Understanding Alzheimer’s Disease

Alzheimer’s disease is a common cause of dementia. Dementia is a general term for loss of memory. Along with loss of short term memory, individuals develop loss of reasoning and thinking; as well as behaviour disturbances.

It is not just a disease of old age, though, it is often seen above 65 years of age. In less than 10% of cases, it is seen in patients between 40 to 60 years of age. It starts with difficulty in learning new things which shows impact on working memory, getting lost in familiar places followed by forgetting people, emotional and behavioural disturbances subsequently leading to a mute, bed bound state.

It is due to death of brain cells or neurons in memory area of the brain causing loss of connectivity with other neurons by the deposition of abnormal protein beta amyloid and tau. What causes this formation of protein is still under research. A combination of genetic, environmental and lifestyle factors is implicated.

The presence of apolipoprotein gene (APOE ) increases the risk but neither all individuals with the gene develop the disease nor all individuals with Alzheimer’s disease have this gene. Presence of metabolic conditions like diabetes, hypertension, heart disease, obesity, obstructive sleep apnea; diet and level of physical and mental activity also are implicated.

Diagnosis is only by clinical history and neurological examination. Imaging like SPECT, PET and MRI brain help in confirmation and ruling out treatable causes of dementia.

It is a slowly progressive disease with no cure as brain cells do not regenerate. Treatment with drugs aims at controlling the symptoms and slowing the progression by regulating the level of neurotransmitters or chemicals.

Care givers have a very challenging and important role in management of patients as caring of a person with Alzheimer’s disease causes physical and financial burden. Care givers also need support to cope up with the stress of handling their loved ones.

The take home message is that a healthy diet and regular exercise early on in life reduces the risk of Alzheimer’s disease. Healthy diet and regular exercise also prevent life style diseases like diabetes, hypertension, obesity and heart problems. Regular walking increases the level of a chemical brain derived neurotrophic factor( BNF) which potentiates memory.

A Mediterranean style of diet rich in fresh fruits and vegetables, nuts, legumes, olive oil has been shown to prevent the progression of disease in patients with minimal cognitive decline, a precursor of Alzheimer’s disease. Diet rich in curcumin, omega-3 fatty acids and cocoa have proven benefits with vitamin B12,D, E  and folate supplements.

Dr Aparna Vijay Kumar Senior Neurologist, Citizens Specialty Hospital