Factors like late-life depression can also contribute to the onset of Alzheimer’s.
(Milcah Anila, Intern Journalist) Lucknow News, Vijayawada: In 1901, Alois Alzheimer observed and treated a 51-year-old patient called Auguste Deter at the Frankfurt asylum and when she died in 1906, her brain was studied by him and Emil Kraepelin. Their identification of a unique pathology in Auguste Deter’s brain leads to the birth of the eponymous disease in the medical literature.
Neurologists and psychiatrists diagnose dementia when an unfortunate patient experiences progressive impairment in at least three of six cardinal domains of brain functions: memory, personality, language, visuospatial skills, praxis, and executive functions.
Alzheimer’s disease is the commonest degenerative dementia. The earliest symptom is usually the impairment in immediate memory with preserved old remote memories. This leads to repetitiveness in questioning, and arguments with family.
Later, personality change, confusion, getting lost in familiar surroundings, impairments in language, and handling gadgets may evolve. The patient with advanced Alzheimer’s disease may need assistance for almost all activities of daily living.
Tragically, end-stage Alzheimer’s disease may deplete the brain of all abilities and result in total dependence for all activities of daily living.
The key pathologies in an Alzheimer’s brain are the abundant occurrence of abnormal protein accumulations: the ones within nerve cells are called neurofibrillary tangles and the ones in the brain tissue are called neuritic plaques. The location within the brain determines the resultant loss of function and atypical symptoms.
Most patients need to be assessed by qualified medical personnel. The quest for a cure has remained elusive despite a century of knowledge and effort.
The risk factors for developing Alzheimer’s dementia include poor education, sedentariness, obesity, diabetes, genetic vulnerability, head injury especially when repetitive, poor gum health, and hearing loss.
Other factors that might contribute to its precipitation are late-life depression and poor sleep hygiene. While many inroads have been made in the understanding of pathophysiological processes leading to its occurrence, a cure remains elusive. This may be due to the understanding that this disease has a long pre-symptomatic phase of the biological build-up of up to fifteen years when a patient may be asymptomatic but the slow biological abnormality has already been set into motion in their brains.
Today, symptomatic therapies do improve the quality of life of affected individuals and their hapless caregivers. Most societies have recognized the need for a psychosocial infrastructure to help affected patients find meaningful activities to participate in while their breadwinners are at work.
Disturbingly, many luminaries and powerful global personalities have fallen prey to this disease emphasizing the reality that the biology of longevity may have its own price.
Recent research suggests that regular exercise, a balanced Mediterranean type diet, maintaining a strong social and familial network, the enthusiastic pursuit of extra-curricular hobbies, sustained sleep and gum hygiene through middle life, the prompt and disciplined therapy of diabetes and depression, avoidance of binge drinking, being multi-lingual, and a robust educational reserve can reduce the risk of future Alzheimer’s disease amongst middle-aged individuals.
Seven years ago, the discovery of an exclusively sleep driven excretory system within the brain accelerated insights into the delicate relationship between sleep hygiene and brain health.
While many questions remain to be answered, it appears that a curative therapy for Alzheimer’s disease may no longer remain a pipedream. The relationship between sleep hygiene and brain health has become a new focus of diligent research.
Young-onset dementia has been observed in varying prevalence figures from around the globe with numbers varying from 73 to 163 per 100,000 population in some studies. True prevalence figures for young-onset dementia from India are not available.
Numerous genes have been implicated in familial young-onset Alzheimer’s disease with Presenilin 1 and 2 being the forerunners. Movies like ‘Still Alice’ and ‘Smile Please’ have portrayed the pathos and tragic human fallout of Alzheimer’s disease manifesting at a young age in the prime of life.
While meaningful therapies have eluded researchers, sensitization of lay persona to the ravages of this illness may spur them to discipline lifestyle contributors to poor brain health. An upbeat outlook, enthusiasm for hobbies, regular exercise, disciplined sleep habits, and successful stress management are investments for future brain preservation.
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