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The age of reason

A recent report reveals that dementia isn’t as uncommon as we think. Question is, are we prepared?

health and fitness Updated: Sep 30, 2009 20:09 IST
Dhamini Ratnam

Gradual loss of memory and cognitive reasoning is often seen to be a ‘natural’ process of ageing. However, not many people recognise that these symptoms may point to a deeper, and more widespread, mental malaise.

A recent report released by Alzheimer’s Disease International states that more than 35 million people worldwide will suffer from AD and other forms of dementia by next year. Dementia, which is the loss of cognitive functioning, remembering, and reasoning to the extent that it interferes with a person’s daily life and activities, “is not part of ageing, but a disorder of the aged,” Dr Charles Pinto, Emeritus Professor of Psychiatry at Nair Hospital, Bombay Central, points out.
However, the risk for dementia increases, as one grows older. It is estimated that one out of every two people above the age of 85 have some form of dementia, while 5 per cent of those above 65 are at risk. While there is no known way of preventing it, reducing one’s risk of heart disease, and keeping physically, mentally and socially active, is believed to reduce the risk of Alzheimer’s disease.

The A word
Alzheimer’s disease (AD) is the most common kind of dementia and accounts for nearly 50 per cent of all dementia cases worldwide. It is an irreversible, progressive brain disease, where the brain develops abnormal clumps and tangled bundles of fibres that slowly destroy memory and thinking skills, and eventually even the ability to carry out the simplest tasks.

The report released by Alzheimer’s Disease International on September 21, also says that number of people suffering from AD and other forms of dementia will double every 20 years. The number of people with dementia in India just four years ago was 32.5 lakh. By 2020, there will be more than 56 lakh people in India with dementia according to the report.

(www.alz.co.uk/research/ asiapacificreport.html)
At great risk
According to Pinto, the increase in number of dementia cases among the old can be attributed to an increase in the aged population, an improved life expectancy and greater awareness of the condition. According to a 2005 World Health Organisation study, life expectancy at birth for men is 64 years, and for women is 66 years. In 2002, life expectancy for both was 53 years.

“Within the next couple of decades, India will have a higher population of older people than it does now. The same holds true for most developing countries,” Pinto said.

At the same time, he pointed out, Indians are at risk for all forms of dementia because of their attitude towards their health. Risk factors for AD include diabetes and hypertension, common ailments among Indians. The lack of proper infrastructural support such as day care centres and homes for persons with dementia, combined with our disinterest in seeking treatment makes us prime targets.

To tackle the epidemic proportions of dementia we are facing, we need to ensure early detection and treatment, by visiting memory clinics and screening camps. At the same time, we also need to recognise the precise nature of AD, and not confuse it with the processes of ageing.

Growing old is not an inexorable journey towards incapacity.

While there are support groups for caregivers to help them cope (see box: Support system), living with a family member who has Alzheimer’s is by no means easy. While drugs currently available for AD help reduce the symptoms and behavioural changes that affect a patient, they cannot arrest the progress of the disease. As a result, the condition of the patient worsens. Khoparkhairne resident Renu Suchdev, 49, took care of her father during the last few months of his illness. She shares her story with us. See ‘Keeping the memory alive’.

What is alzheimer’s?
According to Sailesh Mishra, president, Silver Innings Foundation, and member of Alzheimer’s & Related Disorders Society of India (ARDSI), patients of AD often face difficulty making decisions, short-term memory loss, temporal disorientation, and exhibit signs of depression and aggression.
Patients of AD should continue with activities they have been doing, like keeping accounts or checking the mail, for as long as they can. It doesn’t matter if the account log doesn’t add up in the end — it is necessary for them to establish a habit and stick to it. For this, they need the help of their caregivers. It isn’t enough to tell them to do something — they need to be helped keeping up with the task. Like keeping a journal, for instance. Also, keep their environment as unchanged as possible and simplify instructions for them.
Initial symptoms of AD include repeating statements; misplacing items; forgetting names of familiar persons and objects; getting lost on familiar routes; personality changes; losing interest in things that interested them earlier; inability to learn new information. At an advanced stage, the person forgets everyday details, and loses awareness about him/herself. At such a time, even simple tasks like eating, wearing clothes or bathing become difficult to perform.

cope with the condition
Does an elderly person in your family have AD?
1. Accept that it is a disorder — many confuse it with ageing.
2. There are going to behavioral disturbances that affect daily living — you need to be supportive, not critical.
3. Do not stop their medication.
4. Check for other disorders and take care of physical and nutritional aspects of these people.
5. Don’t take it on all by yourself. Caregivers need to have time out. Divide the work equally among all members of the family, or seek support.

Support system
* Silver Innings Dementia Support Group, for residents from Bhayander to Andheri offer home visits of therapists and training for care givers at a nominal cost. Helpline number: 9987104233.
* Holy Family Dementia Support Group for Caregivers, Holy Family Hospital, Bandra. Will start on October 10, 2009. Contact: Sailesh Mishra, 9819819145
* Dignity Foundation runs a day care centre for dementia patients in Lamington Road. Contact: 23898078. There is also a full-time home for them in Neral. Contact: 02148-236600/236635
* Prof Cathy Greenblat, Professor Emerita of Sociology at Rutgers University, is currently in town delivering a series of lectures on Alzheimer’s Disease. Contact Silver Innings foundation for more details.
* Memory Clinics are present in JJ Hospital, Holy Family Hospital and Sion Hospital.