According to the World Alzheimer Report 2021, Dementia is the 7th leading cause of mortality globally. This report by Alzheimer’s Disease International says that 55 million people are living with dementia presently, and only less than 25% are actually diagnosed. Moreover, this percentage may be much less in low income countries.
Alzheimer’s disease is a common neurodegenerative disease that is usually found in people of old age. It affects their cognitive and behavioural skills by degenerating neurons in some parts of the brain. It comprises around 60 per cent of dementia cases across the globe.
This disease causes plaque formation in the cerebral cortex and hippocampus, the areas for cognitive thinking and memory respectively. Due to this, the memory of the patient gets affected, which in turn impacts their social and occupational health.
Alzheimer’s disease develops slowly, and it takes about a decade for the symptoms to become evident. Prior to this stage, the mild effects on memory experienced by the patient remain unnoticed.
There is no treatment to cure the brain tissue from degenerating at present, but the rate of progression can be slowed with the help of medication. However, the disease may eventually lead to death due to the loss of basic functions like nutrition, excretion, etc.
- Most common symptom is memory loss, which starts from mild confusion and later progresses to severity, where the person has difficulty remembering even basic things like how to swallow.
- Disorientation and feeling lost
- Problems in communication and difficulty in finding words to form sentences
- Delusions, paranoia and hallucinations
- Mood changes and anxiety
- Difficulty recognising faces
- Difficulty solving normal problems like interpreting the clock
- Difficulty in performing day to day tasks like bathing, eating, etc.
Although no single specific cause has been established, genetic, lifestyle and environmental causes have a role in the development and progression of Alzheimer’s disease.
Research has shown that toxic proteins are developed in the brain, which cause neuronal damage leading to their atrophy and damage. This results in shrunken and small brain cells.
The plaque deposits can be of two types:
- Amyloid type: Beta amyloid protein deposits in the brain.
- NeuroFibrillary tangles (NFTs): Tau protein forms a toxic condition called tangles around the brain cells.
- Age: The chances of getting Alzheimer’s disease increases significantly after 60 years of age.
- Family history: Positive history of this disease in patients or siblings with presence of APOE 4 gene increases the chances of getting the disease highly
- Hereditary genetic disorders: Conditions like Down Syndrome are also potential risk factors.
- Sex: Research shows that females tend to get more affected than males, although there is a lack of clarity of reason behind this claim.
- Head trauma: It causes atrophy of neurons that can lead to the disease development
- Untreated depression may contribute to the occurrence of Alzheimer’s disease.
- Excessive alcohol consumption over a long period of time can lead to brain damage, which may play a role in the development of the disease.
- Poor lifestyle: Presence of Diabetes mellitus, hypertension and poor sleep schedule also increases the risk.
There are mainly three stages of this disease:
- Mild Alzheimer: There are small changes in the cognitive and behaviour skills of the person like confusion, taking longer in paying bills, mood swings, etc.
- Moderate Alzheimer: Significant memory loss along with difficulty in recognising faces, impulsive behaviour, delusions, etc.
- Severe Alzheimer: There is severe atrophy of the brain leading to inability to conduct basic day-to-day activities like communication, dressing , eating, etc. The patient is usually bed ridden at this stage.
- Severe problems in communication due to which the person is unable to tell about any pain or discomfort.
- Secondary infection
- Abnormal intake of food and water
- Imbalance leading to falls and fractures
- Forgetting medicines and treatment plans
- Inability of the patient to remember themself and their family members.
These severe complications completely hamper the patient’s normal life to increase the risk of accidents.
Making the correct diagnosis is at times a very difficult task. As forgetfulness is usually associated with the normal ageing process, the initial and early diagnosis of Alzheimer’s remains ignored.
The following steps are taken in order to assess the brain function and structure to make the diagnosis:
- Cognitive and memory tests to assess the person’s ability to think and remember.
- Neurological function tests for the assessment of their balance, senses, and reflexes.
- Blood or urine tests to see whether the affected proteins are getting excreted out.
- CT scan or MRI scan of the brain to assess the atrophy of the brain tissue and deposition of the plaques
- Genetic testing to assess the APOE 4 gene involvement
As of now, there is no medicine or treatment available to cure the disease. However, there are various programmes and support groups both for the patient and their family to assist on managing the signs and symptoms especially in the later stages.
They teach the patient some basic problem solving abilities, communication skills, daily chores, etc., which helps in improving their quality of life.
As no definitive establishment cause is known, there is no fixed preventative protocol. However, taking the following measures will help in maintaining general health of the body and better functioning of all the systems, which will prevent the disease development and progression:
- Healthy diet intake
- Good sleep schedule
- Regular physical activity
- Quitting smoking and consumption of alcohol
- Visiting the doctor as soon as the problem is noticed
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