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Understanding Alzheimer's Disease

  • Geetha Subramaniam

September is World Alzheimer’s Awareness Month. It is the international campaign by Alzheimer’s Disease International (ADI) every September to raise awareness and challenge stigma that surrounds dementia. Alzheimer’s Disease Foundation Malaysia will play a host to the 21st ADI Asia Pacific Regional Conference 2019 on 16-18 August 2019 at Hotel Istana Kuala Lumpur, Malaysia. The Conference and Exhibition will showcase scientific research and advances progress and developments in technology and innovation, dementia care and health care practices, inspired community initiatives and the stories of persons with dementia as well as their caregivers.

Alzheimer’s is the most common cause of dementia- a general term for memory loss and impairment of other cognitive abilities serious enough to interfere with daily life. Alzheimer’s disease begins slowly. It first involves the parts of the brain that control thought, memory and language. People with AD may have trouble remembering things that happened recently or names of people they know. A related problem, mild cognitive impairment (MCI) causes more memory problems than normal for people of the same age. Many but not all, people with mild cognitive impairment will develop Alzheimer’s disease.

With Alzheimer’s disease, overtime symptoms get worse. People may not recognize family members. They may have trouble speaking, reading or writing. They may forget to brush their teeth or comb their hair. Later on, they may become anxious or aggressive or wander away from home. Eventually they need total care. This can cause great stress for family members who must care for them. Experts haven’t determined a single cause of Alzheimer’s disease but they have identified certain risk factors including age, family history and genetics.

Generally, the symptoms of Alzheimer’s disease are divided into three main stages. In the early stages, the main symptoms of Alzheimer’s disease are a memory lapse. For example someone with Alzheimer’s disease may forget about recent conversation or events, misplace items, forget the names of places and objects, have trouble thinking of the right word, ask questions repetitively, show poor judgement or find it harder to make decisions, become less flexible and more hesitant to try new things. As Alzheimer’s disease develops, memory problems will get worse. Some of the middle stage symptoms such as increasing confusion and disorientation for example getting lost, wandering and not knowing what time of day it is, obsessive, repetitive or impulsive behaviour, delusions ( believing things that are untrue) or feeling paranoid and suspicious about carers or family members, problem with speech and language(aphasia) and disturbed sleep. Moreover, other symptoms are changes in mood, such as frequent mood swings, depression and feeling increasingly anxious, frustrated or agitated and seeing or hearing things that other people do not (hallucinations).

dependent 63611 640By this stage, someone with Alzheimer’s disease usually needs support to help them with everyday living. In the later stages of Alzheimer’s disease, the symptoms become increasingly severe and can be distressing for the person with the condition, as well as their carers, friends and family. Sometimes people with Alzheimer’s disease can be violent, demanding and suspicious of those around them. A number of other symptoms may also develop as Alzheimer’s disease progresses such as difficulty eating and swallowing (dysphagia), difficulty changing position or moving around without assistance, weight loss, unintentional passing of urine or stools, gradual loss of speech and significant problems with short term and long term memory. In the severe stages of Alzheimer’s disease people may need full time care and assistance with eating, moving and personal care.

People tend to think that dementia is an inevitable part of ageing but in actual fact, it can be prevented or at least its onset can be delayed, said Malaysian Healthy Ageing Society (MHAS). Dementia can be prevented or delayed by adopting a healthy lifestyle from a young age, said MHAS president Prof Dr Philip George. “Having a healthy lifestyle from a young age includes having a good diet, exercise, being socially connected,” he said in an interview. Prof. Philip who is consultant psychiatrist, said people should make such efforts a habit early in life because once dementia hits, there is no way to stop dementia or reverse it.

As the exact cause of Alzheimer’s disease is still unknown, there is no certain way to prevent the condition. Medicines for Alzheimer’s disease symptoms are only one part of the care for the person with dementia. Cognitive rehabilitation is a type of therapy that can make managing everyday activities easier for people with early-stage dementia. It can help them to maintain their independence. Cognitive rehabilitation therapy is tailored to each individual person and is done in their own homes. Over several sessions, a therapist works with the person with dementia and their carer to set personal goals. The therapist will help them to plan how to meet these goals and will support them in doing so. The type of goal that is set depends on what the person wants to do. Some people wish to find ways of staying independent, for example by learning or re-learning how to use household appliances or mobile phones.

Some may want to manage daily tasks better and will work with therapists on developing strategies to prevent them burning their food when cooking meals or safely withdrawing money from a cash point. Cognitive rehabilitation could be valuable part of the care and home support offered to people who have been diagnosed with dementia. Cognitive Stimulation Therapy (CST) is a series of mental exercise that stimulates the brain. Cognitive Stimulation Therapy offers an opportunity to build up self esteem, create friendship and give life purpose and meaning. CST is a programme of themed activities usually carried out over several weeks in small groups, led by a professional who has been specially trained. Each session covers a different topic and is designed to improve the mental abilities and memory of someone with dementia.

 


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