A loved one suddenly begins to forget a familiar name or to brush his teeth when he wakes up in the morning, or suddenly has difficulty dressing up, or goes for a walk in a familiar neighbourhood and does not return home

You begin to wonder what is happening?

It could be that the person is showing signs of dementia. Dementia is a progressive and irreversible impairment of the intellect, the prevalence of which increases with age.

Dementia develops over time. Changes are seen in cognition, memory, language and visuospatial functions. There could be behavioural disturbances such as agitation, restlessness, wandering, rage, violence, shouting, social and sexual disinhibitions, impulsiveness, sleep disturbances and delusions.

The most common type of dementia today is ALZHEIMER'S. It is a progressive decline of cognitive functions and is characterized by deficits in memory, language and visuospatial functions. It usually starts with slight forgetfulness and slow mental deterioration that finally terminates in delirium and death.

The onset is usually after a physical ailment or a stressful event. 50 -60% of people have dementia of the Alzheimer's type.

Alzheimer's disease usually appears after the age of 60, but it could begin earlier. The first symptom tends to be memory lapses, especially for recent events or newly learned information.

How is Alzheimer's diagnosed?

When Alzheimer's first sets in the person begins forgetting simple tasks like forgetting to brush one's teeth, personal hygiene or other everyday mundane tasks. There is a gradual withdrawal from social activities and interests.

The person begins to forget recent events but does recall events in the distant past. There is disorientation about time and place and lack of contact with reality.

Signs of depression, obsessiveness and suspiciousness are often accompanied with frequent mood changes, unpredictable aggressive outbursts, disorientation and wandering. Lethargy and a loss of concentration and initiative creeps in.

There could also be neurological defects such as gait disturbances, aphasia (inability to communicate verbally or using written words); apraxia (inability to execute a voluntary motor movement despite being able to demonstrate normal muscle function); and agnosia (inability to recognize and identify familiar objects or persons).

The person becomes self-centered, child like, is preoccupied with bodily functions of eating, digestion and excretion. He has uncontrolled eating habits, sleep disturbances, senseless repetitive behaviors and hoarding of useless items.

They also become suspicious and are often convinced that others are engaged in various injurious plots and schemes against them.

Memory lapses though very subtle at first, gradually lead to more significant gaps and confusion. Eventually, the disease leads to severe brain damage that impairs a person's ability to complete everyday tasks as well as skills such as to reason, learn and imagine.

The end stage is a reduction to a vegetative existence and ultimately death from some disease due to limited defensive resources.

Treatment

There is no treatment for Alzheimer's, but antidepressants and tranquilizers help improve behavior like anxiety, depression, agitation and sleeplessness.

In spite of the fact that it is so common, Alzheimer's disease often goes unrecognized or is misdiagnosed in its early stages. Many doctors and nurses, patients, and family members mistakenly view the early symptoms of Alzheimer's disease as the inevitable consequences of aging.

Incontinence, which is a major symptom as the disease progresses can be effectively treated, so it is better to identify this as soon as possible.

Physical activity such as aerobic and weight bearing exercise regimen help increase energy levels, reduce apathy and improve the overall sense of well-being. Since lack of motivation can be a problem, a personal trainer may be helpful to ensure participation in an exercise program.

Keeping the brain active through mental exercises such as puzzles, crosswords and reading helps retard the progress of the disease to a certain extent.

Each person with Alzheimer's is unique and will respond differently, and each person changes over the course of the disease. It is a challenge and can become overwhelming for the person caring for a person with Alzheimer's disease at home. Each day brings new challenges as the caregiver copes with changing levels of ability and new patterns of behavior. It is very essential that the caregiver receives adequate support from family and friends.