Never too early never too late

Dr. Mona Nongmeikapam *

Have you ever cared for a sick person very dear to you? What is the most rewarding part of the whole ordeal? Our dear one returning back to their old healthy self. Or is it the blessings and praises of gratitude they shower upon us after their recovery.

Unfortunately, in Alzheimer’s Disease, there is going to be neither. Dementia is a term used to describe brain disorders include memory loss, difficulty performing familiar tasks, problems with language and changes in personality.

Alzheimer’s disease is the most common cause of dementia, accounting for about 60-70% of all dementias. Other causes include vascular disease, dementia with Lewy bodies, fronto-temporal dementia, Down’s syndrome, etc.

There are about 55 million people worldwide living with dementia and this figure is expected to triple by 2050. Every 3 seconds there is a person being diagnosed with Dementia. The global burden of the illness worldwide is about 1.3 trillion US dollars, which is roughly 10,81,78,85,00,00,000.00 Indian Rupees.

Moreover, the caregiver burden and burnout of this pandemic is immense, with over 50% caregivers reporting that their health has suffered as a result of their caring responsibilities, in spite of their best efforts.

Research indicates that all Dementias including Alzheimer’s disease start many years prior to symptoms. Hence much more focus needs to be emphasized on creating awareness of the lifelong brain health interventions and healthier choices that can be made. Keeping this in mind, the campaign theme for World Alzheimer’s Month 2023 is ‘Never too early, never too late’.

The ‘Never too early, never too late’ campaign aims at:
- Early identification of risk factors,
- Adopting risk reduction measures promptly and
- Prevent the onset of dementia.
This includes ongoing risk reduction strategies for individuals who have already been diagnosed with Dementia and for all of us in general.

Inevitable Risk factors for dementia
1. The greatest risk factor for Alzheimer’s disease and other dementias is increasing age although dementia is not a normal part of ageing.
2. Genes account for less than 1% of dementia cases, and cause young-onset forms in which symptoms usually develop before the age of 60.
3. Women are more likely to develop Alzheimer’s disease than men.

Modifiable risk factors and Preventive measures that can be adopted:

1. Physical inactivity
It is recommended that adults aim for either 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity each week to keep Dementia at bay.

2. Smoking
Avoiding all tobacco products and complete cessation of smoking reduces the risk of dementia.

3. Excessive alcohol consumption
Alcohol consumption more than 21 units weekly increase the risk of dementia. So minimizing or complete avoidance are protective measures that can be adopted.

4. Air pollution
Minimizing the air pollution level in the environment will have many health benefits, including Dementia prevention.

5. Head injury
Preventive measures like adhering to strict road traffic norms, use of helmet and other protective measures, avoiding falls and trauma, prompt and vigilant treatment in case of any head injury are very vital to minimize the rising numbers.

6. Infrequent social contact
Staying socially active and engaging in peer company helps keep Dementia at bay.

7. Less education
A low level of education in early life affects cognitive reserve and is one of the most significant risk factors for dementia. Needless to say, education is a must for all. For all the more reasons.

8. Obesity
Healthy eating, active lifestyle and judicious dieting will delay cognitive decline. The compliments will be just a desirable side-effect.

9. Hypertension
Lifestyle and diet modifications, regular monitoring and medication for hypertension if indicated is effective in preventing dementia.

10. Diabetes
Prompt detection and management of Type 2 diabetes will help in reducing the risk.

11. Depression
It cannot be stressed more. Optimum mental health and prompt treatment for any mental illness especially Depression will curb dementia incidence.

12. Hearing impairment
People with hearing loss have a significantly increased risk of dementia, hence corrective measure like hearing aids will reduce the risk in a large population of people.

Slowly declining memory starting with forgetting what happened in the past 24 hours to not being able to identify family members and then to even forget the basic actions like swallowing after meal, Dementia is a painstaking heartbreaking process for the individuals and their families at large.

They struggle to perform menial chores that they did for decades effortlessly. Making a small conversation and communicate what they have in mind becomes a mammoth task. Slowly disorientation sets in, judgement may waver, mood swings set in and they become incapable of independent living.

There is no cure for Alzheimer’s Disease or most other forms of Dementias. But the mood and behavioural symptoms can be treated and medications are also available to delay the rapid progression of the illness.

Support groups, more awareness, reducing the stigma, encouraging help-seeking behaviour and delaying disease progression by avoiding the modifiable risk factors are steps that cannot be stressed enough.

Early bird catches the worm. And if the worm here is aging gracefully, proactively and independently with beautiful memories, I would say: let us go catch that worm, hook, line and sinker! Starting today.