Alzheimer's disease: The memory thief 🧠😥

That evening, as I was about to close my laptop after editing a new video for my Healthy Lanka YouTube channel, my brother's best friend, Gayan, came to our clinic. He had a very sad and depressed look on his face.

"Oh, doctor, I have a big problem with my mother," Gyan began his story with a sigh. "My mother is forgetting what I just said. She has no memory of where she is or where she wants to go. She doesn't even know what day it is. Not only that, doctor, she is now spitting everywhere and is very dirty. She hides her money and gold in different places in the house and then blames us for stealing it. My wife and children are always having problems because of this. I can't imagine why my strong mother, who used to take care of the entire family's business, suddenly became like this. This is a terrible mental torture for me, doctor."

Although these behaviors were new to Gayan, as a doctor, these symptoms were very familiar to me. I said to Gayan, "Gyan, your mother is not suffering from the usual forgetfulness that comes with age. This is medically known as Alzheimer's Disease . So today, let's talk about what this memory-robbing Alzheimer's disease is, its symptoms, and how to manage a family with this patient."

What is Alzheimer's disease?

Alzheimer's disease is a progressive brain disorder that completely changes memory, thinking, and behavior as our brain cells gradually die.

This is the main cause of 60% to 80% of dementia cases, the most serious mental decline that occurs with aging. This disease is usually most common among adults over the age of 65.

Alzheimer's Symptoms

Here are the main symptoms that help identify Alzheimer's disease in an adult:

1. Difficulty performing daily tasks: Even simple tasks such as making a cup of tea, banking, or making phone calls that used to be perfectly done become gradually forgotten.
2. Difficulty solving problems and making decisions: Inability to think of the right solution even to simple problems that arise in everyday life.
3. Difficulty with language: Not remembering the right words when speaking, asking the same question over and over again, or not connecting the beginning, middle, and end of what is said.
4. Changes in personality and behavior: getting angry quickly for no reason, suspiciousness, trying to isolate oneself from family.
5. Dirty behavior and memory confusion: spitting everywhere, refusing to bathe or clean, hiding belongings and blaming others.

Why does Alzheimer's develop? (Causes & Risk Factors)

Although medical science has not yet discovered the exact cause of Alzheimer's disease, several major risk factors have been identified:

• Age: The risk of developing this disease doubles every 5 years after the age of 65.
• Family history and genetics: If a parent or sibling has Alzheimer's, the risk of developing it increases. In particular, the presence of the APOE-e4 gene increases the risk of this disease.
• Protein deposits in the brain: Brain cells are destroyed by abnormal deposits of proteins called amyloid and tau around brain cells, forming plaques and tangles.
• Heart health and lifestyle: Conditions such as smoking, lack of exercise, high blood pressure, diabetes, and depression negatively affect the health of brain cells.

How is Alzheimer's disease diagnosed?

A doctor can diagnose the disease through clinical examinations and special questionnaires that measure memory. MRI or CT Scan tests are also performed to identify and rule out other brain disorders (such as cancer or stroke).

Is there a cure for Alzheimer's disease?

Currently, there is no specific drug that can completely cure Alzheimer's disease, but medications are used to control symptoms and slow the progression of the disease.

• Drug treatments: Doctors recommend drugs like Donepezil and Rivastigmine to improve brain communication in the early stages of the disease, and drugs like Memantine in the moderate and severe stages. Modern treatments like Aducanumab , which helps remove amyloid protein deposits in the brain, are also currently being tested around the world.
• Supportive Care: Speech Therapy improves communication, and Physical Therapy helps maintain the patient's independent mobility.

Main stages of Alzheimer's disease

• Early Stage: Minor forgetfulness, slurred speech, and minor delays in everyday tasks.
• Moderate Stage: Forgetting where you are, needing someone else's help to dress and clean yourself, and severe changes in behavior.
• Late Stage: Unable to recognize even those closest to them, completely losing the ability to speak, and 100% physically dependent on someone else.

Protecting the mental health of family members caring for the patient

Caring for someone with Alzheimer's is a very tiring and emotionally draining task. This is medically known as caregiver burnout .

To protect the mental health of healthy family members, the responsibility of caring for the patient should be shared among all family members. If necessary, a decision can be made in consultation with the doctor about seeking the assistance of a specially trained caregiver for the patient or seeking the assistance of a specialized day care center that cares for patients.

🚨 Serious symptoms that require immediate medical attention (Red Flags)

When caring for someone with Alzheimer's, be aware of the following emergency situations:

• Delirium: The patient suddenly becomes more agitated, screaming, or confused than usual (this is most commonly caused by urinary tract infections (UTIs) in adults).
• Aggressive behavior and violence: If the patient tries to attack or harm himself or those around him.
• Difficulty swallowing (Dysphagia): Coughing up food or saliva that gets stuck in the throat (there is a risk of food going into the lungs and causing aspiration pneumonia).
• Wandering: If the patient wanders away from home and becomes lost and unable to find their way.

Do's & Don'ts

Scientific sources (References)

• 📚 Alzheimer's disease - NHS
• 📚 Memantine, Donepezil, or Combination Therapy—What is the best therapy for Alzheimer's Disease? A Network Meta‐Analysis - PMC