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The Most Common Cause of Dementia: Alzheimer’s Disease

Alzheimer’s disease is a progressive disorder that causes brain cells to waste away (degenerate) and die. Alzheimer’s disease is the most common cause of dementia — a continuous decline in thinking, behavioral, and social skills that disrupts a person’s ability to function independently.

1. Do you have any statistics to share about Alzheimer’s Disease in Malaysia?

The latest National Health and Morbidity Survey 2018 of Malaysia showed that the prevalence of dementia was 8.5% amongst those aged 60 years and above. The prevalence of dementia was higher in those living in rural areas, females, those with no formal education, and lower-income levels.

2. What are the causes and risk factors of Alzheimer’s Disease?

Alzheimer’s disease is the commonest form of dementia worldwide. It is caused by the abnormal build-up of proteins in the brain cells known as tau protein as well as around the cells called amyloid plaques. These abnormal proteins cause disruption in neurochemical transmission between brain cells and accelerate brain cell death.

The risk factors of Alzheimer’s disease include

  1. advancing age (affects 1 in 5 individuals above 80years of age)
  2. genetic predisposition
  3. low education level (less than 6 years of formal education)
  4. untreated depression in midlife
  5. high vascular burden (high blood pressure, uncontrolled diabetes mellitus, high cholesterol level)
  6. obesity
  7. smoking
  8. excessive alcohol
  9. sedentary lifestyle

3. What are the signs of Alzheimer’s Disease?

Alzheimer’s disease is a neurodegenerative disorder that affects a person’s cognitive function. The commonest sign is poor short term memory, whereby the person will have difficulties recalling recent events, misplaces belongings, forgetting names of familiar contacts, and asking questions repetitively. They may also have trouble understanding spatial relationships like judging distance, forgetting directions easily getting lost in familiar places, and disorientation. People living with dementia will find it difficult to make complex decisions, they may lose the ability to perform a certain task that they were good at, some may have language impairment such as word-finding difficulties. In later stages of the disease, 80% of people living with dementia may experience mood and behavioral changes such as apathy (lack of motivation), agitation, aggression, depression, or anxiety.

4. Can you explain the different stages of Alzheimer’s Disease?

Alzheimer’s disease is broadly divided into mild, moderate, and severe stages. In the mild stages of Alzheimer’s disease, the individual would have developed symptoms of cognitive impairment which interferes with some of their usual activities of daily living, they would require readjustment to their lifestyle in order to stay as independent as possible. The symptoms of dementia at this stage may not be apparent to casual passersby but only noticeable by family and close friends. As they progress to the moderate stage, the deficit of their cognitive function becomes more apparent. They would have more difficulties in maintaining their basic self-care and most will require some form of supervision. They are more likely to exhibit behavioral changes due to frustration and confusion in understanding their surroundings and conversations. The difficulties in expressing themselves may also cause misunderstandings with their caregivers. In the late or advanced stages of Alzheimer’s disease, one would become more confined to their own surroundings. Family and friends will have to exert more effort to communicate and understand the person living with dementia as they may lose the ability to verbalize or even perform their day-to-day activities. They may not remember their families but the emotional attachment to their loved ones helps to engage them in meaningful activities despite the disease progression.

5. How to help those with Alzheimer’s Disease?

People living with Alzheimer’s disease should be treated with dignity as with any normal human being. Understanding the disease and the impairment associated with it helps us to be more empathetic in our communication with persons living with dementia. We should allow time for them to answer as well as avoid being confrontational when they have misunderstandings.

6. Is there any method to reduce or cure Alzheimer’s Disease?

There is currently no cure for Alzheimer’s disease but there are methods to improve the symptoms of dementia. People living with dementia are advised to

  • Maintain good physical activity (exercise at least 3-5times a week)
  • Ensure chronic diseases are well controlled
  • Engage in cognitively stimulating activities
  • Healthy diet – for example the Mediterranean diet
  • Avoid emotional stress
  • Formulate a daily routine which involves the above

There are medications that are used to improve the symptoms of Alzheimer’s disease, and these had to be prescribed and monitored by a medical professional.

7. How to prevent Alzheimer’s Disease?

Reducing the risk of developing Alzheimer’s disease is a lifelong investment. The evidence shows that people who attain a higher level of education are less likely to develop dementia. Hence, it is important to remain mentally active and socially engaged even as a person grows older. Other essential measures include physical exercise with a healthy lifestyle, avoid obesity, untreated depression, and social isolation. Remember to perform regular health checks to ensure your blood pressure, glucose level, and cholesterol levels are in good control.

Article by:

Dr. Khor Hui Min
Consultant Geriatrician
University Malaya Specialist Centre




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