Let's go purple on World Alzheimer's Day (Opinion)

B0Y PRAVEEN AGGARWAL & MANORAMA BAKSHI

Let's wear purple this World Alzheimer's day in support of everyone who is impacted by the disease and supporting those who are trying to cure Alzheimer's.

Every year on September 21, people across the world come together to raise awareness around Alzheimer's. The theme for World Alzheimer's month 2022 is "Know Dementia, Know Alzheimer's".

The theme is the same as in 2021. However, this year special focus is given on post-diagnosis support. The forget-me-not flower is a symbol of Alzheimer's disease and other forms of dementia. The small blue flower represents remembrance and is long associated with dementia. Purple is called the colour of Alzheimer's.

One of the most pressing health issues confronting our world today is the growing number of elderly people suffering from dementia. Declining fertility and increasing longevity result in an increase in the number of older people, as well as an increase in the proportion of elderly people in the population having Alzheimer's.

According to the India Ageing report published by the United Nations Population Fund (UNPFA), the elderly population is growing at a rate of 3 per cent and majority of the cases of Alzheimer's primarily occur in people over the age of 60 years.

India houses the third highest number of people suffering from Alzheimer's, after China and the US. Yet, Alzheimer's is a hidden problem in India as it is not formally diagnosed in a medical setup. People consider memory loss as an inevitable part of the ageing process and hence never get tested for it.

Although dementia is a condition that impairs thinking, memory and reasoning, brutally reducing the quality of life, it is not a disease in itself. It is instead a collection of symptoms caused by degenerative neurological diseases that impairs brain function by damaging areas of the brain responsible for learning, memory, decision-making, and language processing.

Alzheimer's is the leading cause of dementia today, affecting over 50 million people. Other neurodegenerative disorders that cause dementia include Parkinson's disease and Huntington's disease, but Alzheimer's accounts for 60-80 per cent of dementia cases worldwide.

Chronic diseases, compared to other types of diseases, consume most of the resources in the health systems. Alzheimer's Disease (AD) is a chronic cerebral disorder and is the most common type of dementia. Currently, there is no real cure for Alzheimer's disease as per World Alzheimer Report.

However, there are treatments that can help slow down the progression of the disease. The scientific research community and medical community across the world is making valiant efforts to delay the onset of this disease, treat it and better still, prevent it. As with any disease, it is very important to diagnose Alzheimer's disease early and to optimally manage the symptoms to improve the prognosis of the disease.

Unfortunately, there are no specific commonly performed tests that confirm the diagnosis of Alzheimer's. However, some of the tests taken by medical practitioners for the diagnosis of Alzheimer's Disease are physical examinations like muscle tone strength, neuro reflexes, sense of hearing, neuro-motor analysis, blood tests like thyroid imbalances, neurological testing and brain imaging, according to a study.

The study, recently published in Frontiers in Neurology and presented at the 8th European Academy of Neurology Congress, was conducted by a team based out of Copenhagen University Hospital and the University of Copenhagen in Denmark establishing a link between Covid-19 and Alzheimer's.

Individuals who tested positive for Covid-19 experienced Alzheimer's disease 3.5 times more frequently than people who were Covid-negative. Even as the country has fought Covid pandemic well, a concrete plan for the people suffering from Alzheimer's is far away. Patients who are diagnosed with Alzheimer's disease or any other form of progressive dementia are still subjected to social stigma despite the development of our country and the rise in education levels. People often do not want to confess that they have a family member or friend suffering from dementia

There's currently no cure for Alzheimer's disease. But there are medicines and therapies available that can temporarily reduce the symptoms. The various approaches that can be followed to improve the quality of life of those suffering from Alzheimer's are:

Pharmacological treatments for symptoms of Alzheimer's

To date, there are no disease-modifying therapies for Alzheimer's, meaning that no medicine available currently can stop or slow down the brain damage that is caused by Alzheimer's. There are, however, several medications that can temporarily reduce the symptoms of dementia such as memory loss and decline in motor skills, thinking ability and language processing. These medications only provide symptomatic relief with the hope of reducing the probability of dementia getting worse very quickly.

Behavioural Therapy

Apart from practical things such as following a daily routine and keeping track of medications using electronic reminders, calendar clocks and weekly pill boxes, several activities and coping strategies can be employed such as reading, solving puzzles, and playing games.

* Social engagement of any sort with friends and family makes life more satisfying

* Keeping up with activities that are enjoyable and contribute to general wellness such as music, playing with pets, getting massages and indulging in aromatherapy

* Reminiscing life experiences and making a personal record can help with improving mood

* Alternative treatments like yoga, naturopathy

Exercise and Nutrition: Taking care of their own health and well-being by spending time with friends or engaging in hobbies, eating healthy, exercising regularly and practising relaxation techniques such as deep breathing and meditation, Yoga, meditation, exercise, swimming, reading, writing, walks, sports etc.

Some examples of healthy food choices:

* Plenty of water, juice and other healthy beverages - The individual suffering from Alzheimer's must consume several full glasses of liquids. However, caffeine-containing liquids that interfere with sleep should be avoided.

* A diet low in fat and rich in fruits and vegetables - such a diet is encouraged to maintain better cognitive health [Source]. High-calorie milkshakes, smoothies and other health shakes with blended vegetables and fruits along with protein supplementation are also good options

* Omega-3 fatty acids - Available as supplements or in fish oil, these are essential fats that are known to be healthy for the heart and brain. These may help prevent cognitive decline. Some supplements of vitamins (Vit E, B and C), folate, selenium and various herbal mixtures are widely promoted as being good for cognitive health, however, there is no conclusive scientific evidence to show that taking such supplements slows the progression of Alzheimer's disease.

Government support going forward:

A concerted effort by the government of India to set up a National Dementia Policy or a National Policy on Alzheimer's disease with a well-defined national action plan using scientific data as is done in developed countries.

* Making dementia a national priority by developing new national policies and legislation

* Increasing awareness about dementia and improving its identification.

* Ensuring community support and comprehensive dementia care models guaranteeing carer support packages.

* Increasing funding for dementia research. Supporting and establishing National Institute for Aged that can do treatment and research for age-related ailments as well as a National Fund for the Aged to provide free health counsellors for elderly people living alone

(Dr Praveen Aggarwal is Co-founder and Director at Consocia Advisor; Dr Manorama Bakshi is a Public Health Expert, and Head of Healthcare and Advocacy at Consocia Advisory. The views are personal)