Alzheimer

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September: World Alzheimer’s Month

September 21: World Alzheimer’s Day

What is this disease all about?

Alzheimer’s disease is a progressive disease that destroys memory and other important mental functions. It’s the most common cause of dementia — a group of brain disorders that results in the loss of intellectual and social skills. These changes are severe enough to interfere with day-to-day life.

In Alzheimer’s disease, the brain cells themselves degenerate and die, causing a steady decline in memory and mental function. Current Alzheimer’s disease medications and management strategies may temporarily improve symptoms. This can sometimes help people with Alzheimer’s disease maximize function and maintain independence.

But because there’s no cure for Alzheimer’s disease, it’s important to seek supportive services and tap into your support network as early as possible.

According to the US-based Alzheimer’s Association, there are over 4 million people in India who suffer from some form of dementia.

Alzheimer’s disease vs dementia

Dementia is a syndrome and not a disease, which Alzheimer’s is. The two are, however, closely related. Dementia’s various symptoms include loss of memory, thinking skills, problems with language, changes in the mood, deterioration in behaviour and an individual’s ability to perform everyday activities. It is most commonly caused by Alzheimer’s disease, which accounts for dementia in over 50-75% of the cases. Dementia can be caused by other diseases such as Parkinson’s and Huntington’s disease as well. It also has types, such as Lewy body and vascular dementia. 

What are the causes?

Scientists believe that for most people, Alzheimer’s disease results from a combination of genetic, lifestyle and environmental factors that affect the brain over time.

Less than 5 percent of the time, Alzheimer’s is caused by specific genetic changes that virtually guarantee a person will develop the disease. Although the causes of Alzheimer’s are not yet fully understood, its effect on the brain is clear. 

Alzheimer’s disease damages and kills brain cells. A brain affected by Alzheimer’s disease has many fewer cells and many fewer connections among surviving cells than does a healthy brain. As more and more brain cells die, Alzheimer’s leads to significant brain shrinkage. When doctors examine Alzheimer’s brain tissue under the microscope, they see two types of abnormalities that are considered hallmarks of the disease:

Plaques: These clumps of a protein called beta-amyloid may damage and destroy brain cells in several ways, including interfering with cell-to-cell communication. Although the ultimate cause of brain-cell death in Alzheimer’s isn’t known, the collection of beta-amyloid on the outside of brain cells is a prime suspect.

Tangles: Brain cells depend on an internal support and transport system to carry nutrients and other essential materials throughout their long extensions. This system requires the normal structure and functioning of a protein called tau. In Alzheimer’s, threads of tau protein twist into abnormal tangles inside brain cells, leading to failure of the transport system. This failure is also strongly implicated in the decline and death of brain cells.

Symptoms

At first, increasing forgetfulness or mild confusion may be the only symptoms of Alzheimer’s disease that you notice. But over time, the disease robs you of more of your memory, especially recent memories. The rate at which symptoms worsen varies from person to person.

Memory

Everyone has occasional memory lapses. It’s normal to lose track of where you put your keys or forget the name of an acquaintance. But the memory loss associated with Alzheimer’s disease persists and worsens, affecting your ability to function at work and at home. 

Disorientation and misinterpreting spatial relationships: People with Alzheimer’s disease may lose their sense of what day it is, the season, where they are or even their current life circumstances. Alzheimer’s may also disrupt your brain’s ability to interpret what you see, making it difficult to understand your surroundings. 

Changes in personality and behaviour: Brain changes that occur in Alzheimer’s disease can affect the way you act and how you feel. People with Alzheimer’s may experience Depression, Anxiety, Social withdrawal, Mood swings, Distrust in others, Irritability and aggressiveness, Changes in sleeping habits, Wandering, Loss of inhibitions, Delusions, such as believing something has been stolen.

Many important skills are not lost until very late in the disease. This is because information, skills and habits learned early in life are among the last abilities to be lost as the disease progresses. Capitalizing on these abilities can allow you to continue to have successes and maintain a high quality of life even when you are into the moderate phase of the disease.

Risk Factors

Increasing age is the greatest known risk factor for Alzheimer’s. Alzheimer’s is not a part of normal aging, but your risk increases greatly after you reach age 65. Nearly half of those older than age 85 have Alzheimer’s. People with rare genetic changes that virtually guarantee they’ll develop Alzheimer’s begin experiencing symptoms as early as their 30s.

Family history and genetics: Your risk of developing Alzheimer’s appears to be somewhat higher if a first-degree relative — your parent or sibling — has the disease. 

Sex: Women may be more likely than are men to develop Alzheimer’s disease, in part because they live longer.

Lifestyle and heart health: Some evidence suggests that the same factors that put you at risk of heart disease also may increase the chance that you’ll develop Alzheimer’s. Examples include:

• Lack of exercise
• Smoking
• High blood pressure
• High blood cholesterol
• Elevated homocysteine levels
• Poorly controlled diabetes
• A diet lacking in fruits and vegetables

These risk factors are also linked to vascular dementia, a type of dementia caused by damaged blood vessels in the brain. 

Lifelong learning and social engagement: Studies have found an association between lifelong involvement in mentally and socially stimulating activities and reduced risk of Alzheimer’s disease.