What is Alzheimer's disease?
Prema was 59 years old when she started having problems with her memory. She could not remember names or phone numbers. She repeated many of her daily tasks assuming that they hadn't been done earlier. Sometimes, she asked her husband the same question over and over again. Prema was friendly and courteous by nature, but of late, she had become quite aggressive with others. Her husband was worried due to this unusual behavior and he decided to consult a doctor. After listening to Prema's story, and after conducting specific tests, the doctor diagnosed the condition as Alzheimer's.
This fictional narrative has been constructed to aid the understanding of this disorder by placing it in a real life situation.
Alzheimer's disease is an irreversible neurodegenerative disorder that causes a steady decline in memory, thinking skills and other important mental functions. Alzheimer's is a type of dementia and is progressive, that is, the symptoms become more severe as time passes, and significantly disrupts a person's ability to manage daily tasks.
What are the symptoms of Alzheimer's disease?
A person in the early stages of Alzhiemer's may experience loss of memory. As the disease progresses, the symptoms become severe. Although some symptoms are common, their severity and the way they affect a person may vary.
Memory: Slow decline in memory, which makes the person forget events, conversations, names of family members and other people. The person may misplace things and may find it difficult to remember day-to-day events.
Disorientation and misinterpreting spatial relationships: The person may not be able to sense the season, day of the week, time and the current life situations. The brain may also not be able to interpret what the person sees, making it difficult to understand the surrounding environment. This problem will eventually lead to the person getting lost in familiar places.
Speaking and writing: Difficulty in finding the right words to identify things, express thoughts and participate in conversations. Over time, the ability to read and write also declines.
Thinking and reasoning: Difficulty in thinking and understanding about abstract concepts like numbers. This could lead to problems in managing bank accounts, personal finances, and payments.
Making decisions: Difficulty in observing things or activities and making decisions. For example: switching off lights, closing the tap when water is overflowing, driving slowly in traffic, etc.
Managing daily tasks: Routine activities like bathing, getting dressed, cooking, or playing a favorite game becomes progressively difficult. Eventually, the person may forget these basic tasks and would need assistance.
Personality and behavior: The changes in the brain can affect behavior. The person may have other problems like depression, anxiety, social withdrawal, mood swings, distrust in others, disturbed sleep patterns, irritability or wandering.
What causes Alzheimer's disease?
Doctors and scientists have not yet found an answer for what causes Alzheimer's disease, because there are several factors like age, genetics, environment, lifestyle and overall general health, which may be one of the reasons. In some people, the disease may develop silently for many years before symptoms appear.
Age: Age is considered to be the greatest risk factor for dementia. People above 60 years are more likely to be affected by this disease.
Genetic inheritance: Scientists observe that Alzheimer's could be hereditary, but the theory is not completely proven yet.
Other factors: People suffering from Down syndrome and who are aged above 50 or 60 years are likely to be affected with Alzheimer's.
According to the World Alzheimer's Report, older people are likely to have multiple health conditions. They often have serious co-morbid physical and mental health problems. These multiple illnesses will interact in complex ways to disrupt the person's day-to-day activities and make them dependent on caregivers for all their needs.
What is the science behind Alzheimer's disease?
Research is still being conducted to learn a lot more about what causes Alzheimer's disease. One risk factor for this type of Alzheimer's disease is a protein called apolipoprotein E (apoE).
Everyone has apoE, which helps carry cholesterol in the blood. The apoE gene has three forms.
One protects a person from Alzheimer's disease, and another makes a person more likely to develop the disease. Scientists are yet to discover other genes that increase the risk of Alzheimer's disease or the ones that protect against Alzheimer's disease.
How is Alzheimer's disease diagnosed?
Doctors use several methods to determine fairly accurately whether a person has Alzheimer's or whether the symptoms are caused due to any other physical or mental health issue.
While doing a diagnosis, doctors may:
Make note of the overall health, past medical problems, daily routines, changes in behavior and mood
Conduct tests of memory, problem solving, attention, counting, and language
Conduct standard medical tests, such as blood and urine tests, to rule out other problems that may have caused these symptoms. For example, thyroid problem, side effects of medication, depression, brain tumor, and rupture of blood vessels in the brain can cause symptoms similar to Alzheimer's. And some of these problems are treatable.
Perform brain scans such as computed tomography (CT) or magnetic resonance imaging (MRI), to distinguish Alzheimer’s from other conditions.
Early diagnosis helps
An early diagnosis helps patients and their families plan for the future. They can discuss about the caregiving options while the patient is able to make decisions. Early diagnosis also helps to treat the symptoms of the disease to a great extent.
Getting treatment for Alzheimer's
There is no cure for Alzheimer's disease and no way to slow down the degeneration of brain cells. If treatment is given during the early stages, the person may be able to remain independent and carry out daily tasks for a longer period of time.
Alzheimer's disease is a progressive disease, but its course can vary from 5 to 20 years. The most common cause of death is infection, especially pneumonia.
How to care for someone with Alzheimer's?
A person affected by Alzheimer's experiences a myriad of emotions – frustration, helplessness, confusion, anger, fear, uncertainty, anxiety, grief and much more.
If you're caring for someone with Alzheimer's, you can help them cope with the disease by being there to listen, reassuring the person that life can still be enjoyed, providing support, and doing your best to help the person retain dignity and self-respect.
A calm and stable home environment can help reduce behavioral issues. New situations, noise, large groups of people, being forced to do certain tasks may cause anxiety and stress because when the person becomes upset, the ability to think clearly declines even more.
While your loved one is still able to make important decisions, contact your lawyer and let the patient decide on his/her finances, medical treatment, and other legal matters. The patient can designate someone to make health care decisions and manage finances on his/her behalf. This can help you have a concrete plan when your loved one is no longer able to express his or her wishes.
Caring for the caregiver
Caring for someone with Alzhiemer's can be physically and emotionally draining. Feelings of anger and guilt, stress and discouragement, inner turmoil, grief, and social isolation are common. The caregiver may need support to be able to cope with the situation.
If you're a caregiver for someone with Alzheimer's, you can help yourself by:
Learning as much about the disease as you can
Asking questions to doctors, social workers and others involved in the care of your loved one
Calling on friends or other family members for help when you need it
Spending some time for yourself
Spending time with your friends
Taking care of your health by seeing your own doctors on schedule, eating healthy meals and getting exercise
Joining a support group
Getting support from a local adult day care center, if possible
Many people with Alzheimer's and their families benefit from counseling and support groups. Contact your local Alzheimer's association to connect with support groups, doctors, resources and referrals.
How can Alzheimer's be prevented?
Several studies have been conducted to learn how changes in lifestyle can help prevent Alzheimer's.
Experts observe that diet, exercise or a healthy lifestyle may prevent a person from being affected by Alzheimer's. Since these healthy choices promote good overall health and may play a role in maintaining cognitive health, it is recommended to follow this wellness plan:
Regular exercise has proved to be beneficial for heart health and may also help prevent cognitive decline. Exercise may also help improve mood.
A nutritious diet rich in fruits and vegetables and proteins is another healthy choice that may help protect cognitive health.
Omega-3 fatty acids found in fish is also proved to be good for cognitive health.
An active lifestyle with meaningful activities.