A LONELY JOURNEY
The challenges of Alzheimer’s Disease - Part I
Do you look at the comic strips in the daily newspapers, like I do? If so, you probably saw a recent segment of “Blondie” in which Herb says to Dagwood, “I put the hair cream on my tooth brush, spilled the coffee and forgot where I kept my car keys this morning, what else could go wrong?” And then proceeds to sit on a freshly painted chair in spite of Dagwood’s warning!
Does this happen to you frequently? Do you get ‘senior moments’ a bit more often than before? If so, it may be time for a neurological check up. But don’t panic.
“First it was just an occasional memory loss, not able to get the right word out, then he would omit a whole sentence. Gradually it escalated, forgetting where he was, what he ate for breakfast and now he doesn’t recognize us and his grandchildren,” my friend Gopal was telling me about his 85-year-old father, who is suffering from Alzheimer’s and needs round-the-clock care. “My wife and I are now the fulltime caregivers and can’t go anywhere. We don’t trust anybody else,” he added sadly.
A few weeks ago, our medical society gave a reception and tour of a renovated independent and assisted senior living facility in Hernando County. Instead of the regular tour of the beautiful institution, I opted to see the Alzheimer’s wing. It was an eye-opener; there were so many elderly housed in those quarters, living in a state of fog, needing fulltime attention. Clearly, this is their final stop.
I paused for a moment and realized that America is aging, we are all aging, yes, the first- generation Indians are entering their twilight years. The recent mortality tables show that Americans are living longer, many more crossing 85- and 90-year mark. Soon, we will all have to grapple with age-related medical problems, including a decline in cognitive function. In fact, I have started hearing stories of some of the elderly in our midst afflicted with this problem. Now, that will pose a great challenge for our younger generation.
It is a life nobody is looking forward to – sitting in a wheelchair in diapers, drooling saliva, wearing catheters, unable to feed oneself and more ignominies that go with the condition. Mental powers steadily being replaced by mental confusion. However, we need to face the reality.
Alzheimer's is the most common cause of dementia; the latter defined as “a group of brain disorders that causes progressive loss of intellectual and social skills, severe enough to interfere with day-to-day life.” Often, the disease strikes people in their upper 70s, 80s and beyond, but there is an early onset type that is often hereditary and strikes people in the 50-60 age group, sometimes even younger. Fortunately, this variety is rare, affecting only about 5 percent of the population.
The essential pathology is brain cells degenerate and die, causing a steady decline in memory and mental function. Tangles and plaques appear in neurons from accumulation of a protein called ‘beta-amyloid’. It is like a sticky ‘goo’ that accumulates in the brain and prevents neurons from ‘talking’ to each other. In other words, it causes a disruption in communication within the neurons and hence a block in transmission of stimuli or impulses.
All of us forget a little bit here and there, I do too, which is why I carry cheat sheets and post-it notes to remind myself of chores for the day. But when it goes beyond that stage with steady deterioration of your acquired skills, it becomes abnormal. In other words, the brain loses its ability for ‘acquisition, organization and proper recall’ of the experiences in your daily life.
Alzheimer’s disease affects more than 5.5 million Americans. No doubt, it is a devastating situation, especially for the early onset age group. But it is worse for the caregivers, particularly when the disease progresses and the patient becomes totally helpless. Having treated many patients with advanced Alzheimer’s, I empathize with the former because of the complexities involved in the patients’ care.
To be continued …
Dr. M. P. Ravindra Nathan is a Brooksville cardiologist.