According to Alzheimer's and Related Disorders Society of India, the number of people suffering from this disease is expected to reach 7.6 million. DR RAJNISH KUMAR tells you how medication and cognitive retraining in the early phases can help slow its progression
Millions of people all over the world suffer from Alzheimer’s disease which makes it a global crisis. In India, more than 5.3 million have some form of dementia (a condition in which memory, communication, thinking and social abilities tend to deteriorate), most of which result from Alzheimer’s disease. According to a report published by the Alzheimer's and Related Disorders Society of India (ARDSI), the number of people suffering from Alzheimer’s disease is expected to reach 7.6 million in India. The disease mainly affects the elderly where a combination of environmental and genetic factors usually lead to its inception. While there is no cure available for this disease, medication and cognitive retraining in the early phases can help slow its progression.
The present population of India is estimated to be around 1.39 billion with the elderly population expected to touch 13.1 per cent in 2031. With demographic ageing, India will have to bear the brunt of dementia which will only go up as the years pass on. In 2015, there were nearly 4.1 million persons in India aged over 60 years who had dementia. This is estimated to rise to 6.35 million by 2025 and13.33 million by 2050. The proportion of dementia within the age group of 60-75 years is expected to rise steadily over the coming decades which will further have a devastating impact on the healthcare system of the country. With a lack of awareness, priority and treatment for Alzheimer’s in India, India will face a complexity of issues if steps are not taken in the right direction.
Risk factors
Age
Old age is one of the biggest risk factors for developing this disease. A majority of people who are diagnosed with Alzheimer's disease happen to be of 65 years of age or above.
Genetics
Scientists have identified different variants of genes that increases the possibility of developing Alzheimer’s disease. The most common risk gene that leads to Alzheimer's disease is the APOE-e4 gene. It is estimated that this gene plays a vital role in as many as one-quarter of Alzheimer’s cases.
Family history
The chances of developing the disease increases when someone does have siblings or parents affected with Alzheimer’s. While it is still not completely understood as to what causes Alzheimer’s to run in families, genetics, lifestyle and environmental factors may all play a part.
Cardiovascular Disease
The health of the brain is closely associated to the health of the blood vessels and heart. The heart pumps blood which provides nutrients and oxygen to the brain. Thus, factors that lead to cardiovascular disease also may be linked to a higher risk of developing Alzheimer’s such as obesity, diabetes, smoking, high cholesterol and high blood pressure.
Traumatic Injury to the Brain
The risk of developing Alzheimer's disease increases to a certain extent after a severe or moderate traumatic brain injury, like an injury of the skull or blow to the head that causes loss of consciousness for more than 30 minutes.
Treatment and support
Presently, there are no treatments available to stop the brain damage caused by Alzheimer’s disease. However, different medications are available that can temporarily help improve the symptoms of dementia. These medications primarily work by increasing neurotransmitters in the brain. Research is underway to find better ways to treat Alzheimer’s and other progressive dementias. Currently, lots of pharmacologic treatments and therapies are also being worked upon to focus on stopping the brain cell death associated with Alzheimer’s disease.
The use of behavioural interventions can go a long way in improving the quality of life for both people with Alzheimer's and their caregivers and families. This may include:
Considering the present situation of Alzheimer's disease in India, it is imperative to carry out a thorough pan-India investigation into the current incidence and burden of Alzheimer’s. It is also the need of the hour to provide genetic testing services for the Alzheimer disease's gene (APOE-e4) and fund clinical trials. As Alzheimer’s can have a variety of risk factors including genetic, environmental and lifestyle, clinical trials specific to the country are required without relying on those conducted in developed nations. A better knowledge of risk factors would likely influence patients and family members to seek treatment early and allow healthcare professionals to detect the disease early on.
The writer is HOD, Neurology, Paras Hospitals, Gurugram