Dementia
is a brain disorder that seriously affects a person’s
ability to carry out daily activities. The most common
form of dementia among older people is Alzheimer’s disease
which initially involves the parts of the brain that control
thought, memory and language.

Cause,
cure

The
cause of Alzheimer’s disease is unknown and there is no
cure. However, the disease causes several changes in the
brain – death of nerve cells that are vital to memory
and other mental abilities, and disruption of connections
between nerve cells.

Several
possible factors responsible for the disease: Age, family
history and genetics.

Research
shows that people with heart ailments, diabetes will be
prone to Alzheimer’s disease.

Who
does it affect?

The
disease usually strikes after 60 and is less common among
younger people. In the US, about five per cent of people
in the age 65-74 are Alzheimer’s disease patients. The
risk increases with age, and about 50 per cent of the
Americans in the 85+ age group have the disease.

Misconceptions

Alzheimer’s
Disease is confused with ageing, senility because of lack
of awareness in India.

Numbers

4.5
million Americans suffer from AD

In
India, 3 to 4 million are afflicted by dementia

About
4 per cent of the population over 65 are afflicted with
dementia

Alzheimer's
disease was the most common type (54 per cent)

Followed
by vascular dementia (39 per cent)

Reasons
why people get dementia:

7
per cent of cases were due to causes such as infection,
tumor and trauma

Family
history of dementia was a also risk factor for Alzheimer's
disease

History
of hypertension was a risk factor for vascular dementia

Percentage
of population in South
Mumbai with dementia is 4 per cent (2000)

Will
dementia become a critical problem in India?

Expectation
of life at birth for males has shown a steady rise from
42 years in 1951-60 to 58 years in 1986-90, it is projected
to be 67 years in 2011-16, an increase of about 9 years
in a 25-year period (1986-90 to 2011-16).

The
National Policy of Older Persons 1999, Got of India, outlined
the fact that improved life expectancy has contributed
to an increase in the number of persons 60+ from only
12 million persons in India in 1901, the number crossed
20 million in 1951 and 57 million in 1991. Population
projections for 1996-2016 made by the Technical Group
on Population Projections (1996) indicate that the 100
million mark is expected to be reached in 2013. Projections
beyond 2016 made by the United Nations (1996 Revision)
has indicated that India will have 198 million persons
60+ in 2030 and 326 million in 2050. The percentage of
persons 60+ in the total population has seen a steady
rise from 5.1 per cent in 1901 to 6.8 per cent in 1991.
It is expected to reach 8.9 per cent in 2016. Projections
beyond 2016 made by United Nations (1996 Revision) has
indicated that 21 per cent of the Indian population will
be 60+ by 2050.

Sixty
three per cent of the population in 1991 (36 million)
was in the age group 60-69 years, often referred to as
'young old' or 'not so old' while 11 per cent (6 million)
was in the age group 80 years and over I.a., in the 'older
old' or 'very old' category. In 2016, the percentage in
these age groups will be almost the same, but the numbers
are expected to be 69 million and 11 million respectively.
In other words, close to six-tenths of population 60-69
years can be expected to be in reasonably good physical
and mental health, free of serious disability and capable
leading an active life. About one third of the population
70-79 years can also be expected to be fit for a reasonably
active life. This is indicative of the huge reserve of
human resource.

In
Maharashtra, for example, the growth situation alone looks
like this:

(%)
of the 60 year oldsAbsolute
numbers

to
the total

19615.21%; 20.81 lakhs

1971
5.72% 28.79 lakhs

19816.34%;39.79 lakhs

1991
6.91%;54.52 lakhs

2001
7.91%;72.93 lakhs

2011
9.43%100.35
lakhs

2021
11.72%140.18 lakhs

If
we take 4 per cent as the dementia potential, it will
mean that in 2011, we will have nearly 4 laky people with
Alzheimer's Disease compared to 2,92,000 people as of
now.

In
Mumbai alone, we have 40,000 Alzheimer's Disease affected
even today, if 10 lakhs is the population of 60+.

Kerala
is the only state that has displayed progressive commitment
to the welfare of the aged. It has 30 social security
and welfare schemes to date, such as Schemes for the destitute
old, pension schemes, workers security schemes, etc.

Symptoms

Mild
forgetfulness could be an early symptom. But most people
with mild forgetfulness do not have the disease. As disease
advances, forgetfulness begins to interfere with daily
activities. People in the middle stages of Alzheimer’s
disease may forget how to do simple tasks like brushing
their teeth or combing their hair. They can no longer
think clearly. They can fail to recognize familiar people
and places. They begin to have problems speaking, understanding,
reading, or writing. Later on, people with Alzheimer’s
disease may become anxious or aggressive, or wander away
from home. Eventually, patients need total care.

Diagnosis

An
early, accurate diagnosis of Alzheimer’s disease helps
patients and their families plan for the future. It gives
them time to discuss care while the patient can still
take part in making decisions. Early diagnosis will also
offer the best chance to treat the symptoms of the disease.

Doctors
can only make a diagnosis of ‘possible’ or ‘probable’
Alzheimer’s disease. At specialized centers, doctors can
diagnose the disease correctly up to 90 per cent of the
time. Doctors use several tools to diagnose ‘probable’
Alzheimer’s disease, including:

questions
about the person’s general health, past medical problems,
and ability to carry out daily activities

tests
of memory, problem solving, attention, counting, and
language

medical
tests -- such as tests of blood, urine, or spinal fluid,
and

brain
scans

Sometimes
these test results help the doctor find other possible
causes of the person’s symptoms. For example, thyroid
problems, drug reactions, depression, brain tumors, and
blood vessel disease in the brain can cause AD-like symptoms.
Some of these other conditions can be treated successfully.

Treatment

Alzheimer’s
disease is a slow disease, starting with mild memory problems
and ending with severe brain damage. The course the disease
takes and how fast changes occur vary from person to person.
On average, patients live from eight to 10 years after
they are diagnosed, though some people may live with the
disease for as many as 20 years.

No
treatment can stop Alzheimer’s disease. However, for some
people in the early and middle stages of the disease,
the drugs terrine (Cognacs), donepezil (Precept), rivastigmine
(Exeo), or glutamine (Reading, previously known as Romany)
may help prevent some symptoms from becoming worse for
a limited time. Another drug, meantime (Named), has been
approved to treat moderate to severe Alzheimer’s disease,
although it also is limited in its effects. Also, some
medicines may help control behavioral symptoms such as
sleeplessness, agitation, wandering, anxiety and depression.
Treating these symptoms often makes patients more comfortable
and makes their care easier for caregivers.

What
helps?

A
new study conducted by researchers at The University of
California Irvine suggests that BE-vitamin nutrients found
in oranges, legumes, leafy green vegetables and folic
acid supplements are more effective in limiting Alzheimer's
disease risk than antioxidants and other nutrients.

The
patient’s family

Most
often spouses and other family members provide the day-to-day
care for people with Alzheimer’s disease. As the disease
gets worse, people often need more and more care. This
can be hard for caregivers and can affect their physical
and mental health, family life, job and finances.

-
Dr.Sheilu Sreenivasan

www.dignityfoundation.com
Dignity Foundation is a charitable organization under Societies
Reg. Act 1860 GIBBS/97C, Established in April 1995, to cater
to the needs of the Elderly.

www.dignitylifestyle.org
Dignity Lifestyles Homes is an Elder Care lifestyle-based
Community project of Dignity Lifestyle Trust (DOLT), coming
up rapidly on a 25-acre estate at Neral near Mumbai. DOLT
has been setup by Dignity Foundation, one of India’s leading
Elder Care non-profit organizations, reaching out to approx.
One million Sr. Citizens through various programs.