Alzheimer’s Disease

The quick witted and dashing trade union leader George Fernandes, who went on to become the defence minister of India and is remembered for his fabled flight in a Mig fighter aircraft, is now unable to recognize his own relatives and recall his own name. The “cowboy” American president Ronanld Reagan, the tough no-nonsense British prime minister Margaret Thatcher, and the Hollywood heartthrob Charlton Heston are also among the  26 million suffers worldwide afflicted by Alzheimer’s Disease, that robs  mental functions and reduces one to a blank vegetative state till they die.

Alzheimer’s Disease (AD) is on the rise and is being increasingly recognized. The mother of a senior executive in Lucknow, who suffered from this disease and had became comatose was, in a rare show of  devotion, kept alive for 5 long years with life support at home. And some healthy relatives have cobbled together a group to learn and share from each other about how to care for their affected seniors.

The disease starts usually after 65, and manifests slowly and subtly with forgetfullness of recent events and names (What did the new plumber say his name was? Who had come home last night to meet us?). Some may experience change in moods, undue concern and anxiety, forgeting to do the daily chores or the way back home from an evening walk, and failing to get the right word during cnversation. The withdrwal then begins, as the person sinks into apathy (not quite bothered about a family function going on in the drawing room) and the stare becomes unrecognizing and hollow.

The burden of AD on the family can be heavy. When a husband fails to recognize his spouse of 40 years, it can shatter the heart. Relatives are often caught in a dilemna of whether to let life go on as usual with the affected senior confined to a room with hired attendants (often brings feelings of guilt) or cut out much of the fun of life and stay together indoors with him (not fair to young children, and often hardly matters to the patient as he is obtunded and apathetic to realize).

What causes AD is unclear and is the subject of intense global research. The brain shrinks and develops plaques of a jelly like substance called amyloid. One of the chemical transmitters of the brain, acetylcholine, dries up leading to poor functioning and networking between various parts of the brain.

While the quest for a magic potion for AD continues, scientists have been trying to identify who might be at risk (smokers, diabetics, hypertensives) and what factors might protect (high consumption of fresh fruits, chocolates, coffee and interest in board games).  The familiar dietary ingredient, “haldi (turmeric, curcumin), loaded with anti-oxidants, has emerged as a front runner for  cure.

When I see a patient of AD I am reminded of the old adage “All good things in life are lent, not given”. Our fertile brains are no exception !!

As published in HT City Hindustan Times (Lucknow)