September 21 is World Alzheimer’s Day. The theme for 2023 was ‘Never Too Early, Never Too Late’, emphasising the importance of proactively taking risk reduction measures to hamper and, if possible, prevent the onset of the dementia that characterises Alzheimer’s disease.
Alzheimer’s is a brain disorder that becomes progressively worse and impairs your memory and other mental functions. It is the commonest form of dementia, causing memory loss and interference with your thinking abilities. As memory loss and thinking abilities worsen it interferes with your normal functioning in daily life.
While the exact cause of dementia is unknown, factors have been identified that increase the risk of Alzheimer’s and other forms of dementia. Lifestyle changes to minimise these risks may prevent or slow down the development of dementia.
Although Alzheimer’s disease is commonest among people over 65 years of age, it can affect anyone. In July this year, neurologists at a memory clinic in China diagnosed a 19-year-old teenager with Alzheimer’s disease, making him the youngest person to be diagnosed with the condition in the world.
It is normal for there to be some changes in how quickly we do things and remember things as we grow older. It is also normal to sometimes forget things but remember them later.
What distinguishes Alzheimer’s and other forms of dementia is the inability to remember recently learned information and the effect that the memory loss and other symptoms have on your daily life. There is a slow decline in the ability to remember recent events and conversations, to think and to reason.
Causes
With Alzheimer’s disease brain proteins fail to function normally, disrupting the work of brain cells known as neurons. What causes this to happen is unknown. Age, genetics, lifestyle, the environment and various medical conditions may all play a part.
The neurons become damaged, lose connections to each other and eventually die, causing irreversible changes in the brain. The damage generally starts in the region of the brain that controls memory and spreads to other regions of the cerebral cortex responsible for language, reasoning and social behaviour. By the late stage of the disease the brain has shrunk significantly. The development of the disease begins years before the first symptoms.
Symptoms
The commonest and earliest symptom of Alzheimer’s is difficulty remembering newly learned information.
As the disease progresses, severe symptoms may include disorientation, changes in mood and behaviour, deepening confusion about events, time and place, and unfounded suspicions about family members, friends and professional caregivers. Other symptoms include difficulty speaking, swallowing and walking.
In the early stages of the disease, behaviour and personality changes may include irritability, anxiety and depression.
In later stages symptoms may include anger, agitation, aggression, emotional distress, physical or verbal outbursts, restlessness, pacing, wandering, shredding paper or tissues, hallucinations, such as seeing, hearing or feeling things that are not really there, delusions and sleep disturbances.
Risk Factors
The most common risk factor is age. A family history of Alzheimer’s disease is another one. Other risk factors are high blood pressure, lack of exercise, obesity, high cholesterol, smoking and poorly controlled diabetes.
Many of these risk factors are preventable with lifestyle changes, which is why the theme for World Alzheimer’s Day suggests it is never too early or too late to do something about these risks through changes in lifestyle.
Lack of education and hence probably inadequate cognitive activity has also been identified by some researchers as a risk factor.
There appears to be a strong link between serious head trauma and increased risk of Alzheimer’s, particularly when the injured person is left unconscious.
Prevention
At present there is no way to prevent Alzheimer’s, though the risk of it can be reduced through adopting a healthy lifestyle and the effective treatment of chronic diseases.
Regular physical exercise is an important part of a healthy lifestyle. Exercise may directly benefit brain cells by increasing the flow of blood and oxygen to the brain.
Eating heart healthy food may help protect the brain and reduce the risk of Alzheimer’s disease. Healthy food for the heart includes foods low in sugar and saturated fats, as well as plenty of fruit, vegetables and whole grains.
Staying socially active and maintaining good mental health may also lower the risk of cognitive decline and Alzheimer’s disease.
Protecting your head and avoiding head injuries through wearing hard hats if you work in construction or mining as well as wearing a seat belt when travelling by car and a helmet when riding a motorcycle or engaging in sports where head injuries are common are other preventative measures.
Treatment
At the moment, there is no medication that can cure Alzheimer’s disease or stop it from progressing. However, there are medications that may help lessen symptoms such as memory loss and confusion for a limited time and slow down progression of the disease.
Before doctors prescribe medication for people with Alzheimer’s and other forms of dementia, they typically recommend non-drug treatments, including practical and emotional support,
Cognitive stimulation therapy may be used to keep the mind active with themed activity sessions that challenge the brain. This may include group activities and exercises designed to improve memory and problem-solving skills.
Cognitive rehabilitation to relearn lost skills or develop new compensating skills is another form of therapy. With this technique a trained professional, such as an occupational therapist, works with you and a relative or friend to achieve a personal goal, such as re-learning how to use a mobile phone or do other everyday tasks. It works by getting you to use the parts of your brain that are working to help the parts that are not.
Reminiscence work, that involves talking about things and events from your past, perhaps making use of photos, favourite possessions or music, and life story work, involving the compilation of photos, notes and keepsakes from your childhood to the present day can be useful and improve your mood and well-being.
These different approaches are often combined. Singing, dancing, art and other activities that keep people with Alzheimer’s physically, mentally and socially engaged is recommended as it can lower anxiety while boosting confidence and cognitive skills.
The information in this article is provided as a public service by the Cimas iGo wellness programme, which is designed to promote good health. It is provided for general information only and should not be construed as medical advice. Readers should consult their doctor or clinic on any matter related to their health or the treatment of any health problem. To contact the iGo team, email igo@cimas.co.zw or WhatsApp 0772 161 829 or phone 024-27730663.
