Sunset of memories
Around four million people in India suffer from Alzheimer’s disease, which is two to three times more common in older women than in men. In this three part series on Alzheimer’s, Dr Anil Chawla explains its symptoms, treatment and the extremely important role of a caregiver.
ALZHEIMER’S AND ITS SYMPTOMS
Alzheimer’s disease is a type of dementia. It is also called Senile dementia and is characterised by the impairment of memory, intellectual abilities and associated personality and behaviour changes that occur among elders usually after 65 years of age. It is generally slow in onset and is a progressive, primary degenerative cerebral disease of unknown aetiology. Alzheimer’s disease occurs in a small percentage of individuals of advancing age. According to one study in US, Alzheimer prevalence was estimated to be 1.6% in the year 2000, in both overall and in the 65–74 age group, with the rate increasing to 19% in the older 75–84 group and to 42% in the greater than 84 group. According to 2010 estimates, about 5.4 million people in US suffer from Alzheimer’s. In India, the rough estimate is around 4 million. Alzheimer’s disease is two to three times more common in women than in men. The symptoms of Alzheimer’s include:
a) Forgetfulness or memory impairment
b) Functional and behaviour changes which may be noticed by the family members, like poor judgement, difficulty in making calculations and handling money, inability to write cheques or use public transportation, etc.
c) As the disease advances, the person becomes confused, disoriented and incapable of doing activities of daily living like eating, grooming or using the toilet.
d) Some people develop personality changes like becoming aggressive, suspicious, delusional (holding strange beliefs), quarrelsome and agitated while some develop apathy and become socially withdrawn. Anxiety and depression and sleeplessness can also occur.
e) Mis-identification of objects are common, like the washing machine detergent may be mistaken as wheat flour; a round tablet may be picked up as a key to unlock the door. It goes to the extent that the person may fail to recognise himself or herself in the mirror and say there is someone else.
f) Some people with the disease tend to wander away from home as they hear voices (Auditory Hallucinations) and think that someone is calling them outside. Many get lost as they are confused and disoriented and can’t find their way back.
g) With further advancing disease the control over urinary bladder and bowel is lost leading to incontinence.
h) Total dependence on caregivers develops eventually.
Warning Signs
Forgetfulness or memory disturbances which are becoming perpetual, inability to learn something new or recall recent events are the things which should ring a warning bell. It’s all right if you forget whether it is Monday or Wednesday, why you went to the next room or where you left your keys. It’s not all right if you forget that you have already had breakfast and ask for it again or don’t remember how to make a telephone call; how to find your way around your home or the way upstairs; the names of your spouse or children or whether it is summer or winter.
Cause and Risk Factors
Unfortunately , the cause of Alzheimer’s disease is unknown. A small percentage of Alzheimer’s (less than 1%) which begins early, that is before 60 years of age, may have a genetic basis. Alzheimer’s is largely sporadic and not familial. The main cause is advancing age of the individual. The risk factors are advancing age and family history plus genetic factors in some. Some probable risk factors are also lack of education, oestrogen deficiency, viral brain infections, aluminium toxicity and head injuries.
Next: Diagnosis and treatment
Dr Chawla has 37 years of experience in the medical field. His work has ranged from being a full-time senior consultant in Medicine at IBRA, Oman; Royal Hospital, Oman; Salmaniya Medical Center, Bahrain to being a lecturer-professor at reputed institutes like Oman Medical College; AIIMS and Maulana Azad Medical College in India. He is M.B.B.S, M.D (Medicine-PGI, Chandigarh), M.R.C.P (U.K), F.R.C.P(Glasgow)
Silver Talkies 
preeti jain
August 30, 2011
great article, lot of information.
everybody should read this