South China Morning Post (20 September 2012)
Act on the early signs before the damage is done
Nancy Kwok had always prided
herself on her razor-sharp memory,
so when little things began to slip
her mind – like what she'd eaten the
day before – the 70-year-old thought
it was just due to old age.
It wasn't until Kwok (whose
name has been changed for patient
confidentiality reasons) started
forgetting whether she'd paid bills
and had trouble expressing herself
that her son, Richard, knew
something was wrong. She was
diagnosed with Alzheimer's disease.
Alzheimer's is the most common
form of dementia. Small says it's an
"accumulation of abnormal protein
deposits – plaques and tangles – in
brain regions that control memory
and other cognitive abilities".
There are many factors that
cause Alzheimer's. Genetics is
believed to play a role – about 30 to
40 per cent – and the rest is due to
lifestyle and other non-genetic
factors.
"My mum used to be so full of
life, but as these problems got worse,
she became increasingly frustrated
and withdrawn," says Richard. "She
seems to have stabilised a little,
thanks to medication, but she's not
the same person and her quality of
life has deteriorated."
According to a recent paper in
the Hong Kong Medical Journal,
about 6.1per cent of elderly
Hongkongers have Alzheimer's
disease. That figure is rising because
the population is ageing and age
is the biggest risk factor, says
Dr Gary Small, director of the UCLA
Longevity Centre. Women are at
a greater risk, partly because they
tend to outlive men.
Alzheimer's is the most common
form of dementia. Small says it's an
"accumulation of abnormal protein
deposits – plaques and tangles – in
brain regions that control memory
and other cognitive abilities".
There are many factors that
cause Alzheimer's. Genetics is
believed to play a role – about 30 to
40 per cent – and the rest is due to
lifestyle and other non-genetic
factors. Dr Chong Mei-sian, senior
consultant at the department of
geriatric medicine at Tan Tock Seng
Hospital in Singapore, says diabetes,
heart disease and hypertension are
strong risk factors.
Alzheimer's symptoms typically
begin after the age of 65 with
short-term memory loss. Small says
certain symptoms of mild
Alzheimer's may be similar to other
conditions or the side effects of
some medications, so a proper
medical evaluation is required.
As the condition worsens,
sufferers may have trouble with
simple tasks such as getting dressed
and eating. They often become
withdrawn, agitated and aggressive
as they struggle with basic functions.
This affects caregivers and family
members; caregivers have a 50 per
cent risk of developing depression,
says Small.
There are treatments – both
drug and non-drug – to slow the
progression of Alzheimer's and
temporarily ease symptoms. But Dr
Kay Li-chi, a specialist in neurology
at Hong Kong Adventist Hospital,
says not much can be done to
reverse or prevent Alzheimer's.
However, staying active, keeping up
with one's hobbies and becoming
more social can greatly improve the
sufferer's quality of life.
It's important to keep chronic
medical conditions such as
hypertension and diabetes under
control, and to live healthily and
maintain a positive mental attitude.
Small's book, The Alzheimer's
Prevention Program: Keep Your
Brain Healthy for the Rest of Your
Life, details the physical exercises,
cognitive training and nutritional
factors that can help delay the onset
of the disease.
New research shows there might
be a way to detect if a person is at an
increased risk of developing
Alzheimer's. Erin Johns, a doctoral
student at Concordia University's
Department of Psychology, says
small impairments in memory and
"executive functioning problems"
may be a sign of early-stage
Alzheimer's. These include
problems with attention, planning
activities and making decisions.
Johns wants to make it easier to
be able to identify such people "so
they can be targeted for preventive
strategies that would stop brain
damage progressing". It's a chance
to help them know what to expect
and how to cope, she says.
This month, researchers in the
United States reported that an
experimental drug called
bapineuzumab showed positive
effects in patients with mild to
moderate Alzheimer's. It is made to
work on the biology of the disease,
removing the plaque that damages
nerve cells in the brain. Researchers
will now test the drug on people with
mild mental impairment.
As for a cure, Small says drugs
and vaccines are being tested all over
the world. "The strategy is to develop
a treatment that forestalls the onset
of symptoms," he says. "[But] while
we are waiting for science to catch
up, lifestyle strategies offer a chance
to nip symptoms in the bud."
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Source: South China Morning Post. Reproduced with permission.
