Aug 7, 2010
“Lost her mind, crazy, a wacko, senile” these are the terms we hear in everyday conversations about millions of people who have a serious, debilitating, neurological condition called dementia. It has been estimated that over 29 million people are diagnosed with dementia all over the world and a few more millions go undetected and therefore untreated because they are discounted as cases of age-related senility.
Dementia is characterized by loss of cognitive functions like memory, reasoning, thinking, judgment and so on. A person with dementia might also lose his or her ability to make decisions, to communicate clearly and to have an orientation to place, time and people. Many neglect their appearance, hygiene and personal safety. In some cases, the onset is gradual and in others, it is rapid. It has been found that some forms of dementias can be treated effectively if caught in the initial stages.
There are different types of dementias and not knowing the difference between them makes recognition and treatment challenging. Some of the common types of dementias are: Multi infarct dementia or vascular dementia, Alzheimer’s dementia, and atypical pre-senile dementia.
Alzheimer's dementia
One of the most incapacitating and irreversible dementias is called Alzheimer’s which affects millions of people every year. It is not just forgetfulness. It involves personality changes, neurological changes and also behavioral changes. It is a brain disease which is characterized by multiple lesions in the brain which slowly envelop the entire brain and destroy the cells rapidly. Areas of the brain that control memory, judgment, thinking and feeling are affected the most and as nerve cells in these areas die, a person loses control of all related functions.
Dr. Alois Alzheimer was the first to recognize the symptoms and write about this disease which came to be named after him. To a certain extent, memory loss and cognitive decline are part of growing older. Every person start losing some brain cells after the age of forty but at this age, the brain grows new cells to compensate for the lost ones. Decreased attention and concentration, increased reaction time and slower thinking and problem solving skills and loss of short term memory are some of the common symptoms of cognitive decline associated with aging. In Alzheimer’s dementia however, this decline is markedly rapid and the brain is unable to generate new cells.
What are some of the symptoms of Alzheimer's Dementia (AD)?
• Loss of recent memory: Even though the person has just finished his or her breakfast, he/she might say something like “They don’t feed me at all; it has been ages since I ate.” Asking the same questions and repeating oneself are the initial symptoms to appear in those suffering from AD. Switching on the stove and forgetting to turn it off can be a fire hazard; People go to bed with a lit cigarette in their hand which can also burn the mattress down and set the whole house ablaze in minutes. Misplacing personal items like keys is very common.
• Problems with language, calculation, abstract thinking, and judgment: The person with AD might have difficulty finding words to express himself/herself; lose all inhibitions, modesty, sense of shame etc- may undress in public, not be able to differentiate between the bathroom and the living room. They may have difficulty knowing the time of day, date, and place which is commonly seen during the middle stages of the disease. Persons with dementia are often confused and wander away from home or familiar surroundings and are unable to trace their way back home.
• Depression, anxiety, and personality changes: Suspicion, aggression, abusive and assaultive behaviors, crying spells, extreme dread are some of the symptoms that appear as the disease progresses.
• Late in the disease process, the person may experience hallucinations- they start seeing things and hearing noises, people talking; they may start gesturing and talking to themselves. Delusions or unshakable false beliefs also develop in some patients and they may say people are out to kill them, people are plotting against them, family members are conspiring against them, stealing their belongings, etc.
• In the advanced stages of this illness, a person may lose his or her ability to walk, sit without support, and may lose bladder and bowel control. Alzheimer's disease is incurable and is degenerative. The person eventually becomes completely dependent on family caregivers for all activities of daily living.
In a nutshell, it is a cruel disease which literally robs a person of his or her dignity and identity! AD can result from the accumulation of two kinds of abnormal structures in the brain- amyloidal plaques and neurofibrillary tangles which are directly related to the plaques and lesions found in the brains of people with AD. In simple language, the brain develops some dark spots and knots which lead to rapid decay of cells. What exactly causes the formation of these plaques and tangles in the brain is still being investigated.
What does research say?
The following are some of the preliminary findings of several research studies on Alzheimer’s dementia (AD) which could perhaps help keep Alzheimer’s at bay.
• People who take turmeric in their daily diet do not develop cognitive decline.
• Those who eat fish everyday have lower incidence of AD compared to those who don’t.
• Those with a history of diabetes, heart diseases, and high levels of LDL cholesterol are at a higher risk of developing AD.
• People who keep their brains fit after retirement by mental exercises- crosswords, number puzzles, chess, and reading have a lower incidence of AD.
• Family history of AD increases a person’s risk for dementia.
• Brain tumors, infections or head injury can also lead to the development of dementia in later years.
• Increasing the intake of foods rich in vitamin B can help decrease AD risk. Oranges, legumes, leafy green vegetables, wheat germ, broccoli are useful. Folic Acid supplements are also suggested.
• Loneliness is a risk factor for AD.
• Taking cholesterol lowering statins lowers the risk of developing AD.
• Physical exercise helps slow down the aging process and cognitive decline.
• Pranayamas, especially anulom-vilom pranayam reportedly helps in the regeneration of brain cells and prevents cognitive decline.
• High stress-levels in adult years can lead of a rapid loss of cognitive functions in later life.
(Excerpts from various sources)
Living with someone who has Alzheimer’s Dementia
Living with someone who has Alzheimer’s dementia is a Herculean task for family members and loved ones. Memory loss experienced by the person becomes a frustrating and agonizing experience for family. Unpredictable nature of the person’s behavior often makes the family and loved ones walk on eggshells. It is difficult to predict when the person is going to flare up.
It is important for the family and loved ones to be compassionate and to understand that the abusive, assaultive outbursts are part of the illness and have nothing to do with what the family does or says. Sometimes they express doubts and suspicions even about the right intentions of family and friends. They get angry without any provocation and lash out at loved ones for silly reasons. Care should be taken to ensure that the person does not feel stupid no matter how silly the behavior is.
They often feel anxious and fearful: they imagine that the loved ones are out to get them or harm them in some way. Those who have ‘sun-down syndrome’ usually sleep during the day and feel comfortable when there is broad day light but are afraid at night. Leaving the lights on in the bedroom will help them feel secure.
Caring for someone who has this debilitating disease is not very easy. Even the most loving and patient family members lose their cool. Compassion is the key in understanding someone with Alzheimer’s. We don’t scream and yell at a 2 year-old who has peed in his pants, do we? But we somehow have difficulty in coping with the same behavior of an 80-year-old. Family needs to educate itself on the symptoms and admit that the person is like a child trapped in a grown up’s body, that’s all.
Gradually, as the disease progresses, the person loses memory completely and is unable to recognize family and friends. The capacity to learn new things, to follow simple instructions, to speak, to write, that we take for granted is lost. They don’t know how to bathe, how to eat, how to dress up and become totally dependent on others for all the activities of daily living. It is often painful for loved ones to watch a person deteriorate so rapidly. A calm, docile individual taking a180 degree turn and transforming into an aggressive, volatile human being is quite unnerving to say the least.
It is time to wake up!
India has enjoyed comparatively a low incidence of Alzheimer’s compared to the developed countries but global experts now caution that developing countries like India and China will be impacted worst in the next few years. According to World Health Organization, currently there are more than 18 million people suffering from Alzheimer’s dementia worldwide.
Despite international research and advancement of scientific knowledge, we still know very little about this deadly disease and are far away from finding a cure for AD. What we have been able to do to date is to slow down the progression of the disease or manage a few of the psychotic and neurological symptoms associated with Alzheimer’s. It is about time we woke up from our slumber and got ready to tackle this calamity.
Dr Lavina Noronha - Archives :