Dr Amit Dias, who attended the International conference on Alzheimer’s disease held in Chicago, shares the recent advances and hope on the horizon for people with dementia and their families on World Alzheimer’s day today
It was way back in 1906 that the German neuro-pathologist Alois Alzheimer found Beta Amyloid in the brain of a person presenting with memory and behavioural problems. Today the disease is named after him and we still consider B-Amyloid to be one of the major causes for the neuronal damage inside the brain which progressively leads to memory impairment. However over the years, the scientific community realised that Alzheimer’s disease is more complex than we thought and there are several other pathways by which the disease occurs. If we have to find a cure, then these pathways need to be explored. This was the consensus at the International Conference on Alzheimer’s disease in Chicago which resolved to step up the efforts to find a cure for Alzheimer’s disease. New mechanisms such as inflammation, neuro-protection and Tau tangles are being explored.
Improving Diagnosis
There is a lot of research in the area of developing better bio-markers for diagnosing and monitoring the prognosis of Alzheimer’s disease. The absence of good bio-markers also hamper drug development. Today, we do have a B- Amyloid PET scan which can help in making an early diagnosis of Alzheimer’s disease. One can now make a diagnosis before the onset of the signs of dementia. However it raises one critical question- what happens after one gets an early diagnosis? The focus of the research community is to invest in disease-modifying drugs which will alter the course of the disease.
Prevention of Alzheimer’s disease:
According to research, Alzheimer’s disease is a lifestyle disease – just like diabetes, hypertension and heart disease and what is good for the heart is good for the brain. There are several trials on drugs designed to prevent the onset of Alzheimer’s disease before the onset of dementia.
Solutions in technology
Technology can play an important role in various aspects of dementia diagnosis, management and care. Artificial intelligence and smart homes can prompt the person with dementia and help them live independently and ensure safety. Technology can help the caregiver take care of their loved one from a distance. Tracking devices blend with their lifestyle and do not give a feeling of invading their privacy. We do see the need of this in the state of Goa wherein we often find older parents living in Goa while children are abroad or live elsewhere. They then find it difficult to manage if their loved one develops dementia given the situation that most old aged homes ironically do not take in people with dementia. We need to develop locally relevant assistive devices to help family members looking after a person with dementia and their caregivers.
Improving treatment
With greater understanding of the pathology, one can revisit the approaches for treatment. We now know that neurofibrillary tangles and senile plaques involve the most primitive part of the brain consisting of the amygdala, hippocampus etc. Currently there is no proven cure for Alzheimer’s disease, but medications are available to protect the brain cells and improve the formation of memories by acting on the neurotransmitters in the brain.
Latest developments in India:
Management of a person with dementia is very expensive. In a major boost to the advocacy campaign carried out relentlessly by the Alzheimer’s and Related Disorder’s Society of India, Health Minister Shri JP Nadda recently announced that free drugs and diagnostic facilities will be made available to all dementia patients under the free drugs initiative by the center. He was speaking at the International Symposium on Alzheimer’s disease held in Bengaluru last week. Addressing the issues of accessibility he said that the 1.5 lakh subcenters that will soon provide geriatric care all through the country which will include dementia. This is a major development in reaching out to the 4 million people in Goa. Government of Goa has also been sensitive towards the problem and has taken cognizance of the problem in the state. We have over 5000 people with dementia in the state of Goa and we need to act soon.
(The writer is a faculty at the department of Preventive Medicine at Goa Medical College, founder secretary of the Dementia Society of Goa and an active member of the Alzheimer’s and related Disorder’s Society of India)
