Tryst with Alzheimer's disease

Samarjit Kambam *

Combination of two brain diagrams in one for comparison. In the left normal brain, in the right brain of a person with Alzheimer's disease
Pix - wikipedia/Garrondo

It is human nature to feel and think about life, not about death, as if we are to last forever. Even though we know that the biological clock is ticking inside us relentlessly making us to age with each passing day, we don't give a damn whether we are getting closer to our natural death. Same is the case is with diseases also.

As long as we don't experience the reality of suffering from one kind of disease or another, particularly a terminal one, we carry on our lives as though we will be disease free for the rest of our lives. This human nature is in fact a boon for us humans. Otherwise we'll be living with fear for every tick of the clock for the rest of our lives.

When we go to a bank, we feel as if everybody has got fat cash in their accounts. When we visit a jail, we feel as though the world is filled with convicts. When we go to a stadium or a sports academy, we feel like the world is filled with sportsmen. When we meet with an accident or when we witness an accident on the road, mental fear builds up inside us giving us a "fear of the ride".

To some, such incidents create post traumatic stress disorder for the rest of their lives. To some, fear from such incidents is short lived for time is the greatest healer for us humans. When we go to a hospital, our spirit goes down as if the world is filled with sick people and most particularly when we come across a terminally ill patient with no hope for cure, our spirit dips further.

There are many diseases in the world out of which some are incurable such as Cancer, Diabetes, Schizophrenia, Poliomyelitis, Creutzfeldt-Jacob disease, Parkinson's, Asthma, Progeria, AIDS etc. out of which Alzheimer's is one of them, a kind of disease not caused by pathogens but due to progressive genetic disorder which affects the brain.

Researchers and medical experts opine that Alzheimer's is the most common form of Dementia (Dementia is a general term for a decline in mental ability causing one to have loss of memory severe enough to interfere with daily life), a progressive disease that destroys memory and other important mental functions.

It is a neurological disorder in which the death of brain cells causes memory loss and cognitive decline. A neurodegenerative type of dementia, Alzheimer's starts mild and gets progressively worse. While they cannot be seen or tested in the living brain affected by Alzheimer's disease, postmortem/autopsy will always show tiny inclusions in the nerve tissue, called Plaques and Tangles.

Alzheimer's disease has been identified as a protein misfolding disease (Proteopathy), caused by plaque accumulation of abnormally folded Amyloid Beta protein which are small peptides, 39–43 amino acids in length and Tau protein in the brain. The abnormal protein clumps, inclusions, in the brain tissue are always present with the disease.

Alzheimer's account for 60 to 80 percent of dementia cases. Memory loss and confusion are the main symptoms of Alzheimer's. Others include worsened ability to take in and remember new information such as repetitive questions or conversations, misplacing personal belongings, forgetting events or appointments, getting lost on a familiar route, impairments to reasoning and complex tasking, lack of exercising judgment such as poor understanding of safety risks, poor decision-making ability, inability to plan complex or sequential activities, impaired visuospatial such as inability to recognise faces or common objects or to find objects in direct view, inability to operate simple implements or orient clothing to the body, impaired speaking, reading and writing such as difficulty in thinking of common words while speaking, hesitations during speech, spelling, and writing errors, changes in personality and behavior such as out-of-character mood swings including agitation, less interest in vocational activities, low motivation or initiative, apathy, social withdrawal, loss of empathy, compulsive, obsessive or socially unacceptable behavior.

Affected people increasingly rely on others for assistance, often placing a burden on the caretaker; the pressures can include social, psychological, physical, and economic elements. What is of great concern is that Alzheimer's disease can start even from the age of 19 years without the person knowing it and the symptoms and progression gets somewhat later, say, 30-35 years.

Alzheimer's disease being common, many notable people have developed it. Well-known examples are former United States President Ronald Reagan and Irish writer Iris Murdoch, both of whom were the subjects of scientific articles examining how their cognitive capacities deteriorated with the disease. Other cases include the retired footballer Ferenc Puskás, former Prime Ministers Harold Wilson (United Kingdom) and Adolfo Suárez (Spain), Indian politician George Fernandes, actress Rita Hayworth, actor Charlton Heston, author Harnett Kane, Nobel Laureate Charles K. Kao, novelist Terry Pratchett, director Jacques Rivette, and politician and activist Sargent Shriver. The list is endless.

I wasn't much interested in Alzheimer's until one of my senior co-workers who had been working even before I completed my HSLC exam and whose age may be around 51 years started showing the early symptoms. Being a progressive disease, his loss of memory began playing havoc to him. He consulted many doctors and was prescribed medications advising him that it may be due to stress and tension. But his condition kept on worsening.

The progressive deterioration rendered him unable to perform simple official tasks which he had been doing for so many years. Speech difficulties became evident due to an inability to recall vocabulary which leads to frequent incorrect word substitutions followed by progressive lost of writing and reading skills. His memory problems worsened and even failed to recognise co-workers. Behavioural and neuropsychiatric changes became more prevalent.

With the passage of time the disease rapidly progressed and he became dependent upon a caretaker, his eldest son. He couldn't remember the road to the office which he had been travelling to and fro for more than 25 years. So, he was always accompanied by his son whenever he came to office. He was not able to perform even the simplest office tasks independently. He even forgot his office room let alone rooms of other Sections. His options got very limited and there was only one choice left for him – to quit his job on premature retirement and become a pensioner.

Whenever he comes to the office assisted by his son to give his signature on the pensioner's payroll, he didn't know the way to the Accounts Section. All the office staff felt really sorry for him. He was such a nice person, a real gentleman, a quiet and calm person who never kept a grudge with others.

Sometimes I wondered why the Almighty has given him such an ordeal making his life a hellish one. When he came to my room accompanied by his son, he forgot my name and told me that I look quite familiar with somebody. In fact, he had not known me at all. Whenever, he comes to the office after every three months, his condition deteriorated in a fast and furious way.

He wasn't able to give his signature on the revenue stamp as he has forgotten half part of his signature. His son, as a caretaker really had a hard time looking after him. His son told me that he had forgotten the way to the bathroom at home and can't remember the names of his wife and family members. Sometimes I also began to develop fear thinking to myself, "What if I also have genetic disorder just like him".

Hearing about Alzheimer's is one thing but encountering a person suffering from the same is another which really gives me the creeps. As there was nothing I could do to do away with his disease, I told his caretaker son to dedicate the best parts of his life to his father and enter marital life somewhat later than others which he wholeheartedly obliged. That advice was the only help I could render for his father.