Is Canada Prepared for the Surge of Dementia?

What Was the Question? How can health policy decision-makers prepare for the potential future use of new and emerging treatments for Alzheimer disease (AD) and other dementias? What Did We Do? We identified emerging technologies for early diagnosis. We assessed the infrastructural capacity to deliver amyloid-targeted therapy in Canada, including the availability of PET-CT imaging equipment for confirming treatment eligibility, access to MRI units for monitoring treatment side effects, and IV infusion clinics for administering the treatment. We engaged with clinicians who treat people with dementia, researchers involved with dementia-related health research, and people with dementia and their caregivers. What Did We Find? There are several emerging diagnostic technologies — including blood, imaging, saliva, and ocular tests, and artificial intelligence algorithms — that could diagnose AD in its early stages more easily and quickly. The availability of PET-CT and MRI units, radiopharmaceuticals, and cyclotrons is currently not sufficient to accommodate the implementation of amyloid-targeted therapies in Canada. People living with dementia described barriers to accessing adequate, appropriate, and equitable care. Clinicians and researchers said that access to timely and reliable diagnosis must be improved. What Does This Mean? Our work highlights recent advances in AD diagnosis and treatment, related health system gaps in terms of accessing diagnostic testing and treatment, and the unmet needs of people living with dementia and their caregivers. It is important that health systems prepare for the potential surge in the number of people with dementia who might need additional diagnostic tests, treatments, monitoring, and models of care.