By, Dr. Sreekanta Swamy, Lead Senior Consultant – Neurology, Aster RV Hospital
It is very important to create public awareness about Alzheimer’s disease, educate them to identify the disease in the early stage, to update the recent happenings in the diagnosis, and management of this problem.
Alzheimer’s Disease is the major cause of dementia. Dementia is a broad name for all those conditions which result in memory impairment. AD amounts to 70-75% of all dementias. There are other types of dementias which are less common e.g.: vascular dementia, frontotemporal dementia, dementia with Parkinson’s disease. Dementia like features can also be seen in some reversible conditions of brain like: Drug toxicity, metabolic changes, infections etc.
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Nearly 55 million people like with dementia all over the world, which expected to increase to 180 million in 2030. Over 60% of all [persons with dementia live in low- and middle-income countries. In India nearly 8.8% of people who are older than 60 years of age suffer from dementia. This is because of the increased survival of the aged population with improved healthcare facilities all over the world. Dementia is commonly seen after the age of 60 years. Dementia has significant physical, psychological, social and economic impact. In a study in 2019 the dementia related economical impact was nearly 1.3 trillion globally.
When we talk about dementia – mostly we mean dementia of Alzheimer’s type as it is the most common type of dementia.
Even though Alzheimer’s Disease was described as early as 1906 by German doctor Alois Alzheimer, till date there are no definitive methods to prevent it, or permanent cure. What ever we have at present is to slow down to progression. Lots of research are going on to find curative and preventive medications,
Alzheimer’s Disease is a progressive neurodegenerative disease resulting in significant memory impairment.
The disease affects mostly people above 60-65 years, females are more affected than males. It is commonly mistakes by general public as well as healthcare personnel as simply old age related changes, hence can go undiagnosed in a significant number of people. Rarely seen in people below 40 years of age(about 10%), and most of these are supposed to be due to genetic defect
Usually, progression of this disease is classified as early, middle and later stages.
In the early stage-mild mood changes, or behavioral changes which are not normally seen in healthy individuals, along with mild memory impairment mostly for recent events(may keep forgetting the things kept in an place, things to do , difficulty to remember the events)
In the middle stage- memory symptoms worsen to the extent of difficulty remembering the familiar names, sometimes not able to recognize the relatives and friends. Difficulty to find the way back when going out etc. Other symptoms like depression, anxiety, agitation, hallucination and sleep disturbances are common. His daily activities are significantly affected at this stage
In the late stages, the affected person cannot even recognize his own family members, total loss of insight, loss of bowel and bladder control, Death usually occurs due to multiple systemic causes, like infection, pneumonia etc.
The main pathological change in brain is due to accumulation of protein call beta amyloid which forms plaques outside the nerve cells and another abnormal protein called Tau inside the nerve cells in the brain, which results in dysfunction and disconnection of neuronal signal transmission.
Normally doctors investigate these patients to find out if there are any treatable causes, the important investigations are few blood tests , brain scan(PET scan), CSF examination
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As of now there are no medication to cure this disease, few of medications available since many years are given to slow down the progression of memory impairment.
Of late, two drugs have been approved by FDA-USA which has brought lots of hope for the Alzheimer disease sufferers. Bothof these are supposed to be helping if given in early stage.
Few factors are supposed to increase the risk of developing dementia as noted in several studies
Age- after 60 yrs- changes of developing Alzheimer’s disease increase with age.
High blood pressure, Diabetes, obesity, chronic alcohol consumption, chronic smoking, depression, social isolation etc. Managing these factors from the early ages may help prevent developing dementia at the latter age
Many NGO and Governmental associations are formed to help the people with Alzheimer’s disease and their care givers all over the world including India, the purpose of these is to educate care givers, financial help , educate healthcare providers, and update various advancements in the research filed concerning to Alzheimer’s Disease.
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