Alzheimer's Disease (AD), has disrupted the lives of many families. And as stated on the Alzheimer's Association website, as many as 5.3 million Americans are living with AD.
However, consultant neurologist at Neurodiagnostics Limited, Dr Daniel S. Graham, said, so far, there is no specific data on the prevalence of AD in Jamaica, but epidemiological studies worldwide consistently indicate that the prevalence doubles every five years between ages 65 and 85.
"Classically, AD is seen most often in persons older than 60 years. However, individuals in their third decade have been unequivocally diagnosed with the disease," said Dr Graham.
Alicia Williams'brother, James was in his early 60s when he first starting showing signs of memory loss.
"We were at a family get-together when he could not remember where he was or who he was," said Williams.
She said that the family did not know what was happening. They thought that perhaps his memory loss had something to do with him falling off a ladder sometime before. But, thereafter, he was diagnosed with AD. She noted that, since her brother's diagnosis, she has come across others with the disease. She said she noticed that they become confused, their memory deteriorates over time and sometimes they suffer total memory loss. She said she finds that they often repeat themselves a lot, for example, they will ask you the same question 10 times. This is the reason she believes her brother stopped talking three years ago before he died earlier this year.
Degenerative dementia
Dr Graham said that AD is the most common of the primary degenerative dementia, a term applied to those cases with degeneration of brain cells (neurons) for which the cause is not established.
He explained that the disease was named for a German neurologist, Alois Alzheimer, who in 1907 described the case of a 51-year-old woman with memory impairment, delusions and subsequent disintegration of language. He further pointed out that the term dementia refers to an acquired state of persistent impairment of mental/intellectual abilities, severe enough to interfere with the individual's customary occupational and social activities.
Dr Graham said that age is the most dramatic associated factor that predisposes someone to develop AD. He added that other factors include:
1. Family history of dementia - increases the relative risk three to four times (at least up to age 80 years).
2. Genetic factors - presence of apolipoprotein (Apo E) gene increases the risk of developing the disease and the rate of progression, once developed. Apolipoprotein E is a plasma protein produced by the liver and certain specialised cells in the brain and spinal cord. The gene (APOE) that codes for the Apo E protein has three forms, one of which, if inherited, is a powerful risk factor for AD.
3. Gender - being female confers a slightly greater risk in some studies. The additional risk associated with the female gender may be particularly strong among women with the apolipoprotein E gene.
Common symptoms of AD
The neurologist said that the common symptoms of AD include:
1. Memory loss affecting job skills or other activities.
2. Difficulty performing familiar tasks.
3. Problems with language.
4. Disorientation.
5. Impaired judgement.
6. Problems with abstract thinking.
7. Continuous misplacement of personal possession.
8. Changes in mood or behaviour.
9. Changes in personality.
Care is challenging
Like Williams, many individuals have or had loved ones who are suffering/have suffered from this dreadful disease. And caring for them is very challenging. Williams said that though her brother's wife was his main caregiver, it was very difficult caring for him. She added that when the wife died, they had to get a full-time nurse to care for him. But, in his latter days (about eight months) before he passed on, he was placed in a nursing home because he needed round-the-clock attention.
Dr Graham also agrees that caring for the patient with AD is a major challenge. "Taking care of the patient's hygiene and physiological needs is often more complex than one imagines. Even though bathing might seem like a common, easy activity, it can become very stressful, challenging and often dangerous."
He added that it is important to respect, as much as possible, the patient's independence. He said the caregiver must adopt the attitude of someone who helps and co-operates, rather than a position of control or command. Safety in the home is of great importance and often requires modification and rearrangement of existing layout.
Give special attention to
He further pointed out that special attention must be given to:
1. Physical and verbal agitation
2. Hallucinations and delusional behaviour
3. Wandering and pacing
4. Sleep disruption
5. Eating difficulties, and
6. Symptoms of depression and anxiety.
He also said that family members of patients with AD need to be educated about what to expect and plans to minimise caregiver stress must be implemented.
Names changed