Dr S K Gupta
The World’s Population is aging. Improvement in health care in the past century have contributed to people living longer and healthier lives. However, this has also resulted in an increase in the number of people with non-communicable diseases, including Dementia. Current estimates indicates that 44 million people worldwide are living with dementia. This number will double by 2030 and triple by 2050. Dementia does not just affect individuals. It also affects and changes the lives of family members. Dementia is a costly condition in its social, economic and health demensions. Nearly 60 percent of the burden of Dementia is concentrated in low and middle-income countries and this is likely to increase in coming years.
According to World Health Organization the Human brain is most complex structure of our body which is responsible for each and every activity of our body happening automatically such as beating of heart breathing and all other activities performed consciously.
To perform these functions brain has 100 billion neurons and their 300 trillion connections almost like a master computer with so many different programmes. These connections are communicating with each other through electrical and Chemical signals. It is this unique ability of brain which makes us to peform different functions like, walking, talking, thinking, reasoning and remembering and behaving the way we do. Dementia literally means “Loss of ability to think.”
The diseases which was described in 1907 by Alois Alzheimer’s is more than 100 years of Alzheimer’s disease.
Dementia deprives us from all those attributes that make us human, our capacity for love, for planning and reasoning for making and recalling memories and it happens due to loss or malfunctioning of neurons. Thus dementia is gradual irreversible decline of brain function which slowly interferes with a person’s ability to carry out tasks of normal daily living.
Dementia may be defined as a diffuse deterioration in the mental capacities, resulting from brain dysfunction; usually secondary to organic disease of the brain. It manifests itself primarily in thought, memory and intelligence and secondarily affects feeling and conduct which can be of sufficient severity to interfere with social and or occupational functioning.
Incidence of dementia in developing countries accounts for more than 50 percent of the global elderly population. By the year 2020 approximately 70 percent of the World’s elderly popularion will be in the developing countries and India accounting for more than 15 per cent of them.
Alzheimer’s disease is the most common cause of dementia in western countries with increasing incidence and have an immense social impact. In India it accounts for a sizable percentage of all cases of dementia in old age. Alzheimer’s disease is more common in females and sometimes it may be seen in more than one member of a family.
The Brain Atrophies with age and which is inevitably, but these changes are mild and may not manifest, clinically. By contrast severe degrees of diffuse cerebral atrophy that evolve over a few years and invariably associated with dementia and the underlying pathologic changes in these cases most often prove to be those of Alzheimer’s disease.
The number of risk factors associated with Alzheimer’s disease are :-
Head Injury
Parental age
Depression and
Smoking
The Patient with Alzheimer’s disease presents with memory disturbance -forget fullness is the major symptom. Small day to day happenings are not remembered and which may be ignored. Appointments are for gotten and possession are misplaced. Question are repeated again and again. Remote memory is preserved and recent is lost. Patient usually forget what breakfast he has taken, speech also gets affected-patients forgets to recall words, ultimately speech becomes difficulty.
Faults in balancing the checkbook, mistakes in figuring the price of items and is unable to carry out simplest calcuations. In some patients visospatial orientation becomes defective. The car cannot be parked. Cannot put on clothes properly and way to home is lost.
Late in the course of illness, the patients forget how to use common objects and tools.
Disability or impairment of Judgment and reasoning occurs. Vocabulary becomes restricted and conversation rambling and repetitions, misuse of proper names and inability to formulate phrases or sentences occurs. There may be destruction of speech function as a whole so that speech becomes increasingly meaningless and ends in a jargon.
Lastly patient has difficulty in walking and unsteadness in walking and unsteadiness in gait and ultimately patient losses the ability to stand or walk, being forced to lie inert in bed and having to be fed and bathed and legs curl into a fixed posture of flexion and may pass urine in the clothes.
The symptomatic course of this tragic illness usually extends over a period of five years or more.
Depression with insomnia and anorexia also occurs in 5-8 percent of cases. Delusions and psychotic behaviour increase with progression of Alzheimer disease and present 30 percent of the patients.
Agitation may coexist in upto 20 percent Hallucinations occur with similar frequency which may be visual or auditory.
* Diagnosis of the disease is made by history clinical findings. Blood tests, CT Scan and MRI Scanning.
As on date there is not much treatment for dementia. Therefore, it is important to decrease the impact of disease by reducing the aggravating factors of course the patients are helped by early detection of the disease, exercise, good diet, vitamins and other neuroprotective drugs. Considering the severity of the illness and burden to the society let us come forward to be more aware about the disease and help the elderly population, who are at great risk of this serious illness by making the disease more understandable to common man in the society.
Ways to reduce the risk
No matter what your age or stage of life is you have power to change many variables that influences your brain health. Following habits incorporated early may help to live longer with better brains.
* Mental Exercise :
Build physical and mental activities into everyday- Exercise halts dementia gene from being expressed and keeps your brain healthy. Moderate exercise may be single most effective way to prevent dementia.
* Eat Healthy:
Whole grains, fruits and vegetables, nuts and unsaturated fats. Also research has found turmeric and coconut oil to be protective and may even help new brain cell growth.
* Maintain healthy weight and body shape. Always treat your chronic diseases like high blood pressure, high blood sugar, and abnormal lipids with your doctor’s help.
* Don’t smoke;
* Challenge your mind :
Putting off retirement cuts chances of dementia. “Use it or loose it” Keeping the brain mentally challenges is one way to prevent dementia. Speaking more than one language also seems to help.
* Build a strong social network
Have a positive mindset and purpose to live- Negative mindset and lack of purpose increase risk of dementia.
The theme of Alzheimers Day is “No time to lose”. The key message is that no one has any time to loose, as the number of people with dementia around the world is set to double over the next 25 years.
The message is targeted to people with Dementia their family, members of Alzheimer’s Society, Govt officials, parliamentarian, medical professionals and media. This would also help to destigmatise demystify this condition.
(The author is a neurologist)
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