Alzheimer’s is a devastating ‘Brain Disease’ that affects recent memory and learning mechanisms of the brain eventually debilitating an individual. Recent surge in the incidence has been attributed to an increase in the life span which is an average learning of 80 years today. Loss of memory disables by losing identity, personality and eventually losing the self of the affected. They can’t identify anything including the most loved ones leading to horrifying experiences to the persons affected and to their families.

How is it caused?

At present 50 million are affected in the world and the numbers are expected to rise rapidly leading to severe social,economic and global health challenges soon. It is estimated that 40% of people will be affected at the age of 80 years with this condition. Originally it was described in a patient named August Deter by Dr Alois Alzheimer.

The memory store called Hippocampus (sea horse in Greek ) located in the temporal lobe of the brain gets affected first and eventually spreads to the rest of the brain. The loss of neurons and the synapses will set the progression of the disease. Normally the sensory information from the sense organs are received in the form of electrochemical energy and then the brain compiles and computes the data and projects it as information based on the stored memory and information.

Due to the loss of connectivity in the brain , such computation fails and hence the failure of recognition. It can start with difficulty in remembering simple things, misinterpretations and eventually to serious failure of recognition and remembrance of everything. The neurons in the brain are riddled with beta amyloid plaques which eventually form tangles that kill the neuron itself.

The cell death triggers an inflammatory reaction and the Microglial cells which normally do housekeeping and upkeep of the brain by removing the toxins, gets activated and turns against the brain cells itself. They will in turn destroy and clean up the entire neurons and axons progressively shrinking the brain structurally and functionally.

Best ways to prevent Alzheimer’s

Recently 30 new genes have been identified that are responsible for activating abnormal immune response by microglia as well as the Neuro inflammation. Advances in MRI imaging can identify the plaques in the brain very early. It takes nearly 10 to 15 years for the symptoms to manifest after the appearance of the plaques. Hence early diagnosis can help to identify and stall the onset of the disease.The only hope for the future lies in early prediction in those with strong family history and testing them for abnormal genes, early detection by MRI imaging and on suspicion treating Neuro inflammation aggressively.

Recent research indicates that the beta amyloid protects the brain from the invaded microbial agents. It forms the plaque to trap the microbes to protect nerve cells from any subclinical infection. CD 33 gene has been found to be responsible for triggering Neuro inflammation. So future goals should be to prevent all subclinical infections that can affect the brain, understand the microbial relations with the brain, treat the tangles with appropriate interventions and control the inflammation in order to avoid Alzheimer’s.

Ways to preserving brain health :

Lifestyle modification, good sleep for 7-8 hours, managing stress with meditation, healthy interactions with people, avoiding loneliness, walking with barefoot at least for 20 minutes in a day, good exercise, proper diet with high fibre and keep learning new things can go a long way in preserving brain health and preventing Alzheimer’s disease.

In a bid to facilitate early diagnosis of Alzheimer’s and to provide comprehensive treatment, Brains has also started a unique “Memory Clinic”. This step by Brains is to mark the World Alzheimer’s Day (September 21st).

Dr. NK Venkataramana,
Founder Chairman & Chief Neurosurgeon,
Brains Hospital.

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Dementia is a condition that is caused by injuries to the brain or any disease that affects various functions of the brain, including memory. It is also identified by symptoms that affect the daily activities of an individual and a disability/difficulty in communicating. Alzheimer disease starts with mild symptoms that can be recognized years before it progresses to an extreme level leading to dementia. However, early diagnosis and treatment may help slow the progression. A comprehensive evaluation is especially important in excluding reversible conditions that appear similar to Alzheimer’s. Patients suffering from Alzheimer’s disease begin to notice difficulty in their normal day-today behavioural and mental activities. Some of the symptoms that point toward Alzheimer’s disease are as follows:

• Forgetfulness
• Difficulty in understanding, remembering, recalling
• Misplacing belongings
• Inability to take decisions
• Inability in recognizing familiar things, routes and objects
• Difficulty in finding the right words to speak, repeating conversations
• Changes in personality, mood swings, obsessiveness, compulsiveness, social withdrawal, etc.

The early diagnosis of a person suffering from Alzheimer’s is facilitated by recognizing the above mentioned symptoms. There are no readily available tests that can confirm the condition; however, the doctor will check to see if the neurological functioning is impaired due to other reasons, by way of blood or urine tests, a CT scan, MRI test, etc. Memory tests are carried out to determine the stage of the condition.

Alzheimer’s is a condition that arises due to brain cells being damaged. This damage cannot be reversed; it can only be treated so that the pace of progression of damage is reduced. Therapy plays an important part in the treatment for Alzheimer’s disease. Interaction with people, day care and nursing programs, light activities and keeping track of any other problems those seem to be arising as a result of Alzheimer’s helps in keeping the condition in check. In addition to this, there are other drugs that aid in easing this process of treatment.

People with initial symptoms of Alzheimer’s disease will find it hard to recognize or accept the condition, and it is often their family and loved ones who notice such problems at first. Medical assistance should be sought at the earliest. Early diagnosis and effective treatment helps in ruling out treatable/ reversible conditions that mimic Alzheimer’s, as well as slowing the progression of the disease and ensuring an improved quality of life for patients once the diagnosis is confirmed. Drugs that help in maintaining acetylcholine neurotransmitter levels in the brain are useful in these patients. Depending on the patient’s condition, antidepressants and/ or anti-anxiety medications may also be required. The proper course of medication can be decided after a thorough clinical evaluation and appropriate testing are completed. A significant part of treatment is also focused on assisting the patient’s loved ones cope with the process of caring for their affected family member. There is a lot of cutting edge research happening in this field right now, and we are very hopeful of discovering better ways to treat this condition, and perhaps even cure it in the near future.

Dr. Vishakhadatta Mathur Kumaraswamy
MBBS, DM
Consultant – Neurology
Columbia Asia Hospital
Whitefield
Bengaluru – 560066
Ph: 080 6165 6666

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