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Health File
New Delhi, 3 February 2010
Ageing
People & Dementia
MIND THAT
waning BRAIN ACTIVITY
By
Dhurjati Mukherjee
The magnitude of dementia has been on the rise with an increase in the
number of the ageing population. It is generally recognized that dementia is
characterized by loss or decline in memory or other cognitive abilities. It is
caused by various diseases and conditions that result in damaged brain cells. A
patient is affected by dementia if he suffers from: inability to generate coherent
speech or understand spoken or written language; inability to recognize or
identify objects, assuming intact sensory function; inability to execute motor
activities, assuming intact motor abilities, sensory functions and
comprehension of the required task and inability to think abstractly, make
sound judgments and carry out complex tasks properly.
Different types of dementia have been associated with distinct symptom
patterns and distinguishing microscopic brain abnormalities. Experts believe
that symptoms of different types of dementia also overlap and can be further
complicated by co-existing medical conditions. One may mention here the
identified common types of dementia which include, Alzheimer’s disease,
vascular dementia, dementia with Lewy bodies, Parkinson’s disease,
Frontotemporal dementia, Creutzfeldt-Jacob disease and normal pressure
hydrocephalus.
To take stock of the situation, two national conferences were recently
held in Delhi
and in Kolkata by the Alzheimer’s & Related Disorders Society of India
(ARDSI). The former agreed on a national
dementia strategy, which would help the growing dementia movement in the
country by the following means: promoting dementia as a health and social
priority; involving dementia in all key programmes of the nodal ministries;
advocating adequate policies and support for dementia care; and ensuring
provision for early diagnosis and cost-effective treatment other than short and
long term care.
The national meet, which was attended by 80-odd experts from across the
country and the US, France, the UK
and Canada chose to
deliberate on the problem of dementia, specially with regard to India.
Obviously, the disease symptoms of the ageing population as also the lack of
active habits of a major section of this group have complicated the problem.
The participating neuroscientists admitted that creating awareness among the
medical community, professional caregivers and the patient’s families was
indeed going to be a big challenge for them to meet.
Looking ahead, Dr. K Jacob Roy, founder and chairman of ARDSI observed
that the strategy was designed to chalk
out ideas to face the challenges posed by dementia to medical science and also
to the society. However, Dr. P S Mathuranan of the Sree Chitra Tirumal
Institute for Medical Science & Technology, Trivandrum pointed out that the document was
specifically intended to increase the number of day centres for early diagnosis
and better care of the disease. Importantly, it sought to convince the
government to extend help in setting up these centres, subsidize the currently
available medications for the disease and set up full-fledged centres as people
affected by dementia need professional care without any doubt.
Prior to the national consultative meet, the ARDSI met in Kolkata where
experts connected with the 15 chapters across the country as also foreign
neuroscientists had brain-storming sessions. The experts particularly
deliberated on the reasons for the occurrence of the disease, which may be
attributed to hypertension, diabetes and smoking as also lack of B12 and
Folic Acid. In fact, Prof Shyamal Das of the Bangur Institute of Neurosciences,
Kolkata added another component of the disease which he said could be triggered
by TB mild cognitive impairment (MCI). The prevalence of MCI in India is
similar to that of western nations though in percentage terms it is lower in
the country. Prof Das, who has been researching on the inter-relationships
between MCI and dementia and whether the former could be controlled has also
written a book entitled: Understanding Dementia: Disease, Treatment &
Cure.
According to Dr Michael Splaine, Director of State Policy & Advocacy
Programs of the Alzheimer’s Association, US, says that in Alzheimer’s disease
as in other types of dementia, increasing numbers of nerve cells deteriorate, A
healthy adult brain has 100 billion nerve cells or neurons with long branching
extensions connected at 100 trillion points but gradually these connections
begin to fail and eventually cells die. Alzheimer’s disease can affect
different people in various ways but the most common symptom pattern begins
with gradually worsening difficulty in remembering new information.
Prof. Andrew Kertesz of the Clinical Neurological Sciences of the
University of Western Ontario, Canada discussed that frontotemporal dementia
(FTD) has been a relatively new form of the disease where people in their 50s
have been found to be affected. It was only in 2008 that protein abnormality
has been found to be a main cause of the disease. Explaining about Alzheimer’s,
the most common form of dementia, he said that degenerated myeloid destroys the
brain cells, but vaccine against the ameloid is presently in an advanced
experimental stage. Apparently, this has already worked in rats and should also
work in human bodies.
In this connection, Prof. Kertesz observed that a small percentage of
Alzheimer’s disease cases, varying from 5 to 10 per cent, are caused by rare
genetic variations found in some families. In these inherited forms of
Alzheimer’s, the disease tends to develop before the age of 65, sometimes in
individuals as young as 40.
Most neuroscientists said that basic causes of neurological diseases –
whether epilepsy or the various forms of dementia -- are not exactly known. The
western experts said that broadly speaking the most common ailments in their
country related to heart, cancer, cardiovascular and Alzheimer’s diseases
though the situation is a little different in India, where epilepsy was more
common than dementia.
Regrettably, doctors and current medical opinion are unanimous that no
treatment is so far available to slow or stop the deterioration of brain cells
in dementia. However, researchers have identified strategies that may have the
potential to change its course. Despite the current lack of disease-management
of dementia and also Alzheimer’s can significantly improve the quality of life
through all stages of the disease.
As is generally agreed the health of the brain is closely linked to the
overall health of the heart and blood vessels. If risk factors such as high
cholesterol, Type 2 diabetes, high blood pressure and overweight could be
checked, cognitive decline of the brain may be delayed or even avoided. A few
experts suggested that a low-fat diet in fruits and vegetables may support
brain health as also a robust social network and active intellectual habits and
activities. ---INFA
(Copyright,
India News and Feature Alliance)
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