The Long Goodbye

By Edeline Anne Goh

“If he flubs a lyric or gets confused on stage, I wouldn’t want people to think, ‘What’s the matter with him? Is he drunk?’” Kim Campbell was talking about her husband Glen Campbell on Time.com. Kim revealed that her husband, who is known for many chart-topping songs including ‘Rhinestone Cowboy’, has been battling Alzheimer’s disease since 2011.

Alzheimer’s is a condition that gradually robs a person’s identity, independence, memories and dignity. Sadly, it has yet to receive the attention it needs resulting in a misconception by many that Alzheimer’s is a mental illness or simply a ‘part of ageing’. Despite years of research, scientists have yet to find a cure.

In conjunction with World Alzheimer’s Day on September 21st, Urban Health takes a look at this debilitating disease and some of the important details you need to know.

What Is Alzheimer’s?

Alzheimer’s disease, which is often described as ‘The Long Goodbye’, is the most common neurodegenerative disease that causes dementia.  Dementia is described as a group of symptoms that produce memory loss, mood changes, depression and communication problems.

At the moment, the true cause behind Alzheimer’s remains unknown but it has been discovered that this condition is associated with a progressive loss of neurons that produce acetylcholine — a chemical messenger in the brain. Post-autopsy brain examinations in Alzheimer’s patients also reveal abnormal ‘plaques’ or protein deposits that disrupt normal communication between neurons that may lead to neuronal cell death.

This can affect everyday skills and simple activities such as cooking, turning on the television, identifying familiar faces or even forming complete sentences. These problems are often highly frustrating or even devastating for the patient and his loved ones.

4 A’s and Psychiatric Symptoms

Being able to identify the signs and symptoms of Alzheimer’s disease is vital for early diagnosis of this disease. These signs can be classified as the 4 A’s and psychiatric symptoms which are:

Amnesia – Memory loss that progresses from short term to long-term loss.

Aphasia – The loss of communication abilities which includes speaking, writing, understanding and remembering words.

Apraxia – The inability to carry out normal, daily activities and programmed motor tasks, starting from more difficult learned tasks and eventually progressing to simpler ones like putting on clothes, brushing teeth or even bathing.

Agnosia — The inability to interpret information from the 5 senses to form accurate perceptions of the message conveyed.

The final sign to look out for involve psychiatric symptoms such as personality changes, depression, hallucinations and delusions.

Preventing Alzheimer’s

Research is currently underway to connect lifestyle or health factors to the prevention of Alzheimer’s. While waiting for a definite answer, there is certainly no harm in leading a healthy lifestyle as a preventive measure.

Stimulate your mind

Most people tend to fall victim to a sedentary lifestyle as they get older and this is cause for concern. A good way to prevent this from happening is to focus on keeping your mind and body active, no matter what your age. You can do this by keeping in touch with your friends and making a special effort to make new ones so you can stay socially active.  Besides that, you can always open your mind to new experiences and skills by travelling, volunteering or learning a fun, new skill by enrolling yourself in a music or language class. If you prefer staying indoors, keep yourself occupied with word games, puzzles and board games. If you are not a fan of any of the above, make it a point to find an activity or hobby that will challenge you mentally and physically.

Healthy Eating

Indulge in super foods for your brain such as DHA, EPA, flavanoids as well as vitamins K and E, which are believed to play a powerful role in preventing dementia. Aside from that, make sure you consume a variety of fruits, vegetables, whole grains and legumes. Healthy eating will go a long way toward keeping both your mind and body healthy through the years.

Exercise Your Way to Health

Allocate a half-hour slot in your busy schedule to sweat it out at least three times a week. Work it out with exercise routines such as weight bearing exercises and aerobics to improve your overall health. If you prefer, find an exercise buddy to help you get motivated. After all, why not share the benefits of working out? You can also bring a friend along for a walk around your neighbourhood. This is good for your social life and your health!

Treating Alzheimer’s

Although scientists are yet to find a cure for this disease, there are treatments available to delay the progression of cognitive symptoms.

These include a series of treatments approved by the Food and Drug Administration (FDA) in the United States such as Cholinesterase inhibitors that can increase the levels of a brain chemical called acetylcholine. Acetylcholine is usually prescribed to patients experiencing mild to moderate stages of Alzheimer’s. For patients who have reached the moderate to severe stage of this disease, memantine, which seems to have a fairly positive effect, may be prescribed.

Vitamin E may sometimes be included as part of the treatment but it is not FDA approved and should only be consumed upon medical advice as it can potentially interact with lipid-lowering and anticoagulant drugs (drugs that prevent blood clotting).

Living with Alzheimer’s

If you have been diagnosed with Alzheimer’s, it does not mean that it is the end of the road. In fact, there are a few simple lifestyle changes that you can make to remain independent for as long as possible and enjoy your life.

Here are some steps you can take:

  • Keep a memory notebook and use memory aids such as post-it notes which you can paste in a common area such as on your fridge door or your dressing table
  • Ask people close to you to call and remind you of important events or appointments
  • Plan enjoyable activities to fill your day. Make sure you are able to safely carry out these activities on your own
  • To ensure better communication, don’t be afraid to ask the person you are having a conversation with, to speak a little slower or repeat what they said if you have difficulty understanding
  • Don’t be ashamed to ask for help if you need it
  • A list of relevant emergency numbers such as your spouse’s or caregiver’s contact number as well as your doctor’s should be kept in large print next to your home phone.
  • Keep important information such as emergency contact numbers and addresses in your wallet These will come in useful if you have lost your way or need help remembering relevant information.
  • If you are consuming medication, note instructions clearly and use a tablet box to help you keep track of your consumption.

Caring For Patients with Alzheimer’s

Alzheimer’s disease can disrupt even the most loving relationships. It can stand between lifelong spouses and loved ones, quietly erasing wonderful, shared memories. Caring for a patient with Alzheimer’s is undoubtedly a challenging task so it helps. Here are some tips to help you take care of a loved one with Alzheimer’s.

  • Take time out if you are feeling frustrated. If it is safe, leave the room for a little while and get some fresh air.
  • Patiently repeat simple instructions and do not interrupt when the patient is talking.
  • Help the patient find words to express his thoughts and feelings
  • Have a daily routine in place.
  • Try not to demonstrate your anger or frustration. Step back and take deep breaths to calm down.
  • Reassure the patient that he is safe
  • Comfort the patient and let him know that you are always there, especially during difficult times
  • Keep well-loved objects and photographs around the house as a constant reminder about the many wonderful moments that the patient shared with loved ones.

Alzheimer’s is not an ordinary part of ageing and early diagnosis is essential. According to the Alzheimer’s Disease Foundation Malaysia, an estimated 50,000 Malaysians are suffering from Alzheimer’s but the majority of them remain undiagnosed.

Awareness is crucial it will help with managing the disease; allowing you and the people around you to make essential lifestyle changes to help you cope. These adjustments will make things a lot easier for everyone to adapt to the gradual progression of the disease, which may stretch out over ten or even twenty years.

The most important point to remember is to take things one step at a time and to keep in mind that there will be  ‘good days’ and ‘bad days’. Alzheimer’s may be the long goodbye but there is no reason why you shouldn’t create as many good memories as you can with the time that is left.

10 Early Warning Signs

Visit your doctor especially if you are experiencing these symptoms:

  1. Memory problems that disrupt your daily life
  2. Difficulty in problem solving with numbers and following a plan
  3. Difficulty managing familiar and routine tasks
  4. Losing track of time and space
  5. Difficulty understanding visual images and judging where things are in space
  6. Losing the ability to hold a conversation or find the right word to express yourself
  7. Misplacing things and being unable to retrace steps to find it
  8. Increasingly poor judgment
  9. Withdrawal from family and social obligations
  10.  Mood and personality changes that are unpredictable

Keep your mind fit and healthy with these mind games.

Sudoku Insert: To be taken from the internet – please include name of website where it’s taken from.

Word Search

Put your mind to the test and spot 4 United States celebrities or personalities who have been diagnosed with Alzheimer’s disease.

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  1. Glen C_ _ _ _ _ _ _ (Country singer)
  2. Ronald R_ _ _ _ _ (40th United States President)
  3. Richard S_ _ _ _ (Founding Investor and Chairman of Crocs. Inc)
  4. James D_ _ _ _ _ (Played “Scotty” in Star Trek series)

<Answers to be turned upside down and smaller fonts> Answers: 1. Campbell 2. Reagan  3. Sharp 4. Doohan

Go Purple!

World Alzheimer’s Day happens on the 21st of September every year. This year’s theme is Dementia: A journey of caring. To show your support for Alzheimer’s patients and their loved ones, join others around the world and step out in purple! Put on your best purple outfit —your purple shoes, bangles, dress, t-shirt or even pants! Don’t forget to spread the word to everyone around you.

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