The theme for World Alzheimer’s Day 2017 is ‘Remember Me. Alzheimer’s is a type of dementia that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks. A disorder characterized by severe memory loss, it accounts for 60% to 80% of all cases of dementia. A neuro degenerative disease, it is caused by progressive loss of brain cells which leads to the loss of nerve cells and connections.
Diet supplements including Vitamin B 12 can improve the memory but do little to slow down the progression of the disease. Drug therapy can be introduced in order to improve the quality of life for a patient. Certain drugs can be used to slow down the rate of deterioration however there is no one particular drug that can effectively stop the decline. Presently, there are over 46 million people worldwide who suffer from dementia. This number is estimated to reach 131.5 million by 2050. Every 3 seconds a new case of dementia is reported.
Dr. Praveen Gupta, Director and HOD, Neurology from Fortis Memorial Research Institute sheds more light on Alzheimer’s and its management.
Understanding Alzheimer’s and recognizing the early symptoms:
- Cognitive and behavioral decline from previous levels of functioning and performing.
- A gradual onset of cognitive deterioration over months and years. Patient may seem fazed, disoriented and confused.
- Memory loss is most prominent, especially in the area of learning and recalling new information.
- Language problems, in which case one struggle’s to find the right words.
- There is an inability to recognize objects and faces and to comprehend separate parts of a scene at once.
- There is a difficulty with reading text (Alexia).
- There is a marked decline in the ability to reason, judge and solve problems.
There are both avoidable and unavoidable risk factors associated with Alzheimer’s:
Ø Unavoidable risk factors
- Age: More likely in older people, a greater proportion of over-85-year-olds suffer from Alzheimer’s.
- Family history: If there is family history of Alzheimer’s then the person is at higher risk of suffering from the disease.
- Genetic Predisposition: Having a certain gene (the apolipoprotein E or APOE gene) puts a person, depending on their specific genetics, at three to eight times more risk than a person without the gene.
- Gender: Being female puts one at a higher risk (more women than men are affected).
Ø Avoidable risk factors
- Sleep Disorders: Sleep disorders such as the breathing problems and sleep apnea, if left untreated can cause Alzheimer’s.
- Blood Vessels Risk: Diabetes, high cholesterol and hypertension can cause strokes and increase the risk of dementia.
- Head Injury: While head injuries do not directly cause Alzheimer’s, the severity of trauma inflicted can have a role to play in the onset of the disease.
Testing and Diagnosis:
- While there is no specific test through which Alzheimer’s can be ascertained and diagnosed, doctors rule out all other possibilities by testing the blood and urine.
- Multiple brain scans (CT, MRI, EEG, and PET) are also conducted to get a clearer image of the functioning neural pathways.
- There must be memory loss and impairment in one other area of cognition for a diagnosis of dementia such as Alzheimer’s to be made.
- These criteria also need to be progressive (a worsening compared with how the person has been before), and severe enough to affect daily activities.
- The mini mental state examination (MMSE) is a common cognitive test to help diagnose Alzheimer’s disease. It is also sensitive to the severity of the disorder (a score under 10 is said to be severe).
- Biomarker Tests can be carried out to check whether someone is at higher risk of Alzheimer’s or not.
- Loss of Odor Identification Test can be administered as degeneration of the olfactory senses is indicative of the severity of cognitive impairment.
Looking at it from a human angle perspective, patients with dementia are often unable to assert their basic rights and freedoms. At times physical and chemical restraints are used to control and curtail them. An appropriate and supportive legislative environment based on internationally accepted human rights standards is required to ensure the highest quality of service provision to people with dementia and their care givers.