Alzheimer’s disease: Signs you should not ignore

BY SYLVESTER OJENAGBON

No one prays for or expects to suffer any form of memory loss at any stage in life. Yet, that was the reality of an estimated 57 million people living with dementia worldwide as of 2021. And Alzheimer’s disease is the most common cause of dementia; it accounts for 60-70% of cases.

Dementia is an umbrella term for a group of symptoms affecting cognitive abilities, while Alzheimer’s disease is a specific type of dementia. Other types are vascular dementia, Lewy body dementia, and frontotemporal dementia.

Now, Alzheimer’s disease is a progressive, neurodegenerative disorder that primarily affects the brain and causes a decline in memory, thinking, and reasoning skills. It is largely caused by the abnormal buildup of proteins in the brain, forming amyloid plaques and neurofibrillary tangles. This buildup disrupts communication between brain cells and leads to a decline in memory, thinking, and other cognitive functions.

Scientists believe a combination of genetic, lifestyle, and environmental factors can contribute to the development of Alzheimer’s disease over time. For example, certain genes, like apolipoprotein E (APOE), have been linked to the risk of Alzheimer’s disease. Also, high blood pressure, smoking, and other lifestyle factors can contribute to the development of Alzheimer’s disease.

Prolonged exposure to air pollution and chronic exposure to various toxins, such as certain pesticides and heavy metals, may increase the risk of developing neurodegenerative diseases like Alzheimer’s.

Studies have equally shown that people who have experienced a traumatic brain injury, particularly those 50 or older, have a higher risk of developing dementia, including Alzheimer’s disease.

The truth is that age is the most significant risk factor for Alzheimer’s disease, with most individuals developing the disease after 65 years old. Unfortunately, early-onset Alzheimer’s disease strikes earlier in life, and this is defined as before the age of 65 (usually between 30 and 60 years of age). It is estimated to affect around 5% of those with Alzheimer’s disease.

In the early stages of Alzheimer’s disease, a person may primarily experience short-term memory lapses, such as misplacing items, forgetting recent conversations, or having trouble finding the right words. And the person might be aware of these difficulties. Long-term memories from the distant past often remain largely intact in these early stages.

In the middle stages, memory problems become more severe. The person may have difficulty recognising familiar faces (including family and friends), forget personal history, and may not remember names, even of those close to them. He or she might experience increasing disorientation and confusion, and get lost in familiar places.

In the late or most severe stages, memory loss is profound. The person may have no awareness of his or her surroundings or recent experiences, lose the ability to communicate, and fail to recognise loved ones. He or she becomes completely dependent on others for care.

In addition to memory loss, people with Alzheimer’s disease may experience changes in behaviour and personality, such as unusual outbursts, agitation, or suspicion. These changes can be a source of frustration for both the person and their family, who often find themselves in a caretaker role.

Early-onset Alzheimer’s disease can, however, present with uncommon symptoms, such as speech difficulties, impaired executive function, or visual problems, rather than the typical memory loss seen in late-onset Alzheimer’s disease. It may also progress more rapidly than the late-onset form of Alzheimer’s.

Curiously, women are generally at a higher risk of developing Alzheimer’s disease than men. In fact, they are twice as likely to develop the disease compared to men. Although the precise reasons are still being researched, several factors contribute to this increased risk. Women tend to live longer than men, and age is the biggest risk factor for Alzheimer’s disease. Menopause, with its associated hormonal shifts, may play a role. Oestrogen helps neurones use glucose for energy, and its decline during menopause may contribute to brain changes.

Some research suggests differences in brain structure and function between men and women, which may affect Alzheimer’s disease risk. Cultural factors, like access to education and stimulating careers, can also influence Alzheimer’s disease risk, with historical disparities impacting women. And some studies suggest that the APOE4 gene, a major risk factor for Alzheimer’s disease, may unduly affect women.

It is pertinent to note that the progression of Alzheimer’s is variable, and symptoms can be different from person to person. Again, the experience of memory loss is not uniform; it can similarly vary from person to person. Some types of memory or brief moments of recognition may persist longer than others, even in advanced stages. It is equally relevant to point out that, although not everyone with mild cognitive impairment develops dementia, it is a stage that can precede Alzheimer’s disease.

Now, to reduce your risk of Alzheimer’s disease, it is important to focus on a healthy lifestyle that includes a balanced diet, physical and mental activity, avoiding smoking, and managing other health conditions. Specifically, it is essential to prioritise a diet rich in fruits and vegetables, regular exercise, managing chronic conditions like high blood pressure and diabetes, and staying mentally engaged. Regular social interaction in midlife has equally been linked to a lower risk of developing dementia later in life.

Early symptoms of Alzheimer’s disease can be subtle and may be misinterpreted as normal ageing or other conditions. It is, therefore, crucial to consult a doctor if you or someone you know is experiencing some of the symptoms, especially if they are interfering with daily life. Although the disease currently has no cure, early detection and proper management can significantly slow down its progression, thus improving quality of life and potentially delaying the onset of more severe symptoms.

Ojenagbon, a health communication expert and certified management trainer and consultant, lives in Lagos.