World Alzheimer’s Day 2019: When does 'forgetfulness' become 'dementia' become Alzheimer's?

In India alone, more than 4 million people suffer from some sort of dementia including Alzheimer’s disease.

Alzheimer's disease is a form of dementia — the most common form of it. It contributes to 60–70 percent of all dementia cases — a chronic, progressive condition in which there is deterioration in the ability to process thought — affecting life a lot more than what can be expected from the normal aging process.

An estimated 50 million people around the globe lived with dementia in the year 2017 and the number is expected to double every 20 years reaching about 75 million in the year 2030. In India alone, more than 4 million people suffer from some sort of dementia including Alzheimer's.

Therefore, it becomes imperative to raise awareness about this condition and know about the treatment options available.

All Alzheimer's patients share a characteristic symptom of the disease: dementia.

All Alzheimer's patients share a characteristic symptom of the disease: dementia.

How does Alzheimer’s disease progress?

A lot of research is looking into the root cause of Alzheimer’s disease. But little progress has been made so far. It has been observed that changes in brain chemistry may begin several years before the visible symptoms start like memory loss start to appear.

During its early or preclinical stage, the condition remains asymptomatic. However, during this time abnormal deposits of proteins in the form of amyloid plaques and tau triangles start to form throughout the brain. As the disease progresses, the symptoms worsen and by the final stage the damage is widespread and the brain tissue has significantly shrunk.

When does 'forgetfulness' become 'dementia'?

Being forgetful about a few things is okay. You may sometime forget to switch off the fans or find it very difficult to remember the name of your distant cousin. Being forgetful comes naturally with aging as well. However, conditions such as dementia may affect brain function and lead to severe memory loss. So when does someone actually know that their dear one may be suffering from Alzheimer’s or any other form of dementia?

As per the US National Institute of Ageing, patients suffering from Alzheimer’s along with memory loss experience various other problems. They may forget their address and wander clueless for a very long time. They may find it very difficult to deal with numbers and pay their bills. Such people may exhibit behavioural changes and may have difficulty in carrying out their daily activities.

Brain scan showing signs of dementia. Alzheimers

Brain scan showing signs of dementia. Image:

In severe cases, people may forget usual activities such as bathing and even responding to normal communication. Depending on the degree of symptoms, dementia can be one of three stages.

Mild (First stage) dementia

In this stage a person may be able to carry out normal activities such as driving, working, taking part in social activities, etc. However, they may experience memory elapses where they find it difficult to remember things they have just read, names of people they recently met and even forget some most commonly used words.  The family and friends may begin to notice symptoms at this stage.

Moderate (Second stage) dementia

The second stage is the longest and may prevail for many years. During this stage, the patients may find it difficult to deal with numbers and forget even the most memorable days of their lives. They may be unable to recall the school and college they graduated from or the year they got married etc.

Patients at this stage may have an altered sleep cycle. They may also be unable to decide what clothes they should wear as per the current season. Personality and behavioural changes become very prominent during this stage. Patients require a lot of attention and care to cope up with this condition.

Late (Third stage) dementia

In this stage, a person becomes completely unaware of the surroundings and doesn’t know how to respond or communicate. They may forget how to walk, sit or even swallow. During this stage, the patients require 24*7 assistance and care.

Alzheimer's disease factsheet.

Alzheimer's disease factsheet. Image courtesy: Global Stem Cells

Diagnosis and Treatment

To arrive at a diagnosis, the doctors may start by looking at the medical and family history of the patient. The patient’s mental functions are assessed in detailed way by standard medical scoring systems such as Mini-Mental State Examination (MMSE). The doctor may order imaging tests such as  MRI and CT scan of the brain to rule out other causes of mental dysfunction, such as a tumor or an infection before Alzheimer’s can be diagnosed as it is a diagnosis of exclusion.

Till now, there is no cure for Alzheimer’s; however, medications are available to help delay the progression of the disease and even control its symptoms. However, caring for Alzheimer’s patients is a big responsibility as people suffering from this condition require extensive medical care and support. Therefore, it is important for patients and caregivers to discuss all aspects of care with the treating team and prepare one.

The author is a Senior Consultant to the Medical Team at

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