October 10 is World Mental Health Day
Alzheimer’s disease is the most common cause of dementia and accounts for 50%-75% of all cases. It destroys brain cells and nerves disrupting the transmitters which carry messages in the brain, particularly those responsible for storing memories. Alzheimer’s disease was first described by Alois Alzheimer in 1906.
During the course of Alzheimer’s disease, nerve cells die in particular regions of the brain. The brain shrinks as gaps develop in the temporal lobe and hippocampus, which are responsible for storing and retrieving new information. This in turn affects people’s ability to remember, speak, think and make decisions. The production of certain chemicals in the brain, such as acetylcholine is also affected. It is not known what causes nerve cells to die but there are characteristic appearances of the brain after death. In particular, ‘tangles’ and ‘plaques’ made from protein fragments are observed under the microscope in damaged areas of brain. This confirms the diagnosis of Alzheimer’s disease.
Typically, Alzheimer’s disease begins with lapses of memory, difficulty in finding the right words for everyday objects or mood swings. As Alzheimer’s progresses, the person may:
- Routinely forget recent events, names and faces and have difficulty in understanding what is being said
- Become confused when handling money or driving a car
- Undergo personality changes, appearing to no longer care about those around them
- Experience mood swings and burst into tears for no apparent reason, or become convinced that someone is trying to harm them
In advanced cases people may also:
- Adopt unsettling behaviour like getting up in the middle of the night or wander off and become lost
- Lose their inhibitions and sense of suitable behaviour, undress in public or make inappropriate sexual advances.
A reasonably accurate diagnosis of dementia can be made by taking a careful history of the person’s problem from a close relative or friend, together with an examination of the person’s physical and mental status. There is, however, no simple test to make a diagnosis and dementia can only be confirmed with certainty by examining the brain after death. When making a diagnosis, it is important to exclude other treatable conditions that cause memory loss such as depression, urinary infection, vitamin deficiency and brain tumour.
The impact of a dementia diagnosis depends greatly upon how it is made and imparted. Evidence suggests that when people with dementia and their families are well prepared and supported, initial feelings of shock, anger and grief are balanced by a sense of reassurance and empowerment.
An early diagnosis is helpful, because it:
- enables carers and people with dementia to be better equipped to cope with the disease progression
- provides people with dementia with an opportunity to make decisions about their financial and legal affairs while they still have the capacity to do so
- gives people with dementia a better chance to benefit from available drug and non-drug therapies that may improve their cognition and enhance their quality of life.
- Alzheimer’s disease: Frequently Asked Questions
- Early symptoms of dementia
- Overcoming the stigma of dementia (Video)
- Cases on the rise in India
- Stigma and social exclusion are major barriers
- Dementia set to triple by 2050 but still largely ignored