Article by Dr. Sreekanta Swamy, Head of Neurology, Aster RV Hospital, JP Nagar, Bangalore
Alzheimer’s Disease (AD) is a slow and progressive brain disorder which results in the gradual worsening of memory and thinking skills, eventually resulting in an inability to do even simple things over time. It is the most common type of dementia (a group of diseases which results in memory impairment). It amounts to nearly 70% of all causes of dementia. Why people develop this disorder is not yet known so far. The sufferer experiences symptoms because the nerves present in the brain that carry out the function of thinking, memory, learning (called cognitive functions), are damaged or impaired.
There are nearly 55 million people affected with dementia all over the world and nearly 70-80% of them have been diagnosed with Alzheimer’s disease. This number is projected to increase to 155 million in 2050. As the healthcare system is improving all over the world, the number of aged population is also increasing which results in more number of elderly people being diagnosed with dementia.
Sufferers of AD experience loss of productive abilities, increased dependence on family for care and create a huge economic impact on the society. Nearly 50% of Alzheimer patients are living in resource poor countries. It is commonly seen in people over the age of 60-65 years of age, and increases in number with the increase in age.
AD is caused due to the accumulation of a protein called beta- amyloid outside the nerve cells and an abnormal protein called tau inside the nerve cells. These accumulations result in the impairment of supply of nutrients to nerve cells in the brain and finally death of the nerve, which then progresses and results in shrinkage of the brain. These changes initially involve the nerve cells in the brain which are responsible for memory and learning, but as the disease progresses it will involve other parts of the brain.
The average life span after diagnosing AD is about 4-8 years, but some can live up to 15-20 years
The progression of Alzheimer’s disease can be divided into 3 stages.
Stage 1. Mild or early stage
In this stage most people can function independently in many areas and may need assistance with some activities. They are able to drive and take part in most activities. An important feature in this stage is the impairment of recent memory which may show slow worsening over time. This stage usually lasts for 2-4 years.
Stage 2. Moderate
In this stage most people show impaired memory, difficulty in remembering names, places, confusion, inability to recognize familiar places, mood changes, aggression, sleep disturbances, hallucinations and delusions. Many people show uninhibited and improper behavior. They may have stiffness of the limbs, limitation of movements. Most people required assistance for their day to day activities. This stage is usually long duration spanning from 2-10 years
Stage 3- Severe Stage
In this stage all the affected people need total assistance for all the day to day activities round the clock. They may be incontinent, feeding may be difficult and mobility may be significantly restricted, with poor recognition of self and surrounding. This stage may last for 1-3 years
All those people who are around the age of 60-65 years, who show impairment of their recent memory- like forgetting familiar names, forgetting places of objects, difficulty in finding familiar ways and places should be evaluated by a neurologist. This is important because while dementia could be the reason, the root cause can be another treatable condition if evaluated correctly and with treatment a patient can significantly improve.
Currently there is no permanent cure for Alzheimer’s disease anywhere in the world. Some of the medications which can delay the progression of the disease are used in all the affected patients.
Many studies suggest that the following helps in slowing the progression
- Getting regular exercise to stimulate your brain’s ability to maintain good brain health
- Stay socially engaged. Connecting face-to-face with others can help improve your cognitive function
- Eat a brain-healthy diet. The right foods can help reduce inflammation and promote better communication between brain cells.
- Get quality sleep to flush out brain toxins and avoid the build-up of damaging
Most importantly, a person affected with this disease has to be supported by a multidisciplinary team which is supervised by a Neurologist, psychiatrist, psychologist, physiotherapist and most importantly expert nursing care. The caregiver plays an important role in the management of person with Alzheimer’s disease along with the help of other family members