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Understanding Alzheimer’s in India- Causes, Management and Treatment

Understanding Alzheimer’s in India- Causes, Management and Treatment



Mental health has always been a blanketed topic in our country. People approach multispeciality hospital services related to cardiology, neurology, gastrology, and many other physical conditions but seeking help from a psychiatrist or mental health professional remains undone. The social taboo around mental health is one of the reasons behind India’s low mental wellbeing as a nation.

We are facing age-related diseases like Alzheimer’s Disease, dementia, and depression because of our low focus towards mental wellbeing. Old people often suffer the most due to the lack of awareness and acceptance. The major illness that is associated with the age factor is Alzheimer’s disease and it is a global health crisis that needs to be addressed properly.

Alzheimer's in old age

What is Alzheimer’s Disease?

Alzheimer’s disease is a neurodegenerative disorder which means this disease attacks the brain. This progressive disease breaks down and destroys neuronal connections in the brain and causes a decline in memory, thinking, behaviour, and other mental abilities. 

It starts as a mild impairment in memory and change in personality and becomes worse as the days pass by. Do not confuse Alzheimer’s with dementia because both are different and click here to know the difference. In order to overcome Alzheimer’s, all you need is to have knowledge about – how to help or how to manage? Go ahead and learn more!

What are the Causes of Alzheimer’s Disease?

  • Old age – Advancing age puts a person at greater risk of getting Alzheimer’s. As per a study, the risk of Alzheimer’s doubles every 5 years after the age of 65 and reaches almost 50 per cent after the age of 85. Yet it is not just a disease of old age. Around 5 percent of Alzheimer’s patients experience the early onset of the symptoms in their 40s or 50s.

  • Genetics – Inheriting APOE-e4 gene from parents puts a patient at a greater risk of developing Alzheimer’s. The APOE-e4 gene is implicated in 20-25 per cent of Alzheimer’s cases. The risk increases with a proportional increase in the number of gene copies inherited from parents. Although it is not a certainty, the presence of the gene can trigger early onset of the Alzheimer’s symptoms.

  • Family history – A research indicates higher chances of developing Alzheimer’s, in case one has a parent, sibling or relative suffering from the disease. This can be a result of either genetic or environmental factors affecting them.

Warning Signs & Symptoms of Alzheimer’s Disease

  • Memory difficulties – One of the most common warning signs in Alzheimer’s disease is memory loss. Particularly, the individual continuously forgets the last learnt information, important events and dates.

  • Difficulty in planning – Losing track while performing simple or familiar tasks makes the individual feel confused. Ultimately, they become frustrated due to blankness. They often find it difficult to plan things and maintain a routine.

  • Difficulty understanding direction – Due to the abrupt memory decline, the individual might get lost in familiar locations. Or may face troubles in driving to a well-known location.

  • Confused with place and time – An individual with Alzheimer’s disease might find it difficult to remember  dates, place and time more constantly.

  • Repeating the same questions – Sometimes the person may tend to ask the same questions again and again. This is due to the abrupt thought impairment.

  • Disagreeing with opinions – They might resist other’s opinions for their mistakes of forgetfulness. They may also not accept or understand something that is happening immediately.

  • Difficulty with familiar tasks – The individual might face trouble in focusing on regular assignments which they used to do earlier. Especially, the person finds it hard to remember or perform the tasks that deal with numbers.

  • Misplacing things – The person may place things in unusual or inappropriate spots. The individual cannot recall the steps to find them again. Additionally, they may accuse others of stealing or misplacing more frequently over time.

  • Poor judgement – A person with Alzheimer’s disease might encounter a few drastic changes in the area of judgement or decision-making. This factor might make them feel overwhelmed and reduce overall concentration.

  • Social withdrawal – Due to their experiences with the changes within themselves and the environment, they might start to isolate themselves from the family, friends and surroundings.  

Alzheimer’s Signs and Stages

Based on the theory of Dr Resiberg’s system, here are the seven stages of Alzheimer’s disease:

  • No Impairment – During the early phase of the disorder, the individual won’t experience any symptoms of Alzheimer’s disease. They may look and behave in a very normal manner.

  • Very Mild Decline – At this stage, the individual experiences a minimal level of symptoms such as misplacing things, forgetting words or forgetting the due dates. The person may not get distracted due to the minimal effect of the disorder. It’s hard for the individual and their loved ones to notice the mild symptoms of Alzheimer’s. The detrimental changes in this stage are often dismissed as the normal effects of ageing.

  • Mild Decline – At this stage, the individual may experience the mild decline symptoms of Alzheimer’s disease such as forgetting recent things, repeatedly asking the same questions, finding difficulty in planning or being organised.

  • Moderate Decline – The effect of the disorder gets severe during this stage. The individual may encounter issues such as forgetting the details about themselves, may face trouble with date, place and time and have difficulty in decision making.

  • Moderately Severe Decline – The individual may start finding difficulty in recognising familiar faces and may have trouble in recollecting the address or phone numbers. They may dress inappropriately. . They may display signs of continuous confusion.

  • Severe Decline – At this stage, the individual needs constant supervision and regular professional care. They will be needing assistance for daily activities. Individuals during this stage may lose bowel and bladder control . They may fail to remember close ones or frequently mistake the person for someone else, for instance, they think of their son as a brother.

  • Very Severe Decline – The seventh is the final stage of Alzheimer’s diseases. At this stage, the individual loses the ability to communicate and respond to the situation. The person may not be able to perform basic tasks such as walking, sitting or swallowing food.

Alzheimer’s Disease: Treatment Options

Once you visit a doctor, the doctors’ team will decide on a treatment plan based on:

  • Your age
  • Your physical health and medical history
  • The stage of Alzheimer’s (it can be an early-onset or a moderate to severe level of impairment)
  • Lifestyle factors based on which certain medicines or therapy can be decided
  • Yours or your family’s preferences

Is Alzheimer’s curable?

Unfortunately, there is no known cure for Alzheimer’s disease as of today. But there are multiple treatment options that help ease the difficulty in the daily life of individuals suffering from Alzheimer’s. Treatment also reduces the impact of the symptoms and delays the progression of the disease for as long as possible. It preserves the essence of who the person truly is and allows them to be as independent as possible without damaging pre-existing relationships. A supportive atmosphere and physical health strategies like good health practices and exercising may help in avoiding early-onset dementia and Alzheimers. Few of the treatment options are:

  • Medication

During the early stages, your doctor may prescribe medication to increase the  level of the neurotransmitter acetylcholine which helps maintain learning and retain memory and helps nerve cells communicate with each other.

During later stages, your doctor may prescribe a drug called memantine or other forms of the medicine to help block the effects of excessive levels of the neurotransmitter glutamate and stop it from causing further damage to brain cells.

Other necessary medication like antidepressants or antianxiety medication may be prescribed to treat the depression or anxiety that can come with Alzheimer’s. Antipsychotics can also be prescribed to treat any hallucinations, agitation, and aggression that may accompany the disease in some cases.

  • Non-Medical Treatment

Like with anything, medication cannot have full effect if treatment is not holistic. Other forms of treatment, activities, and caregiver support are just as important for caregivers. Some forms of non-medical treatment that are available are:

  • Cognitive stimulation therapy involves taking part in group activities and exercises that are designed to improve memory and problem-solving skills.

  • Cognitive rehabilitation which involves daily regular work with a trained professional or a family member who can monitor and regularly train the individual to do basic tasks by practising each step regularly and maintaining a schedule. It works by getting them to use the parts of the brain that are working to help the parts that are not functioning optimally.

  • The third type of approach is very effective, that is reminiscence and life story. In this approach, the individual is encouraged to talk about things and events from their past. Or at least be constantly reminded of things from their past with the help of photos, favourite possessions, or favourite music. Evidence shows that this approach can improve mood and well-being and also cognitively engage the brain using familiarity.

How to Support Someone with Alzheimer’s Disease?

Remind yourself at all times that the person is not acting mean or difficult, these are just symptoms of the disease. Identifying the cause and how the symptoms are being experienced by the person may help you better understand the problem as well.

Avoid being confrontational with the person even when they say things or express desires that don’t make sense to you and sometimes even behave like a child in doing so. For example, if a person repeatedly stands by the door and says they see their friend going to work and demand that even they want to go (when in fact, in reality, this situation doesn’t exist), instead of arguing with them, try to creatively agree with them and find a make-believe story that they may be comfortable with.

Respond to the emotion, not the behaviour -, flexibly, patiently, and supportively. Create a calm and peaceful environment by reducing as much noise, glaring light, and limited space, and constant background distraction as possible.

Give the person time to rest and do nothing between any tasks that you might be trying to engage them in. Remind yourself that the confusion and agitation can be very exhausting for them. Acknowledge the person’s requests and respond to them creatively. Remember not to take the person’s behaviour personally and remember to meet other people, join support groups where you can and share your experiences and difficulties.

10 Things to Do to Prevent Alzheimer’s Disease

Just as there is no known cure for the disease, steps to prevent it are not foolproof. Healthy lifestyle habits can help in preventing cognitive decline. Some of them are:

  • Eat Healthy Diet – Many studies show that following the Mediterranean diet (plenty of veggies, beans, whole grains, fish and olive oil) and Omega-3 fat foods such as cold water fishes (salmon, tuna, trout seaweed can minimize the danger of cognitive impairment and Alzheimer’s disease.

    It is advisable to cut down sugary foods and high carb foods such as flour, rice, and keep an eye on hidden sugars in all the packed food. Because of these foods, there might be an increase in the level of blood sugar which inflames the brain.

  • Do Regular Exercise – It might sound very familiar and too common but the results from it are so effective. According to the Alzheimer’s Research and Prevention Foundation, regular exercise can drop the risk of Alzheimer’s up to 50%. This habit can stimulate the cerebellum’s ability to sustain the old memories and maintain new ones.

    Target at least 150 minutes of intense exercise at least once in a week. Stay active and boost your brain by doing activities such as walking, jogging, yoga and aerobics to strengthen the brain areas blended with multitasking, planning and organising. Exercising also improves memory.

  • Be Social – It’s okay to talk about suffering, try to take out the social egos apart and be engaged with the discussion about Alzheimer’s to someone who you feel trustworthy – might be family, friends, or clinical professionals. Be open and direct towards the path of better recovery and cure. Sharing the precise information is the key which eliminates the misconception about the disorder. Focus on what the medical professionals prescribe.

  • Learn Different and More – The important groundbreaking theory by NIH ACTIVE for the suffering individuals is “use it or lose it”. The individuals who are keen to show off their interest in learning new things and challenge their brain are less likely to develop Alzheimer’s.

    Put yourself in a situation of learning new things such as practising a foreign language, learning musical instruments, taking a new hobby like reading good books or playing some strategy games or puzzles can create patterns and rhythms inside the memory connections.

  • Manage Stress – The heavy toll that takes on the brain is stress. Increase in stress might result in hampering the nerve cell growth, shrink in memory and much more. To overcome stress and minimise the risk of  Alzheimer’s, it is mandatory to follow some effective activities such as breathing exercises, building inner peace, maintaining a sense of humour, stop smoking, and controlling blood pressure and cholesterol levels.

  • Avoid Hypertension – Hypertension has the odds of raising the risk of both vascular dementia and Alzheimer’s disease. Mediation and the right diet is a good defender against Alzheimer’s.

  • Quit Smoking – Risk of developing dementia and Alzheimer’s disease is higher with smoking. A research institute in Finland found that smoking 2 packets of cigarettes every day will increase the chance of getting Alzheimer’s in the near future.

  • Stop Being Cynical – According to a new study published in the medical journal, Neurology explains people with high levels of cynicism to be more likely to develop dementia.

  • Try to Stay Away from Stress & Stressors – Stress can increase the probabilities of Alzheimer’s and its severity. Making yourself occupied may help to combat stress. Avoid situations or people with negative thoughts and stress-inducing behaviour.

  • Sound Sleep – Having a great sleep for 6 to 8 hours may help the brain to reduce the levels of amyloid plaques which is the important factor that majorly contributes to Alzheimer’s disease.

Dealing with Alzheimer’s disease can be difficult especially when you know that it cannot be cured but that does not mean that you need to succumb to a lifestyle that you do not want and let the disease win.

So whatever you went through is 100% effective for the short-term threshold for long-term remedies, it is advisable to knock the doors of medical professionals, so be clear and be cleared! Call us @ +91 9741476476.

FAQs: Alzheimer’s Disease

Who does Alzheimer’s affect?

Age is the biggest factor in getting Alzheimer’s. Most of the people affected by this disease are over the age of 65. The risk chances double or increase above this age.

Women are twice as affected than men and mostly after the age of 65.

Does the health and lifestyle of a person have an impact on Alzheimer’s condition?

Yes, medical conditions like stroke, diabetes, and heart problems, and also the conditions of high cholesterol, high blood pressure, and obesity in midlife, increase the risk of Alzheimer’s. These risks can be at low by keeping these medical problems under control. People adopting a healthy lifestyle and active lifestyle which combines social and mental activity and regular physical exercise will help to lower the risk of developing Alzheimer’s disease.

What are the symptoms of Alzheimer’s Disease?

  • Struggle for finding the right word in the conversation or even sometimes forget names

  • Forget about the events, appointments, etc

  • Lose things around the house

  • Lose themselves in familiar places

  • Face difficulty in decision-making, dealing with problems, planning, concentrating and in organizing

  • Vision-related problems which include difficulty with in-depth perception, reading and colour contrast

  • Withdraw from work and social engagements

  • Changes in personality and mood

  • Misplace the items and unable to retrieve them again

What is the difference between Dementia and Alzheimer’s Disease?

Dementia is not a specific disease. It describes a range of symptoms that affect the thinking capability, memory, and social abilities of a person and interfere with their daily functioning.

When a person is said to have dementia or Alzheimer’s, it means they have primary memory problems linked with other cognitive and as well as behavioural issues. Dementia is most of the time caused by Alzheimer’s disease.

What are the available drug and non-drug treatment options to treat Alzheimer’s disease?

Presently there is no specific remedy for treating Alzheimer’s, but various activities and support like non-drug treatment methods can do a lot in helping the person to live well. Also talking to a professional like a psychiatrist or a clinical psychologist, or even an occupational therapist can help in overcoming the problem.

Some of the drug treatments like antidepressants can temporarily alleviate the symptoms or even slow down the progression of the disease in some people. The psychotherapies such as cognitive behavioural therapy, neurofeedback & supportive therapy may also be useful. Counselling as well helps the person in adjusting to the diagnosis.

What are the side effects of drugs used to treat Alzheimer’s symptoms?

The common side effects of the drugs include loss of appetite, frequent bowel movements nausea, vomiting, diarrhoea, headache, confusion, constipation, and dizziness. Starting your treatment at a low dose and continuing it to a higher dose helps to reduce the side effects. Also, taking these medications with proper food might help in minimizing the side effects.

Since Alzheimer’s progresses modestly, the symptoms and effects can change over time. If you are taking medications, it is good you decide how long you should continue your medication with your doctor.

Who should you talk to regarding Alzheimer’s care?  

It would best for you to reach out to a mental health team that includes a psychiatrist, psychologist and/ or a counsellor. They would help you with a holistic approach to the treatment. 

How can I help as a caregiver?

Being a caregiver (whether family or friend) for a person with Alzheimer’s can get very challenging. It can get distressing and confusing for you as you take care of the person, manage the symptoms, get frustrated, feel guilty, stop taking care of your own mental health.

Being an Alzheimer’s caregiver requires patience, creativity, stamina to ride it out to see the rewarding nature of helping someone you care about. It’s important to remember to take care of yourself as this can be so stressful that you forget to focus on your nutrition and exercise.