Memory lane: going down and down and...

By Roshan Peiris

Alzheimer's disease is fatal and like cancer gives no hope to the sufferer. Whereas in cancer there are remission periods and less discomfort, in Alzheimer's there is no relief.

In Sri Lanka, Alzheimer's is found among many an adult over the age of sixty five, sometimes among even younger patients. Earlier it went undiagnosed worldwide. This most malicious disease was discovered by Dr. Alzheimer only in 1901. Even upto 1960, only a hundred cases were identified and described. But today in the United States, Alzheimer's is one of the most common diseases in those over sixty five years and sometimes among those in late middle life.

In Sri Lanka for quite sometime the disease was seen as another, symptom of old age. Doctors now, however, watch out for it. Dr. J. B. Peiris Sri Lanka's foremost Neuro Physician after the late George Ratnavale who was his guru, is sensitive and knowledgable about the disease.

Dr Peiris said "so far, no one since Alzheimer has found out the cause of this distressing disease, hence there is no known cure nor even some kind of medical help to arrest the disease. One thing is established and that is that the disease is ten percent genetic". Hardly a consoling thought.

It was, said Dr. Peiris, that at one time thought the disease was a kind of response by an individual to the exposure to aluminium or else to some kind of virus, yet nothing has been proven.

One can take consolation that a great deal of research is dedicated to finding some means of cure if not to arrest the rapid spread of this most sad disease. One has, he said, to find ways and means to stop the deterioration of the brain's nerve cells.

As the doctor summed up, it is hard on those who have to see it daily and attend to those who suffer from the disease. The patient gradually loses track and does not know what is happening.

According to Dr. Peiris one of the "first symptoms that can be noted is a gradual and quiet failing of memory function. In such cases we try span tests and give the patient words."

The brain has its own archives which stores memories of what happened long years ago. These remain intact and so an Alzheimer's patient can remember the distant past, but not the present be it names or incidents. The first thing to go is short term memory and so one forgets recent events".

"The next to be affected is orientation in space" that is the person suddenly begins to lose his or her way even around ones familiar home and surroundings.

Apparently the back and frontal lobes of the brain are not affected. The back lobes, the oxipital lobes are not affected. Hence for a long time the person can talk and also the motor functions succumb slowly to the disease, hence the patient can walk. Talking and walking explained the doctor, are not affected during the early part of the disease.

The disease is due to the death of the nerve cells of the brain. Cells in batches die but what causes the death of the brain cells is not known, hence finding a cure has eluded the dedicated researchers in the United States where the disease is common. There have been some experiments with local neuro transmitters but so far no conclusive evidence.

The doctor said the deterioration is slow, taking about one to three years for the first phase to take hold of the fated person when she or he loses words used in everyday life.

The next phase is when there is no co-ordination and relevance in speech content and finally the patient does not know what he or she talks and in addition most pitiable of all the patient becomes incontinent and finally ends up bedridden.

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