Don't forget Alzheimer's disease

Few things terrify people as much as Alzheimer's disease. It is a major cause of dementia (the progressive deterioration in the ability to process thought). There are many other causes of dementia, some of which are reversible. Therefore, diagnosing Alzheimer's necessitates attempting to rule out the other causes of dementia - by history, examination and investigation.

Alzheimer's disease is of varying chronicity. It denies its victims access to their higher brain activities, eventually disconnects everyday functions, and robs loved ones of the person that was once near and dear to them, leaving a completely helpless human being in constant need of care and attention until the inevitable.

Many of us worry if we are at risk for or already have symptoms of Alzheimer's disease. I once heard it said that if someone asked you about a movie that you saw the previous day and you could not recall the names of the actors ... don't worry too much. However, if you can't recall seeing the movie, you have a problem.

The likelihood of getting Alzheimer's increases with: age (the risk doubles every five years over age 65 and nearly half of the people over 85 probably have it); a history of a first-degree relative with the disease; female gender (perhaps because, on average, women live longer); chronic diseases (especially poorly controlled diabetes, high blood pressure and high cholesterol); smoking; poor nutrition; mild cognitive impairment; lack of social engagement; mental and/or physical inactivity.

Signs of Alzheimer's include: serious memory lapses; confusion in place and/or time; increasing frequency of misplacing things permanently (and eventually accusing others of stealing them); major difficulties in planning and executing hitherto accustomed tasks and activities (like banking, shopping, picking up the grandchildren); becoming lost on familiar routes; constantly repeating oneself, frequently searching for words, getting easily lost in conversations; difficulty understanding visual images; poor judgement in making decisions; poor hygiene; withdrawal from leisure and work activities; and noticeable changes in mood and personality.

Currently, there is no way to prevent the beta-amyloid deposition (senile plaques), phosphorylated tau deposition, neurofibrillary tangles, neuron degener-ation, and synaptic loss seen in Alzheimer's disease, and we certainly cannot cure it, but available treatment exists. There are three medications available here, one of which now comes as a generic. If started early, they can slow the mental and physical deterioration of Alzheimer's.

Trouble on the horizon?

Thanks to modern science and medicine, there are approximately seven billion people on the planet right now (20 per cent are children, 80 per cent are adults and 17.5 per cent of those adults are 65 and older). However, it is predicted that within 10 years, people 65 and over will outnumber children under five years old for the first time in history. Jamaica is no exception. This has extremely serious social, health and economic ramifications.

The National Health Fund (NHF) covers the approximately 1.7 per cent of Jamaicans living with HIV/AIDS. Extrapolating the data suggests that Alzheimer's may surpass HIV/AIDS cases in the not-too-distant future. Unfortunately, because of obvious financial constraints, the NHF last expanded its list of chronic diseases covered in 2005. It does not cover Alzheimer's, even though it probably afflicts about 13 per cent of the 7.6 per cent of Jamaicans over 65 years of age.

Once again, I join with voices like Dr Albert Chen, family practitioner and gerontologist, in petitioning the Government not to forget Alzheimer's disease when next adding new conditions to the NHF list of drugs.

The Alliance On Ageing (Jamaica) is inviting the public to a free lecture on this year's World Alzheimer's Day theme, 'The Faces of Dementia', at the Guardian Life Auditorium, 12 Trafalgar Road, Kingston 5, on Wednesday at 6:30 p.m. The guest speaker will be Professor Denise Eldemire-Shearer. RSVP: 943-9137.

Garth A. Rattray is a medical doctor with a family practice. Email feedback to columns@gleanerjm.com and garthrattray@gmail.com.