Alzheimer’s Disease-2

Reading about an Alzheimer’s disease patient’s story will clarify more about the disease because as has been mentioned, it is not a disease of pain, injury, infection or cancer. It is the disease of a slowly damaging brain which affects the patient and his/her family, friends, neighbours and the society.

Suresh [name changed], a 71-year-old man, was referred to a psychiatrist by his family doctor for symptoms of depression that had not responded to medication. Suresh’s wife reported that he had begun to change at age 68, about a year after his retirement. He had stopped playing cards and going out with his friends, which he had enjoyed all his life. He no longer looked forward to going out of the house, and he refused to socialize. Instead, he sat on the sofa all day and watched TV or napped. His wife said he was sleeping 10-13 hours a day instead of his normal seven hours.

His wife worried that retirement had left Suresh depressed, and she had mentioned her concerns to their family doctor. Their doctor agreed and prescribed an antidepressant. Suresh’s symptoms did not improve on the medication, and the doctor then referred him for a psychiatric evaluation.

Suresh’s younger brothers had major depression that was treated with psychotherapy and antidepressant medication. His mother had developed dementia in her 70s.

Suresh had graduated from college with a degree in engineering. He had led a successful professional life as a corporate manager and retired at age 67. He and his wife were married for 45 years. They did not have any major marital problems. The couple had and had two children and five grandchildren. All of them were in good health. So, there was no cause for Suresh to lose his mental balance and become mentally ill. Till he was 70 years, he had been outgoing, energetic and well organized. But after 77 years, he had lost the good life that he had always enjoyed.

Suresh had high blood pressure and high cholesterol since many years and was taking medicines for these conditions.

The psychiatrist examined him. It showed he was alert and cooperative and had steady but slow speech. But Suresh had a limited range of emotional expressions. He denied feeling sad or guilty. He felt he had retired too early. He was aware that his wife was worried about him. Suresh accepted that he had less energy and that is why he was less active in the recent times. He blamed the negative changes on his retirement.

During psychiatrist’s examination, Suresh could name the year but not the month or day of the week when he met his doctor. He was shown many objects, he named only one of three objects after two minutes. He performed three out of five subtractions correctly. He could name four common objects around him correctly. When told to do so, he repeated a long sentence without error. With a paper and pencil, he was able to draw the face of a clock and he placed the numbers correctly.  But he could not draw the clock hands to show the time as 10 minutes after two.

These tests along with many other tests helped the psychiatrist diagnose Suresh with Alzheimer’s disease. As presently there is no treatment except for a few medicines, Suresh’s wife and children had to adjust to his worsening mental condition.

As time passed, Suresh gradually further withdrew from his surroundings. He was not bothered about his deteriorating health. He went to a hair cutting saloon and forgot his home address. He was given an identification card which showed his address and that helped people bring him back. Once he was taken to the police station as he was found wandering in a no entry zone. 

However, in the presence of his family he could remember very old events of the seventies and eighties. When anyone mentioned the city of Nagpur, he used to say, my daughter lives there. The sad part was that the person who mentioned Nagpur was his own daughter.

If Alzheimer’s disease patients are supported by their spouse or family, they can usually live a comfortable life. Family or failing that institutional support is the only thing that can help Alzheimer’s disease patients.