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Alzheimer's disease: A cause of progressive dementia in senior citizens

Published : Friday, 7 December, 2018 at 12:00 AM  Count : 1383

Alzheimer's disease: A cause of progressive dementia in senior citizens

Alzheimer's disease: A cause of progressive dementia in senior citizens

Alzheimer's disease is practically ranked as the third leading cause of death just behind heart disease and cancer for older people in the United States. As Bangladesh, bearing the world's eighth-largest population of more than 160 million, the expected number of people over 60's is projected to be increased to 9% by 2025 and 21% by 2050. According to the Alzheimer's  Society of Bangladesh,  it is estimated that there are about 4,60,000 people with dementia in Bangladesh in 2015 while the number will rise to 8,34,000 in 2030 and 21,93,000 in 2050 respectively. Hence, Alzheimer's going to be a bigger burden for us in the upcoming decade.
What is Alzheimer's disease?
Alzheimer's is a type of dementia that causes problems with loss of memory and thinking skills, behavioural disturbance and eventually, the ability to carry out the simplest tasks for elderly people usually after the 60s. Like all types of dementia, Alzheimer's is caused by irreversible and progressive brain cell death. Therefore, initial symptoms are mild but they become more severe over time.
What really happens in the brain?
In 1906, Dr Alzheimer, the disease is named after whom, noticed a suspicious death of a woman who had been suffering from an unusual mental illness. Her symptoms included memory loss, language problems and unpredictable behaviour. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangles bundles of fibres (now called neurofibrillary, or tau, tangles). These plaques and tangles in the brain are still considered as some of the main features of Alzheimer's disease. Another feature is the loss of connections between nerve cells (neurons) in the brain. Many other complex brain changes are thought to play a role in the destruction and death of nerve cells that causes memory failure, personality changes and other symptoms of Alzheimer's disease.
Dr Abhishek Bhadra Honorary Medical Officer, Internal Medicine BSMMU

Dr Abhishek Bhadra Honorary Medical Officer, Internal Medicine BSMMU

Symptoms of Alzheimer's:
Though the early symptom of Alzheimer's started with memory loss, the first symptoms may vary from person to person. Primarily, alongside dementia, people get difficulties in daily simple tasks like driving a car, cooking a meal or paying bills. Moreover, others may be unable to learn new things, to carry out multi-step tasks such as getting dressed or cope with new situations. In addition, some patient may ask the same questions over and over, get lost easily, lose things or put them in odd places and find even simple things confusing. As the disease progresses, some people become worried, angry or violent. Consequently, memory loss and confusion grow to worsen and people begin to have problems even recognizing family and friends. Finally, the patient cannot communicate and are completely dependent on others for their care. Near the end, the person may be in bed most or all of the time as the body shuts down.
Risk factors:
Increasing age is the greatest known risk factor as the majority of people with Alzheimer's are 6o and older. However, early-onset Alzheimer's occurs between a person's 30s and mid-60s though it is very rare. Beside this, a positive family history, carrying certain genes, repeated traumatic brain injuries, exposure to some environmental contaminants (such as toxic metals, pesticide, and industrial chemicals) are responsible for the disease.
Treatment and prevention:
Alzheimer's has no current cure but treatments for symptoms are available and research continues. Although current Alzheimer's treatments cannot stop Alzheimer's from progressing, they can temporarily slow the worsening of dementia symptoms and improve quality of life for those with Alzheimer's and their caregivers. For this reason, more emphasis should be given on prevention. There are some modifiable factors that may help to prevent Alzheimer's include:
* Getting regular exercise: Living an active lifestyle is good for everyone, including people with Alzheimer's disease. Studies have suggested that physical activity in later life can help to reduce cognitive decline. Although exercise won't cure the disease, it can improve a person's mood, confidence and self-esteem. It can also lower the risk of heart disease, some forms of cancer and other ailments. Gardening, swimming, walking, even simple dancing are great ways to stay active outside.
* Peace of mind: Yoga can ease stress and boost strength and flexibility. Researchers found that people who did yoga for 3 months had better memories than those who did other "memory enhancement exercises," such as crossword puzzles.
* Maintaining a healthy heart: Managing the risk of cardiovascular disease, diabetes, obesity, smoking, and high blood pressure finally help in keeping good mental health.
* Following a varied and healthy diet: Studies show people who eat a Mediterranean diet (rich in vegetables, fish and nuts while limiting intake of red meat and replacing butter with healthy fats, such as olive oil) and get plenty of physical activity are the least likely to get Alzheimer's.
* Continue learning: Participating in lifelong learning and cognitive training help to prevent dementia.
* Be more social:  Some studies suggest that staying mentally and socially engaged may possibly reduce the risk of Alzheimer's.
* Take care of yourself: Make sure that you take at least a few minutes to do something you enjoy every day. Stay in touch with friends and keep up with hobbies when you can. Find friends or relatives to be your support person to avoid loneliness.
When to see a doctor:
According to Alzheimer's Association in the USA, if anyone notices any of the following 10 Warning Signs of Alzheimer's in oneself or someone other, there is no scope to ignore them rather should have an appointment with a doctor. 10 warning signs are:
1)    memory loss that disrupts daily life
2) challenges in planning or solving problems,
3)    difficulty completing familiar tasks at home, at work or at leisure,
4)    confusion with time or place,
5)    trouble understanding visual images and spatial relationships
6)    new problems with words in speaking or writing,
7)    misplacing things and losing the ability to retrace steps,
8)    decreased or poor judgment,
9)    withdrawal from work or social activities,
10)    changes in mood and personality.
It is a matter of great regret that, along with stigma there is very little awareness and knowledge regarding dementia among the people of Bangladesh and for this reason, people with this disease do not get proper care and are isolated from the society at large. Though Alzheimer's is not a big issue for the present time, to prevent a future fatal mental disease we all should accept the reality, recognize the problem as well as come forward with everything possible from our own stand in mitigating its sufferings.

Myths about  Alzheimer's disease
*    Myth 1: Memory loss is a natural part of ageing.
*    Myth 2: Alzheimer's disease is not fatal.
*    Myth 3: Only older people can get Alzheimer's.
*    Myth 4: Treatments are available to stop the progression of Alzheimer's disease.

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