Alzheimer’s care: Early diagnosis and Slowing disease progression
Dr Sherrini Bazir Ahmad
Alzheimer’s disease is a brain disorder affecting millions globally and is becoming more common as populations age.
In Malaysia, about 44,000 people are living with Alzheimer’s, and this number is expected to grow. As we mark World Alzheimer’s Day this month, it is crucial to highlight the importance of early diagnosis, advanced treatment options and a holistic approach to managing this growing health issue.
Dr Sherrini Bazir Ahmad, Consultant Physician and Neurologist at Subang Jaya Medical Centre (SJMC) emphasised that while forgetfulness is a common aspect of ageing, the early signs of Alzheimer’s go beyond just memory loss.
“Early Alzheimer’s impacts not only memory but also reasoning, ability to learn, planning, language, and behaviour.” These changes interfere with daily life and signal more serious brain function issues. “This is not a normal part of ageing,” said Dr Sherrini, urging family members and caregivers to stay alert for these signs.
One of the challenges in managing Alzheimer’s is distinguishing early symptoms from normal ageing. According to Dr Sherrini, subtle signs like frequent disorientation, confusion, and changes in language and behaviour should prompt family members to seek professional advice. Early recognition is critical to slowing the disease’s progression and implementing effective care plans.
Why accurate diagnosis matters
Alzheimer’s is the most common form of dementia, making up about 70% of all cases. Getting an accurate diagnosis helps families to prepare and plan for the future, both emotionally and financially. Dr Sherrini said, “An early and accurate diagnosis is essential for planning. This includes appointing caregivers, making legal and financial decisions, and discussing long-term care options.”
Dementia comes in many forms, from Lewy Body Dementia (DLB), Fronto-Temporal Dementia (FTD) to other neurological conditions such as multiple sclerosis and Parkinson’s disease. Each may present different symptoms or care needs. Knowing the specific type of dementia helps doctors manage it more effectively.
Treatment options to slow progression
Currently, there is no cure for Alzheimer’s disease, but medications can help slow the progression of cognitive decline. Dr Sherrini explained that disease-modifying therapies are now available, particularly for individuals with mild cognitive impairment or early-stage Alzheimer’s. These therapies target beta-amyloid, a protein that abnormally accumulates in the brain, forming plaques that are toxic to neurons.
People with Alzheimer’s disease experience memory loss and cognitive decline due to the damage caused by these plaques. By reducing the buildup of beta-amyloid protein, these therapies aim to slow the progression of the disease. However, Dr Sherrini emphasised that while these treatments show promise, their long-term effects remain uncertain, and patients need to be carefully selected for treatment due to the risk of side effects.
In addition to medications, a comprehensive care plan may also involve referrals to mental health professionals. This is especially important for managing behavioural symptoms such as anxiety, depression, or hallucinations, which commonly arise in the later stages of Alzheimer’s disease.
Emotional and psychological challenges
Dr Sherrini points out that Alzheimer’s doesn’t just affect memory, it also impacts emotional and psychological well-being. “Patients often experience depression, anxiety, and grief as they struggle with the loss of independence.” These emotional changes can make the disease even harder to manage if not properly addressed.
To help patients cope, families are encouraged to create a stable environment, maintain familiar routines, and involve the patient in meaningful activities. “Open communication about the disease and involving mental health professionals can make a big difference in managing emotional challenges,” adds Dr Sherrini. Sometimes, medication may also be necessary to help with mood disorders or anxiety.
Lifestyle choices, reducing risks of Alzheimer’s
Preventing Alzheimer’s through lifestyle choices is important. Dr Sherrini warns that poor lifestyle choices such as lack of exercise, an unhealthy diet, and uncontrolled cardiovascular risk factors such as diabetes, hypertension, smoking, and excessive alcohol consumption can significantly increase the risk of Alzheimer’s.
“Maintaining a healthy diet, engaging in regular physical activity, and keeping your brain active through cognitive engagement can help lower your risk,” she advised. Managing conditions like high blood pressure, high cholesterol and obesity early on is also important for brain health.
Caregivers’ role in treatment and emotional support
A personalised care plan is critical once Alzheimer’s is diagnosed, and caregivers are a central part of that plan. “Caregivers play an essential role in attending appointments, managing treatments, and monitoring any behavioural changes,” said Dr Sherrini. Given the long-term nature of Alzheimer’s care, caregivers must also plan for their own mental and emotional well-being to prevent burnout.
“Caregiver fatigue is a serious concern, and it’s important for those looking after Alzheimer’s patients to have access to support systems.” This may include professional counselling, respite care, or joining support groups like the Alzheimer’s Disease Foundation Malaysia (ADFM), where caregivers can connect with others facing similar challenges.
Advanced diagnostic tools: Neuroimaging
To aid in the early detection of Alzheimer’s, advanced diagnostic imaging has become invaluable. Prof. Dr Norlisah Mohd Ramli, Consultant Clinical Radiologist and Neuroradiologist at SJMC, explains that MRI (Magnetic Resonance Imaging) and PET (Positron Emission Tomography) scans play a crucial role in identifying brain changes before significant symptoms arise. “We can detect hippocampal atrophy on MRI scan, one of the earliest indicators of Alzheimer’s. PET scans are also useful, particularly those that use amyloid and glucose metabolic activities, to visualise disease patterns,” she shared.
Recent advancements, such as Arterial Spin Labeling (ASL), provide even more accurate diagnostic results. ASL, a non-invasive MRI technique, measures brain blood flow, allowing for earlier detection of neurodegenerative changes without the need for contrast injections or radiation. These tools allow physicians to diagnose Alzheimer’s earlier and more accurately, guiding treatment plans before significant symptoms emerge.
Once imaging results confirm a diagnosis, personalised care plans are crafted to address the specific needs of each patient.
Prof. Dr Norlisah shared the case of a 60-year-old lecturer who presented with memory decline and executive function issues. “The family and neurologist observed that the patient was abnormally quiet. Through the use of MRI, we identified a variant of Alzheimer called semantic dementia, which impacts the part of the brain responsible for speech. With this diagnosis, we tailored a treatment plan that specifically targeted the unique challenges posed by this form of dementia.”
Hope through research and innovation
While Alzheimer’s remains a challenging diagnosis, ongoing research and advancements in treatment offer hope. The future of Alzheimer’s care rests on continued innovation in neuroimaging, disease-modifying therapies, and lifestyle interventions aimed at reducing the risk and slowing the progression of cognitive decline.
“By leveraging the latest advancements in diagnosis and treatment, we can offer patients a better quality of life and help families prepare for the future,” concludes Prof. Dr Norlisah. Through early detection and a personalised approach to care, Alzheimer’s patients and their families can navigate this challenging journey with greater confidence and support.
Visit Subang Jaya Medical Centre to learn more about Alzheimer’s and its treatment options.
Category: MJN enews
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