Rising trend of prevalence of Alzhemier’s disease

In the light of the hectic lifestyles of today, it is not surprising to find a rising statistical trend of the prevalence of Alzhemier’s disease. The WHO (2007) estimates that while there are currently about 18 million people worldwide with Alzheimer’s disease, this figure is projected to nearly double by 2025, especially in the developing countries.

As we get busier in our daily lives, running behind deadlines, multitasking and getting stressed, it is fairly common for most of us to experience lapses of memory. We might not remember the deadline for a submission until the last minute, we may miss our appointment for our doctor’s visit, may forget to shop for groceries on the way back home, or might stand in front of an open cupboard and wonder what we were looking for!

While forgetfulness and memory decline is accepted as a normal part and parcel of the degenerative ageing process, it is necessary to spread an awareness of the warning signs, which could enable the earlier identification of an Alzheimer’s disease. Earlier identifications would pave the way for beginning the treatment process. Even though the deterioration caused by Alzheimer’s disease cannot be reversed or stalled, its progress can be slowed, with the provision of appropriate support networks for the person as well as the family in order to help preserve the functioning for a longer period of time.

Whenever a person is suffering from memory loss that disrupts the person’s functioning in his or her daily life, there is an indication of suspecting the diagnosis for an Alzheimer’s disease. Even though its lifetime prevalence rates are significantly higher in the older populations, nevertheless an earlier onset is not uncommon, and hence we should be aware of the signs and symptoms of Alzheimer’s disease.
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• -Inability to recall previously learnt information – The most common signs of Alzheimer’s disease include misplacing things frequently, forgetting names, appointments, important dates or events; asking the same questions repeatedly. Such individuals begin to depend on others’ guidance and assistance for things they might have previously been confident of completing independently.
• -Difficulty in recalling vocabulary of common words - Often these people might have problems with new words both in oral as well as written forms. They might have problems in following or joining conversations, and hence would often be seen avoiding communication in social situations. They might stop in the middle of a conversation, not knowing how to continue, forgetting where they left off, and ending up repeating themselves. They can struggle to find the right word, and often get confused in spellings as well.
• -Social withdrawal - Such people may end up excluding themselves from social situations, in order to avoid an embarrassment due to their confused state. They avoid making conversations, and prefer staying alone.
• -Difficulty in recognizing familiar people – It can be very distressing for family and friends, as the person may start getting confused and misrecognizing the familiar people around them, mixing up their names, and at later stages even being unable to recognize their near and dear ones, treating them like strangers instead.
• -Disturbances in executive functioning – They are unable to plan and organize activities, and find it difficult to keep track of monthly accounts, forgetting the sequence of a familiar recipe, along with difficulty in concentrating on tasks, with delayed reaction times, and slower responses.
• -Disorientation – Such people may often get confused with time or place, losing track of days, seasons, years and even the passage of time very easily. They might forget where they are, or how they reached there, and for how long they have been there.

• -Daily tasks become a chore – Even familiar and routine tasks may end up becoming a challenge, as they might find it difficult to complete tasks at home, work or for leisure. Often such people do not admit that they do not recollect how to go about such mundane chores, and are even labelled as being lazy and unmotivated to complete their routine tasks.
• -Changes in mood and personality – People with Alzheimer’s disease usually tend to become irritable and easily upset. It is annoying for them to realize their helplessness, and this frustration often leads to suspiciousness and mistrust of others around them. They remain confused, and may also become anxious or depressed.

It is important to realize that Alzheimer’s disease does not just impact the individual’s life, but furthermore also has an adverse influence on the caregivers. In fact getting support from the family and friends is a vital step towards the management of Alzheimer’s disease. Since it is a progressive degeneration, enabling an earliest identification and seeking professional help is imperative to be able to reduce the pace of deterioration. With the help of medications as well as neuropsychological support, it is possible to help the individual preserve his level of functioning for a longer period of time.

The relation between memory and emotions is clearly established, and research has shown evidence for changes in lifestyle to help improve our memory.

• -Lifestyle management – Regular physical exercise, and adequate sleep and appetite are essential to help in reduction of our stress levels, thereby helping us stay mentally active. We should organize our daily schedule in order to manage a healthier lifestyle.
• Memory aids – Using visual cues like wall charts, post-it notes, checklists, and calendar diaries helps in planning as well as remembering. Repetitive practice and mental retracing helps in learning newer information, using methods like chunking, first letter acronyms, method of loci and word games.
• -Intellectual stimulation – It is important not only to keep ourselves physically fit, but also mentally active. Solving Sudoku, mazes, and other puzzles, reading, or learning any novel activity like a new language or musical instrument, that makes us use activate our brain cells is the best exercise we can provide to maintain our memory.

(Author is director, Mental Health & Behavioural Sciences, Fortis Hospital)