Withered skin, feeble bones and a fractured memory – “Is Akhtar dead?” inquires Parveen, a seventy year old housewife living in the suburbs of Islamabad, every morning she asks about her late husband. Being a victim of Alzheimer’s, an insidious disease which impairs memory, thinking and behaviour, Parveen has to relive the demise of her partner every single day. Her daughter carefully changes the subject by asking, “Mother, would you like to go out?”. An offer mostly accepted by Parveen. A safe diversion from a tormenting question.
In the medical lexicon, the term dementia is used to describe memory loss along with other cognitive problems severe enough to hamper daily life. The most common cause of dementia is Alzheimer’s disease which is characterised by a progressive loss of brain cells leading to the shrinkage of the brain matter associated with memory and thinking.
September is World Alzheimer’s Month, an international effort to raise awareness about the disease and remove misunderstandings which have resulted in barriers to diagnosis and subsequent treatment. September 2018 marked the seventh anniversary of this campaign.
With a weight of just three pounds the human brain is the most complex and the least understood human organ. It has over a hundred trillion synapses, which are the junctions between two brain cells and are lost in those suffering from Alzheimer’s. While the definitive cause of Alzheimer’s is largely debated, a consensus exists amongst neuroscientists that the fate of a person prone to Alzheimer’s is decided at the synapse. Alzheimer’s patients have an excess of a protein component known as beta amyloid at the synapse, which heralds the beginning of the disease.
The victims of Alzheimer’s are mostly aged 65 or above, the patient’s skin and the brain share a similar characteristic, i.e. wrinkles. Out of approximately 50 million Alzheimer’s patients found world wide, around 2 million live in Pakistan and the numbers are mounting due to the rapidly growing population of the elderly people. A report funded by the National Institute of Health which was produced by the U.S. Census Board, states that 8.5 percent of people across the globe (617 million) are aged 65 or above. These figures are expected to rise to almost 17 percent of the world’s population by 2050 (1.6 billion). With an increase in the older population comes a number of acute and long-term health problems, out of which Alzheimer’s is one of the most common.
Currently available medicines only provide symptomatic relief and so we are left with preventive measures such as regular exercise, adequate sleep and mentally stimulating activities which helps to preserve the brain synapse by removing the offender, beta amyloid
The implications of dementia and Alzheimer’s is not only limited to the physical and psychological health of the patient alone, rather it affects a variety of people including family members, carers and the society at large.
There is a fine line which differentiates Alzheimer’s from the normal ageing process. Occasional memory lapses such as forgetting why one entered a particular room or where one put the car key is either a consequence of physiological ageing or a carefree attitude. But when car keys are found inside the fridge or it becomes difficult to recall names, that is when alarm bells should be set off. As the disease advances, symptoms such as language problems, disorientation, mood swings, neglecting self-care, and behavioural issues arise, which eventually lead to disability and dependence on others.
Despite the advancements in the science of medicine a sense of fear and stigmatization surrounds Alzheimer’s, most of which stems from the fact that even after years of research and experimentation, we still do not have the cure for this disease. Currently available medicines only provide symptomatic relief and so we are left with preventive measures such as regular exercise, adequate sleep and mentally stimulating activities which helps to preserve the brain synapse by removing the offender, beta amyloid. The high percentage of Alzheimer’s patients in Pakistan is suggests that those above the age of 40 should focus more on these preventive steps so that they can live an Alzheimer’s free life.
The writer is a medical doctor based in Islamabad. He tweets at @rajakhalidshab
Published in Daily Times, October 2nd, 2018.