Early attention is key to Alzheimer's

Alzheimer’s disease is one of the most dreaded afflictions among
people above 60 years of age. And it’s becoming one of the most
serious public health issues for governments as the population ages
everywhere, boosting the number of cases dramatically.
       While existing medical treatments remain only partially effective, a
healthy lifestyle involving some socialising appears to be a wise
approach to limit the risk of Alzheimer’s developing.
       Alzheimer’s disease is one of more than 70 types of dementia
disorders, all of which slow mental functions significantly enough to
affect daily activities. Alzheimer’s is the most common dementia,
accounting for almost 80 per cent of cases.
       The initial symptoms include memory loss, impaired thinking and
reasoning, anxiety, irritability, social withdrawal and often
depression.
       There is no specific test to confirm its presence, leaving doctors to
mainly rely on clinical examination, blood tests and imaging
technology.
       The main risk factor is age, but Alzheimer’s is not associated with
the normal ageing process. It often starts around age 65. After that,
the risk of contracting it doubles about every five years. Nearly half
of people over 85 have Alzheimer’s.
       And yet early onset – 5 to 10 per cent of the cases – can appear when
you’re in your 40s. A generic cause is often discovered among these
younger patients.
       The cause of Alzheimer that leads to the premature death of brain
cells is unknown. Researchers have noted abnormal proteins and
shortages of certain chemicals in the brain, and these factors are now
considered potential targets for treatment.
   Family history and genetics are among the risk factors apart from
age, as are mild cognitive impairment, smoking, high cholesterol,
obesity, hypertension, diabetes and lack of exercise.
       These factors also play a role in common cardiovascular illnesses
that can lead to damage in the cerebral arteries and subsequently
induce dementia of vascular origin. People with Alzheimer’s disease
frequently display brain changes characteristic of vascular dementia.
       Alzheimer’s patients gradually develop an increasingly severe
cognitive impairment.
       The disease will ultimately affect the physical functions, which can
lead to complications such as incontinence, difficulty in swallowing,
injuries from falls and infections – in particular pneumonia and
problems with the urinary tract.
       The treatment includes medicine, a healthy lifestyle and, more
importantly, a caring environment.
       But the US Food and Drug Administration has criticised nutritional
supplements such as multivitamin-mineral-hormone cocktails that are
promoted for Alzheimer’s, saying no beneficial effect has been proved
and they could be unsafe in the long term.
       In contrast, physical exercise benefits the cardiovascular system,
including the heart and brain arteries, and there is some evidence
that it helps improve Alzheimer’s symptoms.
       On the prevention side, although there is no specific approach, the
best evidence today is the reduction of heart risk, as mentioned
earlier, as well as mentally and socially stimulating activities.
       Adopting as early as possible a healthy lifestyle – with no smoking,
a healthy diet, regular exercise, moderate alcohol consumption and
stress management – will surely limit the risk of developing heart
illnesses and vascular dementia, and most likely Alzheimer disease.


Dr Gerard Lalande is managing director of CEO-Health, which provides
medical referrals for expatriates and customised executive medical
checkups in Thailand. He can be contacted at  [email protected]