Dr. Sharon Cohen talks about dementia

Neurologist Dr. Sharon Cohen of the Toronto Memory Program is hopeful that by the end of this year or next, there will be a drug that slows down the progression of Alzheimer’s disease.

“More drugs will follow,” said the medical director of the program that does research into Alzheimer’s disease and other dementias, including participating in clinical trials that range from pre-diagnosis to late stage disease.

Cohen said she is “not pinning her hopes on just one drug” rather she said she believes it will take a cocktail of drugs, two or three different ones that will help slow down the progression of these diseases that currently affect more than 17,000 York Region residents, a number which is expected to more than double by 2031.

And while there is hope on the horizon, getting to this point has been slow, Cohen said, in part because of the stigma associated to Alzheimer’s disease and other dementias.

“If you are older, you don’t have the same voice, same advocacy,” she said. The disease is misunderstood and the older population is perceived of as “expendable.”

“The disease is very complicated. The brain is still a mystery.”

Up until recently, research into these diseases has been “primitive.” A brain autopsy after death was the only way to be certain whether someone actually had the disease.

“We now have the advantage of significant strides in early diagnosis, more sophisticated study designs, and smarter drugs.”

There are now PET scans, an imaging test that allows doctors to diagnosis Alzheimer’s disease in life, spinal taps that also offer early diagnosis, and, last October, a blood test for diagnosis of Alzheimer’s came on the market. This blood test is quite expensive and is available mainly in the United States, but Cohen said that more blood tests are coming and in a year or two, these will make Alzheimer’s disease much easier to diagnose.

And that early diagnosis is important, and not offering the opportunity to people is part of the stigma, Cohen said.

People are often worried about getting themselves diagnosed because of the of the fear associated with the disease and its path. Doctors often don’t want to diagnosis it because the is no hope or cure. But Cohen said there are lots of reasons why finding out you have this disease is important.

“Knowledge is often empowering, not telling someone is cruel,” she said.

Providing people with that diagnosis early means they can put the things in place they will need before they lose the ability to make those decisions – not just wills and powers of attorneys, but also how you would like to live out the remainder of your life.

And finally, an early diagnosis means people can tap into the resources available to them - programs and services, education and medicine that will help the symptoms of the disease.

It also allows people the option to participate in clinical trials.

Cohen said many people don’t realize those trials are available and she often hears that if they knew, they would have participated.

“There are a lot of reasons why” people should be diagnosed early, she said.

Currently, the Toronto Memory Program offers between 15 and 20 trials, with many more coming up that are “very promising. More will follow.”

While Cohen hopes for a cure for Alzheimer’s disease, which killed both her grandparents and her parents (Cohen calls herself a “ticking time bomb”), in the next generation’s lifetime, she is optimistic those living with the disease can have a better quality of life and the disease itself can be prevented.

While studies have shown that lifestyle changes – eating better, exercising more, mental simulation and less stress – can reduce a person’s risk of Alzheimer’s disease by about 30 per cent (and if something improves your overall health, why wouldn’t you do it,) she said “it’s naïve to think it can prevent all Alzheimer’s diseases (or other dementias), just like it is unrealistic to think living well can prevent all types of cancers.”

There is a “protective benefit” to lifestyle changes, but it’s not that black and white. There is a genetic component as well, which is why early testing using less “primitive tests” and finding the cocktail of drugs to slow down the decline in those living with Alzheimer’s disease and other dementias, and continued research into a cure is so important.

Anything “that slows down the progression of Alzheimer’s disease and improves the quality of life is good, that is really worthwhile.”

Dr. Sharon Cohen is the guest speaker at this year’s Forget-Me-Not Breakfast, taking place virtually April 24 from 10 to 11:30 a.m. Dr. Cohen will be speaking about the latest in dementia research and will have time for questions at the end. Tickets are $10. Proceeds from the event will go to support programs and services to help York Region residents impacted by dementia.

Sponsorships are available. Contact Carol Dowell, events coordinator, at [email protected] for details. For tickets, click here.