How to take care of Alzheimer�s patients amid coronavirus pandemic

New Delhi, 21-Sep-2020

While the country is seeing a rapid increase is daily cases of coronavirus cases, non-COVID patients also continue to suffer as access to healthcare becomes increasingly difficult for them. Elderly and those with cognitive issues are particularly vulnerable. On the occasion of World Alzheimer�s Day, which is celebrated on 21 September each year, we talked to Dr Prashant Makhija, Consultant Neurologist, Wockhardt Hospital, Mumbai Central, who shares some insights into the illness, including how to recognize its symptoms and certain dietary modifications which can be useful in these patients.

What is Alzheimer�s disease?
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Dr Prashant Makhija: It is a neurodegenerative disorder that occurs due to abnormal plaque deposition in nerve cells resulting in their progressive loss. It is usually observed in patients beyond the age of 60 years. Initial symptoms are related to recent memory impairment and word-finding difficulties which often go unnoticed and are attributed to age-related issues. Patients may forget their recent conversation, where they had kept their wallets, they may even forget whether they had food or not, they may forget bank/ATM passwords and may face difficulty in finding words during their conversation, they may also forget their way to home. These issues often result in an argument with family members and colleagues. Some patients present with prominent behavioral symptoms - family members may observe a change in the personality of the patient over time, there may be mood changes such as depression and irritability, hallucinations are also observed. As the illness progresses, memory and behaviour changes become increasingly prominent and patients become more and more dependent on their family members for even routine daily activities.

Why is it important to seek consultation?
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Dr Prashant Makhija: Although there is no curative therapy for the illness and neither there are medicines to reverse the degenerative process, there are certain medicines which have modest benefit for the memory issues. It is therefore important to recognise the symptoms early. Timely and regular follow-up with a neurologist along with good supportive care can minimise the suffering of these patients. Whenever we observe above symptoms in elderly family members, it is important that we seek consultation from a neurologist rather than brushing them aside as age-related issue. Many of the memory and behaviour issues may be related to vitamin deficiencies such as vitamin B12 and hormonal imbalances, including thyroid. Early and appropriate management of these deficiency states can result in significant improvement of these patients. Sometimes incidental blood accumulation in brain coverings can present as confusion and sleepiness in elderly patients and can be easily picked up in brain scan, treatment of which results in reversal of the symptoms related to it.

Is there a set of dietary guidelines for Alzheimer�s patients?
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Dr Prashant Makhija: Caregivers should ensure adequate intake of fresh fruits and green leafy vegetables for such patients. Here are a few tips that can help boost the health of a patient as well as that of your family:-

1. Vegetables such as broccoli, cauliflower, spinach and tomatoes are beneficial. It will be a good idea to avoid eating junk, oily, spicy, and processed food to boost your brain health and stay fit and fine.
2. Include berries and oranges in the diet- these are rich in antioxidants and help fight inflammation and reduce oxidative stress, which can lead to the ageing of the brain.
3. Foods rich in omega-3 fatty acids such as beans, nuts, salmon, tuna, and mackerel can help tackle cognitive impairment.
4. Ensure that patients take adequate amount of water and avoid sugary and carbonated beverages.