Madiha (name changed) was 55 and was living a normal, happy life with her family till her husband and daughter started noticing some stark changes in her. The otherwise alert and prompt woman suddenly became absentminded. It started with simple things like having confusion with the days and events, asking the same thing repeatedly, making mistakes in calculating her home bills and expenses, and misplacing things frequently. The symptoms became more noticeable when at times she was found losing track of her whereabouts.
Gradually Madiha displayed a general lack of interest in everything she did and became quite passive in her behaviour. These symptoms became quite recurrent, and that’s when the alarm bell rang. Her husband, fearing that Madiha was losing her mind, consulted a neurologist and there she was detected of suffering from Alzheimer’s.
Alzheimer’s is a physical disease that affects the brain and leads to the loss of connections between nerve cells and to the death of nerve cells and loss of brain tissue, says Dr Hamsa Baravi, neurologist at KIMS Oman Hospital. Living with Alzheimer’s can be a traumatic experience and isn’t easy both for the patient or the caregiver. Talking about this challenging ailment Dr Hamsa tells in details about the disease, its early symptoms, and ways to cope.
“The early symptoms include losing items like keys and glasses, struggle to find the right word in a conversation or forget someone’s name, forget about recent conversations or events, get lost in a familiar place, forget appointments or anniversaries, struggling to follow a conversation or repeating themselves, problems judging distance or seeing objects in three dimensions, difficulties in parking the car, difficulties making decisions or solving problems, problem in carrying out a sequence of tasks (e.g. cooking a meal), becoming confused or losing track of the day or date,” she says.
The later stage symptoms include memory loss and the communication, reasoning and orientation capabilities get highly affected and the person requires more day-to-day support from those who care for them.
“Some people develop delusions or hallucinations. They may have difficulties eating or walking without help, and can become increasingly frail. Eventually, the person will need help with all their daily activities,” she adds.
The disease mainly affects people over 65, more women than men, and it is rarely inherited. Diabetes, stroke, heart problems, high blood pressure, high cholesterol, and obesity increase the risk of the disease.
Dr Hamsa informs that there is no single test to diagnose Alzheimer’s.
“We first need to rule out conditions that can have similar symptoms, such as infections, vitamin and thyroid deficiencies, depression and side effects of medication. There will be a gradual worsening of memory over several months. A family member may be more aware of these changes than the person with suspected Alzheimer’s is,” she says.
The person may undergo CT scan or MRI brain, which can show whether certain changes have taken place in the brain and to rule out certain conditions such as stroke, tumour.
Talking about the treatment options Dr Hamsa says that there is currently no cure for it, but there is a lot that can be done to enable someone to live well with the condition. This will involve drug and non-drug care, support, and activities. There are drug treatments that can temporarily alleviate some symptoms or slow down their progression in some people.
“For a person in the mild or moderate stages a drug such as donepezil or rivastigmine may help improve concentration, motivation and aspects of daily living such as cooking, and shopping,” says Dr Hamsa.
For those in the moderate or severe stages, a different kind of drug such as memantine may help with mental abilities and daily living, and ease challenging behaviours such as agitation and delusions. These medicines can only be taken when prescribed by a neurologist. Dr Hamsa feels that talking therapies for depressed or anxious patients may also be tried. General non-drug approaches often help. These include social interaction, music, reminiscence, exercise or other activities that are meaningful for the person.
“They are generally tried before additional drugs are considered, particularly antipsychotics,” adds Dr Hamsa and rekindles hope to those battling this disease.
Dr Hamsa Baravi, neurologist at KIMS Oman Hospital can be contacted at + 968 2476 0100