Alzheimer’s Disease: Greatest Threat to Healthy Aging

According to a report by Alzheimer’s Disease International (ADI) titled ‘Dementia in the Asia Pacific Region’ the number of people with dementia in the region will increase from 23 million in 2015 to almost 71 million by 2050. It also notes that by the middle of the century, more than half of the total number of people with dementia worldwide will live in the Asia Pacific region

Alzheimer’s Disease (AD) is a chronic neurodegenerative disease, and is the most common form of dementia that usually starts mild and gets progressively worse. Early symptom is short-term memory loss (difficulty in remembering recent events), with disorientation, behavioural issues, problems with language, not understanding simple instructions, and mood swings and other cognitive difficulties in later stages. As the disease progresses, often the person affected secludes himself from family and society. The average life expectancy after being diagnosed in such cases is normally three to nine years (with variations in speed of progression of the disease).

World Alzheimer’s month

21st September, 2017 will mark the fifth global World Alzheimer’s Month, an international campaign to raise awareness and challenge the stigma that surrounds dementia. World Alzheimer’s Month was launched in 2012. The impact of World Alzheimer’s Month is growing, and people are more aware of the disease but the criticism and misinformation that surrounds dementia still remains a global problem that requires attention worldwide.

Important facts on Alzheimer’s disease

• Alzheimer’s disease is the most common type of dementia.
• There are an estimated 44 million people who have Alzheimer’s or a related dementia worldwide.
• 2 in 3 people with Alzheimer’s disease are women.
• 1 in 3 seniors dies with Alzheimer’s or other dementia.
• Due to the physical and emotional toll of caregiving, Alzheimer’s and dementia caregivers had $9.7 billion in additional health care costs of their own in 2014.
• The global cost of Alzheimer’s and dementia is estimated to be $605 billion, which is equivalent to 1% of the entire world’s gross domestic product.
• Alzheimer’s and other dementias are the top cause for disabilities in later life.

Causes of Alzheimer’s disease

The cause of Alzheimer’s disease is poorly understood. It is a neurodegenerative disease, in which the total brain size shrinks and the nerve cells and connections get fewer gradually. If post-mortem/autopsy is done, the affected brain always shows tiny inclusions in the nerve tissue called plaques and tangles.

These plaques are a result of build-up of a protein called beta-amyloid (or "amyloid plaques") and are found between the dying cells in the brain. The tangles are formed within the brain neurons as a result of disintegration of another protein, called tau. Till date, there is no conclusive study that fully understands the reason behind this disease. Several different factors are believed to be involved. Factors that can act as a precursor to developing the condition include aging, a family history of Alzheimer’s, and carrying certain genes.

Symptoms of Alzheimer’s disease

The first symptoms of Alzheimer’s vary from person to person. Memory problems are typically one of the first signs of cognitive impairment related to Alzheimer’s disease. Symptoms can be diagnosed at any stage of Alzheimer’s and care and management can be dictated after monitoring the progression through the stages of the disease. For an initial diagnosis of Alzheimer’s disease, the medical practitioner must first be satisfied that there is dementia. It involves cognitive or behavioural symptoms that show a decline from previous levels of functioning and performing and interfere with ability to function at work or at usual activities.

The cognitive decline is in at least two of the five symptom areas listed below:

• Worsened ability to take in and remember new information
• Impairments to reasoning, complex tasking and exercising judgment
• Impaired visuospatial abilities
• Impaired speaking, reading and writing
• Changes in personality and behaviour
• A gradual onset "over months to years" rather than hours or days (the case with some other problems) Alzheimer’s disease progresses in several stages: preclinical, mild, (sometimes called early-stage), moderate, and severe (sometimes called late-stage).

Stages of Alzheimer’s disease

Alzheimer’s disease unfolds in various stages. The stages are often blurry and the symptoms can vary -- but they can be a guide and help effective care of the sufferer.

Stage 1: Preclinical Behaviour

This is a very early phase and you might not notice anything amiss in your loved one’s behaviour or reasoning. A PET scan is needed to reveal whether the person is suffering from Alzheimer’s. Symptoms become more prominent as the friend/relative moves into next 3 stages.

Stage 2: Mild decline

At the start of this phase, there are still not many behavioural differences, however, forgetting a word or misplacing objects could have begun. As the stage progresses, the person might start having difficulty performing independent tasks, and hinder one’s thinking and reasoning, such as:

• Forgets something he just read
• Asks the same question over and over
• Has more and more trouble making plans or organizing
• Can’t remember names when meeting new people

Stage 3: Moderate Decline

During this period, the problems in thinking and reasoning that you noticed in stage 2 get more obvious, and new serious issues appear. This includes forgetting his personal details, trouble putting right date and amount on the cheque, forgetting the month or season or even trouble cooking or ordering meals. Being delusional and forgetting relations is also common during this stage.

Stage 4: Severe Decline

Many basic abilities in a person with Alzheimer’s, such as eating, walking, and sitting up, are hindered at this progressive stage. You can still be involved by feeding the person with soft, easy-to-swallow food, helping him use a spoon, and making sure he drinks. This is important, as many people at this stage can no longer tell when they’re thirsty.

Treatment and prevention of AD

Till date, there is no known cure for Alzheimer’s disease as the death of brain cells in dementia cannot be halted or reversed. However, many therapeutic interventions are available which can help improve quality of life for people suffering with this disease.

Some important elements of dementia care (as mentioned by Alzheimer’s Association) include:

• Effective management of any conditions occurring alongside the Alzheimer’s
• Activities and/or programs of adult day care
• Support groups and services.

Support

As with other types of dementia and neurodegenerative disease, support given by healthcare workers, family and friends to the person suffering from Alzheimer’s Disease can be very therapeutic. It is an important aspect as the needs of the person increase with declining independence. There are support groups for both the sufferer as well as for their caregivers. You can find one in your own locality/region. These groups not only give a better insight about the disease but also, provide an opportunity for respite while meeting other people in similar situations. Some groups meet monthly, others weekly, and they are free and open to anyone.