ALZHEIMER’S DISEASE: A BURDEN AMONG THE ELDERLY

What is Alzheimer’s Disease?

Alzheimer’s disease is a mental degenerative disorder common among elderly individuals and is characterized by gradual loss of memory, cognitive skills, speech and even loss of basic ability to carry out routine tasks. It is also referred to as Senile Dementia due to its prevalence among the older adults and the characteristic loss of cognitive function. It is ranked as one of the leading causes of death among elderly individuals worldwide. Alzheimer’s disease is classified among a group of diseases known as dementias, which are common causes of cognitive malfunction among the elderly. In a number of cases, the disease can get so severe that it affects the daily life of the person, causing them to rely heavily on external support for their routine activities. 

What causes Alzheimer’s Disease?

The pathophysiology of the disease is quite complex and the exact cause is not fully understood by Scientists. The disease develops from a complex interplay of several factors such as lifestyle, environment and genetics, which culminate into age-related adverse changes in the brain. On a basic level, Alzheimer’s disease is said to be caused by an abnormal accumulation of certain proteins in the brain, which are known as ‘amyloid’ and ‘tau’ proteins. The amyloid protein deposits tend to form plaques around the brain cells, while tau protein deposits form tangles within the brain cells. As the brain cells become damaged due to the buildup of these proteins, there is an accompanying decrease in certain chemical messengers in the brain called neurotransmitters, which are involved in signal conduction between brain cells. An example of such neurotransmitter is acetylcholine, which has been observed to be commonly depleted in the brains of persons with the disease. The damage to brain cells and depletion of acetylcholine over time eventually leads to destruction and shrinkage of brain tissue in various parts of the brain.

The process of development of the disease is known to take place many years (up to a decade) before the symptoms actually appear. There are a number of risk factors for Alzheimer’s disease, which include being above the age of 60 years, having a family history of dementia, being a sufferer of Down’s syndrome, having severe head injuries, and also having a cardiovascular disease. Other minor risk factors include living a sedentary lifestyle, loneliness or social isolation, untreated depression and having prior loss of hearing. 

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What are the Signs and Symptoms of Alzheimer’s Disease?

The first symptoms of the disease vary widely among individuals. The most typical sign of Alzheimer’s disease is the development of memory problems, a condition called mild cognitive impairment (MCI). This includes temporary memory loss, impaired cognitive function (reasoning and comprehension), loss of sense of smell, vision/spatial problems, etc. Such persons typically experience difficulty answering questions without repetition, handling money and paying bills, signs of wandering and absentmindedness, and spending longer time to complete normal daily tasks. As the disease progresses to a moderate stage, the loss of memory and cognitive function worsens, along with confusion or delirium, hallucinations and delusions, inability to recognize family and friends, and difficulty carrying out multistep tasks such as dressing up or fixing a meal. As the disease progresses to the severe stage, the elderly persons lose their ability to communicate effectively, are unable to carry out any cognitive functions like reasoning or remembering concepts, and they become completely dependent on others for their care. At this stage, the brain tissue has shrunk significantly and brain damage is irreversible, leading to the shutdown of other body systems, and the individual becomes bedridden till the point of eventual death.

Source: New Scientist. https://bit.ly/3gn3xqg

How can Alzheimer’s Disease be diagnosed?

There are several methods employed in the process of determining if a person with memory problems has Alzheimer’s disease or not. The medical history of the patient plays a basic role, along with memory, language and cognitive skill tests to gauge their mental function. Standard medical diagnostic tests like blood and urine lab tests, as well as CT and MRI brain scans are used in the process of diagnosis to confirm if the individual is positive for Alzheimer’s disease or not. Such tests may be repeated periodically to give the doctor more information about how the person’s memory and other cognitive functions are changing over time.

How can Alzheimer’s Disease be treated?

The disease is complex and cannot easily be treated by any single specific drug or intervention, neither does it have any cure. The current methods of treating Alzheimer’s disease focus on helping the individual maintain mental function, treating the underlying disease process, and managing their behavioral symptoms. Some medications exist which are currently in use for treating the disease, such as Rivastigmine, Donepezil and Memantine. These drugs work by regulating neurotransmitters in the brain, with the aim of reducing the symptoms and helping with some behavioral problems. A certain drug called Aducanumab has been approved as a modification therapy for treating Alzheimer’s disease, as it has shown to be effective in reducing the accumulation of amyloid deposits in the brain and also helps to slow the progression of the disease. However, the medication has not yet been shown to affect clinical outcomes in improving cognitive skills or dementia. Several other disease-modifying medications are currently being manufactured and tested in clinical trials with elderly persons suffering mild cognitive impairment, to ascertain their effectiveness as potential treatments.

How can Alzheimer’s Disease be prevented?

There are no specific preventive measures that have been proven to be completely effective against the disease, but a number of factors exist that may play a role in reducing one’s risk of developing Alzheimer’s disease and other types of dementia. These factors revolve around living a healthy lifestyle and include regular exercise, avoiding smoking, maintaining proper mental health, eating a balanced diet, controlling cardiovascular risk factors like high blood pressure, and regularly utilizing cognitive and memory skills. Maintaining these factors is pivotal to ensuring the overall good health of elderly persons, and has a cumulative effect in reducing the risk of Alzheimer’s disease among the elderly.

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