Still Alice, the 2014 film about a linguistic professor and her family facing challenges as she is diagnosed with Alzheimer's disease, gives the world a glimpse of how it would be like living with a person losing her memory. In reality, not every case is like that.
"My mum always complains that we do not have time for her," said singer Kulapong "Bird" Bunnag. "So once we took her to the beach, spending nights with her. When she came back home, she complained that we never took her anywhere."
Kulapong's mother was diagnosed with Alzheimer's -- a degenerative brain disease and the most common form of dementia. In Thailand, according to statistics from the Ministry of Public Health, around 600,000 people were reported to have Alzheimer's in 2015, with approximately 100,000 new cases found every year. The number of Alzheimer's patients is predicted to reach 1.1 million by 2030.
Realising the significance of Alzheimer's prevention and treatment, Chulabhorn Royal Academy, in collaboration with six medical institutes -- Chulalongkorn University's Faculty of Medicine, King Chulalongkorn Memorial Hospital under the Thai Red Cross Society, Mahidol University's Faculty of Medicine under Ramathibodi Hospital, Mahidol University's Faculty of Pharmacy, the National Centre for Genetic Engineering and Biotechnology (Biotec), King Mongkut's University of Technology North Bangkok and King Mongkut's University of Technology Thonburi -- have launched a comprehensive Alzheimer's screening campaign for Thais. The campaign is also to mark the 60th birthday of HRH Princess Chulabhorn in July last year.
Targeting those aged 55-85, the campaign aims to provide free Alzheimer's screenings and treatments for 1,000 qualified Thais. Those interested can complete a questionnaire to help determine their own risk. People prone to the disease will undergo preliminary physical evaluation and further tests, including brain MRI and PET scans.
Prof Dr Thiravat Hemachudha of Chulalongkorn University's Faculty of Medicine said an increasing number of Thai elderly are found to fall prey to Alzheimer's. Around 5-8% of those over 65 are reported to suffer the degenerative brain illness. More alarmingly, statistics reveal that around 50% of those over 80 are likely to suffer Alzheimer's.
"A number of factors are responsible for Alzheimer's risks," explained Dr Thiravat. "They include obesity, diabetes, high blood pressure, cigarette smoking, alcohol and diet. There is also research and evidence that calcium supplements, especially if taken by those aged above 60, increase the likelihood of suffering Alzheimer's. Acid-reduction medication for patients suffering GERD, called PPIs [proton pump inhibitors] also contributes to an increased chance of Alzheimer's, if taken long-term."
To understand Alzheimer's and to differentiate it from other memory-related illnesses, it is paramount to understand that there are two major types of degenerative brain disease -- curable and incurable. Degenerative brain diseases that are curable are, for instance, memory problems that are consequences of depression, side effects of antihistamines (drugs that treat allergy) that can trigger memory loss if taken long-term, hydrocephalus (a condition wherein there is too much fluid within the brain) and hormone-related memory problems.
Alzheimer's, unfortunately, falls into the incurable type of degenerative brain disease. Once diagnosed, it is irreversible and will slowly destroy memory and thinking skills. In the end, patients will lose the ability to carry out even the simplest tasks, like walking or swallowing.
"Alzheimer's patients will not die of Alzheimer's but of complications," said Asst Prof Dr Sukcharoen Tangwongchai, head of the Department of Psychiatry, Chulalongkorn University's Faculty of Medicine.
"There are three stages of Alzheimer's. First, patients will only start to have difficulties recalling things which affect their daily lives. Then they will begin to have behavioural problems, confusion, anxiety, difficulty sleeping and using language. They will lose their sense of direction and need others to care for them as they progressively lose the ability to do things themselves."
In later stages, patients will lose the ability to communicate and become completely dependent on others for their care. Near the end, they may become bedridden most or all of the time as the body shuts down.
Do I have Alzheimer's if I forget where I put my keys? Forgetfulness does not always mean Alzheimer's, added the specialist.
"Difficulty remembering names is common among the elderly. Or as they age, it might take them more time to recall things. But for an event that already took place and they cannot at all recall -- as if it never happened -- this might be a significant sign, and brain evaluation might be required."
Although brain degeneration is irreversible, it can be delayed. Regular exercise is one of the strongest shields against Alzheimer's, and it must be started no later than middle age or around 40.
Brain exercise is also essential. "Anything, any activity that allows you to use your brain, will do," advised Dr Sukcharoen.
Social interaction even after retirement and healthy diet are all the mantras against Alzheimer's. Those with such underlying diseases as diabetes and high cholesterol should keep their sickness in check.
"And look after your mental health," he concluded. "Control your stress and depressive moods. If you have signs of psychological issues, seek psychological consultation. Visiting a psychiatrist is not a social scar."
What causes Alzheimer’s
- Increasing age is the most important known risk factor for Alzheimer’s. The number of people with the disease doubles every five years after age 65.
- Studies have shown that Alzheimer’s patients are found to have an accumulation of two proteins, called amyloid and tau. Though autopsy studies show that most people develop these two proteins as they age, those with Alzheimer’s tend to develop far more and in a predictable pattern, beginning in the areas important for memory, before spreading to other regions.
- Scientists, however, do not know exactly what role amyloid and tau play in Alzheimer’s disease. Most experts believe they somehow play a critical role in blocking communication among nerve cells and disrupting processes that cells need to survive. It’s the destruction and death of nerve cells that causes memory failure, personality changes, problems carrying out daily activities and other symptoms of Alzheimer’s disease.
Information from the US National Institute of Ageing and the US Alzheimer’s Association.
For more information on Chulabhorn Royal Academy's comprehensive Alzheimer's screening campaign, call 02-576-6601--5 (during office hours) or visit www.ad.cra.ac.th. Registration ends Jan 31.
