Something to remember

Alzheimer's disease is a brain disorder that gradually destroys the ability to reason, remember, imagine and learn. It$$$___$$$$$$___$$$s different from the mild forgetfulness normally observed in older people. Over the course of the disease, people with Alzheimer$$$___$$$$$$___$$$s no longer recognise themselves or much about the world around them. Depression, anxiety, and paranoia often accompany these symptoms. Although there is no cure, new treatments help lessen Alzheimer$$$___$$$$$$___$$$s symptoms and slow its progression. Alzheimer$$$___$$$$$$___$$$s is marked by abnormal clumps (called senile plaques) and irregular knots (called neurofibrillary tangles) of brain cells. For reasons not well understood, these plaques and tangles take over healthy brain tissue, devastating the areas of the brain associated with intellectual function. Alzheimer's disease is sometimes called `pre-senile dementia' and sometimes `senile dementia'. In medical jargon, the term `senile' simply means `old', not a `loss of mental faculties' as it denotes in common usage. Also, in medical jargon, `pre-senile' means `younger than 65'. Doctors use pre-senile dementia to describe Alzheimer$$$___$$$$$$___$$$s disease that develops before 65, and senile dementia for Alzheimer$$$___$$$$$$___$$$s that develops after 65.

While Alzheimer$$$___$$$$$$___$$$s disease usually affects those over 65, a rare and aggressive form of Alzheimer$$$___$$$$$$___$$$s can happen in some people in their 40s and 50s. Alzheimer$$$___$$$$$$___$$$s disease progresses slowly, taking between three to 18 years to advance from the earliest symptoms to death. The average duration of the disease is eight years. Death results not from the disease itself but from some secondary illness such as pneumonia or urinary tract infection. Right now, treatment of Alzheimer$$$___$$$$$$___$$$s disease focusses on slowing its progression and coping with its symptoms.

• Family history
• Genetics
• Down syndrome
• Increasing age

There is no sure-fire way to prevent the onset of Alzheimer$$$___$$$$$$___$$$s disease. But some preventive treatments (such as estrogen for women) are promising.

At its onset, Alzheimer$$$___$$$$$$___$$$s is marked by simple forgetfulness, especially of recent events or directions to familiar places. People with the disease may have personality changes, such as poor impulse control and judgement, distrust, increased stubbornness, and restlessness. The next stage of the disease is characterised by greater difficulty in doing things that require planning, decision-making, and judgement, driving a car for instance. Everyday skills such as personal grooming aren$$$___$$$$$$___$$$t affected, but social withdrawal begins. Eventually, they can$$$___$$$$$$___$$$t do simple tasks of daily living such as eating, bathing, and using the toilet. They may lack interest in personal hygiene and appearance, and lose their usual sexual inhibitions. They may have a hard time recognising all but their closest daily companions. Communication of all kinds becomes difficult as written and spoken language ability dwindles. Withdrawal from family members begins and the person may become agitated, displaying belligerence and a denial of the illness. In the last stages of the disease, people with Alzheimer$$$___$$$$$$___$$$s become bedridden, unable to recognise themselves or their closest family members. They may make small, purposeless movements and communicate only by screaming out occasionally. Essentially, the brain forgets how to live. Death often results from pneumonia and from complications of immobility.

Since there are so few treatments for Alzheimer$$$___$$$$$$___$$$s disease, many of the available therapies attempt to improve the quality of patients$$$___$$$$$$___$$$ lives, keep them safe, and make caring for them easier. Experts are upbeat that new treatments will, in the not-too-distant future, turn the illness into a manageable chronic condition, similar to diabetes or asthma. But progress comes slowly, and to date, there have been no breakthroughs.

Physical activity has many well-documented health benefits. Among them, exercise helps you guide your loved one with Alzheimer$$$___$$$$$$___$$$s disease more confidently, effectively, and energetically. Exercise with your affected loved one. Take walks together. Or do anything else you both enjoy. It improves the person$$$___$$$$$$___$$$s appetite and sleep. It has a calming influence that minimises challenging behaviour. And it$$$___$$$$$$___$$$s tiring, so it helps control wandering.