World Alzheimer's Day: Symptoms And Prevention Of Alzheimer's Disease
Alzheimer’s disease is a brain disorder which leads to gradual worsening and loss of memory. In later stages, the affected individuals are unable to hold a conversation or respond to their environment.Alzheimer’s disease is one of the most under-recognised public health crises of the 21st century. 1-9 people in the age group of 65 years or more, and 1-3 people in the age group of 85 years or more, have been identified to have Alzheimer’s disease.
In the earlier stages, memory loss and confusion may be mild, for example, a person may find it difficult to recall recent events or to make decisions. In the later stages, a person may not recognise their family members, may forget relationships, call family members by other names, or face difficulty in locating their home. They may even forget what a pen or a fork is used for. These changes are some of the most painful ones for the caregivers and immediate families. While the existing medications cannot stop Alzheimer’s disease, they may help lessen symptoms for a limited time.
Early Warning Signs
Here are few early warning signs of Alzheimer’s disease:
1. Asking the same question, over and over again.
2. Repeating the same story, word-for-word.
3. Difficulty completing tasks or activities that were previously done with ease and orderliness.
4. Money problems: difficulty paying bills or balancing a chequebook.
5. Getting lost in acquainted surroundings, or misplacing things.
6. Disregard for hygiene and grooming: avoid bathing or wearing the same clothes repeatedly.
7. Difficulty making decisions: depend on someone else, such as spouse, to make decisions or answer questions, they previously would have handled themselves.
Presence of one or more of these symptoms indicate the need of examination by a medical specialist trained in evaluating memory disorders.
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The target of prevention programs in Alzheimer’s and Mild Cognitive Impairment (MCI) is to delay the onset or worsening of symptoms by a few years. This would have a huge influence on public health. The available research evidence suggests that physical activity, intellectual activity and social engagement are the most helpful factors in reducing Alzheimer’s and cognitive decline. Some encouraging results are seen with nutritional, pharmacological and lifestyle modifications. Vitamins and antioxidants don’t have a proven role in reducing the risk of dementia.
The ‘National Institute on Aging (NIA)’ encourages the role of exercise to prevent diseases, to maximise independence and improve mobility, while reducing depression. Thirty minutes of exercise to improve endurance, strength, balance, and stretching is recommended. Higher education has a protective effect; mental exercise and training increase “brain reserve”, thereby, delaying or even preventing cognitive decline.
The ‘Mediterranean diet’, rich in antioxidants consisting of fresh fruits, plant foods, olive oil, dairy products, fish and poultry with limited amounts of eggs and red meat, is known to provide some protection against cognitive decline. Marital status, participation in social and political events in the community, contact with family and friends also help in delaying or preventing cognitive decline. In particular, people who are single and live alone are at an increased risk of Alzheimer’s disease. Social activities may protect people against developing cognitive decline.
Although at present, Alzheimer's disease has no cure, but available treatments can temporarily slow-down dementia and its symptoms and improve quality of life. Early recognition of its symptoms and using appropriate strategies to prevent the progression, remain critical in effective management of Alzheimer’s disease.
Dr Pawan Ojha is a Consultant Neurologist and Stroke Specialist at Hiranandani Hospital, Mumbai.