- Date : 02/07/2021
- Read: 8 mins
Women have a one-in-five chance of developing Alzheimer’s by the age of 65, compared to one-in-eleven for men, studies show.
Those who have seen the 1995 thriller The Net will remember Sandra Bullock’s character, wrongfully accused of murder after an identity theft, breaking down as she begs her mother for help but failing to get a response. The older woman, suffering from Alzheimer’s, cannot recognise her daughter, or even understand what is happening.
It is a poignant scene, but one that family members and caregivers of those suffering from Alzheimer’s disease, or any other form of dementia, will empathise with. Alzheimer’s patients lose their normal abilities – cognitive, physical, and functional – which, as Bullock’s character portrayed in the movie, can be intensely stressful and emotional for family members.
Alzheimer’s can happen to anyone after a certain age, with evidence showing elderly women being more vulnerable than men their age. Worse, dementia is often overlooked in the early stages and can deteriorate fast. And here’s the scariest part: there is currently no treatment to stop Alzheimer’s disease from progressing.
So much so, US President Joe Biden warned this May: “If we do not do something about Alzheimer’s in America, then every single solitary hospital bed [in the country]... will be occupied in the next 15 years by Alzheimer’s patients.”
What is dementia and Alzheimer’s disease?
Dementia is not a disease; it is a syndrome, usually of a chronic or progressive nature, of deterioration in cognitive function, or the ability to process thought beyond what is normal with ageing. It affects memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement.
The impairment in cognitive function is commonly accompanied – and occasionally preceded – by deterioration in emotional control, social behaviour or motivation. Dementia is also used as a catch-all term (as with heart disease), covering a wide range of specific medical conditions, including Alzheimer’s disease.
Alzheimer’s, on the other hand, is one specific disease – a progressive neurologic disorder that causes the brain to atrophy (shrink) and brain cells to die. It is the most common form of dementia and may contribute to 60%-70% of dementia cases. Studies have established that Alzheimer’s can cut a person’s lifespan by about eight years.
Worldwide, at least 44 million people are estimated to be living with dementia, making it a global health crisis. In India, the number of affected people is 4.4 million, and this is expected to double by 2030. According to the Alzheimer’s and Related Disorders Society of India (ARDSI), 90% of people with dementia in India are never diagnosed or treated.
How can one diagnose dementia and Alzheimer’s?
Often, one of the first signs of Alzheimer’s disease, especially in the first year or two of its onset, is the forgetting of important dates or events or information learned recently, or asking the same question repeatedly. In this period, the onset of the disease is gradual. Close relatives, friends, and sometimes even professionals can miss the signs; they tend to mistake these signs as normal, age-related problems.
However, typically, people forget names or appointments with advancing years but generally remember them later, unlike those with Alzheimer’s or dementia.
The second clue to look for is regular errors in managing household finances. Errors in accounting are normal for people with failing eyesight that comes with ageing. However, when people start having difficulty concentrating and take much longer to do things than they did before, it is time to sit up and take notice.
The third sign would be when someone starts facing difficulty in completing daily tasks, such as reaching a familiar location, or making a routine grocery list. It is normal to forget where one kept the TV remote, but forgetting how to get to a once-familiar place should ring a warning bell.
The fourth tell-tale sign is when one starts losing track of dates, seasons, and the passage of time. A normal part of ageing would be forgetting what day it is – occasionally. But people with Alzheimer’s will struggle to understand something not happening immediately, or grasping where they are or how they got there.
The fifth sign relates to recognising or identifying visuals; as said earlier, failing eyesight is a normal part of ageing. However, those with Alzheimer’s will face difficulties with balance or trouble reading because of misjudging distance or being unable to determine colour.
The sixth sign of Alzheimer’s would be forgetting words. In normal circumstances, people tend to grope for words as they age, but those living with the disease are likely to have trouble following a conversation.
The seventh and eighth signs would be an extension of earlier ones; as following a conversation gets difficult, afflicted persons will tend to withdraw from social activities. Similarly, poor judgment will show itself when they try to keep themselves clean – and fail.
The ninth clue will be an inability to locate misplaced things. Normally, a person will misplace things occasionally and retrace their steps to find them. Afflicted people won’t be able to retrace those steps.
Finally, there will be mood swings. Typically, when a person ages, they develop specific ways of doing things and becomes irritable when that routine is disrupted. With Alzheimer’s patients, it is worse; they become confused, suspicious, depressed, fearful, or anxious.
Related: Simple ways to keep your brain active as you grow older
Why is Alzheimer’s more common among women?
One critical aspect of dementia and Alzheimer’s disease that we should take note of is that women seem to be more vulnerable. No one knows why, but the numbers point to this. As per one study, women in general have a 1-in-5 chance of developing Alzheimer’s by the age of 65, compared to 1-in-11 for men.
ARDSI says the exact number of affected women in India is not available, but accepts that its prevalence among women is higher in the country compared to men. In its Dementia India Report 2010, ARDSI also rules out gender as a risk factor. As per its assessment, the number is higher among women in India because they “live longer”.
But more and more researchers are rejecting women’s longevity as a factor behind the higher prevalence among them, and are looking for other reasons.
For one thing, women’s longevity is not unique to India alone; it is universal. Similarly, the prevalence of dementia and Alzheimer’s among women is also higher than among men globally. For instance, the Chicago-based Alzheimer’s Association says 3.2 million of the 5 million Americans living with Alzheimer’s – or 64% of the affected population – are women.
The Alzheimer’s Association is trying to ascertain whether “biological or genetic variations or differences in life experiences” could be valid factors for this. “We need to delve into that and find out why,” Maria Carrillo, its chief science officer, has said. “There is a lot that is not understood and not known.”
What causes dementia and Alzheimer’s?
In 2017, a commission instituted by the prestigious medical journal The Lancet – the Lancet Commission – released a report on dementia that identified nine contributing factors:
- Inadequate education on the subject;
- Hearing impairment;
- Physical inactivity;
- Diabetes, and
- Low social contact.
The report, titled Dementia Prevention, Intervention, and Care, was updated in 2020. It added three more factors:
- Excessive alcohol consumption;
- Traumatic brain injury, and
- Air pollution.
“Together, the 12 modifiable risk factors account for around 40% of worldwide dementias,” The Lancet says.
Researchers have also suggested that age, family history, and genetics have a role to play. Moreover, there is evidence of increased risks due to conditions that damage the heart and blood vessels. Apart from diabetes, these include heart disease, stroke, high BP, and high cholesterol.
Related: Want to be healthy, happy, and financially free? Here’s how
How can dementia and Alzheimer’s be prevented?
The Lancet Commission lays out broad guidelines at both governmental and individual levels to prevent dementia and Alzheimer’s. These include better education and better living conditions ensured at the policy level, and better awareness of health risks at the individual level.
Researchers also suggest that a conscious effort at healthy ageing may reduce the risk of developing Alzheimer’s and other dementias. Eating a balanced diet, staying socially active, avoiding smoking and alcohol, and exercising both the body and mind will help, they say.
It is never too early – and never too late – in the course of one’s life to make efforts at preventing dementia. A healthy lifestyle that includes social interactions, appropriate diet, and both physical and mental exercise, will keep the body and mind fresh. Of course, you should work with your doctor to monitor your heart health and treat any problems that may arise.
In India, external help is near-absent, with no professional adult day-care options or structured cognitive rehabilitation programmes available. As a result, it falls on family members to take care of dementia patients. Taking care of for someone with dementia is a selfless act, and caregivers – who in India are mostly family members – often tend to be swept up in a rush of anger, frustration, and grief.
If you are in that position, you will undoubtedly be aware of the fatigue, stress, and isolation that the role brings. But just think – if not you, who will the patient turn to in the helplessness of old age? New age health tricks and tips every woman needs to know