Text Equivalent - Mapping Connections: An understanding of neurological conditions in Canada

Figure I-1: Projected population distribution, by age group, Canada, 2011 and 2031

The bar graph shows an age pyramid with estimates of the Canadian population distribution in 2011 and in 2031. On the graph, the horizontal axis shows the proportion of the population, and the vertical axis shows the age groups, divided into age groups starting from 0 to 85+ years, increasing in increments of five.

With the aging of the population, the distribution of the population changes. Between 2011 and 2031, the graph illustrates that the proportion of the total population represented by the younger age groups decreases, while the proportion of the total population represented by older age groups increases.

Data were from the POHEM-Neurological modelling platform, cerebral palsy model, from Statistics Canada and the Public Health Agency of Canada.

The following table lists the proportion of the population in each age group for the years 2011 and 2031:

Figure I-1: Projected population distribution, by age group, Canada, 2011 and 2031
Age group 2011 distribution (%) 2031 distribution (%)
<1 1.1 1.0
1 to 4 4.3 4.2
5 to 9 5.3 5.4
10 to 14 5.6 5.6
15 to 19 6.4 5.5
20 to 24 6.6 5.3
25 to 29 6.6 5.4
30 to 34 6.8 5.9
35 to 39 6.9 6.7
40 to 44 7.1 6.8
45 to 49 7.9 6.6
50 to 54 8.0 6.4
55 to 59 7.0 6.1
60 to 64 5.9 6.0
65 to 69 4.6 6.3
70 to 74 3.4 5.9
75 to 79 2.6 4.7
80 to 84 2.0 3.3
85+ 1.9 2.9

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Figure 1-1: General health among respondents age 15+ years living with a neurological condition, Canada, 2011-2012, SLNCC 2011-2012 Project [16]

The bar graph shows the distribution of self-reported general health in two categories (fair/poor versus excellent/very good/good) for each neurological condition under study. On the graph, the horizontal axis shows the proportion of the population in each general health category, and the vertical axis lists the populations by neurological condition.

The distribution of fair/poor health varied by neurological condition, from 13.6% among those with cerebral palsy to 58.1% among those with a brain tumour. Self-reported fair/poor health was also high among those with stroke (55.4%), spinal cord tumour (54.1%), Parkinson's disease (53.9%), spinal cord injury (48.9%), and Alzheimer's disease and other dementias (48.4%).

Data were from the 2011-2012 SLNCC from Statistics Canada. SLNCC stands for Survey on Living with Neurological Conditions in Canada. ALS stands for amyotrophic lateral sclerosis. Data were weighted to represent the Canadian population living with a neurological condition and were based on self- or proxy-report. E signals that the reader should interpret the data with caution, because the coefficient of variation was between 16.6% and 33.3%. F signals that the data were unreportable due to small sample size or high sampling variability.

The following table lists the proportion of the population in each general health category for each of the neurological conditions under study:

Figure 1-1: General health among respondents age 15+ years living with a neurological condition, Canada, 2011-2012, SLNCC 2011-2012 Project [16]
Neurological condition Excellent/very good/good health (%) Fair/poor health (%)
Full SLNCC sample 74.0 26.0
Alzheimer's disease and other dementias 51.6 48.4
ALS F F
Brain injury (traumatic) 68.4 31.6
Brain tumour 41.9 58.1
Cerebral palsy 86.4 13.6 E
Dystonia 59.5 40.5 E
Epilepsy 72.4 27.6
Huntington's disease F F
Hydrocephalus 92.5 F
Migraine 80.4 19.6
Multiple sclerosis 64.4 35.6
Muscular dystrophy 53.1 E 46.9 E
Parkinson's disease 46.1 53.9
Spina bifida 73.2 26.8 E
Spinal cord injury (traumatic) 51.1 48.9
Spinal cord tumour 46.0 E 54.1 E
Stroke 44.6 55.4
Tourette syndrome 83.6 F

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Figure 1-2: Prevalence of mood disorders among respondents age 15+ years living with a neurological condition, Canada, 2011-2012, SLNCC 2011-2012 Project [16]

The bar graph shows the prevalence of self-reported mood disorders for each neurological condition under study. On the graph, the horizontal axis shows the populations by neurological condition, and the vertical axis lists the prevalence.

Based on point estimates, the prevalence of mood disorders varied by neurological condition, from 17.1% among those with epilepsy to 38.3% among those with a traumatic brain injury. Self-reported mood disorders was also high among those with brain tumour (35.5%).

Data were from the 2011-2012 SLNCC from Statistics Canada. SLNCC stands for Survey on Living with Neurological Conditions in Canada. ALS stands for amyotrophic lateral sclerosis. Data were weighted to represent the Canadian population living with a neurological condition and were based on self- or proxy-report. E signals that the reader should interpret the data with caution, because the coefficient of variation was between 16.6% and 33.3%. F signals that the data were unreportable due to small sample size or high sampling variability.

The following table lists the prevalence of mood disorders for each of the neurological conditions under study:

Figure 1-2: Prevalence of mood disorders among respondents age 15+ years living with a neurological condition, Canada, 2011-2012, SLNCC 2011-2012 Project [16]
Neurological condition Has mood disorder (%)
Full SLNCC sample 23.0
Alzheimer's disease and other dementias 29.7
ALS F
Brain injury (traumatic) 38.3
Brain tumour 35.5 E
Cerebral palsy 20.4 E
Dystonia F
Epilepsy 17.1
Huntington's disease F
Hydrocephalus F
Migraine 24.9
Multiple sclerosis 22.5
Muscular dystrophy F
Parkinson's disease 22.5
Spina bifida 19.3 E
Spinal cord injury (traumatic) 29.2
Spinal cord tumour F
Stroke 23.0
Tourette syndrome 25.1 E

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Figure 1-3: Prevalence of impaired cognition among respondents age 15+ years living with a neurological condition, Canada, 2011-2012, SLNCC 2011-2012 Project [16]

The bar graph shows the prevalence of self-reported impaired cognition for each neurological condition under study. Impaired cognition is shown in two categories (memory limitations and thinking/problem-solving limitations). On the graph, the horizontal axis shows the populations by neurological condition, and the vertical axis lists the prevalence for these two categories.

Based on point estimates, the prevalence of memory limitations was usually higher than thinking/problem-solving limitations, except among those with cerebral palsy, where thinking/problem-solving limitations were higher at 59.7% (compared to 26.5% for memory limitations). Memory limitations were highest among those with Alzheimer's disease and other dementias at 93.7%, and lowest among those with cerebral palsy at 26.5%. Thinking/problem-solving limitations were highest among those with Alzheimer's disease and other dementias at 91.8%, and lowest among those with migraine at 18.2%.

Data were from the 2011-2012 SLNCC from Statistics Canada. SLNCC stands for Survey on Living with Neurological Conditions in Canada. ALS stands for amyotrophic lateral sclerosis. Data were weighted to represent the Canadian population living with a neurological condition and were based on self- or proxy-report. E signals that the reader should interpret the data with caution, because the coefficient of variation was between 16.6% and 33.3%. F signals that the data were unreportable due to small sample size or high sampling variability.

The following table lists the prevalence of memory and thinking/problem-solving limitations for each of the neurological conditions under study:

Figure 1-3: Prevalence of impaired cognition among respondents age 15+ years living with a neurological condition, Canada, 2011-2012, SLNCC 2011-2012 Project [16]
Neurological condition Memory limitations (%) Thinking/problem-solving limitations (%)
Full SLNCC sample 41.6 27.8
Alzheimer's disease and other dementias 93.7 91.8
ALS F F
Brain injury (traumatic) 68.3 53.0
Brain tumour 60.1 44.4
Cerebral palsy 26.5 E 59.7
Dystonia 46.3 E 23.7 E
Epilepsy 49.8 43.4
Huntington's disease F F
Hydrocephalus 51.0 E 45.6 E
Migraine 35.4 18.2
Multiple sclerosis 48.2 30.6
Muscular dystrophy 37.1 E 32.7 E
Parkinson's disease 55.1 41.0
Spina bifida 43.9 E 33.1 E
Spinal cord injury (traumatic) 54.5 38.6
Spinal cord tumour 39.9 E F
Stroke 53.3 45.0
Tourette syndrome 56.9 36.5 E

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Figure 1-4: Prevalence of impaired mobility among respondents age 15+ years living with a neurological condition, Canada, 2011-2012, SLNCC 2011-2012 Project [16]

The bar graph shows the prevalence of self-reported impaired mobility for each neurological condition under study. Impaired mobility is shown in three categories (mobility limitations, requires mechanical support, and requires a wheelchair). On the graph, the horizontal axis shows the populations by neurological condition, and the vertical axis lists the prevalence for these three categories.

Based on point estimates, the prevalence of mobility limitations was always the highest category because it contains the other two categories. Mobility limitations were highest among those with Alzheimer's disease and other dementias at 58.4%, but was also high among those with muscular dystrophy at 52.4%. Mobility limitations were lowest among those with migraine at 6.6%. The requirement of mechanical support such as braces, a cane, or crutches was highest among those with Alzheimer's disease and other dementias at 45.7%, and again lowest among those with migraine at 5.2%. Wheelchair was required for mobility for 37.6% of those with cerebral palsy and 32.5% of those with muscular dystrophy.

Data were from the 2011-2012 SLNCC from Statistics Canada. SLNCC stands for Survey on Living with Neurological Conditions in Canada. ALS stands for amyotrophic lateral sclerosis. Data were weighted to represent the Canadian population living with a neurological condition and were based on self- or proxy-report. E signals that the reader should interpret the data with caution, because the coefficient of variation was between 16.6% and 33.3%. F signals that the data were unreportable due to small sample size or high sampling variability.

The following table lists the prevalence of mobility limitations, requirement for mechanical support, and requirement for wheelchair for each of the neurological conditions under study:

Figure 1-4: Prevalence of impaired mobility among respondents age 15+ years living with a neurological condition, Canada, 2011-2012, SLNCC 2011-2012 Project [16]
Neurological condition Mobility limitations (%) Requires mechanical support (%) Requires a wheelchair (%)
Full SLNCC sample 18.2 13.3 6.0
Alzheimer's disease and other dementias 58.4 45.7 19.6
ALS F F F
Brain injury (traumatic) 21.0 14.9 E 7.4 E
Brain tumour 28.9 E 25.9 E F
Cerebral palsy 47.1 29.3 E 37.6 E
Dystonia F F F
Epilepsy 15.5 11.4 6.3 E
Huntington's disease F F F
Hydrocephalus 28.4 E 13.2 E 22.1 E
Migraine 6.6 E 5.2 E 1.0 E
Multiple sclerosis 49.3 30.4 20.2
Muscular dystrophy 52.5 E F 32.5 E
Parkinson's disease 49.6 39.1 16.4 E
Spina bifida 29.9 E 19.0 E 18.0 E
Spinal cord injury (traumatic) 44.3 27.1 18.0
Spinal cord tumour 44.2 E F F
Stroke 46.9 38.9 13.2
Tourette syndrome F F F

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Figure 1-5: Prevalence of pain and discomfort among respondents age 15+ years living with a neurological condition, Canada, 2011-2012, SLNCC 2011-2012 Project [16]

The bar graph shows the prevalence of self-reported pain and discomfort for each neurological condition under study. Pain and discomfort is shown in three categories (moderate/severe, pain prevents some activities, and pain prevents most activities). On the graph, the horizontal axis shows the populations by neurological condition, and the vertical axis lists the prevalence for these three categories.

The categories of pain/discomfort preventing some and most activities were complimentary. The category of moderate/severe pain was independent. Based on point estimates, moderate/severe pain was highest for those with a spinal cord tumour, at 51.2%. It was also high for those with muscular dystrophy (47.6%) and brain injury (42.7%). The prevention of some activities due to pain was highest for those with dystonia (45.8%). The prevention of most activities due to pain was highest for those with spinal cord injury, at 36.6%, but was also high for those with stroke, at 22.2%.

Data were from the 2011-2012 SLNCC from Statistics Canada. SLNCC stands for Survey on Living with Neurological Conditions in Canada. ALS stands for amyotrophic lateral sclerosis. Data were weighted to represent the Canadian population living with a neurological condition and were based on self- or proxy-report. E signals that the reader should interpret the data with caution, because the coefficient of variation was between 16.6% and 33.3%. F signals that the data were unreportable due to small sample size or high sampling variability.

The following table lists the prevalence of moderate/severe pain, pain preventing some activities, and pain preventing most activities for each of the neurological conditions under study:

Figure 1-5: Prevalence of pain and discomfort among respondents age 15+ years living with a neurological condition, Canada, 2011-2012, SLNCC 2011-2012 Project [16]
Neurological condition Moderate/severe pain/discomfort (%) Pain prevents some activities (%) Pain prevents most activities (%)
Full SLNCC sample 29.9 21.6 10.2
Alzheimer's disease and other dementias 37.0 20.4 16.0 E
ALS F F F
Brain injury (traumatic) 42.7 25.4 19.3
Brain tumour 39.5 39.0 9.7 E
Cerebral palsy 30.4 E F F
Dystonia 40.4 E 45.9 E F
Epilepsy 25.0 16.5 E 9.8 E
Huntington's disease F F F
Hydrocephalus F F F
Migraine 27.8 21.2 8.1 E
Multiple sclerosis 41.8 26.5 17.1 E
Muscular dystrophy 47.6 E 29.8 E F
Parkinson's disease 32.6 24.1 12.6 E
Spina bifida 40.8 E 23.0 E 17.9 E
Spinal cord injury (traumatic) F 40.0 36.6
Spinal cord tumour 51.2 E 35.8 E F
Stroke 40.5 21.4 22.2
Tourette syndrome F F F

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Figure 1-6: Average Health Utilities Index global score among respondents age 15+ years living with a neurological condition, Canada, 2011-2012, Microsimulation Project [10]

The bar graph shows the Health Utilities Index - Mark 3 (HUI3) global score for each neurological condition under study. The HUI score can range from negative values to 1. A score of one indicates no disability, a score between 0.89 and 0.99 indicates mild disability, a score between 0.70 and 0.88 indicates moderate disability, and a score less than 0.70 indicates severe disability. On the graph, the horizontal axis shows the populations by neurological condition, and the vertical axis shows the HUI score, ranging from 0 to 1.

In general, almost all the HUI scores were under 0.70, indicating severe disability. Based on point estimates, only the HUI score for migraine (at 0.79) and Tourette syndrome (at 0.71) were in the moderate disability range. The lowest HUI score was for Alzheimer's disease and other dementias, at 0.21.

Data were from the 2011-2012 SLNCC from Statistics Canada. SLNCC stands for Survey on Living with Neurological Conditions in Canada. ALS stands for amyotrophic lateral sclerosis. Data were weighted to represent the Canadian population living with a neurological condition and were based on self- or proxy-report. F signals that the data were unreportable due to small sample size or high sampling variability.

The following table lists the HUI global score for each of the neurological conditions under study:

Figure 1-6: Average Health Utilities Index global score among respondents age 15+ years living with a neurological condition, Canada, 2011-2012, Microsimulation Project [10]
Neurological condition HUI score
Full SLNCC sample 0.71
Alzheimer's disease and other dementias 0.21
ALS F
Brain injury (traumatic) 0.52
Brain tumour 0.57
Cerebral palsy 0.49
Dystonia 0.64
Epilepsy 0.67
Huntington's disease F
Hydrocephalus 0.63
Migraine 0.79
Multiple sclerosis 0.55
Muscular dystrophy 0.49
Parkinson's disease 0.51
Spina bifida 0.66
Spinal cord injury (traumatic) 0.41
Spinal cord tumour 0.60
Stroke 0.49
Tourette syndrome 0.71

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Figure 1-7: Prevalence of bladder and bowel incontinence among respondents age 15+ years living with a neurological condition, Canada, 2011-2012, SLNCC 2011-2012 Project [16]

The bar graph shows the prevalence of bladder and bowel incontinence for each neurological condition under study. Bladder and bowel incontinence are shown in separate categories. On the graph, the horizontal axis shows the populations by neurological condition, and the vertical axis lists the prevalence for these two categories.

Based on point estimates, bladder incontinence was always higher than bowel incontinence for every neurological condition. Self-reported bladder incontinence was highest for those with Alzheimer's disease and other dementias and multiple sclerosis (both at 56.8%), but was also high for those with Parkinson's disease (55.0%) and spinal cord tumour (48.5%). Self-reported bowel incontinence was highest for those with Alzheimer's disease and other dementias (31.7%) and was also high for those with Parkinson's disease (30.8%) and multiple sclerosis (29.7%).

Data were from the 2011-2012 SLNCC from Statistics Canada. SLNCC stands for Survey on Living with Neurological Conditions in Canada. ALS stands for amyotrophic lateral sclerosis. Data were weighted to represent the Canadian population living with a neurological condition and were based on self- or proxy-report. E signals that the reader should interpret the data with caution, because the coefficient of variation was between 16.6% and 33.3%. F signals that the data were unreportable due to small sample size or high sampling variability.

The following table lists the prevalence of bladder and bowel incontinence for each of the neurological conditions under study:

Figure 1-7: Prevalence of bladder and bowel incontinence among respondents age 15+ years living with a neurological condition, Canada, 2011-2012, SLNCC 2011-2012 Project [16]
Neurological condition Bladder incontinence (%) Bowel incontinence (%)
Full SLNCC sample 24.9 12.5
Alzheimer's disease and other dementias 56.8 31.7
ALS F F
Brain injury (traumatic) 33.6 15.0
Brain tumour 28.6 E 14.1 E
Cerebral palsy 23.1 E 19.2 E
Dystonia 32.2 E F
Epilepsy 30.6 18.5
Huntington's disease F F
Hydrocephalus 28.3 E F
Migraine 16.8 7.2 E
Multiple sclerosis 56.8 29.7
Muscular dystrophy 30.1 E 26.0 E
Parkinson's disease 55.0 30.8
Spina bifida 43.2 E 22.8 E
Spinal cord injury (traumatic) 44.8 F
Spinal cord tumour 48.5 E F
Stroke 41.9 23.2
Tourette syndrome F F

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Figure 1-8: Working status among respondents age 18 to 64 years living with a neurological condition, Canada, 2011-2012, SLNCC 2011-2012 Project [16]

The bar graph shows the distribution of work status for Canadians age 18 to 64 years in each neurological condition under study. Work status is shown in three categories (working, did not have a job, and permanently unable to work). On the graph, the horizontal axis shows how the population is divided into these three categories and adds to 100%, and the vertical axis lists the populations by neurological condition.

Working indicated that the respondent had a job or business in the last week. Migraine has the most respondents in the working category, at 69.9%. Those with Parkinson's disease had the lowest proportion in the working category, at 14.6%. Of those who did not have a job in the past week, the highest proportion was seen in those with hydrocephalus, at 53.5%. Of those who were permanently unable to work, the highest proportion was seen in those with muscular dystrophy, at 48.5%.

Data were from the 2011-2012 SLNCC from Statistics Canada. SLNCC stands for Survey on Living with Neurological Conditions in Canada. ALS stands for amyotrophic lateral sclerosis. Data were weighted to represent the Canadian population living with a neurological condition and were based on self- or proxy-report. E signals that the reader should interpret the data with caution, because the coefficient of variation was between 16.6% and 33.3%. F signals that the data were unreportable due to small sample size or high sampling variability.

The following table lists the distribution of work status by working, did not have a job, and permanently unable to work for each of the neurological conditions under study:

Figure 1-8: Working status among respondents age 18 to 64 years living with a neurological condition, Canada, 2011-2012, SLNCC 2011-2012 Project [16]
Neurological condition Working (%) Did not have a job (%) Permanently unable to work (%)
Full SLNCC sample 62.1 26.0 12.0
Alzheimer's disease and other dementias F F 46.6 E
ALS F F F
Brain injury (traumatic) 38.2 34.1 27.8
Brain tumour 50.1 F F
Cerebral palsy 37.9 E 39.3 E 22.9 E
Dystonia 42.4 E 38.0 E F
Epilepsy 51.9 30.6 17.5
Huntington's disease F F F
Hydrocephalus F 53.5 E F
Migraine 69.9 21.8 8.3 E
Multiple sclerosis 40.2 35.1 24.7
Muscular dystrophy F F 48.5 E
Parkinson's disease 14.6 E 42.2 E 43.2 E
Spina bifida 50.7 37.7 E F
Spinal cord injury (traumatic) F F F
Spinal cord tumour F F F
Stroke 29.5 E 41.4 29.4
Tourette syndrome 57.0 F F

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Figure 1-9: Projected indirect economic costs due to working-age death and disability, by select neurological condition and age group, Canada, 2011, 2021, and 2031, Microsimulation Project [10]

The bar graph is a complex display showing projected indirect economic costs over time, by age group, and for a selection of neurological conditions. These indirect economic costs are due to working-age death and disability. On the graph, the horizontal axis shows three concepts: first, there are seven neurological conditions (Alzheimer's disease and other dementias, brain injury, cerebral palsy, epilepsy, multiple sclerosis, Parkinson's disease/parkinsonism, and spinal cord injury). Second, for each neurological condition, three time periods are shown (2011, 2021, and 2031). Finally, for each time period, total indirect costs are presented for five age groups (15 to 34 years, 35 to 49 years, 50 to 64 years, 65 to 74 years, and 15 to 74 years). The vertical axis lists the total indirect costs.

Data were expressed in 2010 Canadian dollars. Brain injury had the highest total indirect economic costs, regardless of time period or age group. Relatively speaking, Parkinson's' disease/parkinsonism had the lowest total indirect economic costs, regardless of time or age group. Costs typically increased in age group until peaking in either the 35 to 49 or 50 to 64 year age group and then declining. Costs always increased over time.

Data were from the POHEM-Neurological modelling platform from Statistics Canada and Public Health Agency of Canada. Traumatic brain and spinal cord injuries were based on hospitalized cases, and excluded injuries that did not present to hospital.

The following table lists the various total indirect costs over time and age group for each of the neurological conditions under study:

Figure 1-9: Projected indirect economic costs due to working-age death and disability, by select neurological condition and age group, Canada, 2011, 2021, and 2031, Microsimulation Project [10]
    Indirect cost with neurological condition
Neurological condition   Alzheimer's disease and other dementias Brain injury (traumatic; hospitalized) Cerebral palsy Epilepsy Multiple sclerosis Parkinson's disease/parkinsonism Spinal cord injury (traumatic; hospitalized)
Calendar year   2011 2021 2031 2011 2021 2031 2011 2021 2031 2011 2021 2031 2011 2021 2031 2011 2021 2031 2011 2021 2031
Age group 15 to 34 years $0 $0 $0 $934,678,114 $939,983,298 $926,658,200 $292,816,305 $295,626,412 $305,069,532 $614,204,025 $612,906,709 $617,705,276 $48,887,361 $53,246,136 $50,649,314 $0 $0 $0 $61,869,283 $64,486,818 $63,457,105
35 to 49 years $112,844,799 $109,254,395 $116,592,572 $3,723,046,415 $3,793,292,910 $4,114,091,772 $451,180,875 $478,549,848 $534,184,671 $1,144,520,510 $1,170,306,145 $1,266,888,342 $591,143,646 $571,488,147 $633,061,104 $32,119,356 $30,629,460 $34,712,133 $238,995,891 $233,205,547 $251,351,490
50 to 64 years $447,333,517 $534,219,873 $511,483,343 $2,688,389,415 $3,069,458,281 $3,063,140,697 $235,818,246 $279,414,212 $290,606,116 $792,668,655 $890,004,020 $886,515,608 $695,644,896 $784,350,716 $741,508,085 $205,874,102 $244,042,356 $231,347,677 $199,516,671 $233,241,232 $227,326,624
65 to 74 years $47,275,142 $73,503,213 $94,501,057 $56,828,931 $89,363,545 $114,425,932 $3,540,606 $6,069,898 $8,173,856 $26,446,697 $42,059,342 $53,069,580 $16,277,843 $24,209,523 $30,509,618 $20,854,230 $30,975,246 $39,453,987 $4,719,765 $7,380,615 $9,491,829
All ages (15 to 74 years) $607,453,458 $716,977,481 $722,576,972 $7,402,942,874 $7,892,098,034 $8,218,316,601 $983,356,032 $1,059,660,369 $1,138,034,175 $2,577,839,888 $2,715,276,216 $2,824,178,807 $1,351,953,746 $1,433,294,522 $1,455,728,121 $258,847,688 $305,647,063 $305,513,797 $505,101,611 $538,314,213 $551,627,049

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Figure 2-1: Health service utilization in the past year among Canadians with and without neurological or other chronic health conditions, by health professional type, Canada, 2010-2012, LINC Project [9]

The bar graph shows the utilization of health services in the past year by health professional type. Canadians with a neurological condition in the LINC study were compared to the general Canadian population, Canadians living with one or more chronic condition(s), and Canadians living with two or more chronic conditions. This is shown on the horizontal axis, and is shown for each health professional type (general practitioner, specialist, nurse, chiropractor, physiotherapist, psychologist, social worker or counsellor, other therapist, or mental health consultant). On the graph, the vertical axis lists the proportions of health service utilization, by each of these four populations, for each health professional type.

In general, the use of a general practitioner and chiropractor was high for any of the populations (with or without a neurological or chronic condition). For general practitioners, the Canadian population with two or more chronic conditions (which included asthma, arthritis, back problems, high blood pressure, chronic bronchitis/emphysema, diabetes, heart disease, cancer, ulcers, urinary incontinence, bowel disorders, mood disorders, or anxiety disorders) had the highest utilization. For chiropractors, the general Canadian population had the highest utilization. For the other health professional types, Canadians with a neurological condition in the LINC study had the highest utilization.

Data were from the 2010-2012 LINC survey from the LINC Project and the 2009-2010 CCHS from Statistics Canada. LINC stands for The Everyday Experience of Living with and Managing a Neurological Condition. CCHS stands for Canadian Community Health Survey. CCHS data were weighted to represent the Canadian population living in the community and were age-sex-standardized to the LINC population.

The following table lists the proportions of health service utilization by each population for each health professional type under study:

Figure 2-1: Health service utilization in the past year among Canadians with and without neurological or other chronic health conditions, by health professional type, Canada, 2010-2012, LINC Project [9]
  General practitioner (%) Specialist (%) Nurse (%) Chiropractor (%) Physiotherapist (%) Psychologist (%) Social worker/counsellor (%) Other therapists (%) Mental health consultant (%)
LINC study participants 90.8 65.5 36.3 84.6 36.1 15.4 20.7 18.4 38.5
General Canadian population 80.7 33.4 12.4 87.4 11.8 4.3 4.9 3.3 11.9
Canadian population with one or more chronic conditions 91.2 48.2 18.4 83.6 17.8 8.6 10.1 5.1 24.0
Canadian population with two or more chronic conditions 93.3 54.9 21.8 83.0 19.7 12.1 14.4 5.8 32.0

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Figure 2-2: Formal and informal assistance use among respondents age 15+ years living with a neurological condition (excluding migraine), by type of assistance, Canada, 2011-2012, SLNCC 2011-2012 Project [16]

The bar graph shows the prevalence of self-reported formal and informal assistance use by Canadians living with a neurological condition but excluding migraine. On the horizontal axis, formal and informal assistance use are shown in separate categories for each of the types of assistance (any, personal care, medical care, managing care, help with activities, childcare, transportation, meal preparation or delivery, emotional support, and other). The vertical axis lists the proportion.

The population presented here was limited to only those who reported receiving assistance, and categories were not mutually exclusive. The use of informal assistance was typically much higher than formal assistance use for all types of assistance except for personal care and 'other' care, where formal assistance use was higher. Formal assistance was used most often for help with activities, with 51.7% of respondents reporting this type of assistance. Informal assistance was used most often for emotional support, with 81.3% of respondents reporting this type of assistance. Informal assistance was also high for help with activities (78.7%) and transportation (77.1%).

Data were from the 2011-2012 SLNCC from Statistics Canada. SLNCC stands for Survey on Living with Neurological Conditions in Canada. Data were weighted to represent the Canadian population living with a neurological condition and were based on self- or proxy-report. E signals that the reader should interpret the data with caution, because the coefficient of variation was between 16.6% and 33.3%. F signals that the data were unreportable due to small sample size or high sampling variability.

The following table lists formal and informal assistance use for the various types of assistance under study:

Figure 2-2: Formal and informal assistance use among respondents age 15+ years living with a neurological condition (excluding migraine), by type of assistance, Canada, 2011-2012, SLNCC 2011-2012 Project [16]
Type of assistance Formal assistance (%) Informal assistance (%)
Any (at home, work, or school) 21.2 47.0
Personal care 48.6 40.4
Medical care 35.7 39.4
Managing care 19.6 57.2
Help with activities 51.7 78.7
Childcare F 7.6 E
Transportation 38.0 77.1
Meal preparation or delivery 31.9 63.0
Emotional support 35.2 81.3
Other 13.0 E 2.5 E

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Figure 2-3: Frequency of informal assistance use among respondents age 15+ years living with a neurological condition (including and excluding migraine), by sex, Canada, 2011-2012, SLNCC 2011-2012 Project [16]

The bar graph shows the distribution of informal assistance use by sex for Canadians living with a neurological condition (including and excluding migraine). Informal assistance use is shown in three categories (none, on a monthly basis or less, and daily or on a weekly basis). On the graph, the horizontal axis shows how the population is divided into these three categories and adds to 100%, and the vertical axis lists the population with a neurological condition, including and excluding migraine, by sex.

Women always used more informal assistance than men, but men used it more frequently (on a daily or weekly basis instead of on a monthly basis or less). When migraine was included, the use of informal assistance was not as high as when migraine was excluded from analysis.

Data were from the 2011-2012 SLNCC from Statistics Canada. SLNCC stands for Survey on Living with Neurological Conditions in Canada. Data were weighted to represent the Canadian population living with a neurological condition and were based on self- or proxy-report. E signals that the reader should interpret the data with caution, because the coefficient of variation was between 16.6% and 33.3%.

The following table lists the distribution of informal assistance use by category (none, on a monthly basis or less, and on a daily or weekly basis) by sex and including and excluding migraine:

Figure 2-3: Frequency of informal assistance use among respondents age 15+ years living with a neurological condition (including and excluding migraine), by sex, Canada, 2011-2012, SLNCC 2011-2012 Project [16]
  All SLNCC data Excluding migraine
  Women (%) Men (%) Women (%) Men (%)
None 58.4 65.5 48.5 58.9
On a monthly basis or less 18.3 7.1 E 8.7 E 5.7
Daily or on a weekly basis 23.3 27.4 42.9 35.4

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Figure 2-4: Projected number of Canadians who are likely candidates for informal care, by select neurological condition, Canada, 2011, 2016, 2021, 2026, and 2031, Microsimulation Project [10]

The bar graph is a complex display showing the projected number over time of Canadians living with select neurological conditions who will require informal care. On the graph, the horizontal axis has two components: first, there are seven neurological conditions listed (Alzheimer's disease and other dementias, brain injury, cerebral palsy, epilepsy, multiple sclerosis, Parkinson's disease/parkinsonism, and spinal cord injury). Second, for each neurological condition, it shows five time periods (2011, 2016, 2021, 2026, and 2031). The vertical axis lists the total number.

For all neurological conditions under study, the projected number of Canadians requiring informal care increased in a stepwise fashion. The projected number requiring care was highest for those living with Alzheimer's disease and other dementias, and showed a large increase in 2031 to 522,000, which is double the number seen in 2011. The projected number requiring care was lowest for those living with spinal cord injury, which showed little increase over time.

Data were from the POHEM-Neurological modelling platform from Statistics Canada and Public Health Agency of Canada. Traumatic brain and spinal cord injuries were based on hospitalized cases, and excluded injuries that did not present to hospital.

The following table lists the number of Canadians requiring informal care over time for each of the neurological conditions under study:

Figure 2-4: Projected number of Canadians who are likely candidates for informal care, by select neurological condition, Canada, 2011, 2016, 2021, 2026, and 2031, Microsimulation Project [10]
Neurological condition 2011 2016 2021 2026 2031
Alzheimer's disease and other dementias 261,414 304,061 356,045 428,689 522,213
Brain injury (traumatic; hospitalized) 333,832 362,366 392,145 422,422 453,824
Cerebral palsy 48,254 51,020 54,481 58,254 61,797
Epilepsy 84,265 91,082 97,708 104,882 113,049
Multiple sclerosis 52,412 58,667 64,285 69,352 73,224
Parkinson's disease/parkinsonism 48,886 56,831 66,977 79,821 94,684
Spinal cord injury (traumatic; hospitalized) 23,310 25,534 27,804 30,482 32,297

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Figure 2-5: Projected number of hours of informal caregiving per week, by select neurological condition, Canada, 2011, 2016, 2021, 2026, and 2031, Microsimulation Project [10]

The bar graph is a complex display showing the projected number of hours of informal caregiving provided per week for a selection of neurological conditions. On the graph, the horizontal axis has two components: first, there are seven neurological conditions listed (Alzheimer's disease and other dementias, brain injury, cerebral palsy, epilepsy, multiple sclerosis, Parkinson's disease/parkinsonism, and spinal cord injury). Second, for each neurological condition, it shows five time periods (2011, 2016, 2021, 2026, and 2031). The vertical axis lists the total number representing hours per week.

For all neurological conditions under study, the projected number of hours per week spent providing informal care increased in a stepwise fashion except for spinal cord injury, which remained fairly flat over time. The projected number of hours per week spent providing informal care was highest for those living with Alzheimer's disease and other dementias, and increased from 19 million in 2011 to 39 million in 2031. The projected number of hours per week spent providing informal care was lowest for those living with spinal cord injury, and ranged from 486,000 in 2011 to 702,000 in 2031.

Data were from the POHEM-Neurological modelling platform from Statistics Canada and Public Health Agency of Canada. Traumatic brain and spinal cord injuries were based on hospitalized cases, and excluded injuries that did not present to hospital.

The following table lists the number of hours per week spent providing informal care for each of the neurological conditions under study:

Figure 2-5: Projected number of hours of informal caregiving per week, by select neurological condition, Canada, 2011, 2016, 2021, 2026, and 2031, Microsimulation Project [10]
Neurological condition 2011 2016 2021 2026 2031
Alzheimer's disease and other dementias 19,235,612 22,458,177 26,277,847 31,579,388 38,524,969
Brain injury (traumatic; hospitalized) 5,973,190 6,534,886 7,112,350 7,732,292 8,347,794
Cerebral palsy 1,431,843 1,504,951 1,615,502 1,725,412 1,827,497
Epilepsy 1,950,742 2,144,243 2,324,204 2,541,001 2,829,843
Multiple sclerosis 1,478,236 1,715,027 1,937,694 2,155,617 2,286,601
Parkinson's disease/parkinsonism 2,358,369 2,741,609 3,230,859 3,837,186 4,592,978
Spinal cord injury (traumatic; hospitalized) 485,623 541,456 593,855 657,873 702,239

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Figure 3-1: Prevalence of Alzheimer's disease and other dementias, by sex and age group, British Columbia, 2009/2010, BC Administrative Data Project [1]

The line graph shows the prevalence of Alzheimer's disease and other dementias by sex and age group. On the graph, the horizontal axis shows five age groups (65 to 69, 70 to 74, 75 to 79, 80 to 84, and 85+). The vertical axis shows the rate per 100,000 population. A data table showing the rates for women, men, and both is also included below the horizontal axis.

Alzheimer's disease and other dementias increased exponentially with age. For both sexes combined, the rate climbed from 915.7 per 100,000 population in those age 65 to 69 years to 24,699.9 per 100,000 population in those age 85+ years. The rate was higher for men in the 65 to 69 and 70 to 74 year age groups, but was higher for women in the other age groups.

BC stands for British Columbia. Data were based on 2009/10 health administrative data provided by the BC Ministry of Health in the BC Administrative Data Project.

The following table lists the rates of Alzheimer's disease and other dementias per 100,000 population for each age group under study:

Figure 3-1: Prevalence of Alzheimer's disease and other dementias, by sex and age group, British Columbia, 2009/2010, BC Administrative Data Project [1]
  Crude prevalence rate/100,000 population
Alzheimer's disease and other dementias Age Both Men Women
65 to 69 916 989 844
70 to 74 2,747 2,801 2,696
75 to 79 6,499 6,312 6,675
80 to 84 12,843 12,021 13,474
85+ 24,700 21,101 26,633

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Figure 3-2: Prevalence of parkinsonism, by sex and age group, British Columbia, 2009/2010, BC Administrative Data Project [1]

The line graph shows the prevalence of parkinsonism, which includes Parkinson's disease, by sex and age group. On the graph, the horizontal axis shows ten age groups (40 to 44, 45 to 49, 50 to 54, 55 to 59, 60 to 64, 65 to 69, 70 to 74, 75 to 79, 80 to 84, and 85+). The vertical axis shows the rate per 100,000 population. A data table showing the rates for women, men, and both is also included below the horizontal axis.

At about 55 to 59 years of age, the rate of parkinsonism increased markedly, from 127.0 per 100,000 population for both sexes to 1996.3 per 100,000 population for both sexes in the 85+ year age group. Parkinsonism was always higher in men than in women.

BC stands for British Columbia. Data were based on 2009/10 health administrative data provided by the BC Ministry of Health in the BC Administrative Data Project.

The following table lists the rates of parkinsonism per 100,000 population for each age group under study:

Figure 3-2: Prevalence of parkinsonism, by sex and age group, British Columbia, 2009/2010, BC Administrative Data Project [1]
  Crude prevalence rate/100,000 population
Parkinsonism Age Both Men Women
40 to 44 23 27 18
45 to 49 41 46 36
50 to 54 66 83 49
55 to 59 127 161 94
60 to 64 269 327 212
65 to 69 478 575 383
70 to 74 834 1,036 641
75 to 79 1,346 1,653 1,067
80 to 84 1,863 2,365 1,484
85+ 1,996 2,623 1,679

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Figure 3-3: Prevalence of multiple sclerosis, by sex and age group, British Columbia, 2009/2010, BC Administrative Data Project [1]

The line graph shows the prevalence of multiple sclerosis, by sex and age group. On the graph, the horizontal axis shows fifteen age groups (15 to 19, 20 to 24, 25 to 29, 30 to 34, 35 to 39, 40 to 44, 45 to 49, 50 to 54, 55 to 59, 60 to 64, 65 to 69, 70 to 74, 75 to 79, 80 to 84, and 85+). The vertical axis shows the rate per 100,000 population. A data table showing the rates for women, men, and both is also included below the horizontal axis.

The prevalence of multiple sclerosis followed an inverted U-shape when viewed by age group. The rate of multiple sclerosis was lowest in the 15 to 19 year age group, and increased markedly to peak in the 55 to 59 year age group for both women and men. From there, the rate decreased markedly. The prevalence of multiple sclerosis was twice as high for women than men in all age groups.

BC stands for British Columbia. Data were rounded to the nearest ten. Data were based on 2009/10 health administrative data provided by the BC Ministry of Health in the BC Administrative Data Project.

The following table lists the rates of multiple sclerosis per 100,000 population for each age group under study:

Figure 3-3: Prevalence of multiple sclerosis, by sex and age group, British Columbia, 2009/2010, BC Administrative Data Project [1]
  Crude prevalence rate/100,000 population
Age Both Men Women
Multiple sclerosis 15 to 19 20 10 20
20 to 24 30 20 40
25 to 29 60 30 100
30 to 34 120 60 180
35 to 39 190 90 290
40 to 44 250 110 390
45 to 49 300 150 440
50 to 54 340 160 520
55 to 59 390 210 560
60 to 64 360 200 510
65 to 69 300 180 410
70 to 74 210 150 260
75 to 79 160 100 220
80 to 84 120 80 150
85+ 60 30 80

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Figure 3-4: Prevalence of traumatic brain injury, by sex and age group, British Columbia, 2009/2010, BC Administrative Data Project [1]

The line graph shows the prevalence of traumatic brain injury, by sex and age group. On the graph, the horizontal axis shows eighteen age groups (1 to 4, 5 to 9, 10 to 14, 15 to 19, 20 to 24, 25 to 29, 30 to 34, 35 to 39, 40 to 44, 45 to 49, 50 to 54, 55 to 59, 60 to 64, 65 to 69, 70 to 74, 75 to 79, 80 to 84, and 85+). The vertical axis shows the rate per 100,000 population. A data table showing the rates for women, men, and both is also included below the horizontal axis.

The prevalence of traumatic brain injury showed an interesting trend by age group. The rate of traumatic brain injury was high in the teenage and young adult age groups of 10 to 14, 15 to 19, 20 to 24, 25 to 29, and 30 to 34. The rate then decreased and remained relatively stable until it increased again in the older age groups of 80 to 84 and 85+ years. For all ages, the rate of traumatic brain injury was higher in men than in women.

BC stands for British Columbia. Data were rounded to the nearest ten. Data were based on 2009/10 health administrative data provided by the BC Ministry of Health in the BC Administrative Data Project.

The following table lists the rates of traumatic brain injury per 100,000 population for each age group under study:

Figure 3-4: Prevalence of traumatic brain injury, by sex and age group, British Columbia, 2009/2010, BC Administrative Data Project [1]
  Crude prevalence rate/100,000 population
Age Both Men Women
Traumatic brain injury 1 to 4 90 100 90
5 to 9 220 270 170
10 to 14 460 570 350
15 to 19 900 1,170 620
20 to 24 1,140 1,640 630
25 to 29 1,210 1,780 650
30 to 34 1,180 1,760 610
35 to 39 920 1,400 450
40 to 44 800 1,180 420
45 to 49 780 1,130 430
50 to 54 740 1,040 430
55 to 59 690 970 420
60 to 64 690 960 430
65 to 69 750 1,020 480
70 to 74 870 1,140 610
75 to 79 1,050 1,330 800
80 to 84 1,290 1,610 1,050
85+ 1,820 2,160 1,650

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Figure 3-5: Prevalence of traumatic spinal cord injury, by sex and age group, British Columbia, 2009/2010, BC Administrative Data Project [1]

The line graph shows the prevalence of traumatic spinal cord injury, by sex and age group. On the graph, the horizontal axis shows eighteen age groups (1 to 4, 5 to 9, 10 to 14, 15 to 19, 20 to 24, 25 to 29, 30 to 34, 35 to 39, 40 to 44, 45 to 49, 50 to 54, 55 to 59, 60 to 64, 65 to 69, 70 to 74, 75 to 79, 80 to 84, and 85+). The vertical axis shows the rate per 100,000 population. A data table showing the rates for women, men, and both is also included below the horizontal axis.

The prevalence of spinal cord injury jumped from 6 per 100,000 population in the 10 to 14 year age group to 94 per 100,000 population in the 35 to 39 year age group (for both sexes). The rate of spinal cord injury remained high in the adult age groups, and then decreased in the oldest age group of 85+ years. After the age group of 15 to 19 years and before age 80, the rate of spinal cord injury was at least twice as high in men compared to women.

BC stands for British Columbia. Data were based on 2009/10 health administrative data provided by the BC Ministry of Health in the BC Administrative Data Project.

The following table lists the rates of spinal cord injury per 100,000 population for each age group under study:

Figure 3-5: Prevalence of traumatic spinal cord injury, by sex and age group, British Columbia, 2009/2010, BC Administrative Data Project [1]
  Crude prevalence rate/100,000 population
Age Both Men Women
Traumatic spinal cord injury 1 to 4 0 0 0
5 to 9 3 3 4
10 to 14 6 7 6
15 to 19 18 26 10
20 to 24 51 75 26
25 to 29 65 95 36
30 to 34 89 133 46
35 to 39 94 149 41
40 to 44 93 142 45
45 to 49 89 140 39
50 to 54 97 143 51
55 to 59 82 132 32
60 to 64 78 124 33
65 to 69 83 132 36
70 to 74 84 130 41
75 to 79 94 142 50
80 to 84 93 116 75
85+ 73 88 65

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Figure 3-6: Projected number of deaths, by select neurological condition, Canada, 2011, 2016, 2021, 2026, and 2031, Microsimulation Project [10]

The bar graph is a complex display showing the projected number of deaths over time in Canadians living with select neurological conditions. On the graph, the horizontal axis has two components: first, there are seven neurological conditions listed (Alzheimer's disease and other dementias, brain injury, cerebral palsy, epilepsy, multiple sclerosis, Parkinson's disease/parkinsonism, and spinal cord injury). Second, for each neurological condition, it shows five time periods (2011, 2016, 2021, 2026, and 2031). The vertical axis lists the total number of deaths.

For Alzheimer's disease and other dementias, brain injury, epilepsy, multiple sclerosis, and Parkinson's disease/parkinsonism, the projected number of Canadians dying increased in a stepwise fashion over time. The projected number of deaths over time remained stable for cerebral palsy and spinal cord injury. The projected number of deaths was highest for those living with Alzheimer's disease and other dementias, and was comparatively low for cerebral palsy and spinal cord injury.

Data were from the POHEM-Neurological modelling platform from Statistics Canada and Public Health Agency of Canada. Traumatic brain and spinal cord injuries were based on hospitalized cases, and excluded injuries that did not present to hospital.

The following table lists the number of deaths in Canadians living with each of the neurological conditions under study:

Figure 3-6: Projected number of deaths, by select neurological condition, Canada, 2011, 2016, 2021, 2026, and 2031, Microsimulation Project [10]
Neurological condition 2011 2016 2021 2026 2031
Alzheimer's disease and other dementias 49,671 55,885 62,045 70,673 84,600
Brain injury (traumatic; hospitalized) 14,126 15,047 16,415 18,195 20,066
Cerebral palsy 737 921 965 986 1,001
Epilepsy 7,707 8,225 8,993 9,790 10,111
Multiple sclerosis 2,458 2,662 2,750 3,024 3,449
Parkinson's disease/parkinsonism 7,963 8,972 10,007 11,373 13,818
Spinal cord injury (traumatic; hospitalized) 1,061 1,102 1,144 1,278 1,387

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