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On 07 Oct, 2023, Seniors hosted their weekly Health Live Webinar with Dr Kaustubh Mahajan, a Senior Neurologist who spoke on and answered questions about Alzheimer’s Disease: Tips for Patients and Caregivers.
Dr Kaustubh Mahajan is a well-known Neurologist with experience of over 15 years in the field. Dr Kaustubh Mahajan is Consultant Neurologist at the SL Raheja Hospital, Mahim, Mumbai (a Fortis associate).
He has completed his MBBS and Post-Graduation from Seth G S Medical College, Mumbai and completed his training in DNB (Neurology) subsequently. He is also a member of the prestigious American Academy Of Neurology.
He is a member of IMA, MCI and Neurological Society of India. He specialises in Headaches, Stroke Care, Movement Disorders and Epilepsy.
Dementia is a group of degenerative disorders involving issues majorly with cognition. As the age advances, the condition tends to get more and more prominent.
Parkinson’s disease is also a neurodegenerative condition which involves issues majorly concerning mobility.
Cognition simply implies to the way you think. And the way we think depends upon many things. This includes:
- Memory- recent memory and long term memory.
- Recent memory includes memory of things that happened yesterday or 2-4 days/ a week
- Long term memory/ remote memory includes recollection of things that happened years For example, your anniversary, the school you went to
- In degenerative dementias, it is always the recent memory that is affected and the remote memory is intact.
- Ability to make decisions
- Behaviour- the patient can become either too dull or to over active
- Executive functioning ie how an individual functions in their day to day life
- Perception- delusions, hallucinations, paranoia are commonly associated perceptive disorders associated with dementia
And the above mentioned domains are affected in a patient with dementia.
In dementia, when we see someone close to us start to forget things, we jump to the conclusion of Alzheimer’s disease/ dementia. Which is why it is important to understand that dementia is a group of disorders of which Alzheimer’s disease is a part and all the most common causes for dementia.
Before arriving at the conclusion of diagnosing a patient with dementia, the patient is labelled as a patient of dementia, under evaluation. While evaluating the patient, we will try to rule out all other causes of dementia before arriving at the diagnosis of Alzheimer’s.
Alzheimer’ disease is a slowly progressive, degenerative condition without a definitive cure. It is thus important to rule out all other causes of dementia in a patient before diagnosing him as a patient with Alzheimer’s disease.
When a patient is diagnosed with Alzheimer’s disease, there are two victims, the patient himself and the caretaker- who as the symptoms of the patient worsens, also has a harder time if he has not learnt how to deal with and take care of a patient of dementia.
Dementia is a degenerative condition, but it would not be entirely correct to call it a disease of the elderly. Because even though the disease presents in the elderly, the disease actually starts many years prior to the presentation of the disease. For example, if the disease presents at the age of 70, it is likely that the disease might have started at the age of 40 years.
The disease pathology starts around the 4th decade of life, and if no intervening and preventative steps are taken at the time, it will lead to a downhill course and the presentation of dementia will occur sooner.
By the time the symptoms present, the disease has progressed to 80% of its potential and once cognitive decline and functional disability sets in, it has reached 90% of its course.
Technology is advancing at a fast pace, with a major focus on dementia. And even though there have been leaps and bounds of advancement in the field, the focus is now shifting from cure to prevention of the disease itself. This is because by the time dementia is diagnosed, the disease has progressed significantly in your brain, making it difficult to reverse the management, hence making it difficult to cure. This is why prevention of the disease will help alter the course of disease or at least delay it, with hopes of reversal.
At present we do not have any medicine to cure dementia. There are however medicines to make the patient better and comfortable. But there are no medicines available to cure the condition or treat it from its roots, in allopathy, ayurveda or homeopathy.
There are also no medicines available to prevent the worsening of the disease.
Dementia can be prevented even if you have a genetic background. It is the environmental factors which rule and decide whether you will have dementia or not. Thus, modifying these environmental risk factors can help in the prevention of dementia.
Types of dementia:
- Fronto temporal dementia
- Lewy body disease dementia
- Vascular dementia
- Alzheimers dementia
In Alzheimer’s dementia, the main domain that is affected is the recent memory. Whereas in front-temporal dementia (2nd most common type of dementia) the most common domain to be affected is the behaviour- it becomes inappropriate and changes are seen in the behaviour, the memory however remains intact till the end.
Preventative measures you can take to prevent Alzheimer’s dementia:
- Neurofibrinary tangles (NFTs) are toxins which get accumulated in the brain due to improper sleep which induces a chemical inflammatory reaction which starts shrinking the hippocampus (responsible for recent memory) over a period of time. Thus, a proper amount of uninterrupted sleep is important.
- Good circulation to the brain- have a good exercise regime.
- Improve the brain reserve. As we see the technology advancing, there are too many distractions and devices which are not healthy for the brain. Feeding our brain with irrelevant and large amounts of sleep, leading to a pile up of the connections which will require a good amount of sleep to clear the tangles. Learn something new everyday and strengthen those connections to improve your brain reserve.
- Have a purpose in your life. Join volunteer groups or clubs.
- Pursue a hobby, learn something new and keep yourself engaged.
- Socialise more and often
- Practice writing with your non-dominant Go out of your comfort zone, an attempt something challenging
Consuming food items which are rich in antioxidants are good, these include items such as Vit A, Vit C rich rich fruits, salmon, omega 3 fatty acids, nuts.
Only food without any exercise and adequate amount of sleep will not help.
