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Disease profile: Dementia

Worldwide numbers of dementia cases are estimated to hit 131.5 million by 2050.

India is unlikely to be exempt from this trend as conditions in the country indicate numbers are set to rise rapidly. India has an aging population, and with increased life expectancy in recent years the number of individuals living to the age of 65 and over is rising. Above this age the rate of dementia incidence increases at an almost exponential rate.

India is entirely unprepared for a future in which the prevalence of Alzheimer’s disease rises sharply, according to the Alzheimer’s and Related disorders Society of India (ARDSI). There is currently no government policy put in place to address Alzheimer’s disease patients.

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Prevalence

Two decades ago the condition was considered to be rare in India. However, current estimates place the number of patients with dementia in India at around 4 million. This may be a conservative estimate as countless numbers of people in rural communities may live with the condition without a diagnosis.

While Alzheimer’s disease is the most common type of dementia, many other conditions exist such as lewy body dementia and vascular dementia.

 

Symptoms

The nature of the condition is a gradual mental degeneration, for some this may occur more rapidly. With the degeneration of brain function due to neuronal death comes a reduction in a person’s capabilities. This may involve memory loss or hindrances when performing previously simple tasks.

In the case of Alzheimer’s disease it is typically the short term memory that is affected first. This may leave an individual capable of recalling events that took place when they were a child, yet unable to recall an event that occurred a few moments ago. In some instances, the individual may forget people, which can often lead to confusion or aggression.

In the more advanced stages of the disease, a patient may be bedridden and require round-the-clock care.

 

Prevention and treatment

 

The specific causes of Alzheimer’s disease, as well as other types of dementia, are unclear. It is known that issues with the aggregation of the amyloid protein or misfolding of the tau protein are the chemical drivers of the disease, though the reasons behind these are less well understood.

There is a known genetic component behind dementia, though to what extent genes play a role in causing the disease as opposed to environmental factors is unclear. Advice on leading a healthy lifestyle may aid in reducing the risk of dementia, though those with genetic risk factors may not be able to prevent the onset of dementia with just healthy lifestyles.

Once dementia is diagnosed, there is no cure. The symptoms may be managed as well as the progression of the condition delayed, but there are no current treatments that can reverse the onset of the condition.

Non-drug treatments may improve some of the symptoms of the condition. Activities that involve mental exercise are also advised. There are also a number of medications that may slow the progression of the disease such as donepezil, rivastigmine or galantamine. These may help with memory loss and concentration deficits. In severe cases, these drugs are usually replaced with memantine, which may also alleviate some of the confusion and distress associated with late stages of dementia.

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