Alzheimer’s Disease – Need to Remember Some Facts
Every 3 seconds someone in the world develops dementia…… “Memories Are Worth Fighting For”
By Dr K M Hassan, Director Neurology, Max Super Speciality Hospital, Noida.
What is the disease burden – Alzheimer’s disease (AD) is a growing public health problem among the elderly in developing countries. Also called Senile Dementia, it is a slowly progressive neurodegenerative disease of the brain that destroys memory and other important higher mental functions. AD accounts for 60-70% of all cases of dementia. There are estimated over 30 million people with AD worldwide with a sizeable burden of disease in India with its ageing population. It most often begins in people over 65 years of age. In India the annual incidence of AD among seniors aged more than 65 years is estimated to be approximately 10 per 1000.
Why it develops – Brain cell connections and the brain cells themselves degenerate and die, eventually destroying memory and other important mental functions. The cause of AD is not well understood. Probable contributors are genetic factors, depression, head injuries, hypertension, obesity amongst others which are presumed to predispose to development of AD.
How do patients present – People with AD mainly suffer from progressive pattern of cognitive and functional impairment. They usually present with decline in cognitive functions such as forgetfulness, difficulty thinking and understanding, mental confusion particularly in evening, delusion, making things up, difficulty concentrating, inability to learn new things, inability to do simple calculation, or inability to recognise common things. People with AD also suffer from behavioural changes in form of becoming aggressive, irritable, agitated, meaninglessly repeating own words; they may have personality changes in form of restlessness, lack of restraint, or wandering and getting lost; or they may suffer from mood changes in form of anger, apathy, general discontent, loneliness, or mood swings; they may have psychological problems such as depression, hallucination, or paranoia.
Why is early recognition important – Initial symptoms are often mistaken for normal ageing. It requires a medical diagnosis by a skilled Neurologist. Laboratory tests and neuroimaging may be required to exclude conditions which may mimic AD, as treatment of the mimics may be beneficial. Although there is no definitive cure for AD, medications and other management strategies may be beneficial in early stages.
What can be done – No treatment stops or reverses its progression, though some medications may temporarily improve symptoms. Treatment consists of cognition enhancing medications and management strategies aimed to improve symptoms. Supportive measures, physical exercise, occupational therapy amongst others are integral part of comprehensive management strategy of AD. Management requires a multi-disciplinary approach under expertise of Neurologist, Psychiatrist, Clinical Psychologist, Physical therapist, Occupational therapist, Speech therapist and, last but not the least, primary care provider.
Note: The information provided is a general medical advisory and does not necessarily apply to everyone. This information is not intended to provide medical advice. Please consult a doctor or contact a health care provider if you have a medical problem. If you have a medical emergency, call your doctor or emergency number immediately.