Written By: Pavitra Sampath | Published : October 17, 2014 6:43 PM IST
Most of us think that Alzheimer's is a condition that affects only the elderly, but astonishingly this disease can strike early as well. Early-onset Alzheimer's is clinically described as Alzheimer's that affects a person before the age of 65. We spoke to Dr Manoj Khannal, Consultant- Neurology at Max Super Speciality Hospital, Shalimar Bagh about this form of Alzheimer's and how a patient can be rehabilitated. Here are excerpts from the interview.
What is early onset Alzheimer's?
Early onset Alzheimer s are familial Alzheimer Disease which occur before the age of 45 years; which are of two forms early onset autosomal dominant and late onset familial AD. Around 0.1% of the cases are familial forms of autosomal (not sex-linked) dominant inheritance, which usually have an onset before age 65.
Who is most prone to it?
Early onset of Alzheimer s occurs in case of genetic defect. Genes involved can be
a. Amyloid precursor protein (APP)
b. Presenilin 1 (PSEN1)
c. Presenilin 2 (PSEN 2)
Mutations in this gene causes increase in blood and brain levels of beta- amyloid whose accumulation results in the disease.
Can a person with no family history of the condition suffer from it?
Yes there are sporadic cases of Alzheimer s. Most cases of Alzheimer's disease do not exhibit autosomal dominant inheritance and are termed sporadic AD, in which environmental and genetic differences may act as risk factors. The best known genetic risk factor is the inheritance of the 4 allele of the apolipoprotein E (APOE). Between 40 and 80% of people with AD possess at least one APOE 4 allele. The APOE 4 allele increases the risk of the disease by three times in heterozygotes and by 15 times in homozygote. Like many human diseases, environmental effects and genetic modifiers result in incomplete penetrance. For example, certain Nigerian populations do not show the relationship between dose of APOE 4 and incidence or age-of-onset for Alzheimer's disease seen in other human populations. (Read: How to reduce your risk of Alzheimer s disease)
If a person has a family member who has suffered from Alzheimer's, can they prevent the condition?
At present, there is no definitive evidence to support that any particular measure is effective in preventing AD. Global studies of measures to prevent or delay the onset of AD have often produced inconsistent results. Epidemiological studies have proposed relationships between certain modifiable factors, such as diet, cardiovascular risk, pharmaceutical products, or intellectual activities among others, and a population's likelihood of developing AD. Only further research, including clinical trials, will reveal whether these factors can help to prevent AD. A. Medications -- Although cardiovascular risk factors, such as hypercholesterolaemia, hypertension, diabetes, and smoking, are associated with a higher risk of onset and course of AD; statins, which are cholesterol lowering drugs, have not been effective in preventing or improving the course of the disease. B. Life style changes -- People who engage in intellectual activities such as reading, playing board games, completing crossword puzzles, playing musical instruments or regular social interaction show a reduced risk for Alzheimer's disease. C. Diet -- People who eat a mediterranean diet have a lower risk of AD. and it may improve outcomes in those with the disease. Those who eat a diet high in saturated fats and simple carbohydrates have a higher risk.
How is a patient with Alzheimer's treated with rehabilitation?
The Neuro Rehab program differs for patient to patient. It depends upon the symptoms, expression and progression of disease. There are different programmes being run by physiotherapist and speech therapist. A guide used in patients as follows below used in several centres.
1. Physical exercise and social activity are important, as are proper nutrition and health maintenance.
2. Plan daily activities that help to provide structure, meaning, and accomplishment for the individual.
3. As functions are lost, adapt activities and routines to allow the individual to participate as much as possible.
4. Keep activities familiar and satisfying.
5. Allow the individual to complete as many things by himself/herself as possible. The caregiver may need to initiate an activity, but allow the individual to complete it as much as he/she can.
6. Provide 'cues' for desired behavior (i.e., label drawers/cabinets/closets according to their contents).
7. Keep the individual out of harm's way by removing all safety risks (i.e., car keys, matches).
8. As a caregiver (full-time or part-time), it is important to understand your own physical and emotional limitations.
Image source: Getty images
Follow us on Facebook and Twitter for all the latest updates! For daily free health tips, sign up for our newsletter.
