Tuesday, October 16, 2018
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Medical Files

Erasing one’s mind

B.C., previously a civil engineer who’s just barely in his early 60s, took close to a minute before he could even remember the name of his wife of 35 years. Whereas before, he could remember every detail of the housing plans he constructed, he cannot even determine now whether he’s in the doctor’s clinic or a hotel or a church.

Dr. T.D. was one of the well-respected and admired doctors in her province. Although she didn’t have any formal specialty training, she was acknowledged as a peer by trained specialists in her area because of her keen “clinical eye” and adroit skills at physical examination and evaluation of every patient who came to her for consultation. She also avidly updated herself with her journal reading and regular attendance in medical conventions.

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However, about 15 years ago, she was noted to have flight of ideas whenever she gave scientific lectures. This became worse such that she would stop in the middle of a sentence not remembering what she wanted to say. We haven’t heard about her for quite a while, then several years ago we were shocked to hear that she passed away already.

Both Dr. T.D. and B.C. are victims of Alzheimer’s disease.

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Incurable, degenerative

Alzheimer’s disease (AD), also called senile dementia of the Alzheimer type, or simply Alzheimer’s, is an incurable, degenerative and terminal disease which can turn previously brilliant minds into dull and dim-witted individuals. It is the most common form of dementia, a medical condition referring to a degeneration of mental or cognitive function. Although some deterioration in the mental ability of a person is expected with age, the deterioration in AD is more pronounced than what is generally expected. It literally erases all of one’s memories, and practically one’s whole mind. Although AD is often diagnosed in people over 65 years of age, it can also afflict even younger individuals who can barely be classified as an elderly.

A few years ago, it was reported that there were close to 27 million sufferers of AD worldwide. The incidence is still increasing since we have an aging population, and it is predicted that by 2050 one out of every 85 individuals will have AD.

Common symptoms

The presentation of AD can vary from one individual to another through the course of the disease, but there are some common symptoms. At the start, the symptoms are dismissed as “part of growing old” or simply “senior moments.” Some may think that one’s mental lapses are just stress-related. Hence, many cases of AD remain undetected and progress undiagnosed for years.

Early on, patients with AD are unable to acquire new memories. They may forget what they just said a few minutes ago, so they tend to be repetitive or makulit. They have difficulty in recalling recently observed events. To diagnose AD, the doctor usually does simple behavioral assessments and tests for mental or cognitive function. A brain scan may also be requested.

As the disease advances, afflicted individuals show undue irritability and mood swings, more frequent mental lapses, long-term memory loss, and because of their embarrassing mental infirmity, they tend to withdraw and avoid gatherings. Later, they are no longer able to carry out activities of daily living such as eating, bathing and dressing up. Bodily functions also deteriorate, and ultimately they die. The mean life expectancy once a diagnosis is confirmed is approximately seven years. Only one out of 30 individuals afflicted with AD is expected to live more than fourteen years after diagnosis.

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Still uncharted territory

Despite advances in medicine, AD is still essentially an uncharted territory. The cause and manner of progression of Alzheimer’s disease are not well understood. Research indicates that AD is associated with some unique abnormalities in the brain consisting of plaques and tangles, but nothing definite is known. Because its cause remains a mystery, treatment also remains a puzzle. Currently recommended treatments offer a small symptomatic benefit. There is still no known treatment that can delay or halt the progression of the disease.

Mental stimulation with analytical activities such as playing sudoku or doing crossword puzzles, as well as regular physical exercise and a balanced diet are believed to help prevent AD and prevent its progression if already suspected, but at best these may be considered a sensible but not proven way of managing the disease.

A recently published study indicates that with optimal control of vascular risk factors such as hypertension, diabetes, cholesterol problems and smoking, there’s a good chance of preventing AD or retarding the deterioration from mild cognitive dysfunction, regarded as an early stage of AD, to more severe stages. Well, it can retard, but not totally halt.

Vaccines are now being developed to also prevent further progression in those with early AD. The initial results look promising but by my estimate, it will take another 10 years before we can have such vaccines available in the market.

Meanwhile, those with mild AD can probably just take little comfort in the fact that they’re in good company. Former US president Ronald Reagan and famous Hollywood icon Charlton Heston also had Alzheimer’s disease.

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