Dementia is now the 5th leading cause of death, worldwide. Every 3 seconds someone develops this syndrome which is estimated to be affecting approximately 50 million people, globally. Approximately 60% of people living with dementia are from low or middle-income countries.
Dementia is the general term used to refer to a decline in mental ability to the point of interfering with a person’s daily life. Therefore, Alzheimer’s is a type of dementia that affects memory and thinking as well as other mental abilities which can influence behaviour.
About World Alzheimer’s Day
The fact that dementia is a global problem is reason enough to expect that much is known about the syndrome. However, in many places there is very little or no knowledge of the disease. The need to create awareness about dementia and the need to challenge the stigma and discrimination that surrounds Alzheimer related dementia, are the main reasons why the World Alzheimer’s Day and Month were started.
The World Alzheimer’s Day (WAD), held every year on 21st September, is part of the World Alzheimer’s Month which offers a longer period of time for Alzheimer associations around the world to raise awareness. The WAD is the peak of the World Alzheimer’s Month and this year, 2019, marks its 10th anniversary.
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Understanding Alzheimer’s Disease
Even though the term dementia is often used interchangeably with Alzheimer’s, dementia is actually not a disease but a rather a collective term used to refer to symptoms that affect the brain, causing a deterioration in cognitive function, memory, thinking, learning capacity, language, development, behaviour and a person’s ability to perform normal everyday activities.
Alzheimer’s disease is the most common type of dementia accounting for 60% to 80% of dementia cases, globally.
What causes Alzheimer’s
Alzheimer’s occurs when there is a protein build up in and around the brain cells. These proteins include amyloid which is a form of plaque deposited around the brain cells, and tau which forms tangles within the brain cells. What leads to these protein deposits is, however, not clear.
There are several factors that are believed to increase the risk of developing Alzheimer’s disease. These include:
- Family history: Having a close family member who has Alzheimer’s can increase your risk of the condition. This can be due to inheritance of a single gene from the parents. Therefore, if you have had several family members develop dementia, you might need to seek genetic counselling to find out your chances of developing Alzheimer’s disease as you grow older.
- Genetics: Certain genetic faults such as those that cause Down Syndrome can increase Alzheimer’s risk as it can cause a build-up of amyloid plaques in the brain over time.
- Age: Older people around 65 years and above, are at a higher risk of developing Alzheimer’s. However, it is not a part of aging and it also does not mean that younger people cannot get dementia.
- Head injuries: Having severe head injury can also increase a person’s risk of developing Alzheimer’s.
- Lifestyle Factors: Certain factors such as smoking, being overweight or obese, and having high cholesterol, high blood pressure, diabetes and untreated depression, among other factors, can increase the risk of this disease.
The symptoms of Alzheimer’s progress slowly over years and they progress at different rates depending on the individual. These symptoms can, however, be confused for other conditions.Conditions such as stroke, infections, delirium and certain medicines can make Alzheimer’s symptoms worse.
Symptoms of Alzheimer’s in the early stages include;
- Misplacing items,
- Mood changes like anxiety and periods of confusion or agitation,
- Repetitively asking questions,
- Taking excessive time in making decisions,
- Having trouble thinking of the right word,
- Being hesitant to try new things,
- Forgetting recent conversations, and
- Forgetting names of objects and places.
In the middle stage, Alzheimer’s disease can cause symptoms such as:
- Repetitive, obsessive or impulsive behaviour,
- Increasing disorientation, for instance, not knowing what time of day it is,
- Mood changes like depression and increasing feelings of anxiety and frustration,
- Speech and language problems,
- Sleep disturbance,
- Delusions or paranoia,
At this stage, a person with Alzheimer’s might need help performing everyday tasks like eating, getting dressed and washing.
As the disease progresses, it can be distressing for the people with the condition, their careers and family, as well as friends, as the symptoms become severe. These may include:
- Weight loss which can be severe in some cases,
- Gradual loss of speech,
- Urinary or bowel incontinence,
- Significant short- and long-term memory problems, and
- Difficulty eating, swallowing and even moving around without any assistance.
In some cases, people with Alzheimer’s can be demanding, violent and even suspicious of those around them.
Can Alzheimer’s Disease be Diagnosed?
Early diagnosis of Alzheimer’s will not cure the condition, but it is the best chance at preparing and planning for the future by making the necessary adjustments. This is why if you experience constant memory problems, you need to consider seeing a doctor to determine what is causing your memory problems as they can be caused by other issues such as depression, certain medications, stress, and drug and alcohol use, and other health issues such as lacking certain nutrients in the body or having hormonal disturbances.
Seeing a doctor may not provide a final diagnosis but the doctor can refer you to the right specialist for the necessary assessment. The doctor can, however, also check other aspects of your health and do a physical examination. Some tests that can be carried out are, blood tests which;
- Help in assessing your general health,
- Check how certain organs like the kidneys and liver are working,
- Screen for certain genetic conditions, and
- Check whether you may have an infection.
If a doctor is still not sure which condition you may be suffering from, they can refer you to a neurologist, a geriatrician or a psychiatrist. Tests that can be done to diagnose this condition include:
A memory ability test (cognitive assessments) which involves having your mental abilities like the following assessed by a specialist:
- Concentration and attention span,
- Orientation on your awareness of time and place,
- Vision related abilities,
- Communication and language skills, and
- Short- and long- term memory.
These tests cannot be used alone to diagnose dementia as certain factors such as education can influence the results. Other tests that can be recommended by your specialist to determine the possible causes of your symptoms and the damage caused by these symptoms include:
Imaging tests like computerised tomography (CT), and magnetic resonance imaging (MRI) that assist in getting detailed images of your brain at different angles and other imaging tests like the PET scan and SPECT that are used to check how the brain functions or to determine whether there are any abnormalities in blood flow in the brain.
If your specialist suspects that your symptoms are being caused by epilepsy, they can recommend an EEG to record the brain’s electrical signals.
How is Alzheimer’s Disease Treated?
Alzheimer’s is not curable but there are medications available that help to reduce its symptoms.
- Medicines include Acetylcholinesterase inhibitors (a substance that helps the nerve cells in the brain to communicate with each other), and medications to help with behavioural and psychological symptoms of dementia.
- Cognitive stimulation therapy which involves group activities and exercises to assist people with Alzheimer’s to improve their memory and problem-solving skills.
- Cognitive rehabilitation that involves using parts of the brain that are working to help those that are not.
- Reminiscence and life story that involves using things like your favourite songs and possessions or photos to improve your mood and wellbeing.
Is it Possible to Prevent Alzheimer’s Disease??
It is difficult to prevent something, the cause is not known, which is the case with Alzheimer’s. The best thing you can do is reduce your risk factors for this condition, by:
- Reducing your risk of conditions like cardiovascular disease which increase dementia risk. This can be done by:
1. Not smoking
2. Eating healthy
3. Ensuring your blood pressure is in check
4. Getting treatment for diabetes if you have it
5. Regulating your alcohol intake
- Getting treatment for conditions that are directly responsible for dementia such as depression, hearing loss, social isolation and sedimentary lifestyle (the last by being more active).
- Being socially and mentally active by:
1. Maintaining an active social life
2. Trying out new hobbies
4. Listening to musical instruments
5. Doing voluntary work
6. Learning new languages, among other things
Dementia cases are estimated to reach approximately 82 million by 2030 and 182 million by the year 2050. This World Alzheimer’s Day please take the time to learn more about the condition as well as other mental health issues and help stop the stigma surrounding mental health as that is what stops most people from getting the treatment they need.
You can also offer your support to Alzheimer associations near you or around the world to continue creating awareness on dementia and helping people living with the condition which is a global burden costing to over 800 billion US dollars. If you have a family member or friend living with Alzheimer’s, being there for them and understanding what they are going through is one of the best things you can do for them, apart from helping them get the treatment and care they need.
Early diagnosis of mental health conditions including Alzheimer’s is crucial in helping patients to get the treatment they need to reduce symptoms and to be able to manage them.