September 21st is World Alzheimer’s Day, an international initiative to raise awareness about this disease and other forms of dementia. With cases continuing to rise, this day is an important opportunity to focus on the importance of prevention, research, and care for those affected by the disease.
Alzheimer’s Disease & Impact
Alzheimer’s disease is a progressive neurodegenerative disorder and the leading cause of dementia. People with this disease experience severe difficulties with memory, thinking, and behavior, which affects their daily lives and independence. The impact is not limited to patients alone, but also affects families, caregivers, and the healthcare system as a whole.
According to statistics, it is estimated that more than 55 million people worldwide are living with some form of dementia, with two-thirds of them suffering from Alzheimer’s. By 2050, this number may triple, highlighting the urgent need for research and more effective treatments (GBD 2019 Dementia Forecasting Collaborators, 2022; Scheltens, 2021).
Symptoms and Stages of the Disease
The progression of Alzheimer’s disease includes several stages, starting with mild memory difficulties, such as difficulty recalling recent events and communicating. As the disease progresses, symptoms become more severe, leading to confusion, personality changes, and ultimately loss of self-care.
Early Stage:
- Difficulty recalling recent events
- Short-term memory impairment
- Decreased ability to communicate (aphasia)
- Apraxia (inability to perform motor activities)
Mid Stage:
- Increased cognitive deficits
- Difficulty in self-care
- Disorientation in time and space
- Agnosia (difficulty recognizing objects)
- Sleep cycle disorders, movement problems, falls
Advanced Stage:
- Inability to care for oneself, often bedridden
- Inability to recognize faces, including close relatives
- Swallowing disorder
- Increased risk of complications (thrombosis, infections, aspiration pneumonia)
Psychiatric Symptoms of Alzheimer’s Dementia:
- Mood Disorder
- Depression
- Emotional Lability
- Aggression
- Intense Worry or Anxiety
- Paranoid Ideas
- Perceptual Disturbances (Hallucinations or Delusions)
- Refusal to Eat
Importance of Early Diagnosis
Early diagnosis of Alzheimer’s disease can give patients and their families more time to plan for the future and manage the progression of the disease. It also allows for the delivery of treatments that can slow the progression of the disease and improve the patient’s quality of life.
According to recent research, almost 50% of global dementia cases could theoretically be prevented or delayed by eliminating 14 modifiable risk factors throughout a person’s life (GBD 2019 Dementia Forecasting Collaborators, 2022).
Management at Different Stages of Dementia
(Alzheimer’s Association, 2024)
Initial Stage:
- Establish a consistent daily routine
- Engage in cognitive activities, such as puzzles
- Create a supportive network
- Regular medical check-ups
Mid-Stage:
- Implementing safety measures at home
- Considering professional help
- Managing medications to control symptoms
- Using strategies to manage mood
Advanced Stage:
- Emphasis on palliative care
- Emotional support for caregivers
- Legal and financial planning to manage major decisions
Current management of Alzheimer’s disease includes a multidimensional and individualized approach, which is based on several areas (Yiannopoulou & Papageorgiou, 2020):
- Open Communication: Honest and successful transmission of information and emotions between physician, caregiver and patient for early recognition of symptoms and appropriate guidance.
- Behavioral Approaches
- Simplification and consistency of environment
- Established routines
- Communication strategies, such as calm interactions and plain language
- Planning legal and medical decisions
- Cognitive behavioral therapy
- Exercise, light and music therapy
- Planned short rest periods
- Psychoeducation to understand the effects of dementia
- Encouraging the development of support networks for caregivers
- Pharmacological Interventions: The main drugs for Alzheimer’s dementia are memantine and cholinesterase inhibitors. The earlier treatment is started, the better the memory deterioration is delayed. Although they cannot stop the disease, they can delay it.
Prevention of Dementia
- Brain Exercise: Adopting activities that enhance cognitive function, such as reading, crossword puzzles and language learning. Exercising memory with new data is also beneficial.
- Physical Activity: Encouraging movement with individual or group exercises. Research shows that mild physical activity, such as daily walking, can significantly reduce the risk of dementia.
- Healthy Diet: Adopting a diet that reduces cholesterol and sugar. Olive oil, as a key component of the Mediterranean diet, can help prevent the accumulation of amyloid, which is associated with dementia.
- Management of Health Problems: Important regulation of diabetes, hypertension and other cardiovascular problems. Hearing loss should also be addressed, as failure to intervene increases the risk of dementia.
- Social Engagement: Encourage participation in recreational and social activities to increase social life.
- Reduce Smoking and Alcohol: It is important to stop smoking and consume alcohol within the permitted limits.
World Alzheimer’s Day is an important reminder for all of us about the importance of prevention, research and care. Everyone can contribute to raising awareness and supporting people with dementia and their families, while continuing scientific research brings hope for the future, with the aim of finding treatments that will radically change the course of the disease.
Bibliography
Alzheimer’s Association (2024). Stages of Alzheimer’s. [online] Alzheimer’s Disease and Dementia. Available at: https://www.alz.org/alzheimers-dementia/stages.
GBD 2019 Dementia Forecasting Collaborators (2022). Estimation of the Global Prevalence of Dementia in 2019 and Forecasted Prevalence in 2050: an Analysis for the Global Burden of Disease Study 2019. The Lancet Public Health, 7(2). doi:https://doi.org/10.1016/s2468-2667(21)00249-8.
Scheltens, P. (2021). Alzheimer’s disease.The Lancet, [online] 397(10284), pp.1577–1590. doi:https://doi.org/10.1016/S0140-6736(20)32205-4.
World Health Organization (2023).Dementia. [online] World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/dementia.
Yiannopoulou, K.G. and Papageorgiou, S.G. (2020). Current and Future Treatments in Alzheimer’s Disease: An Update.Journal of Central Nervous System Disease, [online] 12(1), p.117957352090739. doi:https://doi.org/10.1177/1179573520907397.
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