Every year on October 21st, World Alzheimer's Day is observed to raise awareness about this debilitating disease. The goal is to educate the public about early detection, diagnosis, and management strategies.
Dementia and Alzheimer's Disease
Alzheimer's Disease (AD) is the most common cause of dementia, a broad term encompassing conditions that impair memory and cognitive function. While AD accounts for 70-75% of dementia cases, other forms include vascular dementia, frontotemporal dementia, and dementia associated with Parkinson's Disease. Additionally, some reversible conditions like drug toxicity, metabolic changes, and infections can mimic dementia symptoms.
Nearly 55 million people live with dementia all over the world, which is expected to increase to 180 million in 2030. Over 60% of all [persons with dementia live in low- and middle-income countries. In India nearly 8.8% of people who are older than 60 years of age suffer from dementia. This is because of the increased survival of the aged population with improved healthcare facilities all over the world. Dementia is commonly seen after the age of 60 years. Dementia has significant physical, psychological, social and economic impact. In a study in 2019 the dementia related economical impact was nearly 1.3 trillion globally.
When we talk about dementia – mostly we mean dementia of Alzheimer’s type as it is the most common type of dementia.
Global impact
Dementia is a growing global health concern, with an estimated 55 million people affected worldwide. This number is projected to rise to 180 million by 2030. Over 60% of individuals with dementia reside in low- and middle-income countries. India alone has nearly 8.8% of its population over 60 years of age living with dementia, largely due to increased life expectancy.Dementia has significant physical, psychological, social, and economic consequences. A 2019 study estimated the global economic impact of dementia at nearly $1.3 trillion.
Understanding Alzheimer's Disease
Alzheimer's Disease is a progressive neurodegenerative disorder characterized by memory impairment and cognitive decline. It primarily affects individuals over 60, with women being more susceptible than men. While it's often mistaken as a normal part of aging, Alzheimer's Disease can be diagnosed in individuals as young as 40, particularly in cases with a genetic predisposition.
Alzheimer's Disease typically progresses through three stages:Early stage: Mild mood changes, behavioral alterations, and difficulty remembering recent events. In the early stage-mild mood changes, or behavioral changes which are not normally seen in healthy individuals, along with mild memory impairment mostly for recent events(may keep forgetting the things kept in an place, things to do , difficulty to remember the events)
Middle stage: Worsening memory problems, challenges with familiar tasks, and difficulties with language and orientation. In the middle stage- memory symptoms worsen to the extent of difficulty remembering the familiar names, sometimes not able to recognize the relatives and friends. Difficulty to find the way back when going out etc. Other symptoms like depression, anxiety, agitation, hallucination and sleep disturbances are common. His daily activities are significantly affected at this stage
Late stage: Severe memory loss, inability to recognize loved ones, loss of independence, and challenges with basic daily activities. In the late stages, the affected person cannot even recognize his own family members, total loss of insight, loss of bowel and bladder control, Death usually occurs due to multiple systemic causes, like infection, pneumonia etc.
The primary pathological changes in Alzheimer's Disease involve the accumulation of beta-amyloid plaques outside nerve cells and tau protein tangles inside nerve cells. These abnormal proteins disrupt neuronal function and communication.
Diagnosis and Treatment
Diagnosis of Alzheimer's Disease typically involves a combination of medical history, cognitive assessments, and brain imaging tests. While there is currently no cure, medications can help slow the progression of the disease in some cases. Additionally, managing risk factors like high blood pressure, diabetes, and obesity can help reduce the risk of developing Alzheimer's Disease. Normally doctors investigate these patients to find out if there are any treatable causes, the important investigations are few blood tests , brain scan (PET scan), CSF examination. Of late, two drugs have been approved by FDA-USA which has brought lots of hope for the Alzheimer disease sufferers. Both of these are supposed to be helping if given in early stage.
Support and Resources
Many NGO and Governmental associations have been formed to help the people with Alzheimer’s disease and their caregivers all over the world including India, the purpose of these is to educate caregivers, financial help, emotional support, practical advice on managing challenges associated with the disease, educate healthcare providers, and update various advancements in the research filed concerning to Alzheimer’s Disease.
(Author: Dr. Sreekanta Swamy, Lead Senior Consultant - Neurology, Aster RV Hospital)
