World Alzheimer’s Day : Time to act on dementia, time to act on Alzheimer

Dr (Prof) N Heramani, HOD,  Dr Chaoba, AP, Dr Meesha, SR, Dr Nomita, CP
World Alzheimer’s Day, observed annually on September 21, serves as a global reminder of the urgent need to address the growing crisis of dementia and Alzheimer’s disease. As we reflect on this year’s theme, “Time to Act on Dementia, Time to Act on Alzheimer’s,” it is crucial to recognize that these are not distant concerns but pressing issues that demand immediate, collective action. The theme underscores the necessity for a multifaceted approach involving awareness, research, healthcare infrastructure, and societal change to combat these debilitating conditions.
INTRODUCTION
Dementia is an umbrella term for a range of symptoms associated with a decline in cognitive functioning, which interferes with daily life. Alzheimer’s disease, the most common form of dementia, accounts for approximately 60-70% of dementia cases. The defining features of Alzheimer’s disease are progressive deficits in memory and other aspects of cognition.
Family members usually report impaired memory, disorientation, word-finding difficulty, poor speech content, poor object or person recognition, impaired attention, disinhibition, poor planning, poor judgment etc. Behavioural problems such as apathy, hallucinations, delusions, wandering, pacing, and verbal and physical aggression are also reported.
Gradually as the disease progresses there are marked defects in their activities of daily living, mainly- maintaining personal hygiene, dressing, eating, maintaining continence, and mobility.Marked decline can also be seen in basic communication skills, transportation, meal preparation, shopping, housework, managing medications, and managing personal finances.
CURRENT SCENARIO
The World Health Organisation recognises dementia as a global health priority.According to their latest data, there were approximately 55 million people living with dementia worldwide in 2020, a number that is projected to double by 2030 and triple by 2050. This surge underscores the urgency of the call to action.
The scenario isn’t so different in India. According to the 2021 Alzheimer’s Disease Internationalreport, it is estimated that around 5 million people in India are living with dementia, including Alzheimer’s disease. Closer home, while comprehensive data specific to Manipur is limited, regional studies and projections suggest that the prevalence of dementia, including Alzheimer’s disease, in Manipur follows national trends. It is estimated that around 1-1.2% of people aged 60 and older may have dementia, with Alzheimer’s being the most common form.
MANAGEMENT
There is currently no cure for dementia but it can be managed to an extent. Drug therapies do play an important role in retarding the progress of dementia though there willbe some limitations. Drugs are also useful in managing the accompanying behavioural and biological symptoms such as sleep disturbance, hallucinations, aggression, depression etc.
Non-pharmacological management will form the main stay treatment modality for dementia. Examples are:
1. Environmental interventions such as installing bars and grips, removing pointed and sharp object from the individual’s immediate surroundings, keeping the rooms well-lit and well-ventilated.
2. A structured daily routine such as setting a fixed time for sleep, meals, bathing, extracurricular activities etc will make it easier for the individual to go about with his/her daily activities.
3. General principles for communicating with people with Alzheimer’s include: identifying oneself and addressing the person by the names one usually use for them, using short words and simple sentences, asking one question at a time, giving adequate time for a response, repeating when necessary, speaking slowly and enunciating clearly, and accompanying speech with clarifying or reinforcing gestures.
4. Sensory loss found in almost all elderly people is exaggerated in people with dementia. Hence there is need for sensory enhancement through music, massages and other media.
5. Social contactis one of the most important measures. Allow people with dementia to reminisce and tell stories about themselves. Help them interact with and care for a pet. Allow them to go for social events such as weddings. Help them review photo albums or personal memorabilia. Encourage long distance relatives to video-chat with them regularly.
6. Miscellaneous- Light therapy, hearing aids, measures to reduce discomfort and pain due to various reasons such as arthritis, bed sores, urinary tract infections, prolonged immobility etc.
PREVENTION
There are 6 main pillars for preventing dementia.
1. Incorporating at least 15 hours of exercise in a week
2. Being socially active
3. A healthy balanced diet
4. Mental stimulation
5. Maintaining sleep hygiene
6. Stress management
CONCLUSION
World Alzheimer’s Day serves as a powerful reminder that the time to act on dementia and Alzheimer’s is now. The rising prevalence of these conditions demands immediate and comprehensive action from all sectors of society. By enhancing public awareness, advancing research, strengthening healthcare systems, promoting supportive environments, and encouraging policy and advocacy, we can make significant strides in addressing this global challenge.
The fight against dementia and Alzheimer’s is not just a medical or scientific endeavor but a collective societal mission. As we observe World Alzheimer’s Day, let us reaffirm our commitment to creating a world where individuals with dementia are not only diagnosed and treated with the utmost care but also live with dignity and hope. Together, through informed action and compassionate support, we can turn the tide in the battle against dementia and Alzheimer’s.
The writers are from the Dept. of Psychiatry, Shija Academy of Health Sciences