Dementia affects five to eight percent of people above 60 years of age, increasing to around 40 percent as they cross 90 years. This statistic translates to at least one person suffering from it, every minute, world over.
Alzheimer’s disease, which is the most common form of dementia, is mostly an incurable (as of now) degenerative disease. The brain cells in certain parts are destroyed which leads to deficits in cognitive functions, such as memory, language skills, and behaviour.
The destruction of neurons in the brain is caused by an abnormal accumulation of different types of proteins: the amyloid peptide and the hyperphosphorylated Tau (Tubule-Associated Unit) proteins.
It is a disease that re-iterates the supremacy of the mind over the body in an extremely cruel way. Memories, beautiful and also painful but worth preserving, are wiped out indiscriminately, way before their actual expiry date. It is a peculiar disease, where the initial suffering is known to the patient for a while before he slips into the eternal bliss of oblivion.
Thereafter, the caregivers suffer the most. Apart from the physical stress of constantly caring for a fully dependent and bluntly indifferent person, the mental agony is paramount; to see a near and dear one — may be a person who was the sheet anchor of your life, a responsible parent, a perfect wife, a jovial and caring husband, a sibling who was always there for you when you needed them the most — gradually turning into a vegetable, rotting every day. All in front of your eyes.
You see the worst paradoxes of life. An excellent orator goes mute, a once-celebrated intellectual forgets his name, a multitasker finds brushing his teeth too complex, an avid banker loses the ability to do simple arithmetic, an ebullient boisterous socialite becomes a stubborn recluse. It seems like the original person has deserted his body, leaving behind a carcass, embalmed by the natural preservative of life and breath; just to be carried around by others.
A man becomes his own “trophy” in his lifetime, carried loathingly by some as a social burden; and by some as a preserved wreckage of a memorial from the glorious past.
And if you think this was too gloomy, the facts on the ground may be worse. In poor countries, the population of the elderly is growing steadily on one hand, and the social system and family values are decaying at the same pace, on the other.
The restless younger population is struggling daily to achieve higher goals and the needs of life and has no time to sit under the sun on a lazy day with their aging parents. With no financial and social security, the vulnerable elderly population in general, and the Alzheimer’s patients, in particular, are orphaned by their own children they diligently parented once, with sweat and blood.
Prevention and early diagnosis are the best solutions for dementia and particularly Alzheimer’s unless you are unfortunate enough to have the “Alzheimer’s genes” that make you prone to it.
Alzheimer’s constitutes 60 to 70 percent of all cases of dementia. A healthy lifestyle, including a healthy habit of eating fresh food rich in anti-oxidants, a good dose of physical and mental exercise, stress-free life, and taking care of common comorbidities, like hypertension and diabetes, may help.
Modern science has made advancements in the form of functional brain imaging that picks the hypofunction of the affected parts of the brain and quantitatively measures the harmful deposits of “amyloid plaques”, responsible for the disease. Some biomarkers in the blood and cerebrospinal fluid, the watery fluid that cushions around the brain and spine, are also measured in this process. Researchers are trying to find medications that can clear the brain of this “plaque-like deposits”. A trial is on to develop a vaccine against the disease.
Good rehabilitative care and occupational therapy, coupled with medications, can preserve their functional capacity to a great extent.
As a doctor, treating and caring for a demented patient, who is not your relative, epitomizes the purest and the most pristine form of “selfless service” because the person you care for can’t even appreciate your efforts. He is never going to return the favour in words, cash or kind, a vacuous smile is the best you may get; he/she won’t even pray for you or bless you; and he needs your attention and love the most, for sure; and they are the most neglected cohort of the society, helplessly tottering at the fringes, waiting for the final call.
On a philosophical note, the disease also teaches you to celebrate life today, as tomorrow is always shrouded in uncertainty.
Dr. Amit Shrivastava, Senior Consultant – Neurology, Dharamshila Narayana Superspeciality Hospital, New Delhi