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What is Alzheimer’s disease?
Alzheimer’s disease (AD) is a progressive mental deterioration that destroys memory and other important mental functions due to generalized degeneration of the brain. It generally occurs in middle or old age, due to damage of brain tissues. It is a common type ofdementia, a syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities. It is one of the major causes of disability and dependency among older people worldwide. It has physical, psychological, social and economic impact not only on the people with dementia, but also on their care givers, families and society at large. The impact of the disease begins slowly and gets worse over time affecting quality of life and life expectancy.
What is the disease burden?
Alzheimer’s disease (AD) is a growing public health problem among the elderly in developing countries. Also called Senile Dementia, it is a slowly progressive neurodegenerative disease of the brain that destroys memory and other important higher mental functions. It most often begins in people over 65 years of age.
Dementia Statistics
- Every 3 seconds someone in the world develops dementia.
- AD accounts for 60-70% of all cases of dementia.
- Worldwide, around 50 million people have dementia with a sizeable burden of disease in India with its ageing population.
- Nearly 10 million new cases come up every year worldwide.
- In India the annual incidence of AD among seniors aged more than 65 years is estimated to be approximately 10 per 1000.
Why it develops?
In Alzheimer’s disease, damage to the brain usually starts a decade or more before memory and other cognitive problems appear. Brain cells themselves degenerate and die, eventually destroying memory and other important mental functions. Alzheimer’s disease damages and kills brain cells. Patients suffering from Alzheimer’s disease are usually older, but the disease isn’t a normal part of ageing. The cause of AD is not well understood. However, genetic factors, depression, head injuries, hypertensions, obesity amongst others are presumed to cause AD.
What are the symptoms?
Alzheimer’s disease is responsible for robbing people of their memory. People with AD mainly suffer from progressive pattern of cognitive and functional impairment. They usually present with decline in cognitive functions such as forgetfulness, difficulty thinking and understanding, mental confusion particularly in evening, delusion, making things up, difficulty concentrating, inability to learn new things, inability to do simple calculation, or inability to recognize common things.
People with AD also suffer from behavioral changes in form of becoming aggressive, irritable, agitated, meaninglessly repeating own words; they may have personality changes in form of restlessness, lack of restraint, or wandering and getting lost; or they may suffer from mood changes in form of anger, apathy, general discontent, loneliness, or mood swings; they may have psychological problems such as depression, hallucination, or paranoia.
What are the stages of Alzheimer’s disease?
Stage 1– No Cognitive Decline: People in this stage have normal and healthy mental functions with no memory loss.
Stage 2- Very Mild Cognitive Decline: People generally have normal forgetfulness associated with ageing in this stage.
Stage 3- Mild Cognitive Decline: At this stage, a person’s loved ones will begin to notice a cognitive decline. There is an increase in forgetfulness, problem in focusing and concentrating, difficulty in finding the right word, decreased work performance.
Stage 4- Moderate Cognitive Decline: This stage includes decreased memory of recent events and difficulties in completing complex tasks efficiently. Patient also starts withdrawing from family or friends. Physician can detect clear cognitive problems at this stage.
Stage 5 – Moderately Severe Cognitive Decline: People have major memory deficiencies and need help to complete their daily activities. Memory loss is more prominent as the patient may not remember their address or phone number and may not know the time or day or their whereabouts.
Stage 6 – Severe Cognitive Decline: Patients require extensive assistance to carry out daily activities as the ability to speak declines. There is a loss of bladder or bowel control. They have little memory of recent events and many remember only some details of their earlier life.
Stage 7 – Very Severe Cognitive Decline (Late Dementia): In this stage, people have no ability to communicate. They require assistance with most activities. They also lose psychomotor skills like the ability to walk.
Why is early recognition important?
Initial symptoms are often mistaken for normal ageing. Although there is no definitive cure for AD, medications and other management strategies may be beneficial in early stages. It requires a medical diagnosis by a Neurologist. A comprehensive clinical evaluation and neuro-imaging may be required to diagnose AD as many other disorders can be confused with Alzheimer’s disease.
What are the treatments?
At present, there are no treatments to stop or reverse its progression, though some medications may temporarily improve symptoms. AD requires a multi-disciplinary approach under expertise of Neurologist, Psychiatrist, Clinical Psychologist, Physical therapist, Occupational therapist, Speech therapist and primary care provider. Treatment consists of cognition enhancing medications and management strategies aimed to improve symptoms.
Advisory by:
Dr K M Hassan
Associate Director Neurology
Jaypee Hospital, Noida
