KOCHI: Memories are the most beautiful gift we are bestowed upon. It makes up the fabric of our lives and are the markers of the journey through life. Losing all the memories is one of the scariest prospects many of us face as we age.
Dementia is an umbrella term for a range of conditions that involve a loss of cognitive functioning including memory. Worldwide, at least 44 million people are living with dementia and more than 4 million people have some form of dementia in India.
Alzheimer’s disease
Alzheimer’s disease is the most common form of dementia, a brain disorder that impacts daily living through memory loss and cognitive changes. Alzheimer’s Association reports that one in ten people over 65 years of age, and nearly one-third of those over 85, have Alzheimer’s. Symptoms of Alzheimer’s usually develop slowly and gradually worsen over time, progressing from mild forgetfulness to widespread brain impairment.
Causes and risk factors
Unavoidable risk factors for developing the condition include ageing, a family history of Alzheimer’s and carrying certain genes such as Apoe4. Other risk factors that can be modified include high blood pressure, heart disease, stroke, diabetes, high cholesterol obesity, tobacco and excess alcohol use. Factors that increase the risk include undergoing severe or repeated traumatic brain injuries and exposure to some environmental contaminants. Brain tumours, stroke, epilepsy, certain genetic diseases affecting the brain, metabolic ailments, medication side-effects, alcohol and drug abuse, depression, emotional trauma, chronic stress, psychosis, sleep deprivation, delirium, infections such as meningitis, encephalitis, and syphilis, all can lead on to memory loss.
Diagnosing Alzheimer’s disease
There is no single definitive medical test for identifying Alzheimer’s. To receive a diagnosis of Alzheimer’s, the person must have experienced a decline in cognitive or behavioural function and performance compared with how they were previously. Other causes of memory loss have to be ruled out. Sometimes the symptoms of dementia are related to an inherited disorder, so genetic testing may be done. In 2016, researchers published findings suggesting that a change in sense of humour might be an early sign of Alzheimer’s. Recent research suggests that the features of Alzheimer’s, such as brain lesions, may already be present in midlife, even though symptoms of the disease do not appear until years later.
Coping with an Alzheimer’s diagnosis
If diagnosed with Alzheimer’s, the patient may feel anger, be scared about what the future will bring, uncertain about how your memory will change—or all of these emotions at once. Talk with your loved ones. Let them know what is important to you and who you want to make decisions for you when you’re no longer able.
Early-stage management
Encourage to use a notebook or smartphone to create a to-do list each morning and carry it with them. Keep items they use daily in easy to remember places. Caregivers should avoid questions that challenge short-term memory, such as “Do you remember what we did last night?” The answer will likely be “no,” which can be humiliating for someone with Alzheimer’s.
The patient may be having language problems –difficulty recalling words. Supply the word, or gently tell the person that you can come back to it later. Understanding – the patient may fail to understand what you’re saying. Speak slowly so they have more time to process what’s being said. Try a simpler statement with fewer words. Depression– Symptoms of depression and changes in sleeping patterns are common among early-stage patients. Depression is treatable. Make your loved one feel safe and supported and also create a calm environment to open up and talk about their emotions.
Drug therapy
No disease-modifying drugs are available for Alzheimer’s disease, but certain drugs are available which may reduce the symptoms and improve cognition and help improve quality of life. Also, activities and day-care programs with the involvement of support groups and services should be encouraged.
Care for the caregivers
Caregivers will also be dealing with a host of difficult emotions. Understanding what to expect will help to plan for care and transitions. A deeper knowledge of Alzheimer’s can help recognise patient’s capabilities throughout each stage of the disease, and caregiver can make sure whether they have the strength and resources to carry on.
How to prevent Alzheimer’s disease
1. Get moving - Regular exercise stimulates the brain’s ability to maintain old connections, make new ones, and slow deterioration of your cognitive abilities.
2. Social engagement - The more you connect face-to-face with others, the more you engage socially, the better your cognitive function will be.
3. Healthy diet - Eating a brain-healthy diet, such as the Mediterranean diet, can help reduce inflammation, protect neurons, and promote better communication between brain cells.
4. Mental stimulation - By continuing to learn new things and challenge your brain, you can strengthen your cognitive skills and stay mentally active for longer.
5. Quality sleep - Getting quality sleep can flush out brain toxins and avoid the build-up of damaging plaques.
6. Stress management - Unchecked stress takes a heavy toll on the brain, shrinking a key memory area, hampering nerve cell growth, and worsening Alzheimer’s symptoms.
The author is a consultant Neurologist, SUT Hospital, Pattom. (Views expressed are his own.)