On Alzheimer’s day, understanding the disease, and attitude to dementia in India, worldhttps://indianexpress.com/article/explained/explained-world-alzheimers-day-and-its-scenario-in-india-6016544/

On Alzheimer’s day, understanding the disease, and attitude to dementia in India, world

According to the US-based Alzheimer’s Association, there are over 4 million people in India who suffer from some form of dementia.

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Alzheimer’s disease is a progressive brain disorder that usually appears in individuals who are in their mid-60s.

Since 2012, September is being observed as World Alzheimer’s Month meant to spread awareness about the disease, while September 21 is observed as World Alzheimer’s Day.

Alzheimer’s disease is a progressive brain disorder that usually appears in individuals who are in their mid-60s. Very rarely, it may occur in individuals younger than 65 years of age, when it is referred to as early onset Alzheimer’s. The disease was first described by Alois Alzheimer in 1906 and manifests itself by disrupting the message carrying neurotransmitters after it destroys brain cells and nerves. A person with Alzheimer’s also loses the ability to perform day-to-day tasks.

According to the US-based Alzheimer’s Association, there are over 4 million people in India who suffer from some form of dementia. The “World Alzheimer Report 2019: Attitudes towards Dementia”, was released by Alzheimer’s Disease International (ADI), it maps the attitudes of people towards the disease.

Alzheimer’s disease vs dementia

Dementia is a syndrome and not a disease, which Alzheimer’s is. The two are, however, closely related. Dementia’s various symptoms include loss of memory, thinking skills, problems with language, changes in the mood, deterioration in behaviour and an individual’s ability to perform everyday activities. It is most commonly caused by Alzheimer’s disease, which accounts for dementia in over 50-75% of the cases. Dementia can be caused by other diseases such as Parkinson’s and Huntington’s disease as well. It also has types, such as Lewy body and vascular dementia. As per the ADI report, the global costs of dementia have reached to over $1 trillion. The figure is expected to double by 2030.

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According to ADI, there are over 50 million people in the world living with dementia and 58 per cent of these people live in low-middle income countries. The numbers are expected to rise to over 152 million by 2050. Much of the burden of the disease will be on developing and highly populated countries such as India, China and countries in Latin America, where fewer than 10 per cent of the people with the disease receive a diagnosis.

Causes of Alzheimer’s

The exact causes of Alzheimer’s are not yet known. The World Alzheimer Report 2018 notes that there is, however, some degree of consensus among scientists that the disease involves two proteins — beta-amyloid and tau. When the former reaches abnormal levels, it forms plaque that deposits itself between neurons, disrupting cell function. Tau too reaches abnormal levels, as a result of which it forms “neurofibrillary” tangles inside neurons, blocking the transport system of neurons. But scientists do not know what causes these proteins to reach abnormal levels in the first place. It is possible that the reasons could be genetic. The report further refers to a Lancet report from 2017, which claimed that lifestyle factors such as diet, physical fitness, smoking, alcohol are related to one-third of Alzheimer’s cases.

A fully accurate diagnosis of dementia can only be made by examining the brain after death. Therefore for an individual who shows signs of dementia, doctors are only able to make a “reasonably accurate” diagnosis by referring to a person’s case history and symptoms.

Indians’ attitude to dementia

The ADI report’s results are based on over 70,000 responses from 155 countries, the survey for which was undertaken by the London School of Economics and Political Science. Essentially, the report maps how attitudes towards dementia pose a roadblock for people in terms of wanting more information about it, seeking treatment, care and advice, “preventing or delaying people from putting plans in place; progressing to a stage of acceptance and being able to adjust to live with dementia”.

Globally, two in three people think that dementia is caused by normal ageing and 95 per cent of the general public think that they can develop dementia at some point in their lives.

According to the report, 23.4 per cent of Indians with dementia make an effort to keep their dementia a secret when meeting with people. And 7.4 per cent of healthcare practitioners with dementia do the same. Also, 24.3 per cent of the general public perceive people with dementia as “dangerous” and 14.6 per cent healthcare practitioners perceive the same. Of the surveyed Indians, 85.8% said they would take a genetic profiling test to find out if they were at the risk of developing dementia.

Is Alzheimer’s curable?

At present, both Alzheimer’s disease and most causes of dementia have no cure and as a result, are irreversible. The scientific community as yet is working towards methods that can slow down the disease’s progression, but do not know how to stop the disease from occurring or how to stop it’s progression. According to ADI, there exist some drugs that can slow down progression is some patients with Alzheimer’s for periods between 6 and 18 months.