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Dementia and Alzheimer (Recommended)

Sep 12. 2019
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Thailand’s population ageing rapidly, what are the best ways to tackle the certain rise that’s coming in dementia and Alzheimer’s disease?

Tips for Alzheimer’s prevention and care

With Thailand’s population ageing rapidly, what are the best ways to tackle the certain rise that’s coming in dementia and Alzheimer’s disease?

 

Dr Thanatip, what is the medical definition of Alzheimer’s disease?

Generally speaking, dementia is the broad term for people suffering from declining cognitive ability. Alzheimer’s is one of the more specific ailments, accounting for 60-70 per cent of all patients with dementia.

Alzheimer’s is not a new disease –it’s been around for a long time. Symptoms include forgetfulness because it involves loss of short-term memory in the first stage. They might forget they already ate breakfast even though they just did. Or they might leave the house to buy something at a store around the corner and forget halfway there where they’re going. Or they might forget to take along an umbrella when it’s raining.

 

What is the average age at which Alzheimer’s appears in Thailand?

We’ve seen patients from age 60 onwards, with more cases among those in their 70s, 80s and 90s. Not many people were afflicted 30 years ago, when the life expectancy was 60 and death would occur before Alzheimer’s could take hold. Today the average lifespan is 75, so we’ve seen a growing number of people age 75-85 suffering from this illness.

Worldwide, Alzheimer’s suffers over 90 represent about 7 per cent of the senior population, meaning one in every 15. At 75, the ratio is 2-3 per cent. For the general population in Thailand, the ratio is 0.15 per 100.

 

What advice do you give people with a parent suffering from this illness?

First of all, daughters and sons and caregivers must understand that Alzheimer’s is not treatable, but we can mitigate the risks and increase the quality of life for patients.

Once diagnosed, patients on average live another 3-10 years while their cognitive ability gradually declines, to a point where they cannot be fed properly. In the first stage, they might become forgetful and lose short-term memory. In the middle stage, they will also lose long-term memory, perhaps forgetting the names of their own children or life-partner. Emotional disorders, apathy and aggressiveness are also common.

In the final stage, the muscles stop working properly due to cognitive impairment. They will find it difficult to eat or swallow. Even when fed by someone else, they can’t swallow the food.

Family members should help maintain the patient’s quality of life in the initial years, such as taking them on a long holiday while it’s still practical. Outdoor activities also help stimulate cognitive functions and slow memory loss.

In the middle stage, patients might need professional caregivers, since they should not be left alone due to the increasing impairment.

Patients might also need personal tracking devices to avoid getting lost or facing other danger due to their declining brain function.

The economic costs of Alzheimer’s are huge. Figures from the US show that as much as $100 billion is spent on patients annually.

 

Thailand’s baby-boom generation is now 50-70 years old. How do they fit in the picture?

According to research, 30 per cent of the factors involved in Alzheimer’s are known and manageable, such as education level – better-educated people tend to suffer less from cognitive impairment. Someone with hearing impairment might contract Alzheimer’s sooner than average due to the linkage nerves between the brain and auditory organs.

If a parent has a hearing problem, get them immediate treatment and a hearing aid to slow the progress of Alzheimer’s. Obesity, diabetes, alcohol consumption and smoking are other contributing factors, accounting for a combined 10 per cent of the known causes.

 

What’s your advice regarding diet?

According to Japanese research, two magic foods help prevent or slow the progress of Alzheimer’s. Kaeng kari, a yellow curry with turmeric and other herbs, is reported to have this quality, and citrus fruit such as oranges and lemons are beneficial.

The Mediterranean diet with lots of fresh vegetables, olive oil, fish and a small amount of carbohydrates is also good for Alzheimer’s patients.

Other Japanese research shows that the so-called “cogni-cise” – cognitive exercise – is helpful for senior citizens too as a means to prevent or slow the onset of Alzheimer’s.

Physical exercise such as walking is good, while playing board games with friends is another choice. You can see seniors’ groups walking or jogging in Bangkok’s Lumpini Park early each morning. Afterwards they enjoy playing chess or mah-jong or other board games. This is a good example of cognitive exercise, because the seniors are also benefiting from using their brain in calculations while interacting with friends.

Physical and cognitive exercises, plus regular human interaction, are crucial to maintaining good health in old age. Many in their 70s or 80s or even 90s can still enjoy a good quality of life when they maintain a favourable lifestyle. What we see at Lumpini in the early morning is consistent with the research findings from Japan. Such a lifestyle is an effective way to prevent or delay cognitive impairment.

If you’re near or over 50, you should start to take care of yourself and maintain brain function. If you have parents or other older close relatives, make sure they have a hearing check-up. Then manage the risks that might result from initial memory loss, which could lead to accidents and other untoward incidents. They may need caregivers. In more serious cases, they’ll have to stay in a specialist healthcare centre.

It’s a chronic disease needing long-term care, and relatives often worry about the patient’s wellbeing.

Children of parents with Alzheimer’s will find it most stressful as they enter the early stage since they quickly lose the ability to do common things.

Thailand’s life expectancy has risen to 75 on average, with females at 77 and males at 73. Based on current forecasts, my generation, now in their 50s, will live until 90. This Gen X population has a 7 per cent chance of contracting Alzheimer’s. The Gen Y population now 40 or younger may live until 100, but the probability of Alzheimer’s developing is not yet known for them.

They will pass through multiple stages. During their 50 and 60s, they might suffer from heart disease, which is quite manageable today. After 60, they might have some form of cancer, most of which are also more manageable today. Afterwards, they will probably face the final hurdle – cognitive impairment due to old age – which is not yet treatable. We have to live with it and improve the quality of life as much as possible.

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