In 2006 it affected nearly 27 million people worldwide. It is predicted to affect 1 in 85 people globally by 2050. It was first discovered by a German psychiatrist and neuropathologist in 1906. It mostly affects people over the age of 65, but can affect people as young as 35. It is an incurable, degenerative and terminal disease. Dr Andrew Lees, clinical director of the Queen Square Brain Bank for Neurological Disorders called it ‘the silent plague’. It is Alzheimer’s disease, the most common form of dementia.
Although it affects everyone individually, there are many common symptoms. The earliest symptoms are often dismissed as being ‘age-related’ or manifested by stress. In the early stages, the most commonly recognised symptom is an inability to acquire new memories, such as a difficulty in recalling recently observed facts. When Alzheimer’s is suspected, the diagnosis is usually confirmed with behavioural assessments and cognitive tests and is often followed by a brain scan.
Alzheimer’s develops for an indeterminate period of time and can progress undiagnosed for years. The average life expectancy following diagnosis is seven years. Fewer than 3% live for more than 14 years after diagnosis.
As Alzheimer’s cannot be cured and is degenerative, patient care is essential. The main caring role is often taken by the spouse or a close relative. Alzheimer’s disease is known for placing a great burden on caregivers; the pressures can be wide-ranging, involving social, psychological, physical, and economic elements of the caregiver’s life.
As Alzheimer’s begins to affect a person more, they will begin to have difficulties with language. Language problems are mainly characterised by a shrinking vocabulary and decreased word fluency, which lead to a general impoverishment of oral and written language.
Progressive deterioration eventually hinders independence with patients being unable to perform even the most common activities of daily living. Speech difficulties become evident due to an inability to recall vocabulary. Reading and writing skills are also progressively lost. The risk of falls increases dramatically. Memory problems will begin to worsen. The person may fail to recognise close relatives – their spouse of 40 years, their own children or their siblings. Long-term memory becomes virtually non-existent. Behavioural changes become more prevalent. The patient may begin to wander or become more aggressive. This often leads to crying, outbursts of unpremeditated aggression, or resistance to caregiving. Approximately 30% of patients will become delusional.
During the last stages of Alzheimer’s, the patient is completely dependent upon caregivers. Language is reduced to simple phrases or even single words, eventually leading to complete loss of speech. Patients will ultimately not be able to perform even the simplest tasks without assistance. Muscle mass and mobility deteriorate to the point where they are bedridden, and they lose the ability to feed themselves. It will eventually cause death – not directly but mostly as a result of pressure ulcers or pneumonia.
All of this and people still think that it is ok to joke about it – ‘How many Alzheimer’s patients does it take to change a lightbulb? To get to the other side’ or ‘A man with Alzheimer’s walks into a bar and asks the barman, “Do I come here often?” ’.
Alzheimer’s is certainly not a joke. For the families that it affects it would obviously be totally heartbreaking. Children have to live with the fact that their mother or father can no long recognise them. Husbands or wives become strangers to their spouse. Brother’s or sister’s who used to be so close are now like outsiders. Alzheimer’s is a vicious disease, not only to the person affected, but also to their relatives.
Luckily it hasn’t affected my family personally, but I have a few friends who have family members affected by it. For those families how have to deal with it, I don’t know how you do it. You have my upmost respect.