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Alzheimer's Disease: Progressively Forgetting


Alzheimer's is not an obscure illness but an ailment affecting real people in real families like yours and mine. I want you to learn to recognise the signs of Alzheimer's disease, but at the same time be reassured that all forgetfulness is not dementia. – PowerPoint PPT presentation

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Title: Alzheimer's Disease: Progressively Forgetting

Alzheimer's Disease Progressively Forgetting
  • By- Dr Amitabha Ghosh

  • We all forget where we kept that box of
    firecrackers, or the bill that needs to be paid.
    But there is a more serious loss of memory that
    progressively begins to disrupt one's normal
    day-to-day functions. Alzheimer's disease is the
    commonest form of dementia, a disease of old age,
    and becomes increasingly frequent with every
    passing decade after 60 years.
  • Over the age of 80, more than 20 of people have
    mild dementia. Currently, over 3 million people
    suffer from dementia in India alone. In about 20
    years time, the numbers are expected to double,
    thanks to a greater life-span and to better
    identification of patients in large areas of our

The impact
  • Many elderly couples live alone these days. They
    are frail and particularly vulnerable. Their
    children may not live close by and could even be
    in a different country altogether, finding it
    difficult even to come down for Diwali. What
    would be the impact of Alzheimer's disease in
    such a couple?
  • Imagine the pain of seeing your partner slowly
    forget everything that was once special and
    precious to you. Forgetting all likes and
    dislikes, friends and relatives, or how to be
    happy or sad. And one day, even forgetting who
    you are! Imagine your helplessness on being left
    alone, caring for the one you care for most, but
    not knowing how to care. And then there is the
    grocery, the banks, the pension, the medical
    bills, all that for you to sort out. You are old
    and frail yourself but there is no time for all
    that. Medicines help a bit, but for you there are
    no balms of comfort. Such is the impact of
    Alzheimer's disease. It affects two people - the
    patient, but enormously more, the caregiver.

  • Alzheimer's is not an obscure illness but an
    ailment affecting real people in real families
    like yours and mine. I want you to learn to
    recognise the signs of Alzheimer's disease, but
    at the same time be reassured that all
    forgetfulness is not dementia.

Facts about forgetting
  • We all forget things, all the more as we age. A
    certain degree of forgetfulness is normal for
    every age group, especially in the elderly. That
    is not dementia. Some people are naturally bad
    with names, telephone numbers or addresses, as
    the case may be. That is 'normal' for them and is
    not dementia either. Ask their families and you
    will find that they have always been like that.
  • The worry is, when the memory loss exceeds what
    is normal for the person's age, education or
    nature. In such situations, a decline in dayto-
    day function may also be noticed. Appointments
    may be forgotten and memos may need to be kept.
    Shopping lists may be difficult to remember.
    Things may be misplaced and lost a bit too
    frequently. There may be difficulty remembering
    names and even recognising people not seen for a
    few years. Objects that have not been used
    recently may also be forgotten.

  • Wrong names may be used. Some may start losing
    their way, initially in unfamiliar and later in
    familiar places. They may have great difficulty
    in locating their seats in a train or in flight,
    for example.
  • And gradually, even forget the way to their own
    home. Conversation may be affected in many. Some
    cannot stop speaking while others sit quietly by
    themselves with almost nothing to say. Some speak
    with stutters and trip over words. Finding the
    right words may be difficult for many of them.
    Reading and handwriting may be affected
    pronunciation and spelling errors may be
    prominent. Signing a cheque could become a
    harrowing experience. Dressing, cooking, handling
    a remote control, a mobile phone or a push-button
    telephone may become difficult.

  • While any or all of these symptoms may be seen in
    Alzheimer's disease, loss of memory is typically
    the most prominent. Very often it is this loss of
    memory that draws the attention of the caregivers
    and other close relatives. At other times, a
    worried patient himself rings the doctor first.

The memory test
  • There are tests we can do to screen for
    Alzheimer's disease. Some of these are simple
    questionnaires that take around 10 minutes to
    finish. More detailed memory tests can be done
    later. Screening tests are easy to administer,
    require minimum training for the tester and can
    be performed at almost all settings like
    screening camps for Alzheimer's disease, general
    outpatient clinics and special clinics
    exclusively set up for memory disorders.
  • Besides picking out those with Alzheimer's
    disease or other forms of dementia, memory tests
    help us separate those who do not have dementia
    from those who have very mild memory impairments
    (mild cognitive impairment or MCI). This last
    group is particularly important. Most people with
    MCI will be forgetful - but only some will
    develop Alzheimer's disease. Others may have mild
    but significant forgetfulness for several years,
    while a few may even improve and be back to
    normal. Identifying patients with MCI and trying
    to treat them early is an area of major interest
    in Alzheimer's disease research today.

New horizon in treatment
  • Until now, much of the treatment of Alzheimer's
    disease has been symptomatic and not really
    geared to treat the root cause. This is now
    changing. Current international research is
    looking to find molecules that can act against
    the very proteins that cause Alzheimer's disease.
    Many such drugs are now in the pipeline and could
    be expected to hit the shelves over the next few
    years. These drugs seem to work best on patients
    with early and mild Alzheimer's disease. A
    heightened awareness and an early diagnosis of
    the disease are therefore essential.

Lowering the risks
  • Can you reduce your risk of having Alzheimer's
    disease? Researchers have been finding links
    between the occurrence of Alzheimer's disease and
    diseases of the small blood vessels of the brain.
  • MRI scans of the brain can sometimes pick up
    patchy, mini-stroke like areas in the brains of
    patients with Alzheimer's disease. This has led
    to the suggestion that good food, lots of green
    vegetables and an otherwise healthy lifestyle
    could reduce the chances of having Alzheimer's
    disease much as it reduces the risks of brain
    strokes and heart attacks. Turmeric, frequently
    used in Indian food, is also believed to be one
    of the protectors against Alzheimer's disease.

Caregivers' care
  • Looking after the caregivers and their needs is
    as much a part of Alzheimer's disease care as is
    looking after the patient. In this regard our
    social service systems leave a lot to be desired.
    The Alzheimer's disease and Related Disorders
    Society of India (ARDSI), in its own way, is
    trying its best to fill this vacuum. One day,
    drop in at one of their offices, share a thought,
    and show them that you care. Don't wait a whole
    year till the next World Alzheimer's Day 2016
    September 21st. Who knows how long you will
    remember the 'forgotten ones'?

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  • Dr Amitabha Ghosh is Senior Consultant
    Neurologist and Honorary Consultant-in-charge,
    Memory Clinic, Alzheimer's disease and Related
    Disorders Society of India at Apollo Gleneagles
    Hospitals, Kolkata