Dementia Across the Spectrum Webinar Series – Moderate to Severe Dementia & Behavioral and Psychological Symptoms of Dementia (BPSD)

Dementia Surge in an Aging Canada

Canada faces a rapidly escalating dementia challenge as the baby boomer generation enters the highest-risk age brackets. With approximately 772,000 people living with dementia in 2025, daily diagnoses exceed 414, and projections indicate nearly 1 million cases by 2030—a 65% increase from 2020 levels. By 2050, the figure could reach 1.7 million, reflecting demographic shifts where the proportion of Canadians over 65 with dementia rises from 8.4% in 2020 to 13.2%.

In moderate to severe stages, behavioral and psychological symptoms of dementia (BPSD)—including agitation, aggression, apathy, depression, and psychosis—affect up to 90% of individuals. These symptoms often prove more disruptive than cognitive decline alone, leading to heightened caregiver strain, emergency interventions, and accelerated moves to long-term care. Fluctuating and stage-linked patterns complicate management, with neurodegeneration-driven symptoms frequently requiring pharmacological intervention despite risks like increased mortality.

The real-world toll falls heavily on families and the health system. Unpaid caregivers provide hundreds of millions of hours annually, valued in the tens of billions, while many exit the workforce, exacerbating labor shortages. Dementia accounts for significant hospital alternate-level-of-care days, tying up beds and contributing to system congestion. Direct and indirect costs, already at $40 billion in recent estimates, are forecasted to climb steeply—potentially to $110 billion by 2050 or higher—ranking dementia among leading causes of disability-adjusted life years.

Non-obvious tensions include the gap between emerging diagnostic and early-stage treatment advances—such as blood tests and anti-amyloid therapies—and the persistent reliance on symptomatic management for moderate to severe cases. Guidelines prioritize non-pharmacological approaches first, yet resource constraints in low-resource or rural settings limit implementation, while antipsychotic use carries well-documented hazards. Broader societal trade-offs emerge in balancing home-based aging preferences against safety and care demands, as many seniors face crisis-driven transitions to institutional settings amid inadequate community supports.

Stigma, under-diagnosis, and uneven provincial strategies further compound challenges, with only partial progress on national coordination since the 2019 Dementia Strategy. Without accelerated action on risk reduction, workforce training, and infrastructure, the consequences include deepened inequities, prolonged suffering, and unsustainable fiscal pressure.