinson’s Disease is expected to double to more than 163,700, according to the Public Health Agency of Canada and the Canadian Institute of Health Research.

Parkinson’s also has the third highest healthcare costs annually at $120,358,000 following Epilepsy at $208,679,000 and Alzheimer’s and other Dementias at $527,494,000. Persons with Parkinson’s also have the highest rate of prescription drug use compared to other neurological conditions included in the National Population Health Study of Neurological Conditions.

Furthermore, the Mapping Connections: An Understanding of Neurological Conditions in Canada revealed that persons with Parkinson’s have the second highest rate of out-of-pocket expenses at $1,100 following spinal cord injuries.

Persons with Parkinson’s are also more susceptible to cognitive impairment and dementia. 40% of persons with Parkinson’s disease will experience thinking and problem solving limitations while 50% will have memory issues.

Parkinson’s disease also increases with age. 85% of those diagnosed with Parkinson’s are over the age of 65.

The time spent in residential care facilities is about 200 times higher for those living with a neurological condition than those without one. Parkinson’s disease ranks the third highest for those who would enter residential care at 50.5 days for men and 76.1 days for women.

Both men and women with Parkinson’s will lose a total of 15 years in complete health

The Government of Canada reveals that in 2013-2014, about 84,000 Canadians 40 years and older were living with parkinsonism (prevalence 0.4%) while 10,000 were just recently diagnosed with the condition during the aforementioned time period (incidence 55.1% per 100,000 population).

The age-standardized prevalence was 1.5% times higher among males than females (0.5% versus 0.3% respectively) while the age-standardized incidence was 1.7% times higher in males and females (annual incidence: 67.8 per 100,000 population versus 40.3 per 100,000 population respectively).

The epidemiological burden of parkinsonism also increases with age. In 2013-2014, data comparing Canadians 85 years and older with those 40-44 years showed that the prevalence was 169 times higher in the older age group (2.0% versus 0.01% respectively) while the incidence was 48 times higher in the older age group compared to the younger age group (171.5 per 100,000 population versus 3.6 per 100,000 population respectively).

Healthy Aging: Catering to an Aging Population

According to recent statistics released by Statistics Canada, more than 1 in 5 working adults are now approaching retirement. This has profound implications, not just for the Canadian labour force as the article suggested, but also in terms of the federal, provincial and territorial governments being able to address the health care needs of this growing elderly population.

Director for the Centre of Demography at Statistics Canada, Laurent Martel said that the Canadian population now has a larger demographics of persons from 55 to 64 years old compared to persons from 15 to 24 years old.

In 1966, there were 200 persons from 15 to 24 years old for every 100 Canadians from 55 to 64 years old. This is a complete reversal for 2021 where there are 81 persons aged 15 to 24 for every 100 Canadians aged 55 to 64 according to census released on Wednesday.

Meanwhile, the Government of Canada reports that between 2014 and 2036, the average life expectancy for a 65 year old is likely to increase by 1.8 years for women (to 88.8 years) and by 1.9 years for men (to 86.5 years).

Yet in spite of this increased longevity, recent statistics show that 90% of Canadians aged 65 or over live with at least one chronic disease or condition. Hence, urgent action is required from all Governmental and non-Governmental stakeholders in order to enhance Canada’s health care system and ensure that all persons who call this country home have access to high-quality health care services including the aging population.

The Government of Canada’s Budget 2022 entitled, “A Plan to Grow Our Economy and Make Life More Affordable” pinpoints some of the ways that they plan to support research and innovation geared towards healthy aging including allocating $20 million over the next 5 years starting in 2022-2023 to the Canadian Institutes of Health Research for dementia and brain health to improve treatment and mental health for caregivers and exploring diverse models of care.

They also allocated $30 million over 3 years, starting in 2022-2023 to the Public Health Agency of Canada for their Centre for Aging and Brain Health Innovation to support innovations in brain health and aging.

In addition to the above, there are numerous organizations across Canada who are wiling to fund research and innovation targeting healthy aging.

Microbiome and Brain Health

Making everyday changes in your lifestyles can help persons living with Parkinson’s Disease manage their disease more effectively.

Diet and nutrition essential to a healthy microbiome

Aside from doctor prescribed medications, diet and nutrition also play a critical role in helping those diagnosed with PD cope with their illness. Spinach, broccoli, artichokes, asparagus, leeks and onions are some of the foods that help to strengthen your microbiome.

Probiotics also help in ensuring that your gut contains good types of microbes. In addition to a good probiotic supplements that persons can purchase at a health food store, there are also food items such as yogurt that contain the necessary live cultures. However, there are also cases where many products claim to have these cultures, but they actually do not have them. Thus, it is advised that persons with PD speak to their physician on the right types of probiotics foods to meet their needs. Fermented foods are also a great source of probiotics.

Then there are also prebiotics (not to be confused with probiotics). Prebiotics also help to feed your microbiome in a positive way in that it helps with the health of your enteric nervous system.

Apples, bananas, root vegetables, lentils, chick peas, beans, nuts, seeds, garlic, onions and leeks are just some of the foods that are rich in prebiotics.

Choosing foods with complex sugars as opposed to simple sugars is also imperative. Monosaccharides are digested rapidly, which can destroy your microbes. Eating too many simple sugars also tears away at the lining of your intestine, which results in inflammation.

Honey, dark chocolate, apples, berries, bananas, mangoes and sweet potatoes are just some of the foods rich in complex sugars.

Be careful also about the hidden sources of monosaccharides, which can be found in protein bars, smoothies, nut butters and salad dressings among others.

Persons should reduce their intake of red meat, get 8 hours of sleep every night and make time to engage in activities that they enjoy.

Exercise also vital to a healthy microbiome

Physically active people tend to have healthier microbes than those who live sedentary lifestyles. Thus, activities such as walking for 30 minutes on a daily basis would not only help persons with PD cope better, but it would also lead to overall gut health. Furthermore, exercising also helps to strengthen your microbes, which in turn combats stress levels, thereby improving the mental health of persons with PD.

Research and Innovation

Given the fact that neurodegenerative diseases are some of the most complex, undertreated and misunderstood diseases, there is great potential for doctors, scientists, researchers and other professionals to embark on research and innovation that would spark not just conversations about this disease here in Canada and globally, but more importantly help persons including those suffering with them, their family, caregivers, friends and the general public develop a greater understanding of this disease including factors such as the causes, which would hopefully lead to a cure someday.

Canada Research Areas

Some of the potential research areas for Canadians include:

Updated studies on Parkinson’s Disease among men and women. This includes statistics on Parkinson’s Disease specifically and not parkinsonism as a collective.

Why women are less susceptible to Parkinson’s Disease. Does estrogen play a part?

Why men and women experience different symptoms of Parkinson’s Disease.

Why doctors find it harder to develop medications for women suffering from Parkinson’s Disease as opposed to men.

The inequalities in health care between women and men diagnosed with Parkinson’s Disease and why they are diagnosed less frequently, respond differently to therapies, have lower access to care, less social support and poorer quality of life compared to men diagnosed with this disease.

The impact that environmental factors such as pesticides, metals, chemicals, consumer products, air pollution, biological factors and dietary and lifestyle factors such as exposure to tobacco smoke have on being diagnosed with Parkinson’s Disease, especially among men.

Developing diagnostic biomarkers from the microbiome to identify neurodegenerative diseases before they arise.

The differences between the microbiome of healthy individuals compared with those with non-communicable diseases such as diabetes, cardiovascular diseases and cancer.

The role of integrative medicines, alternative medicines and other medical interventions in treating neurodegenerative diseases.

How foods rich in probiotics can enhance one’s immunity.