Zeenath Jahan

Of all incurable diseases, the degenerative brain disorder known as Alzheimer's disease, is the cruelest. It kills its victims twice; the mind dies first, then the body dies. The incidence of this deadly disease grows in direct proportion to the increase in life expectancy, and is therefore an increasing health hazard to older people. The two main types of Alzheimer's disease are Pre-Senile Dementia and Senile Dementia.

Pre-Senile Dementia may strike at any age, and it is believed that there is a genetically inherited predisposition to it.

Senile Dementia strikes after 65 years of age, and though not much is known about it, I believe it is mostly as a result of the accumulated stressors experienced during life.

Brain cells are the only cells in the body that do not rejuvenate or recover from trauma. Each stressful experience during life leaves its mark. Added to this is the fact that each day of our lives we lose a certain number of brain cells. The interconnections between neurons help us cover the gap caused by their loss, and therefore, the greater the interconnections the less are we are aware of our gradual decline. Alzheimer's disease cannot be diagnosed with any degree of confidence except by a post-mortem examination of the victim's brain. The onset of the illness is often not recognized until it has set in. Fading memory and disorientation is usually put down to the normal hazards of old age. Yet, the kind of memory loss suffered in Alzheimer's Disease is different from normal failing memory of old age. For example, it is normal to forget where one has put one's keys; a victim of Alzheimer's Disease, on the other hand, does not remember what keys are meant for.

Once the Disease has set in, it develops in a uniform, gradual sequence. Trouble with language and/or personality changes are some of the first symptoms that all is not well. Personality changes may involve either an alteration or an accentuation of personality traits before the sickness strikes. Loss of intellectual abilities involves, judgment, abstract thought and changes in personality. Impaired judgment and eccentric behaviour are particular symptoms of certain Dementias that affect the frontal lobes the brain.

The first signs are when the victim has trouble making rational judgements. After that, the decline goes at a fairly progressive rate. If there was a rapid start, then it continues rapidly. If the start was slow, it continues slowly. On average, death may occur in six to eight years, although some victims may linger for long as 20 years.

In the earlier stages the individual has some grasp of his deteriorating faculties, reacting with marked anxiety or depression. Generally the victim attempts to conceal or counter this deterioration.

Paranoid ideas, where the patient may imagine plots against him/her may occasionally be quite marked; resulting in accusations and/or physical attacks. Feeling lost in a world that has changed for him, the patient may withdraw from social interactions. He is often confused and bewildered. He cannot understand what is being said. He understands words, but he construes them differently; he is at a loss in the company of people he does not seem to know any more. Afraid and bewildered he slides deeper and deeper into deep depression. The patient may remain neat and well-groomed until well into the disease. Aside from an occasional irritable outburst, they are cooperative and behave in a socially suitable manner.

With progression to the middle stages of the disease, mental disturbances become more obvious. Behaviour and thought processes are also more clearly affected. In the late stage, the patient may be completely mute and, lose motor power and their limbs become rigidly fixed in the fetal position.

So far, no one can pinpoint any single cause for Alzheimer's Disease; and neither has a cure been found for it. Although there are many theories, there are none that can be considered beyond a shadow of doubt, the cause of the disease. There is also a belief that Alzheimer's maybe many diseases clustered under one name. Some of the physical causes of Alzheimer's disease may be: minor strokes in brain capillaries; the continued use of alchohol over a prolonged period of time; a lack of Vitamin B; an accumulation of Aluminum in the brain; severe injury to the brain at any time of life.

Why does one elderly person die in full position of his senses while another succumbs to Alzheimer's disease?

I have drawn certain conclusions, after interviewing many people that have had a first-hand experience with the disease. The psychological factor common to all the cases I studied was a recent traumatic experience of sufficient intensity and duration, compounded with loneliness. The traumatic experience may be either psychological or physical, such as a serious illness or a close encounter with death. Psychological stress may be a real or perceived loss of power or importance and strong feelings of guilt or helplessness. It is a sense of helplessness, a diminished sense of self that leads to frustration and depression. There is a bankruptcy of the self. Loneliness aggravates and accentuates the trauma.

During the course of life, stress and trauma leave their mark on the psyche, with the damage gradually accumulating. By old age there is quite a back-log of `the slings and arrows of outrageous fortune'. If this is compounded by loneliness it results in major depression. So if you have an old parent living alone, do take the time to include him/her in family acitivities; do spend quality time with them; do your best to protect them from sinking into Alzheimer's disease for it will be almost as painful for you as it is for them.

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