Alzheimer’s disease

  (Forget me not, Senile dementia, Profound Memory loss,स्मृति नIश)      
                                                   
                                                    

A brain disorder which is irreversible

Is memory loss, confusion troubling you? 

 21 Sept 2022 World Alzheimer's Day

Aging is not disease. It is the normal arc of life and an ineluctable part of being human 

When a loss of memory begins to create problems in daily life , it is time to take note that it may not be  a natural part of growing old , rather it may be the first signs of dementia. It might be something to tb concern about, if it is disturbing your routine activities. Such symptom s will be commonly seed in people suffering with Alzheimer's disease (AD). Alzheimer's disease is a type of dementia, where progressive degeneration of the brain nerve cells, lead to loss of memory, thinking and langrage skills and behavioral changes. 

Alzheimer’s disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles).  Another feature is the loss of connections between nerve cells (neurons) in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body. It is the most common disease associated with dementia worldwide and affects around 1.7 million people in India.

Alzheimer's Disease (AD) is the most common cause of dementia. This is an incurable, neuro-degenerative and terminal disease. The exact cause and progression of the disease are not well understood. 

A progressive disease that destroys memory and other important mental functions. On average, a person with Alzheimer's lives four to eight years after diagnosis, but can live as long as 20 years, depending on other factors. Alzheimer's is not a normal part of aging. Alzheimer's worsens over time. Alzheimer's disease destroys nerve connections in the brain, making it progressively more difficult to do ordinary things like move around, swallow and feed yourself. While the disease devastates the brain, it does not kill you. Impaired sleep has been associated with Alzheimer's disease.

It may begin with mild memory loss, and symptoms can slowly worsen over time  Did you know that the number of older adults with Alzheimer’s disease is expected to nearly triple over the next 40 years? It affects people in the age group of 65 and above. Early onset of Alzheimer's appears at the age of 40s or 50s, which contributes 5% of cases.  The largest percentage of those with the diseases were African Americans (14 percent), followed by Hispanics (12 percent), and non-Hispanic whites (10 percent).

Along with medication, a will power to combat the unwelcoming changes of body, contributes much in fighting against the disease. Help older persons live happy and satisfying life.

In India, more than 4 million people are estimated to be suffering from AD and other forms of Dementia, giving the country the third highest case load in the world, after China and the US. AD is a hidden problem. Only a fraction of patients are diagnosed and treated. The elderly population which is growing at a fast rate of 3%   may increase the AD cases. Social stigma surrounds AD and dementia is impeding early diagnosis and care. Though it is an disease of an ageing population, 10% cases  are detected at a young age. Family history, exposure to toxic chemicals may be responsible. A form of progressive memory robbing brain condition, can often show up in your 20's or 30's owing to genetic mutations and other factors.

"A Neurodegenerative Menace Of Elderly"

                                                                           

                                                                               

"Early detection of the problem helps in delaying the progression, and  improving the quality of life."

                                                          "O my mind where are you! "

Alzheimer's Disease

                                        "Alzheimer's disease is the most common form of dementia,"
       

Introduction                                              

Those who have seen Mrs. X in mid nineties had pictured her as a lady of magnetic personality proud and totally confident, an epitome of an devoted  wife and an excellent home maker. She was a pillar of strength for  the functioning of the rest  of the household and a wife who would stay  night after night with her husband in ill health and praying him back to health with rock bound faith. Today Mrs. X after almost 29 years is unperturbed, unconcerned and undisturbed even on death of her husband. She has sunk into  profound memory loss and failed to recognize even her husband, a disease medically termed as Alzheimer's (dementia) a brain disorder which is irreversible.

Mrs. X underwent hysterectomy in 2005 shortly after this , she started having problems of short term memory loss. Forgetfulness is a  natural part of menopause and ageing none of then considered getting an expert evaluation done for her. In two years they noticed that there was a decline in her  ability of managing finances or making calculations. She started developing an escapist behaviors and would simply shrug from undertaking new activities and complex tasks These are initial signs of Alzheimer's disease.

What is Alzheimer's disease? Alzheimer's disease is the most common cause of dementia, a loss of brain function that affects memory, thinking, language, judgment and behavior. In Alzheimer's disease, large numbers of neurons stop functioning, lose connections with other neurons, and die. Irreversible and progressive, Alzheimer's disease slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks of daily living. Alzheimer's disease is a brain disorder causing people  to slowly and permanently loose  their memory as well as well as other cognitive functions. It is because of degeneration of brain cells involved with memory and accumulation of abnormal proteins and plaque in the brain. Though its a disease of ageing population, 10% of cases detected at younger age.

The first problem is impaired short term memory. The patient may start asking repeatedly for tea, even after he has had at once, he / she may forget to do things that he is being asked to do. Such as  deposit money in a bank. Patient may even find it difficult to find the right word initially and complete sentences. Also in some patient behavior and  judgement may also get impaired. 

"The best medicine for Alzheimer’s disease in old age is love and affection shown by kith's and kin."

The disease slowly progressed to long term memory loss, Mrs. developed loss of reasoning difficulty on communication with others, decrease judgement abilities and found it difficult even in performing daily activities. Initially precaution had to be taken to ensure safety and comfort because , she was prone to wandering and getting lost.

In 2009 she sank into moderate degree of dementia. She had profound memory loss that interfered with her daily activities and she needed help from others to complete them. She was in a state of confusion and her judgement power also  was severely impaired. Her sleep pattern suffered and there was hostility and verbal outburst in her behavior pattern. Most of time she had a vacant look in her eyes.

After one year Mrs. X was graded  as having dementia. She developed severe impairment of mind  and body. She no longer recognize her spouse and children. She had no sense of time  or current location. Verbal communication was decreased to a point of phrases or more syllables. This was when her husband passed away after some times . Recently her communication degenerated to complete inability to speak. She was in a bed needed help for dressing, bathing, grooming, eating and toileting. Though her heart was tickling she was unaware of her surrounding...

Some decline in memory is normal as we age. This often takes the form of "memory lapses" such as forgetting where one left his or her glasses or mobile. Older memories and memories of personal information such as the names of the family members tend to survive well into old age. But lapses in memory and  slowing of mental responses are a normal part of ageing processes for many people , not an ominous sign of mental detoriation.

Alzheimer's disease

People with Alzheimer's experience difficulties in communication, learning thinking and reasoning. These problems are so severe that they could affect the individual's work, social activities and family life.

 Inside the brain are hundreds of billions of nerve cells connected by trillions of fibers called axons and dendrites. The activity between them controls your thoughts, feelings drives, aspirations and personality. This control center of  all that you do think  and feel is very vulnerable  to its environment as it floats in a bath of cerebro spinal fluid  just like a fish in a tank absorbs what ever is put in a tank. In Alzheimer's disease  many conditions like the  reaction to food, drugs, herbs, body activity, lifestyle and sometimes genetic mapping etc. create a confused interfacing of these fibers followed by neurotic plaques, granular vascular degeneration, Brain sink age  and decreased amount of brain chemicals  involved in communication called neuro transmitter. All of these changes impair  the functions of the brain cells and eventually lead to cellular  death. The sad part is unlike other cells the brain is unable to regenerate new neurons.

• Ayurveda terms this as Smruthi nasha, caused by the depletion of dhatus or tissue elements and upward movement of the excessively accumulated bio- energies. 
• The other reason includes  impairment of sattva guna which refers to an attribute of mind representing consciousness and purity by tamas. Which refers to the attribute of mind that represents obedience and lack of knowledge.
• When Manovaha srotas मनोवाहा  स्रोत  which refers to the channels that carry cyclic impulses chiefly responsible  for memory are troubled by vata dosha वlता दोष  the patients gets affected, which results in malfunctioning of the mental performance.

Intellect is pure, transparent, sharp, accurate and subtle. The abode of intellect which is the carrier of three types of gunas satvik, rajsik, tamsik get disturbed and their balance is lost. Satvik Guna which represents purity and consciousness gets visually impaired by rajas (the attribute of mind  which usually represents energy and dynamism) and Tamsik (the attribute of mind representing passivity and ignorance). Manovaha srotas channels carrying cyclic impulses principally responsible for memory is kindled by the sattva or the intellect. When it is is completely involved in tamas or darkness of the person is affected  and there is mal functioning of the mental activities. It is easier to prevent Alzheimer's than looking for a treatment for correcting it.

Stages of Alzheimer's disease

Pre- dementia : Mild cognitive impairment (MCI) is often found to be a transitional stage between normal ageing and dementia. MCI can be present with a variety of symptoms, and is frequently seen as a prodromal  stage of Alzheimer's disease. There are three stages of Alzheimer's disease.

Early (Mild) stage of Alzheimer's disease : Problem includes : 

• Trouble remembering names of new people/ new places.
• Ask the same question again and again.
• Finding difficulty in making plans or organizing.
• Forgetting material that was just read.
• Loosing or misplacing a valuable object.

Middle (Moderate) stage of Alzheimer's disease : Symptoms will be not noticeable to others, or may include :

• Increase memory loss and confusion (where they are  and what day it is)
• Inability to recall events or one's own personal history (their own address or telephone number)
• Difficulty in recognizing family and friends.
• Lack of concern for hygiene.
• Reduce ability to perform task (e. g, planning dinner) or handling personal finances (e.g. banking, paying bills)
• Changes in sleep patterns such as sleeping during the day and becoming restless at night.
• Risk of wondering and becoming lost.

Late stages of Alzheimer's disease :  

• They will require assistance in performing basic activities of daily living such as eating, walking. and sitting etc.
• Memory loss will become severe where people may be unable to recognize those close to them.
• They find it difficult to communicate  with others as they loss their speech or may even repeat words or even cry.
• Lose awareness of recent experiences as well as of their surroundings.

Dementia & Old age

According to Ayurveda in old age, brain start losing neurons, which in turn affects short term memory. Dementia or memory loss that includes the dreaded Alzheimer's disease silently leads to person to slow and painful life. Actually Dementia, is a condition that denotes the aggravated air element (vata dosha) and depleted kapha.)  Kapha is the base of all activities related to memory and is unctuous personified . Brain is in a state of unctuousness, i.e. its cells are well lubricated with all essential fluids including enzymes, hormones and neuro - transmitters without any blockage. Memory of a person will be intact if kapha facilitates this condition.

The stages of the disease typically progress from mild to moderate to severe. Symptoms usually develop slowly and gradually worsen over a number of years; however, progression and symptoms vary from person to person. The first symptom of Alzheimer's disease usually appears as forgetfulness.

• Mild cognitive impairment (MCI) : अनुभूति (perception) It is a stage between normal forgetfulness due to aging and the development of Alzheimer's disease. People with MCI have mild problems with thinking and memory that do not interfere with everyday activities. Not everyone with MCI develops Alzheimer's disease.
• Risk factor : Age. Most people who develop Alzheimer’s disease are 65 years of age or older. Family history. If you have an immediate family member who has developed the condition, you’re more likely to get it. Genetics. Certain genes have been linked to Alzheimer’s disease.
• Types : Alzheimer’s is of two types :  Early onset and late onset. Early onset is very rare  occurring in patients in the age group of 30 to mid 60,s where children directly inherit this from their parents. The most common type is late onset disorder appearing after 65 years of age, which is due to genetic mutation of a gene called APOE-e4.

People with severe Alzheimer's disease are unable to recognize family members or understand language.                                              

Ayurvedic view on cognition

It is the condition related to patient's age. As people age, their healthy brain tissue start degenerating, thus leading to their deteriorated cognitive ability. The intellectual and social skills affected by the condition eventually start interfering with their  daily life. Symptoms of condition include loss of judgement, lack of memory,, disorientation etc.

Manas मानस  (the mind) indicate the presence and absence of cognition. The knowledge is attained when there is association of Manas (the mind). Indriya इन्द्रियाँ (sense organs), Indriya Arth इन्द्रियाँ  अर्थ  (coordination of sense organs).and Atma आत्मा  (soul).

Dhi, धी , Dhriti धृती  and Smriti स्मृती  are the three most important functional aspects of the Manas. Dhi is the power to discriminate and intelligence. Dhriti is a  power to control, Smriti is the power to recollect the  obtained knowledge Medha मेधा  (cognition) is the power that grasps  and retains the knowledge, with the involvement of mind.

During the normal process of ageing, there is depletion of one biological entity in each decade of life. Medha (cognition) starts depleting by forth decade and Buddhi बुद्धि  (intellect) by the eight decade of life. Jara ज़रा  (old age) is of two types : Kalaja कालज  (normal process of ageing) and  Akalaja अकालाज  (early process of ageing) Alzheimer's disease (AD) belong to akalaja  jara अकालाज  ज़रा  where rate of neuron degeneration is faster than normal ageing.

In Ayurveda Alzheimer's disease is called Smruti Nasha स्मृति नाश  and the main cause behind it is the reduction of dhatus धातू  or tissues. other reason includes impairment of satva guna सत्व गुण which refers to the attribute of mind representing consciousness and purity by tamas तमस  which refers to the attribute of mind that represent obedience and lack of knowledge.

Ayurveda text mention about old age (jara )  and its process. During the normal process of ageing there is depletion of one biological entity in each decade of life.. Medha (cognition) starts depleting by forth decade and Buddhi (intellect) by the eight decade of life.

Jara or old age is of two types : Kalaja (normal process of ageing)) and Akalaja (early process of ageing). Alzheimer's disease(AD), Parkinson's disease, etc, belong to akalaja jara, where rate of neuro degeneration faster than normal ageing.

     "Think well There is nothing in this world that can trouble you more than your own thoughts."

                                                      Consult a Neurologist
Sign & Symptoms       
Stages of Alzheimer's disease

• Apathy, Depression, sleep alteration, anxiety.
• Delusions, hallucinations, anxieties, phobias.
• Head injury contributes at risk factors
• Dementia : Challenges in planning or solving problems: Some people living with dementia may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before. Alzheimer's disease is the most common cause of dementia — a continuous decline in thinking, behavioral and social skills that disrupts a person's ability to function independently.
• Amnesia  - Memory loss that disrupts daily life: One of the most common signs of Alzheimer’s disease, especially in the early stage, is forgetting recently learned information. Others include forgetting important dates or events, asking for the same questions over and over, and increasingly needing to rely on memory aids (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.

• Difficulty completing familiar tasks: People with Alzheimer's often find it hard to complete daily tasks. Sometimes they may have trouble driving to a familiar location, organizing a grocery list or remembering the rules of a favorite game.
• Confusion with time & place: People living with Alzheimer's can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.

• Trouble understanding visual images: For some people, having vision problems is a sign of Alzheimer's. This may lead to difficulty with balance or trouble reading. They may also have problems judging distance and determining color or contrast, causing issues with driving.

            "Intellectually stimulating and socially engaging physical activities lower the risk of AD"

Mental changes in old age

Learning : Older people are cautious about learning, need more time to integrate their responses. are less capable to deal with new material that cannot readily be integrated with earlier experiences.

Reasoning : There is a general reduction in speed  with which the individual reaches a conclusion. This is partly the result of the tendency to become increasingly cautious with age.

Creativity : Older people  tend to lack  the capacity for  or interest in  creative thinking. Thus significant  creative achievements are less common among older people  than among younger one.

Memory : They have poor recent memories but better long term memories. This is due to the lack of attentiveness and hearing impairment.

Reminiscing : The tendency to reminisce about the past becomes increasingly more marked with advancing age

Recall : Recall is affected more by age  than recognition. Many older people use cues, especially visual, auditory and kinesthetic  ones to aid their ability to recall.

Sense of humor :. Old people are humorless people. Reason is due to their comprehension of the cosmic tends to decrease with advancing age

Vocabulary : Detoriation in vocabulary is very slight in old age , because they use words frequently they know. Learning new words in old age is more infrequent than frequent.

Aging and Mental Health

Period of decline : The term senility is used to refer to the period  during old age where more or less physical breakdown and mental disorganization takes place. The individual who become eccentric, carelessness, absentminded, socially withdrawn and poorly adjusted is usually described as "Senile".

Poor adjustment : Because of the unfavorable  social attitudes towards the elderly, it is not surprising that many elderly people  develop unfavorable self concept. Those who have  a history of poor adjustments tend to become more mal adjusted as age progresses than those who earlier personal and social adjustments were more favorable.

Ageing requires role changes : Elderly people are often regarded as useless, because they cannot compete with young people in the areas where highly valued traits are needed the social attitude towards them is unfavourable. Due to this elderly people  develop inferiority and resentment feeling those are not conductive to good personal or social adjustments.

Dementia and old age

Dementia is a progressive degenerative disease that affects the brain and result in impaired memory, thinking and behavior. Dementia seriously interferes with a person's ability to carry out daily activities.

Dementia is irreversible- it cannot be cured. However, there are many conditions with symptoms that seems like dementia but they are not. These reversible condition can be caused by  problems such as high fever, poor nutrition, a bad reaction to a medicine, or a minor head injury.

Sometimes older people have emotional problems that are mistaken for dementia. Feeling sad, lonely, worried or bored may be more  common for older people facing retirement or handling the death of a relative or friend. Adapting to these changes can leave some people  feeling confused or forgetful. Emotional problem can be helped by  supportive friends and family or by professional help from a councilors.

Dementia knows no boundaries- social, ethnic or geographical. It affects 1 in 20 people over 65 years and is more common among the elderly, though it can effect the young too. As the disease progresses , the affected person becomes dependent on others for help with all aspects of daily life. At some point a person with dementia  will need 24 hour care including assistance with routine activities like eating dressing or going to the toilet.

HOW ALZHEIMER’S AFFECTS PERCEPTION

It’s an optical illusion.  This illustrates the difference between sensation and perception. Your eyes see a static picture (sensation). Your brain interprets movement (perception). As Alzheimer's affect perception.

                                                

• Problem with words in speaking and writing: People living with Alzheimer's may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have trouble naming a familiar object or use the wrong name (e.g., calling a "watch" a "hand-clock").

• Misplacing things and losing the ability to retrace steps : A person living with Alzheimer's disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. He or she may accuse others of stealing, especially as the disease progresses.

• Decreased or poor judgement: Individuals may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money or pay less attention to grooming or keeping themselves clean.

• Withdrawal from work or social activity: A person living with Alzheimer’s disease may experience changes in the ability to hold or follow a conversation. As a result, he or she may withdraw from hobbies, social activities or other engagements. They may have trouble keeping up with a favorite team or activity.

• Changes in mood & Personality: Individuals living with Alzheimer’s may experience mood and personality changes. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, with friends or when out of their comfort zone.

Cause    

• Family history
• Genetic mutation
• Exposure to toxic chemicals
• Diet and lifestyle.
• History of Hypertension, Type 2 Diabetes
• Genetic predisposition: Apolipoprotein E (APOE) is a gene that’s been linked to the onset of Alzheimer’s 
• Stressful lifestyle
• Existing cognitive impairment
• Family history :  If you have an immediate family member who has developed the condition
• Down’s Syndrome
• Previous history of head trauma

                              

 Alzheimer's disease is a progressive condition, but the early detection of problem will help in delaying the progress.

  

                            
Diagnosis

Diagnostic tools used : 

A detail neuropsychological testing can reveal can reveal mild cognitive difficulties and blood test to rule out other possible  causes. Histopathology confirmation including a microscopic examination of brain tissue, CT,MRI, etc. are required for definitive diagnosis.

Early screening and detection among young people  through blood test to study fat in blood stream, defective IRS-1 protein and blood marker micro RNA  could lead the way in showing down the Progesterone of the disease. 

• Medical history : AD is diagnosed clinically from patient history.
• Clinical observation.
• Mental status evaluation
• Physical evaluation
• Neurological evaluation : Neuro -  psychological testing can reveal  mild cognitive difficulties.
• Genetic testing
• Blood test to rule out other possible causes
• Histopathology confirmation including a microscopic examination of brain tissue 
• Eye scan may detect Alzheimer's disease in seconds.

• Advance medical imaging with computed Topography (CT)
• Imaging :                                                 

Magnetic resonance imaging (MRI) :  It can detect brain abnormalities associated with mild cognitive impairment (MCI) and can be used to predict which patients with MCI may eventually develop Alzheimer's disease. In the early stages of Alzheimer's disease, an MRI scan of the brain may be normal. MRI of head : Magnetic resonance imaging (MRI) uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. MRI can detect brain abnormalities associated with mild cognitive impairment (MCI) and can be used to predict which patients with MCI may eventually develop Alzheimer's disease. In the early stages of Alzheimer's disease, an MRI scan of the brain may be normal. In later stages, MRI may show a decrease in the size of different areas of the brain (mainly affecting the temporal and parietal lobes). 

Computed Tomography (CT) : (CT) scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body. Physicians use a CT of the brain to look for and rule out other causes of dementia, such as a brain tumor, subdural hematoma or stroke.

Position Emission Tomography (PET)  and /CT of the head : A positron emission tomography (PET) scan is a diagnostic examination that uses small amounts of radioactive material (called a radio tracer) to diagnose and determine the severity of a variety of diseases.
A combined PET/CT exam fuses images from a PET and CT scan together to provide detail on both the anatomy (from the CT scan) and function (from the PET scan) of organs and tissues. A PET/CT scan can help differentiate Alzheimer's disease from other types of dementia.

Single photon emission computed tomography (SPECT) scan is also used for this purpose.
Using PET scanning and a new radiotracer called C-11 PIB, scientists have recently imaged the build-up of beta-amyloid plaques in the living brain. Radiotracers similar to C-11 PIB are currently being developed for use in the clinical setting.

Ayurvedic view of cognition

Manas(The mind) indicates the presence of cognition. The knowledge is attained when there is association of Manas (the mind) Indriya (sense organs). Indriya artha (coordination of sense organs and ams (soul)

                                           "Healthy lifestyle efforts  prevent Alzheimer's."

Institute of Neurosciences Bangur Infrastructural facilities of the Neurogenetic unit (Laboratory)

THINGS TO BE KEPT IN MIND

1 . Focus on wellness : Activities such as listening to music, dancing, reading or listening to books. Gardening and crafts can support patient's health.

2 . Amp up diet : Food with antioxidants, vitamin D, Zinc, healthy fats like Omega 3  along with nutraceuticals could help  in treating.

3. Laughter is the best medicine : Humour is the great way to release stress, helps cope with emotions when caring for a patients

4. Exercise regularly : Regular exercise forms an important part of treatment.

Lifestyle

The most important way to maintain one's mental health is to ensure a healthy life style  by making sure 

• You get adequate sleep. Also you could incorporate the following techniques:
• Identify anxiety and low mood as a feeling rather than who you are.
• Spend time with friends. Talk to someone you trust about what you are feeling and allow them to help you. It will remind you that you don't have to solve all you problems alone.
• Limit your social media usage. Use the digital wellness setting to keep a tab on it
• Follow your passion. If  you don't have any hobbies or passions, it's never too late to start.
• Be aware of your thoughts and feelings. Start a journal. When you are aware of the symptoms you are also more likely to seek help easily.
• If you are tired all these techniques and continue to feel that there has been no change consult a mental health profession.
• Reminders : Keep things in mind over the short term.

                                                

•  Memory games : Games help people not to forget.                              

 

• Activities :  helps prevents dementia

• Playing cards

• LUDO : Not just a game

• Carrom : 

• Snake & Ladder : 

• Lego : Brain game for making a structure

                                         

             

• Jigsaw puzzles : 

                                         

                                  

• Crosswords

• Word search : 

                                      

              

                                         

•  Beach fun cross word puzzles

                                           

Sudoku : It is a logic-based, combinatorial number-placement puzzle. The objective is to fill a 9×9 grid with digits so that each column, each row, and each of the nine 3×3 sub grids that compose the grid contain all of the digits from 1 to 9.

•  Jenga  Wood Block Stacking Game for Adults and Kids 

                                                  

•  Mental game : With match stick

                                                         

                                                         

• Classic pen & paper game

• Rubik square : Play a brain game for sharpening your brain

                                                    

 

• Learn new languages :  To keep the brain active.

Meditation

Meditation to find oneself completely cut off from the worlds., almost submerged in the story which can get him a great improvement in mind powder. It is believed that  when a person goes deep in meditation the power of part of the brain that is damaged by anxiety  or depression is revived.

Massage

For people in tropical countries, taking oil massage daily or at least weekly proves to be quite beneficial. It improves the functions of neuro - system and activates the cells.

Exercise : 

Exercise for brain health

For brain health try interval walking :

How :

Walk for five minutes at a moderate pace, increase the intensity to a brisk walk for two minutes. Alternate longer periods of leisurely walking with shorter period of brisk walking for a total of 30 minutes. How much you pick up the pace in the shorter intervals and for how long is up to you. Interval walking allows you to incorporate higher intensity aerobic exercise into your workout at your own pace. You should start gradually for example having just one or two short segments of brisk walking within 30 minutes period. Than you could work your way up to including more or longer segments of fast pace walking or even jogging.

Why :

Sedentary older adults who went for interval walks significantly improved their memory. Aerobic exercise have been able to create new blood vessels. This allow neuron to survive under adverse environment. Brain growth can lead to improve memory, executive functions and decisive making among other things. Aerobic exercises reduces cognitive decline in older women and men who suffered mini-stroke.

                                                     

Mudra

Dhyana Mudra (ध्याना मुद्रा

Gyanna Mudra (ज्ञान मुद्रा )

Prana Mudra (प्राण मुद्रा)

Diet :

                                            

• Probiotic and pre biotics  Mental health and gut health have a hand in gloves partnership, which means that health of one affects the health of another and vice versa. Hence probiotic and pre-biotic play a huge role in feeding the good gut bacteria. Probiotic includes yogurt ,kimchi, sauerkraut, kefir, kvass, kanji etc. Probiotic also helps retain  vitamin B 12 - an essential vitamin for our neurological system to function. Pre biotics includes garlic, chicory, cacao, Apple cider, vinegar and banana.

Curd Rice widely eaten in South India

• Omega 3 fatty acid : Found in fish (Salmon) ,flax seeds, krill's, chia, kiwi fruit, butternuts, walnuts provide many benefits, including improving  learning and  memory and helping to fight against such mental disorders 
• Diet rich in fruits, vegetables and fibers significantly reduce development of AD.

• Antioxidants rich fruits and vegetables
• Beta- carotene : Apricots,broccoli,cantaloupe,carrots,collards,peaches,pumpkin,spinach,sweet potato.
• Vitamin C :Lemons, oranges pepper, chilies, mangoes, strawberries etc.

• Vitamin E : Nuts and seeds, cold pressed oils ,wheat gram, avocados.

• Complex and unrefined carbohydrates  Good carbs found in whole grains and vegetables can have a calming effect on our mind too. Carbohydrates are linked to the mood boosting brain chemical serotonin. This is precisely why deprivation diet such as zero carbohydrate diets can leave you feeling moody.

• Good quality dark chocolate or cacao Rich in antioxidants, flavonoids, and magnesium a square or two of good quality dark chocolate or cacao can go a long way in uplifting your mood. 

• Selenium & Zinc Brazil nuts, beans, legumes and whole grains, pumpkin seeds and oysters. These trace minerals also improve mood by reducing inflammation, which is often at heighten levels when someone has a mood disorder.

• Cows ghee The regular intake of it with cows milk is intellect promoting. It has shown results in improving powers of grasping, concentration and retention.
• Coconut oil : Cocos nucifera oil consumption in regular diet, along with applied externally on head.

                         "Use a low carbohydrate  and high fat diet to fight Alzheimer disease."

                                                            Keeping your mind stimulated.
                                   

Home Remedies

• Apple : Malus domestica are beneficial in the  treatment of memory loss and mental irritablity. Eating the fruit every day with honey (1 tbsp) followed by glass of milk is effective against  Amnesia.
• Strawberries : Fragaria ananassa, rich in antioxidants good to boost memory.
• Jamun Syzygium cumini  rich in antioxidants good to boost memory.
• Antioxidants or powerhouse Spinach Spinacia oleracea contains all vital nutrients and is regarded as an essential food for body and mind.
• Dry Fruits : are useful in countering poor memory. Walnut Juglans cinerea  20 grams  along with raisins Vitis vinifera and figs Ficus carica  10 grams each everyday is an effective remedy.
• Almonds Prunus dulcis rich in essential fatty acids and nutrients. These are well reputed nerve tonic . Soak 5-7  almonds overnight and eat after peeling. followed by hot milk drink.
• Black Pepper Piper nigrum Mix 5 seeds of freshly grounded  black pepper with honey 1 tbsp and take it both in the morning and evening.
• Brahmi : Bacopa monnieri is an antioxidant herb that is known to slow  brain ageing and strengthen memory. Dry 7 gram of Brahmi  and ground with 7 almonds and about 50 gram black pepper in water. Strain the mixture and sweeten with honey. Every morning drink it empty stomach.
• Sariva Salvia officinalis  Prepare tea from dried Sariva (sage) leaves and have it regularly Sage strengthen the ability of brain to concentrate.
• Rose Merry Rosmarinus officinalis  tea preparation from  leaves refreshes mind  and enhances mental ability.
• Black cumin Nigella sativa  Mix 3 gram of black cumin seeds with honey 2tbsp take this preparation once a day, preferably in the morning.
• Honey : is considered as an anti aging food because of its anti oxidant properties Make this natural sweetener a part of your life as it is beneficial in enhancing memory.

Boost memory power with some of these techniques

• Give your body and mind adequate rest and sleep
• Try to handle stress as it damages the process of remembering. Exercise will help you combat stress and anxiety. Learn the art of relaxation and meditation.
• Always tell your self that you can remember every thing
• Let your brain exercise with brain teasers and small task like recalling details of a text read or a photo you have just observed for a few seconds.
• To prevent forgetfulness try to repeat things without distractions.
• Eat plenty of fruits and vegetables that are a source of antioxidants and nutrients.
• Beta carotene, vitamin C, Zinc, iron. and folic acid are believed to improve memory and brain functioning as we age. Go for diet that provides it all.
• Include phosphorus rich food  in your diet  such as nuts cereals, pulses, egg yolk and milk.
• Fruits rich in phosphorus like grapes, apple, orange, figs, dates etc. should be eaten to strengthen memory.
• People suffering from poor  memory should  drink cow's milk as it is beneficial and  nutritious.

Prevention

• Regular exercise, a proper diet and good sleep reduces the risk of dementia and Alzheimer's disease.
• Since AD has no cure, caregiver must be carefully managed over the course of the disease.                                 

Self Help

It is important to stay mentally active and alert to stimulus by working puzzles and other memory games, this avoids the dis use and calcification of brain. Going back to school to take up  new subjects or hobbies and solving cross word puzzles, memorizing things and events and playing chess are all good stimulators of the brain. The ability to retain and recall things and general memory can best be achieved when staying in a calm environment. Doing too many things at one and the same  time regularly can bring about the appearance of a poor memory. Lifestyle must be free of stress and a hectic life. or activity must be avoided

Small actions and concentrating on a single task at a time helps  the memory therefore one must switch the TV or radio off when involved in other activities. Exercising on a daily basis can help the body  and free the mind, therefore it is good idea to walk  for some time everyday. Relaxation and  and sleep must be in optimal amounts, since the brain must have some rest to recharge and renew itself, If memory is already poor a diary or a book is a good idea, as advice to help forgetful people who can write things down as an aid to memory. Family support in such cases is a must.

Treatment                               

     Modern treatment of AD are pharmaceutical, psychological and caregiving. Trained care giving is an essential part of the disease.

• Memantine (NMDA receptor antagonist) is the drug of choice.
• Acetylcholine esterase inhibitors are also used.
• Antipsychotic drugs are also used for educing aggression and psychosis.
• Psychological therapies including behavioral, emotional, cognitive and stimulatory.
• Immunotherapy and vaccination for amyloid protein is one of the treatment modalities under investigation.
• There is no cure for Alzheimer's disease. However, medications that slow the progression of the disease and manage symptoms are available.                                        
• Alzheimer's is a progressive disorder. Unfortunately, there is no treatment that can cure it. drugs currently used can only reduce the severity of symptoms and make the lives of patients much bearable. Sudden mood changes, hostility, psychotic behaviors, suicidal tendencies are the most worrisome issues with Alzheimer's.

• Dementia care centers create an environment patients love such as reading their favourite books, placing photo albums of loved ones, making their favourite dinners and tailor making care for individual patients.
• Personalized care has proven to reduce anxiety, making patients lives far better.

"Concentration is a mental process rather than stretching your muscles. Every body has an ability to concentrate more or less. Simple mantra is : Do one job at a time. If you work, work and if you play , play. Do not mix the two."

Activities

• Show him how to brush his teeth step by step, or brush yours at the same time. Try an angled, long-handled, or electric toothbrush if you're brushing for him.

• If a woman wants to wear makeup, encourage it. Help her with lipstick and powder, if she wants. Skip eye makeup if it seems too hard for her to tackle.

• To keep shaving safe, use an electric razor instead of one with a blade.

• Helping with chores can boost self-esteem. Ask him to dust, sweep, fix things, sort socks, fold laundry, read a recipe for you, or measure when you cook.

• Stay active. Take a walk together every day to keep muscles strong, boost mood, and help with sleep. If he can't get around well, he may be able to use a stationary bike or resistance bands.

• Playing word games, doing puzzles, talking about current events, or gardening can fuel thinking and memory. Listening to music (and playing "name that tune") can also bring back fond thoughts. Be sensitive -- if you sense he feels frustrated or upset by an activity, try something else.

• If an activity isn't working, it might just be the wrong time. Try it again later.

Grooming

Bathing

• Use a hand-held shower-head, rubber bath mat, grab bars, and a shower stool to prevent falls. If he has trouble getting in and out of the tub, try sponge baths.

• To help relax him during bathing, play calming music and tell him what you are doing each step of the way.

• Give him as much privacy as you can. Put a towel over his shoulders and lap. Clean under the towel with a washcloth or sponge.

• If she tends to get anxious and hitting is a problem, give her a washcloth to hold. She'll be less likely to strike and may calm down.

Getting Dressed

• Make it easier for him to dress on his own. Lay out his clothes in the order he puts them on, or hand him one piece of clothing at a time.

• If he wants to wear the same clothes every day, don't fight it. Buy 3 or 4 sets of them.

• Make sure he has loose clothes that are easy to put on. Shorts and pants with elastic waistbands and slip-on shoes are good. Skip shoelaces, buttons, and buckles.

Eating

• Keep mealtime simple and calm. Turn off the TV and radio. Move unneeded items off the table. If having many foods at once confuses him, serve one thing at a time.

• Use solid-colored plates on a contrasting place mat so it's easier to tell her food from her plate and her plate from the table.

• Remind him to chew and swallow, if you need to. Don't hurry. Be patient, and give him plenty of time to eat.

• As it becomes harder for him to eat on his own, try finger foods like tuna sandwiches, steamed broccoli pieces, or orange segments. If swallowing is hard for him, serve softer foods like applesauce, cottage cheese, and scrambled eggs.             

Ayurveda
Herbs :

• Tab Brahmi vati are effective in management of dementia. Powder with honey.
• Rasayana therapy : which include a set of drugs, formulations, treatments and diet and lifestyle modification. It aids in improving natural immunity. It also enhances the general well being by improving the functioning of all fundamental organs of the body and keep away the signs of early ageing. It aids in increasing natural immunity. It also enhances the general wellbeing by  improving the functioning of all fundamental organs of the body  and keeps away the signs of early ageing. Medha rasayana  is the special class of drug describe for prevention and management of mental disorders and simultaneously managing the consequence of ageing.

Madhya Rasayana : Or Brain Tonic

• Mandukparni Centella asiatica - powder mixed with milk
• Yashtimadhu Glycyrrhiza glabra - juice
• Guduchi Tinospora cardifolia  juice
• Shankhapushpi Convolvulus ternatea - paste. 2 tab at night HS for 1 month and your memory power will become sharp.
• Ashwagandha churana along with ghee and honey helps in memory enhancing. Powder with milk.
• Vacha Acorus calamus Water or milk extract of plant is said to be good tonic for brain.
• Cow's Ghee : The regular intake of cow's ghee with cow's milk is intellect promoting. It has shown result in improving power of grasping, concentration, and retention.

            Dosage : powders, paste 5-10 grams twice daily.  

Therapies  like                                        
                                         

• Matra Basti : (oil enema) with Mahanarayana Taila etc.
• Shirovasti using Brahmi Taila etc.
• Shirodhara : with Balaswagandhadi taila etc.

Shirodhara

• Nasya karma: With Ksheerabala oil, Brahmi grita etc. help in preventing the progression of condition.

    

"There’s no cure for Alzheimer’s, but there are treatments that can slow the progression of the disease and may improve the quality of life."

                     https://madhuchhandacdmo.blogspot.com/2019/10/alzheimers-disease.html