The word de­men­tia means ‘de­prived of mind’. It is a wide-rang­ing term that cov­ers mem­o­ry loss, con­fu­sion, changes in per­son­al­i­ty, a de­cline in think­ing skills and dwin­dling abil­i­ty to per­form every­day ac­tiv­i­ties. There are many types of de­men­tia. Alzheimer’s dis­ease is the most com­mon. “Every three sec­onds some­one in the world de­vel­ops Alzheimer’s Dis­ease,” ac­cord­ing to Alzheimer’s Dis­ease In­ter­na­tion­al (ADI).

Sep­tem­ber 21st marks World Alzheimer’s Day

Every Sep­tem­ber, peo­ple come to­geth­er from all around the world to raise aware­ness and to chal­lenge the stig­ma that per­sists around de­men­tia. The 2021 cam­paign shines a light on the warn­ing signs of de­men­tia, en­cour­ag­ing peo­ple to seek out in­for­ma­tion, ad­vice and sup­port from ADI or the cor­re­spond­ing lo­cal Alzheimer’s As­so­ci­a­tion.

“It is on­ly through a tru­ly glob­al ef­fort that we can raise much need­ed aware­ness and chal­lenge the stig­ma and mis­in­for­ma­tion that still sur­rounds de­men­tia, and we are call­ing on every­one to do some­thing dur­ing Sep­tem­ber, how­ev­er small or large, through our cam­paign ‘Know De­men­tia, Know Alzheimer’s’ Dis­ease” shared ADI.

De­men­tia af­fects learn­ing and mem­o­ry in the brain

The terms de­men­tia and Alzheimer’s are of­ten used in­ter­change­ably. In part, that’s be­cause it is very hard to tell them apart. Usu­al­ly, a spe­cif­ic type of de­men­tia can on­ly be di­ag­nosed by an au­top­sy af­ter some­one has died. Once de­men­tia has de­vel­oped, it is usu­al­ly hard to re­verse. The goal of treat­ment is to man­age symp­toms and slow its pro­gres­sion. Some med­ica­tions can help slow the in­tel­lec­tu­al de­cline in mild to mod­er­ate de­men­tia.

Mem­o­ry loss dis­rupts dai­ly life. An in­di­vid­ual with de­men­tia may get lost in a once-fa­mil­iar neigh­bour­hood. A com­mon symp­tom is dif­fi­cul­ty in re­call­ing new in­for­ma­tion, he or she may have in­creased trou­ble mak­ing de­ci­sions, solv­ing prob­lems, or mak­ing good judg­ments. Mood and per­son­al­i­ty may change. A per­son with de­men­tia can be­come more ir­ri­ta­ble or hos­tile or lose in­ter­est in al­most every­thing.

Alzheimer’s Dis­ease: Three Stages of Pro­gres­sion

Alzheimer’s af­fects peo­ple in dif­fer­ent ways, each per­son may ex­pe­ri­ence symp­toms — or progress through the stages — dif­fer­ent­ly. Alzheimer’s dis­ease typ­i­cal­ly pro­gress­es slow­ly in three gen­er­al stages: ear­ly, mid­dle and late (some­times re­ferred to as mild, mod­er­ate and se­vere in a med­ical con­text).

Ear­ly-stage Alzheimer’s (mild)

In the ear­ly stage of Alzheimer’s, a per­son may func­tion in­de­pen­dent­ly. He or she may still dri­ve, work and be part of so­cial ac­tiv­i­ties. De­spite this, the per­son may feel as if he or she is hav­ing mem­o­ry laps­es, such as for­get­ting fa­mil­iar words or the lo­ca­tion of every­day ob­jects.

Symp­toms may not be wide­ly ap­par­ent at this stage, but fam­i­ly and close friends may take no­tice and a doc­tor would be able to iden­ti­fy symp­toms us­ing cer­tain di­ag­nos­tic tools.

Com­mon dif­fi­cul­ties in­clude:

• Com­ing up with the right word or name.

• Re­mem­ber­ing names when in­tro­duced to new peo­ple.

• Hav­ing dif­fi­cul­ty per­form­ing tasks in so­cial or work set­tings.

• For­get­ting ma­te­r­i­al that was just read.

• Ex­pe­ri­enc­ing in­creased trou­ble with plan­ning or or­gan­is­ing.

Mid­dle-stage Alzheimer’s (mod­er­ate)

Mid­dle-stage Alzheimer’s is typ­i­cal­ly the longest stage and can last for many years. As the dis­ease pro­gress­es, the per­son with Alzheimer’s will re­quire a greater lev­el of care.

Symp­toms, which vary from per­son to per­son, may in­clude:

• Be­ing for­get­ful of events or per­son­al his­to­ry.

• Feel­ing moody or with­drawn, es­pe­cial­ly in so­cial­ly or men­tal­ly chal­leng­ing sit­u­a­tions.

• Be­ing un­able to re­call in­for­ma­tion about them­selves like their ad­dress or tele­phone num­ber, and the high school or col­lege they at­tend­ed.

• Ex­pe­ri­enc­ing con­fu­sion about where they are or what day it is.

• Hav­ing trou­ble con­trol­ling their blad­der and bow­els.

• Ex­pe­ri­enc­ing changes in sleep pat­terns, such as sleep­ing dur­ing the day and be­com­ing rest­less at night.

• Show­ing an in­creased ten­den­cy to wan­der and be­come lost.

• Demon­strat­ing per­son­al­i­ty and be­hav­iour­al changes, in­clud­ing sus­pi­cious­ness and delu­sions or com­pul­sive, repet­i­tive be­hav­iour like hand-wring­ing or tis­sue shred­ding.

Dur­ing the mid­dle stage of Alzheimer’s, the de­men­tia symp­toms are more pro­nounced. the per­son may con­fuse words, get frus­trat­ed or an­gry, and act in un­ex­pect­ed ways, such as re­fus­ing to bathe.

As the need for more in­ten­sive care in­creas­es, care­givers may want to con­sid­er respite care or an adult day cen­tre so they can have a tem­po­rary break from care­giv­ing while the per­son liv­ing with Alzheimer’s con­tin­ues to re­ceive care in a safe en­vi­ron­ment.

Late-stage Alzheimer’s (se­vere)

In the fi­nal stage of the dis­ease, de­men­tia symp­toms are se­vere. In­di­vid­u­als lose the abil­i­ty to re­spond to their en­vi­ron­ment, to car­ry on a con­ver­sa­tion and, even­tu­al­ly, to con­trol move­ment.

At this stage, in­di­vid­u­als may:

• Re­quire around-the-clock as­sis­tance with dai­ly per­son­al care.

• Lose aware­ness of re­cent ex­pe­ri­ences as well as of their sur­round­ings.

• Ex­pe­ri­ence changes in phys­i­cal abil­i­ties, in­clud­ing walk­ing, sit­ting and, even­tu­al­ly, swal­low­ing

• Have dif­fi­cul­ty com­mu­ni­cat­ing, es­pe­cial­ly com­mu­ni­cat­ing pain.

• Mem­o­ry and cog­ni­tive skills wors­en

• Sig­nif­i­cant per­son­al­i­ty changes take place and in­di­vid­u­als need ex­ten­sive care

• Be­come vul­ner­a­ble to in­fec­tions, es­pe­cial­ly pneu­mo­nia.

Hos­pice Care is of­ten Ben­e­fi­cial

The per­son liv­ing with Alzheimer’s may not be able to ini­ti­ate en­gage­ment as much dur­ing the late stage, but he or she can still ben­e­fit from in­ter­ac­tion in ways that are ap­pro­pri­ate, like lis­ten­ing to re­lax­ing mu­sic or re­ceiv­ing re­as­sur­ance through gen­tle touch. Dur­ing this stage, care­givers may want to use sup­port ser­vices, such as hos­pice care, which fo­cus on pro­vid­ing com­fort and dig­ni­ty at the end of life. Hos­pice can be of great ben­e­fit to peo­ple in the fi­nal stages of Alzheimer’s and oth­er de­men­tias and their fam­i­lies.

Can we pre­vent Alzheimer’s Dis­ease (AD)?

As the ex­act cause of AD is still un­known, there’s no cer­tain way to pre­vent the con­di­tion but a healthy lifestyle can help re­duce your risk. Any habits that re­duce the risk of de­vel­op­ing car­dio­vas­cu­lar dis­ease al­so re­duces the on­set of AD.

“The most con­vinc­ing ev­i­dence is that stress man­age­ment, mit­i­gat­ing the risk fac­tors and phys­i­cal ex­er­cise helps pre­vent the de­vel­op­ment of Alzheimer’s or slow the pro­gres­sion in peo­ple who have symp­toms,” says Dr Gad Mar­shall, as­so­ciate med­ical di­rec­tor of clin­i­cal tri­als at the Cen­ter for Alzheimer Re­search and Treat­ment at Har­vard.

For fur­ther in­for­ma­tion:

https://www.alzint.org/get-in­volved/world-alzheimers-month/2021-theme/