World Alzheimer's Day 2021: Know Causes, Symptoms And Treatment For This Condition

Alzheimer's disease is one such Neurological illness of old age, which progresses gradually affecting various aspects of memory in a step wise manner. It leads to atrophy (shrinking) of the brain tissue until the cells finally die. The unfortunate part is that since being a disease of the elderly, many families attribute the memory issues to be a part of the routine aging process. They even refuse to seek medical attention until it worsens to its severe form.

Causes - 
Pathologically there is deposition of abnormal proteins called as Beta amyloid proteins and tau proteins which occurs in clusters called as Plaques and tangles. These abnormal clusters can hinder the neuronal transmission within the brain networks. Since these pathologies are expressed more in the memory zones, memory become the first cognitive function to be affected. Subsequently they involve the behavioural and other executive areas of the brain.

Many researches have shown that the biological process leading to Alzheimer's can be triggered by combined environmental, lifestyle and genetic factors.

Various risk factors explained to develop the dementing illness are some non-modifiable ones like increasing age and genetic inheritance. 

At the same time there are many other modifiable risk factors like uncontrolled blood pressure and diabetes, uncontrolled cholesterol levels, unhealthy habits like smoking, sedentary life style, obesity and so on. 

A special mention has to be made on unhealthy sleep habits- Recently conducted studies from UK have shown that proper, sufficient sleep prevents the formation of the abnormal proteins in the brain. These studies also show that quality sleep also hastens the clearance of these abnormal Beta amyloid proteins.  Sleep is rightly so called as the refresh button of your brain networking system. Sleep hygiene plays a vital role in preventing / postponing Alzheimer's disease. This point has to be understood by many who sacrifice their sleep for various reasons. 

Signs and symptoms - 
Patients with Alzheimers present with stages in levels of symptoms-

In early stages - patients have mild forgetfulness, mood changes like anxiety and irritability. Loss of initiative, decline in communication skills and way finding difficulties can also ensue in the initial stages.

Further it steps into the next stage where the patient becomes confused with shortened attention span. There will be difficulty in reading and writing. Behavioural abnormalities with personality changes can follow. Loss of appetite and self-neglect leading to other secondary health issues can happen. Way finding difficulties leading to anonymity in their own surroundings have also been reported in many cases.

In the final stages patient is unable to recognise self and the family. Comprehending and expressing ideas becomes difficult as the speech is severely affected. Severe disorientation and confusion results. Finally performing the basic daily activities like urination, chewing and swallowing food per se can become a tough task for some patients adding to the care giver's burden

For care givers - 

The above changes that are brought about by Alzheimer's disease can be challenging for the family members and caregivers as the AD patients at certain stage are unable to identify their loved ones. At times they mistake the caregivers as imposters trying to harm them. 
The self-anonymity of the patients makes them feel to be alienated. The caregivers should understand their helplessness by which they can maintain the continuum of care.

Identification and treatment - 
Appropriate diagnosis is a must as there are many overlaps and differentials in the diagnosis of such a cognitive illness. Recent developments in the field has led to remarkable growth in clinical assessments, psychometric testing, cerebrospinal fluid analysis of abnormal proteins (A Beta 1- 42) biomarkers, magnetic resonance imaging (MRI) and positron emission tomography (PET) imaging of the brain to detect symptoms of neurodegenerative diseases at its earliest stages. 

There is no definite cure for Alzheimer's. However the progression can be delayed by using certain medications. These drugs used in various formulations including patching help to alleviate the symptoms.

(Dr. Praveen Chander N is a  Senior Consultant - Headache and Sleep medicine, Department of Neurology at Gleneagles Global Health City, Chennai)

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