Time to act on Dementia, time to act on Alzheimer’s

Dr Mona Nongmeikapam and Dr Aworshim Muivah
Everyone of us might have seen or heard about someone in their old age, who couldn’t remember their own names and even the faces of their loved ones.
Who find it difficult navigating familiar routes and roads, find the rooms in the house confusing and thereby are incapable of taking care of themselves. The world is seeing an increase in the elderly population. Between 1974 and 2024, the population of individuals over the age of 65 years almost doubled – increasing from 5.5 per cent to 10.3 per cent of the total population. United Nations population projections predict an increase of up to 20.7% by 2024 and 2074. This trend is resulting in a rise in the elderly who suffer from Alzheimer’s Dementia, emphasising the need of greater awareness and better preventive measures.
World Alzheimer’s Day was first celebrated on September 21, 1994, in Edinburgh. The day was launched to mark the 10th anniversary of the Alzheimer’s Disease International (ADI). Since then, every year on the 21st September,World Alzheimer’s day is celebrated to raise awareness and challenge the stigma around Alzheimer’s disease. Currently there are about 55 million people affected by Dementia world-wide and 1 in 3 older adults dies with Dementia, making it scarier than breast cancer and prostate cancer combined in terms of mortality.
IS THERE DIFFERENCE BETWEEN DEMENTIA AND ALZHEIMER’S DISEASE?
Dementia is a syndrome due to disease of the brain- slow and gradually progressing, which could affect memory, thinking, orientation, comprehension, cal- culation, learning capacity, language, and judge- ment. The person remains conscious. There could be loss of emotional control, social behaviour, or motivation. There are different types of dementia- Alzhei-mer, Vascular, Fronto- Temporal, Dementia in Parkinson’s, Huntington’s disease, etc.
Alzheimer’s Dementia is the most common type of Dementia. It slowly progresses and primarily affects memory, thinking, and behavior. It often starts with mild memory loss and can advance to more severe cognitive impairments, impacting daily activities and independence.
SIGNS AND SYMPTOMS OF ALZHEIMER’S DEMENTIA
Memory loss is the most common sign of Alzheimer’s disease. Forgetfulness may be subtle at first, but the loss of memory worsens over time until it interferes with most aspects of daily living. Even in familiar settings, a person with Alzheimer’s disease may get lost or become confused. Routine tasks such as preparing meals, doing laundry, and performing other household chores can be challenging. They may find it difficult to recognize people and name objects.
Simple chores like dressing, eating, and personal care require aid. As the disorder progresses, some people with Alzheimer’s disease experience personality and behavioural changes and have trouble interacting in a socially appropriate manner. Sudden agitation, restlessness, withdrawal, and loss of language skills are often seen. People with advanced stages of Alzheimer’s disease are totally dependent on their caregivers.
WHAT ARE THE RISK AND PROTECTIVE FACTORS
Non-modifiable:
i) Age : Most common in those over 65 years.The risk of developing Alzheimer’s Dementia doubles every five years after 65 years
ii) Genetic factors :About 70% of the risk of developing Alzheimer’s dementia is attributed to genetics.
Modifiable risk factor : Chronic illnesses like hypertension, diabetes, cardiac illness, obesity, nicotine and alcohol consumption and a sedentary life-style.
Protective factors against Alzheimer’s dementia include a mix of lifestyle choices, social engagement, and overall health management.
1) Activities that challenge the brain, such as puzzles, reading, and learning new skills, like a new language, game or hobby, can help maintain cognitive function.
2) Physical Activity : Regular exercise is associated with better brain health and may reduce the risk of dementia.
3) Social Interaction : Maintaining strong social connections and engaging in social activities can help reduce isolation and support cognitive health.
4) Healthy Diet : Diets rich in fruits, vegetables, whole grains and healthy fats have been linked to lower dementia risk.
5) Cardiovascular Health : Managing blood pressure, cholesterol levels, and diabetes can contribute to brain health.
6) Sleep Quality : Good sleep hygiene and addressing sleep disorders can support cognitive function.
7) Avoiding Smoking and Excessive Alcohol : These habits are linked to an increased risk of cognitive decline.
8) Lifelong Learning : Engaging in educational activities throughout life can help build cognitive reserve.
9) Mental Health : Managing depression and anxiety is important, as these conditions can impact cognitive health.
10) Genetics and Family History : While genetics play a role, having a supportive and proactive environment can help remove some risks associated with family history.
HOW TO CARE FOR A LOVED ONE AT HOME WHO HAS ALZHEIMER’S DEMENTIA
Managing dementia at home can be challenging, but there are several strategies that families can adopt to create a supportive environment.
1) Establish a Routine
Consistency : Keep daily schedules predictable to reduce confusion and anxiety.
Activities: Plan regular meals, activities, and bedtime.
2.) Create a Safe Environment
Declutter : Remove tripping hazards and keep pathways clear.
Grips and anti-skid flooring : Strategically placed handles/ bars for easy support and anti-skid mats/ flooring are potentially life-saving.
Labels : Use labels on doors, drawers, and common items to help with orientation.
3) Promote Independence
Simplify Tasks: Break down tasks into smaller, manageable steps.
Adaptive Tools: Use utensils and tools designed for easier handling.
4) Engage in Cognitive Activities
Puzzles and Games: Encourage activities like jigsaw puzzles, memory games, or simple board games.
5) Encourage Physical Activity
Gentle Exercises: Incorporate walking, stretching, or chair exercises to promote mobility and health.
6) Support Nutrition
Healthy Meals: Prepare balanced meals and snacks. Involve them in meal prep if possible.
Hydration: Ensure they drink enough water throughout the day.
7) Facilitate Social Interaction
Visit Friends and Family: Encourage regular visits from loved ones.
Group Activities: Look for local community events or groups tailored for seniors.
8) Use Reminders and Aids
Calendars and Notebooks: Use calendars for appointments and daily reminders.
Technology: Set up alarms or reminders on devices.
9) Practice Patience and Communication
Clear Communication: Speak clearly and use simple language.
Active Listening: Be attentive and allow time for them to respond.
HELP FOR THE CARE-GIVER
Taking care of a loved one with Alzheimer’s Dementia, especially in the advanced stages is a big challenge and care-giver burn-out is real. It is vital that one should try to find time to take care of oneself. Oft said, you cannot pour from an empty cup. Some few points which would be of help are :
1) Prioritize one’s own mental well-being.
2) Seek Professional Support if needed.
3) Self-Care: Take time for your own health and well-being to prevent caregiver burnout.
4) Support Groups: Connect with others who are caring for individuals with dementia.
In the words of a wise elderly, Chaminaba Haobani, Puminaba Yangbani !
Dementia is a slow anguishing deterioration of one’s loved ones, which could span over decades, where they remain mere shadows of their previous glorious selves. Early knowledge, preventive measures and sharing the burden are the way forward. The time has come to act on Dementia and to act on Alzheimer’s and the time is now.


(The authors are the Assistant Professor and Senior Resident, Department of Psychiatry, Regional Institute of Medical Sciences, Imphal, respectively)