Alzheimer’s disease is an age-related neurological disease that occurs due to the progressive shrinking, damage, and death (atrophy) of brain cells. Dementia too is an age-related disorder that occurs due to the damage and death of brain cells (atrophy). However, both diseases are not a part of normal ageing.Also Read - Why Crash Dieting is Bad For You, Nutritionist Manisha Chopra EXPLAINS | Watch Video

In India, an estimated 11% of people above the age of 65 years develop Alzheimer’s disease. Over 50 million people the world over have Alzheimer’s disease, of which 5.3 million are in India alone, and it is expected that the number of Alzheimer-related dementia is expected to go up to 10 million by 2040 (1 of every 27 people), as per a 2020 study on dementia. Also Read - Weight Loss Tips: Does Cutting Down on Salt Promote Weight Loss?

Alzheimer’s is the most common cause leading up to dementia. Also Read - One Dead, 40 Others Hospitalised After Attending Funeral Feast in Bihar's Muzaffarpur

Causes & Risk Factors

The exact causes of Alzheimer’s are not known. However, genetics, lifestyle, and environmental factors are identified to be the key factors influencing the progression of this disease, along with the poor and inadequate function of 2 specific proteins in the brain cells (neurons).

  • Age: The disease progresses gradually with the progression of age, and symptoms manifest long after the damage begins in the brain.
  • Family history: The risk increases if a first-degree relative (parent or sibling) suffers from Alzheimer’s.
  • Genetics: Genetics contributes to approximately 1% of all Alzheimer cases wherein the presence of APOE e4 protein (a variation of apoliopoprotein E gene) has been observed.
  •  Beta-amyloid, a fragment of a protein in the brain cells (neurons), begins to gather in clusters (called amyloid plaque, wherein dead cells debris is also a part of this plaque), causing neuron toxicity and malfunction, especially with regard to cell-to-cell communication, and cell death.
  • Tau proteins, which help in the internal neuron-to-neuron transportation of nutrients, change shape and form toxic structures called neuro-fibrillary tangles. These tangles interfere and disrupt the internal support and transportation system among cells.
  • Down’s syndrome: Those with Down’s syndrome have a much higher risk of developing Alzheimer’s 10-20 years earlier, as compared to others.
  • Gender: More women have Alzheimer’s than men, only because they have a longer life span than men.
  • Brain or head injury is found to be linked to cognitive decline associated with Alzheimer’s and dementia in later life
  • Epilepsy is also linked to the increased risk of Alzheimer’s and dementia in later life, and vice versa.
  • Lifestyle: The risk factors enumerated below contribute to a high risk of heart disease which is further linked to brain health and an increased risk of developing Alzheimer’s:
  1. Obesity
  2. Smoking and exposure to secondhand smoke
  3. Poor diet
  4. Lack of exercise and sedentary habits
  5. High blood pressure
  6. High cholesterol levels
  7. Vacillating sugar levels & Type 2 Diabetes
  • Social interaction: Lack of lifelong, consistent and healthy social interaction, low learning abilities and poor education are also linked to the increased risk of Alzheimer’s in later life.

Symptoms

  • Deterioration in brain function manifests gradually in the manner given below. However, interestingly, the part of the brain which deals with skills like reading, appreciation of music, dancing or drawing, may deteriorate at a much later stage:
  1. increasing absent-mindedness,
  2. decreased ability to remember conversations and recent happenings,
  3. memory lapse, memory loss, and difficulty remembering or recognizing previously familiar places, people and objects,
  4. lack of concentration,
  5. difficulty in organizing and articulating thoughts,
  6. inability to multitask,
  7. increasing inability to recognize numbers and dealing with bills and other such;
  8. gradually finding it increasingly challenging to accomplish daily routine tasks such as eating, bathing, and dressing.
  9. Social withdrawal,
  10. Mood disorders, apathy and depression,
  11. Disturbed sleep pattern,
  12. Delusionary behavior

Diagnosis

Through microscopic examination of the brain, plaques and tangles in the brain of an Alzheimer’s patient can only be ascertained as the cause, after death.

  • Blood test:To determine thyroid disorder (T3, T4, TSH) and Vitamin deficiency
  • Neurological health evaluation:
    – Muscle tone and strength, coordination and reflexes.
    – Hearing and vision evaluation.
    – Physical balance.
    – Brain function tests with regard to memory, thought and decision-making skills.
  • MRI (magnetic resonance imaging) of the brain to ascertain any shrinkage.
  • CT (computerized tomography) scan of the brain to ascertain abnormalities caused by a previous brain injury, stroke, or tumor.
  • PET (positron emission tomography) scan helps in determining the pattern of brain degeneration and poor nutrient metabolization, amyloid deposits and tau tangles.

Treatment

Treatment involves:

  • Medication & drugs:
    – Cholinesterase inhibitors to encourage neuron-to-neuron communication, and ease depression.
    – Memantine (Namenda) to support neuron-to-neuron communication.
    – Antidepressants to stabilize mood swings.
  • Dedicated attention and care by helping with daily routine chores, ensuring that necessary items are within the patient’s reach, providing comfortable footwear in order to prevent falls, and displaying photographs to nudge the patient’s memory, etc. among others.

However, cognitive decline, memory loss and daily living activities can only be controlled to an extent to perhaps slow down the progression of Alzheimer’s, as there is no definite cure yet for complete recovery.

(Inputs by Dr. Asha Bhatnagar, MBBS & Lab Director at Lifeline Laboratory)