OOPS! I FORGOT… part 1 (A PEEK INTO THE WORLD OF ALZHEIMER’S)

“Oops I forgot!” is a phrase so mindlessly thrown about in our day to day lives. It’s the default answer of a student who forgot to do his/her homework, an employee who has not turned in some work or a spouse forgetting a wedding anniversary. So when it comes to memory disorders, people just tend to assume that it is just about forgetting inconsequential things and say “what’s the big fuss all about? It’s after all just forgetfulness” However memory disorders are so much more than just a matter of merely forgetting names of people or such things, one can undergo memory loss to such a major degree that s/he forget about his/herself.

In order to have a sneak peek into the world of an individual diagnosed with a memory disorder, one can perform the following task: “please think of all the joyful memories that define your life; people, places, meetings, events etc. Now, imagine waking up one day and you forget all of it, every bit of the lovely memories, just gone as though they’ve disappeared into thin air and they are never coming back”. This experience in a nutshell is what an individual diagnosed with Alzheimer’s disease will have to face sooner or later. The very thought would send a shudder down the spines of even the most hard headed people since; their whole life will cease to exist if this were to happen to them. One of the most common memory disorders is Alzheimer’s disease.

Image result for forgetting aunty acid

According to the Diagnostic and Statistical Manual for mental disorders, 5th edition (DSM-V), Alzheimer’s disease is a progressive neurodegenerative condition resulting in impairment in cognitive function. The clinical symptoms associated with this disease include short term as well as long term memory loss, language disorders, visuo-spatial impairment, mood swings and behavioral disturbances. The average onset is about 65 years of age, but of late cases have been reported among people aged 40-90. In India, there are about 10 million cases reported every year, and most caregivers are clueless about managing and supporting the diagnosed individual which is alarming.

To commemorate the memories of all those who’ve lost theirs, on September 21st viz. World Alzheimer’s Day, let us all take a pledge to gain an insight into the onset and management of the forgetting disease!

THE DIAGNOSIS:

One of the most robust forms of diagnosing Alzheimer’s disease is the use of special PET scans that make use of radioactive tracers to highlight amyloid protein plaques in the brain, which are a hallmark of the disease. This test may allow doctors to diagnose Alzheimer’s at a very early stage- even before any visible signs occur and therefore can be used even when the first signs of forgetting begin to show just to be on the safer side.

Image result for alzheimers brain scan

The most common areas of the brain that are affected in the case of Alzheimer’s disease are the frontal lobe which is responsible for intelligence, behavior and judgment (cognition), the parietal lobe which is responsible for language comprehension and the temporal lobe which is responsible for memory. Since it’s a progressive neurodegenerative disease, at first the connections between cells in the brain are destroyed. Eventually as the cells die in the outer layer of the brain (cortex), which includes the hippocampus that enables the formation of new memories, the brain shrinks and spaces in the brain get larger. Henceforth in the brain image of a person with Alzheimer’s disease one can observe large black areas (deep purple in the image above) which are actually empty.

As all psychologists can’t stress enough upon psycho-education, the first step is to gain an insight into the onset and development of this disease. Knowledge about the disease will empower the diagnosed individual, the caregivers as well as the society at large in effectively managing Alzheimer’s. The 7 stages in the development of Alzheimer’s and management are stated below:

  • Stage 1 portrays normal outward behavior. No particular signs and symptoms are visible except for a slight bit of forgetfulness which may seem very normal since we all forget inconsequential things like people’s names, car keys, or a receipt etc. At this stage, only a Positron Emission Tomography (PET) scan can reveal if a person has Alzheimer’s
  • Stage 2 is characterized by very mild changes (it’s like stage 1, except the frequency increases) such as forgetting things or misplacing objects etc. Signs and symptoms like these are so subtle that even a seasoned doctor would find them hard to catch and diagnose instead of dismissing them off as mere changes on account of ageing
  • Stage 3 is characterized by mild decline of memory and thinking. In the stage, the affected individual forgets something s/he just read, asks the same question several times (e.g. what’s your name?) and has trouble in making plans or organizing things. At this stage, the caregiver should help by making timetables and setting alarms for the diagnosed individual to enhance adherence to routine and appointments. One should also make sure to decrease stress inducing activities as prolonged exposure to stress makes the bodies secrete cortisol which can hamper brain function and thereby be more damaging. At this stage, the diagnosed individual must be encouraged to put his/her legal, financial and medical affairs in order so as to not be burdened with them at a later stage of the disease
  • Stage 4 is called the moderate decline stage and is characterized by the diagnosed individual forgetting details about oneself, having trouble remembering dates, routes, seasons and also trouble in activities involving simple cognitive functions such as making payments at a counter or ordering food off the menu. The caregiver must ensure safety of the diagnosed individual by making sure s/he doesn’t drive, wander off alone etc. so no one takes advantage of him/her financially or physically
  • Stage 5 is called the stage of moderately severe decline and is just an extension of stage 4, except for the fact that mood swings set in. The diagnosed individual might become extremely adamant and angry in various situations. At this stage it is good to document certain defining factors to enable the diagnosed individual remember
  • Image result for mood swing
  • Stage 6 is known as the stage of severe decline. The diagnosed individual here, might recognize faces but forget names, might mistake his/her child as his/her sibling etc. Certain delusions might set in since the diagnosed individual cannot recall the year in which s/he is living in. This stage can be very taxing for the primary caregiver; however studies have shown that individuals in this stage love listening to music, being read to, pursuing hobbies such as watering a garden, taking a long stroll or just looking through some old pictures and videos. This can be seen in the popular movie “THE NOTEBOOK”
    • Stage 7 is called the stage of very severe decline and is characterized by a loss of several basic abilities like eating, drinking, walking, reading etc. At this stage, the primary caregiver must treat the diagnosed individual as a baby and must therefore make sure s/he eats, drinks, sleeps and walks around on time. Infants at least cry out when they are in need of something, but here the individual often cannot even realize or convey that s/he is hungry, thirsty etc. 

      That’s it for psycho-education.

      The  blog on treatment and therapy for Alzheimer’s will be posted on Tuesday.

       

     

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19 thoughts on “OOPS! I FORGOT… part 1 (A PEEK INTO THE WORLD OF ALZHEIMER’S)

  1. It’s a very well knit information. Many are not aware of Alzheimer’s disease. Stages are well defined. Looking forward to part 2 interestingly.

  2. In today’s changed/inactive lifestyle, Alzheimer’s disease is common and your research throws light aplenty on the hidden concepts to manage it effectively. Well presented!

    • Thanks a lot for your constructive feedback. Stay tuned for part 2 of this post to be posted on Friday. It deals with treatment, management and preventing Alzheimer’s.

    • Thanks for stopping by. Part 2 of this post on management, treatment and preventing Alzheimer’s will be posted on Friday. Please stay tuned.

  3. It was an amazing piece of article …. But had a small question … Even we forget few things in normal day to day life but we will recall that same thing some time later …. Is it also a sign of this disease

    • No it is not a sign of Alzheimer’s. Its because certain things which we deem as inconsequential, we don’t memorize properly.

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