Alzheimer's disease is the most common cause of Dementia .Dementia is a collective name for progressive degenerative brain syndromes which affect memory, thinking, behavior and emotion.

Symptoms may include:

  • Loss of memory
  • Difficulty in finding the right words or understanding what people are saying
  • Difficulty in performing previously routine tasks
  • Personality and mood changes

Diagnosis of Dementia

There is no simple test to make a diagnosis and dementia can only be confirmed with certainty by examining the brain at post mortem. 1-lowever, a reasonably accurate diagnosis of dementia can be made by taking a careful history of the person’s problem from a closerelativc or friend, together with an examination of the person’s physical and mental status. It is important to exclude other treatable conditions that cause memory loss such as depression urinary infection, vitamin deficiency and brain tumour.

Symptoms

Typically, Alzheimer’s disease begins with lapses of memory. difficulty in finding the right words for everyday

objects or mood swings. As Alzheimer’s progresses. the person may

  • Routinely forget recent events, names and faces and have difficulty in understanding what is being said
  • Become confused when handling money or driving a car
  • Undergo personality changes, appearing to no longer care about those around them
  • Experience mood swings and burst into tears for no apparent reason or become convinced that someone is trying to harm them

In advanced cases, people may also:

  • Adopt unsettling behavior like getting up in the middle of the night or wander off and become lost
  • Lose their inhibitions and sense of suitable behavior, undress in public or make inappropriate sexual advances.

What care should we provide to patients with Alzheimer’s disease ?

In treating patients with dementia as definitive cure for the condition is not possible. It is very important to provide as much supportive care as possible. Many patients have lost their control over urination; they can be helped with catheters or condom drainage. Frequent change of posture is important to prevent pressure sores. Feeds should be given in upright position as far as possible to prevent fluids from entering in to lungs.

How to handle emotional outbursts of a patient with dementia?

Emotional outbursts and violent behavior are very common problems that caregivers face when dealing with a patient having dementia. Usually, these emotional outbursts are inappropriate responses to any of the basic physical needs of the patient, like hunger, sleep or desire to evacuate bowels. As the patient’s response to these physical needs is altered in dementia, he adopts a violent behavior. Identification of the cause of such outbursts and fulfilling the physical need usually takes care of such episodes. Being told you have Alzheimer’s disease, vascular dementia or any other cause of dementia can come as a shock, even if you have felt that something was not quite right.

Common questions asked about Alzheimer Disease

1.My mother has Alzheimer's disease. Will I get it?

There are a few very rare cases where Alzheimer’s disease does run in families. In these cases, there is a direct link between an inherited mutation in one gene and the onset of the disease. Most cases of Alzheimer’s disease are not of the type that is passed on directly in this way. If a family member has a normal form of Alzheimer's disease. the risk to close relatives is around three times higher than the risk for a person of similar age who has no family history of the disease.

2. Is there a cure?

There is currently no cure for Alzheimer's Disease or for most other causes of dementia. Nor can a cure be expected in the foreseeable future.

3. Are there any drug treatments for. Alzheimer’s disease?

Although there are no drugs that can cure Alzheimer’s disease. there are a number of drug treatments that can help some people with Alzheimer’s disease. The currently available treatments can slow down the progression of the disease in some cases for periods between 6 and 18 months. The main class of such compounds is the cholinesterase inhibitors. These drugs work by reducing the breakdown of acetylcholine in the brain. Acetylcholine is a chemical substance that occurs naturally in the brain and enables nerve cells in the brain to pass to messages to each other.

Research has shown that many people with Alzheimer’s disease have a reduced amount of acetylcholine and it has thought that the loss of this chemical may result in deterioration of memory.

4. Can Alzheimer’s disease be prevented?

Not enough is known about the causes of Alzheimer’s disease for any preventive measures to be recommended.

5. Dad has become Violent. What can I do  

It is important to remember that your father’s aggression is not directly aimed at you but is part of his illness. It is common for people who have Alzheimer's Disease to pass through a phase of being angry and sometimes aggressive.

Although this phase will pass, it may help you in the meantime to consider some of the things that may be triggering your father’s anger. For example. he may not like being forced to accept help to do things that he used to do on his own, such as washing. Sometimes hunger, the need to pass urine or constipation can lead to disruptive behavior. If the angry outbursts have only started recently, they may be due to an infection or pain. Once you have been able to identify some of the things that tend to make your father angry, you may be able to reduce the number of angry outbursts.

6. Memory Loss in Alzheimer’s

Declining memory, especially short-term memory, is the most common early symptom of dementia. People with ordinary forgetfulness can still remember other facts associated with the thing they have forgotten. For example, they may briefly forget their next-door neighbor’s name but they still know the person they are talking to is their next- door neighbor. A person with dementia will not only forget their neighbor’s name but also the context.

The most common early symptoms of dementia are:

  • Memory loss
  • Difficulty performing familiar tasks
  • Problems with language
  • Disorientation to time and place
  • Poor or decreased judgement
  • Problems with keeping track of things
  • Misplacing things
  • Changes in mood or behavior
  • Changes in personality
  • Loss of initiative

Dr. D. Shivanand Pai,   MD; DM (NEURO) , Associate Professor of Neurology ,  KMC, Mangaluru . Clinic : Amrutha Multi Speciality Clinic, Atthavar, Mangaluru . Ph: 0824 2443342, 2443340, 2442341

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New Delhi/Srinagar, Jul 13: The Centre has significantly strengthened the authority of the lieutenant governor in Jammu and Kashmir, empowering him to make decisions on crucial matters such as police and all-India services officers and granting sanctions for prosecution in various cases.

The opposition slammed the Union government's move and termed it a step towards "disempowering" the people of Jammu and Kashmir.

Official sources, however, said the notification does not in any sense alter the balance of powers as enshrined in the Jammu and Kashmir Reorganisation Act, 2019.

The Union home ministry gave more powers to the lieutenant governor on Friday by amending the transaction rules framed under the Jammu and Kashmir Reorganisation Act, 2019. This Act, passed alongside the abrogation of Article 370, bifurcated the erstwhile state into two Union territories -- Jammu and Kashmir and Ladakh.

The sources said that with the amendments to the transaction rules, the powers of the legislative assembly and the functions of the lieutenant governor have been clearly defined and delineated in the Act, and the same has been reflected in the transaction of business rules.

The Union home ministry notification, through which the amendment to the transaction rules of the Act were brought, has been issued to provide better clarity on the processes to enable the smooth administration of the Union Territory of Jammu and Kashmir.

It is a simple amendment to the transaction rules which were issued to avoid any ambiguity, the sources added.

In the past, proposals concerning police, public order, all-India services and the Anti-Corruption Bureau required approval from the finance department of Jammu and Kashmir before reaching the lieutenant governor.

Under the revised rules, such proposals must now be presented directly to the lieutenant governor through the chief secretary of the Union territory.

The lieutenant governor's authority extends further to the appointment of the advocate general and other law officers. These appointments, previously decided upon by the government, will now require the lieutenant governor's approval.

The Centre's decision has met with criticism from some political parties in Jammu and Kashmir who view it as an attempt to undermine the power of an elected government.

The Supreme Court has directed the restoration of statehood in Jammu and Kashmir "at the earliest" and the holding of elections to the assembly by September 30, 2024.

On Saturday, various political parties expressed their disapproval of the Centre's move to grant additional powers to the lieutenant governor in matters concerning police and all-India service officers.

The National Conference (NC) and the People's Democratic Party (PDP) labelled the decision as a step towards "disempowering" the people of Jammu and Kashmir, while the Congress condemned the move as a "murder of democracy".

The Apni Party called for a unified protest against the decision.

Following the Centre's move, decisions regarding prosecution sanctions and filing appeals will also come under the lieutenant governor's purview. Additionally, matters related to prisons, the directorate of prosecution and the forensic science laboratory will be handled directly by the lieutenant governor.

"No proposal which requires previous concurrence of the Finance Department with regard to 'Police', 'Public Order', 'All India Service' and 'Anti Corruption Bureau' to exercise the discretion of the Lieutenant Governor under the Act shall be concurred or rejected unless it has been placed before the lieutenant governor through the chief secretary," the Union home ministry notification stated.

The lieutenant governor's role in bureaucratic matters has also been amplified. Proposals for postings and transfers of administrative secretaries, along with those concerning IAS and IPS officers, will be routed through his office.

Reacting to this order, NC vice-president Omar Abdullah raised concerns about the implications of having a "powerless and rubber stamp" chief minister, who would need the lieutenant governor's approval even for minor appointments.

Despite acknowledging the timing of the decision in relation to the upcoming elections, Abdullah emphasised the importance of a clear commitment towards restoring full statehood of Jammu and Kashmir.

"This is why a firm commitment to laying out the timeline for restoration of full and undiluted statehood for Jammu and Kashmir is a prerequisite for these polls. The people of Jammu and Kashmir deserve better than a powerless and rubber stamp CM who will have to beg the L-G to get his/her peon appointed," he said.

Congress general secretary Jairam Ramesh said the increased powers given to the Jammu and Kashmir lieutenant governor suggested a dim outlook for the restoration of a full-fledged statehood in the near future.

In a post on 'X', he said, "The only meaning that can be drawn from this notification is that full-fledged statehood for Jammu and Kashmir does not seem likely in the immediate future."

PDP chief Mehbooba Mufti's daughter and media adviser Iltija Mufti highlighted the perceived agenda behind the decision, suggesting that it was aimed at limiting the powers of any future elected government in the region.

"The order seeks to disempower the powers of the next Jammu and Kashmir state government only because the BJP doesn't want to cede control or lose its iron grip over Kashmiris. Statehood is out of the question. An elected government in Jammu and Kashmir will be reduced to a municipality," she said.

Jammu and Kashmir Congress president Vikar Rasool Wani echoed the sentiment of democracy being under threat, describing the move as a "murder of democracy" that would hinder the path to true statehood restoration.

Apni Party chief Altaf Bukhari called for unity among political parties in opposing the Centre's decision, warning against the creation of a "powerless assembly" that would diminish the effectiveness of elected representatives in serving the region's interests.

"We appeal to all parties to shun political differences and come together on this issue. If we cannot stand united today, then we will never be. We should ensure that the statehood that we get is not hollow and has all the powers to serve people. We have to be united to serve the interests of the people," Bukhari added.

The sources said the Act was passed by Parliament in August 2019 and the same was upheld by the Supreme Court.

As per section 32 of the Act, the legislative assembly may make laws concerning any of the matters enumerated in the State List except "Police" and "Public Order" or the Concurrent List in the Seventh Schedule to the Constitution of India, they said.

As per section 53 of the Act, the lieutenant governor shall exercise his functions in his discretion in a matter which falls outside the purview of powers conferred on legislative assembly, related to all-India services and the Anti-Corruption Bureau and any other matter which he is required by or under any law to act in its discretion.

Senior CPI(M) leader M Y Tarigami said the amendments constitute "another brazen assault on the remaining nominal rights", virtually "downsizing" a historic state to the status of a bigger municipality. He said it is high time for all political parties to unitedly oppose the "autocratic order" and demand its revocation.