India’s population currently stands at 1.46 billion, with approximately 13.8 million people aged 60 and above—a number expected to reach 180 million by 2030. This significant increase is due to improved life expectancy, which has risen from around 40 years in the 1960s to nearly 70 years today.
As we observe Alzheimer’s Disease Awareness Month in June, it's vital to understand this growing public health challenge. The goal is to spread awareness, promote early detection, and highlight recent advances in diagnosis and management.
Understanding Dementia and Alzheimer’s
Globally, over 55 million people live with dementia, a group of brain disorders that impair memory, problem-solving, language, and other cognitive abilities. While some forms of dementia are treatable, most are progressive. In India, 8.8% of the elderly population (above 60) is affected by dementia—equating to around 5.5 million people (Fogarty International Center, 2023; Longitudinal Ageing Study in India). This figure is projected to rise dramatically to 152 million by 2050.
Among the various forms of dementia, Alzheimer’s disease accounts for nearly 70–75% of cases. It is a progressive, irreversible condition that gradually affects memory, reasoning, and the ability to perform everyday tasks.
What Causes Alzheimer’s Disease?
- Alzheimer’s disease develops as a result of complex brain changes, including:
- Beta-amyloid plaques: Protein fragments that accumulate outside neurons.
- Tau tangles: Abnormal tau proteins that disrupt the transport system inside neurons.
- Neuron damage: These changes lead to the death of brain cells responsible for cognitive and physical functions.
A genetic factor, the APOE e4 variant of the apolipoprotein E gene, has been linked to an increased risk and earlier onset, though carrying the gene doesn’t guarantee one will develop the disease.
Stages of Alzheimer’s Disease
Early Stage
- Subtle mood or behavioral changes.
- Mild short-term memory loss (e.g., misplacing items, forgetting appointments).
- Difficulty remembering recent events.
Middle Stage
- Increasing memory loss; struggles with familiar names and places.
- May fail to recognize close family and friends.
- Behavioral symptoms like depression, anxiety, agitation, hallucinations, and sleep issues become more common.
- Daily activities become significantly impaired.
Late Stage
- Complete disorientation and inability to recognize even close relatives.
- Loss of insight and control over bowel and bladder.
- Patients become fully dependent and are vulnerable to infections and other systemic complications.
Risk Factors and Prevention
Several modifiable risk factors contribute to the development of Alzheimer’s disease, including:
- High blood pressure
- Diabetes
- Obesity
- Chronic smoking and alcohol use
- Depression and social isolation
- Addressing these risk factors early in life may help reduce the likelihood of dementia in older age.
Diagnosis and Management
- Early diagnosis is essential for better management. Key diagnostic tools include:
- Blood tests
- Brain imaging (PET scan)
- Cerebrospinal fluid (CSF) analysis
While there is currently no cure, several medications like donepezil, memantine, and rivastigmine are used to slow cognitive decline. More recently, two FDA-approved drugs—Aducanumab and Lecanemab—have provided hope when administered during early stages of the disease.
Holistic Care and Support:
Caring for someone with Alzheimer’s involves emotional, physical, and financial challenges. Early diagnosis helps families prepare legally and financially, explore living arrangements, and build support systems. Patients and caregivers are encouraged to seek medical advice as soon as progressive memory loss or behavioral changes are noticed in individuals above the age of 60.
Multiple governmental and non-governmental organizations at both national and state levels offer resources and support for caregivers and families navigating this journey.
Conclusion:
As India’s elderly population continues to grow, Alzheimer’s disease is set to become a major public health concern. Awareness, early diagnosis, lifestyle changes, and caregiver support play key roles in managing its impact. By staying informed and vigilant, families and communities can take meaningful steps toward improving the quality of life for those affected.
